A little while ago I posted about a rumour that the LAS would have their budget cut by £25 million come a new government.

After I wrote that Andrew Boff (Conservative member of the London Assembly) got in contact with me and did some asking around in his part of the world.

This is his reply,

I've chased this up with the Conservative Front bench and they have no plans relating to any change in LAS services at all. Andrew Lansley has set out a commitment to cut by a third the cost of administration in the NHS, but equally he's made it clear that front-line services will be protected and hasn't gone into any detail about particular Trusts.

I think that coming up to an election there will be barrage of claims and rumours but I'm fairly confident that this one is probably made up though I don't know who by.

Does this mean that there isn't going to be a cut in our budget? Well, to be honest I'm not sure - but I think that Mr. Boff is genuine in believing so.

Whatever happens he's earned some kudos points from me, even if he is *shudder* Conservative, for paying attention to a lowly blogger like myself.

Now, if only I could get whoever is the minister in charge of ambulance services, and their counterpart in social care to pay attention...

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I may be clearing out some browser tabs and emails today. This may mean more posts than normal.

I wake up at 1:30 am, it's my 38th birthday and I'm awake because shift work has killed my bodyclock. Various parts of my body ache, consequences of a job where heavy, unsafe lifting is sadly a fact of life.

I stare at the ceiling, thoughts running through my head, becoming more and more hate filled as I reflect on my job.

I know that this is in part the trifecta of SAD, nightshifts and a couple of months without a 'decent' job. If I could just do a call where I actually helped someone by using medical skills my mood might improve.

I lay in bed thinking about alcoholics, drunks and wimps - about how personal responsibility seems to have become an incredibly rare thing.

I'm hating myself for doing a job where the health detriments are so pronounced while serving so many people who selfishly think that the A&E and ambulance service are there just for their benefit.

I think on the last few night shifts - of the drunks that we went to. Of people who drink and drink and drink, then 'collapse' in the street - knowing that some idiot like me will come and pick them up before they get too cold (it's only pensioners and hillwalkers who die of hypothermia these days), I'll then take them to hospital where they will continue to be mollycoddled by demoralised nursing staff.

And if you aren't mollycodled enough - well, you can always complain and get someone disciplined or fired.

The government tries to prevent heavy drinking by warning people of the effects on the liver, that they might make a fool of themselves. But people don't care, that is all so very far away. After all, isn't a hangover the sign of a 'good night out'? A badge of pride to be worn in order to prove that you are 'social' and 'popular'?

I like this advert.

But I don't think that it goes far enough.

What I think we need is something that is much more immediate, something much more telling and something that acts as a deterrent to others.

It'll need an act of parliament, but Labour seem to like introducing reams of new legislation.

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My suggestion is this - in order to teach people that the effects of alcohol on both themselves and on society are damaging and far-reaching heavy consumers need to be taught a lesson.

When called to a drunk in the street, the ambulance crew should be allowed to beat the 'patient' up, to give them the fight of their lives, to fill them in, to give them a good shoeing and to knock seven shades of shit out of them.

This will have several effects - primarily it will act as a deterrent to people who get drunk and expect public taxes to be spent looking after them, secondly it will reduce the cachet of sporting a hangover the next day in work, thirdly it will ensure that the 'patient' actually needs the services of an A&E department, fourthly it will allow A&E staff to practice their minor (and not so minor if the ambulance crew gets carried away) injury treatments on a semi comatose patient and finally it'll help de-stress ambulance crews when they find themselves going to the umpteenth drunk of the night.

I suspect that once a person has had their nose broken a few times they may eventually get the idea that drinking in moderation is perhaps a good idea.

(Also the ambulance crew should be allowed to perform 'ABC' on the patient - taking their Access, Barclaycard and Cash. This will have the happy side effect of raising ambulance wages, and thereby raising staff morale.)

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I am not mad.

But I would suspect that in countries where the police are... less 'customer focussed' there is much less public drunkenness.

Perhaps a less extreme measure would be to have the ability for A&E departments to issue fixed penalty fines if the only reason that you are in the hospital is because you were drunk and incapable. I wish the police would do this, but they are fully aware that in the great scheme of things their time is better spent elsewhere, or if not ''better spent', then tied up dealing with Kylee and Jason's domestic dispute over the bottle of White Lightning.

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I suspect that over the next few days I'll be highlighting exactly how wasted my time at work has been - essentially being little more than a taxi driver, and worse than that a taxi driver that can't refuse a punter.

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EDIT: It would seem that some people haven't recognised that this post is largely hyperbole, maybe I should have made it more explicit by suggesting that I 'kill a few - just as an example for the others'? Needless to say I don't actually think that we should go around beating up drunks, but I do think that we should introduce fines for these drunkards who abuse the NHS.

We have a lovely new ambulance at West Ham station. They are quite nice actually, there is much more leg room so it means I don't think I'm stuck in an economy airplane for twelve hours.

They have groovy new electronic systems that talk to you and do things like turn off the lights in order to save battery power - it only sometimes turns off the lights when you really need them.

It has the new electric trolley-beds, which I'm yet to encounter a problem with, although I'm sure that it's only a matter of time before the batteries that drive them start to fail. Maybe I'm being cynical.

The biggest problem is that the engine is incredibly underpowered. There is no acceleration to it at all, and it's that acceleration which you need when you are coming to a stop every five yards as you weave your way through the London traffic.

Sadly it's not there, and it sometimes feels like you need to get out and give it a push.

I blame the LAS management wanting to save money, and the environment - after all they do try to have us out driving around aimlessly, just in case a call comes down the line in the area in which they have deployed us.

(Sorry I'm being cynical, what actually happens is that the psychic computer tells us where the next heart attack is going to happen and so we are dynamically deployed depending on this crystal ball).

This new vehicle has done 2,500 miles. There isn't a mark or a dent on it.

Yet, in the last 41 days, it has needed to be taken off the road to be fixed 22 times.

We tallied it up while we were working on it last night - the picture opposite is the reasons why it has needed to be fixed.

I'm sure that, had we bought this from a shop, we'd be covered under the 'not fit for purpose' legislation and we could get our money back.

Sadly, we work in the world of NHS contracts, and I'm just not that smart to realise why we aren't sending these vehicles back to Mercedes and asking them to get them to do the thing that we have bought them for.

There is obviously a fault somewhere that needs serious fixing.

Here is a picture of the front of the ambulance repair reporting book, where we write down the faults so that the fitters can mend them. It is supposed to be left on the vehicle at all times.

Sadly, the LAS typo monster has struck again and it is down to crews to correct things.

This monster is getting more and more prevalent, the latest big memo - laminated cards sent to every member of staff in the area, told us about the policy for dealing with patients who need to go to a 'heart attach' centre.

I think it's because they have promoted one of my old officers who couldn't spell, and laminated everything.

I think he's doing something like 'business development'.

And, like all writing on the internet where someone comments on grammar or spelling, I'm sure that there is an error on this page.

My excuse (for many things) is that I'm working night shifts - it's all I can do to manage to get into work in the first place...

From the excellent Warren Ellis and his T-Shirt of the week. I'm getting this on both T-Shirt and Hoodie.
It is only available for a week, so if you want one, I'd hurry up and order.
For those that are interested in Print On Demand (and I am) - Ariana Osbourne writes a wonderful little post about the design work on the POD 'Shivering Sands' that she and Ellis worked on together.

A few things to post about today, but first I need to sleep, so until this afternoon I'll give you something to listen to.

For those of you who are interested in the Kindle reader, there is no better podcast than Len Edgerly’s ‘The Kindle Chronicles’, so I was exceptionally privileged to be invited to have a little chat with him.

During the show I talk a little about the problems that Amazon may have in the UK being later to market than the Sony Reader, about open formats and the craziness of regionalisation. We also ponder on the tactile nature of the Kindle and how we seem to be going back to an earlier century.

You can visit The Kindle Chronicles website, or go direct to this particular show page.

You can also subscribe to the podcast via iTunes or download the episode directly.

I'm a massive fan of Charlie Stross and, while I've been wanting to write about the insanity that is the Digital Economy Bill, I think that he has hit the nail on the head.

I'm reproducing his whole article because I believe that it is important to get this message out there, and I hope he doesn't mind that I want to make sure that people read his article and aren't put off by having to follow a link.

I also humbly suggest that you go and read his blog. Then head over to the Open Rights Group and see how you can help. Even if it is just phoning your MP to let them know that punishment without trial is terribly un-British.

Imbeciles

I was trying to think of something coherent to say about the Digital Economy Bill published this week, but I'm too damned angry right now.

I'm a self-employed media professional working in the entertainment industry, who earns his living by creating intellectual property and licensing it to publishers. You might think I'd be one of the beneficiaries of this proposed law: but you'd be dead wrong. This is going to cripple the long tail of the creative sector — it plays entirely to the interests of large corporate media organizations and shits on the plate of us ordinary working artists.

Want to write a casual game for the iPhone and sell it for 99 pence? Good luck with that — first you'll have to cough up £50,000 to get it certified as child-friendly by the BBFC. (It's not clear whether this applies to Open Source games projects, but I'm not optimistic that it doesn't.)

Want to publish a piece of shareware over BitTorrent? You're fucked, mate: all it takes is a malicious accusation and your ISP (who are required to snitch on p2p users on pain of heavy fines) will be ordered to cut off the internet connection to you and everyone else in your household. (A really draconian punishment in an age where it's increasingly normal to conduct business correspondence via email and to manage bank accounts and gas or electricity bills or tax returns via the web.) Oh, you don't get the right to confront your accuser in court, either: this is merely an administrative process, no lawyers involved. It's unlikely that p2p access will survive this bill in any form — even for innocent purposes (distributing Linux .iso images, for example).

I've had problems in the past with idiots at Elsevier issuing DMCA takedown notices against legitimately-posted copies of Accelerando, on the basis of a web search conducted by spider. If this bill goes through, it's going to make it difficult for me to distribute fiction for free (encouraging readers to try my work); I don't want to see folks having their connectivity axed just because a filename they downloaded matches something with an ISBN in Amazon's database.

This bill isn't about securing our creative industries. It's about fucking the little guys, depriving them of channels to reach their public, and about protecting the cartel of big media organizations who are threatened by the development of the public internet. And it stinks from the head down.

I don't like to do incandescent anger (I have blood pressure issues). So I don't usually focus on issues like this on my blog (you want me to live long enough to finish the current book before I stroke out, right?). So I'm going to hand you over to Cory Doctorow, who has the goods, and to the Open Rights Group, who need your support.

That's all for now.

UPDATE: There's a petition on the Number 10 Downing Street website, "to abolish the proposed law that will see alleged illegal filesharers disconnected from their broadband connections, without a fair trial". If you live in the UK, I strongly urge you to sign it. While these petitions are in no way binding, large sign-ups send a warning sign to the government and have, in the past, provoked a re-think on controversial legislation. And this is especially likely in the run-up to a general election (which must be held within the next six months).

I've given up on the NaNoWriMo for this year - too many twelve hour shifts (I'm starting nightshifts today), coupled with some deadlines approaching and I'd have to spend twelve hour shifts when not at work writing to keep up with the schedule.

This doesn't mean I'm abandoning it, I'm going to keep writing it, and I may throw the 'beta version' up somewhere else - be sure I'll let you know when and if I do.

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Back to writing about ambulance work, work that often seems stranger than fiction.

The job I'm writing about today would, if shown as a 'Casualty' episode, have me groaning at the screen at how unlikely the events were.

We were sent to a 'male, collapsed', on the screen was the patient's name - it was a name I was somewhat familiar with.

It was a name I used to go by (sometimes I feel like Old Ben Kenobi remembering his time as Obi wan Kenobi with the amount of names I had...).

I've mentioned my father once on this site - in 2005 I wrote this,

The short version of my history with my father is that he left home when I was around fourteen (my brother was around twelve), and married another woman (without divorcing my mother first – an oversight on his part, he is after-all barely literate). Since then I haven’t seen or heard from him, which was a bit strange as the split between mum and him wasn’t acrimonious.

So my attitude toward him has basically been ‘Fuck him’, it appears that he wanted us out of his life as quickly as possible, and he has succeeded admirably on that point.

So…why was I thinking about how I’d love to meet with him, tell him how excellent my life is? I’d love to let him know that my brother is an excellent teacher and is getting well paid for his work. I’d love him to see how his walking out on us only freed both my brother and I to go on to do things that we love doing. I’d love to show him how relaxed and chilled out my mother is now. I’d love someone to read this blog out to him, so that he could know that I’m doing better without him in my life.

Actually…I wonder if he is still alive?

So – for one moment after not thinking about him for years, I’d love to rub his nose in how good my family and I have it now he isn’t on the scene.

And now I find myself going to someone who could well be him...

We arrived on scene, I was driving and I'd been telling my crewmate about my history with my father. It looked like the place where I'd last seen him more than twenty years ago, but I wasn't sure.

Then we entered the flats and from the tickle in my memory it was obvious that this was where he lived.

He was laying on the floor with one of our FRU people already looking after him. The FRU looked at us and started to give us a handover.

'This is *Firstname* *Secondname*', he said.

'I know', I replied, 'it's my dad.'

'Hey, your son is here', the FRU said.

'He probably wouldn't recognise me', I said back as my father turned to look at me.

The job itself was fairly simple, carry him downstairs, into the lift - then, after running some tests, off to hospital.

I wheeled him into the lift, it was small so his 'wife' walked down the stairs - me, my crewmate and my dad, alone in the lift.

He looked up at me and said the only two words he would say to me during the time we spent together that night.

'Say nothing'.

Now, if I had even the slightest care about him, those two words would rip out my soul and stamp on it. It would break my heart. That his son, who he hasn't seen for twenty or more years is here, saving his life and all he wants is for me to say nothing to him.

He has his new life, and he wants nothing to do with me, or my brother.

'Fuck him' would indeed seem to be the right attitude to have had over him, and I'm very glad that I've not worried, fretted or even given a moments consideration to the man that walked out on me and my brother. Now I knew why we'd never had even a birthday card from him.

He had obviously wanted to wash his hands of us.

So I switched to 'full on professional' mode. I spoke to his 'wife' (who seems quite a nice person actually) to get his history and I drove him to hospital.

After dropping him off I asked my crewmate if she thought it would be a good idea if I walked in to him, told him how well our family is doing without him and then walked out.

She rightly pointed out that despite wanting to give him a slap when he'd said 'say nothing' to me, it would do no good.

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So we left him at hospital - I don't know if he lived or died. To be honest I don't care - I care less than I would were he one of the strangers I pick up normally.

I told my mum about it, and she was furious - I think she would have quite liked to have turned up at the hospital herself, but I assured her that once my shift was over I'd stopped thinking about him.

So yes, stranger than Casualty - although I'm sure that Casualty would have had us reconciling...

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Oh, that 'other project' I mentioned? It's my new group website. And it's open.

A couple of days at work and then two days off where my brain refused to get out of idle means that I've seriously fallen behind schedule for NaNoWriMo. If I don't have the chance to get going then I'm unlikely to 'win'. Still, even if I don't finish the 50,000 words by the end of November, I'm still planning on finishing this thing.

What I do with it once it's written may be something... interesting.

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It would seem that Judith’s lead has paid off, she’s leading be down some cobbled Swedish backstreets to a bar where I’m to meet a family that is dodging their responsibility to the ‘Home Care Plan’. They have a relative that is comatose in hospital and while they should be taking care of him, instead they had sold everything and gone underground.

Judith is ahead of me, and I’m watching her short ponytail swinging left and right in from of me. Every few steps she takes another puff on the cigar that she has clenched between her teeth.

She was late back to the hotel last night, I heard her crashing into the ajoining room at 4am. This morning she smells of sweat, smoke and alcohol. She’s also in a grumpy mood.

“In there”, she has abruptly stopped and started pointing at a tiny ramshackle bar, “I’ll be in later, I just want to make sure that we haven’t been followed. Lots of dodgy bastards around here.”

She then ignores me and pretends to take an interest in the clothing shop opposite the pub, staring deep into it’s large shop window.

I enter them pub and it’s so dark it take a moment for my eyes to acclimatise to the dark. Sitting at a table, a bowl of bacon pasta in front of them are the two people I’m here to see.

Mr and Mrs ‘Sundin’, (not their real name), are essentially on the run from the law.

Every family in Sweden (as in much of the developed world) has a responsibility enshrined in emergency legislation to look after any close relative that becomes affected by CLBD-7. These laws were passed to enable hospitals in countries with socialised medicine to continue providing care for those unaffected.

One year ago Mrs Sundin’s mother failed to wake up from a night’s sleep, since then she has been comatose.

The law says that, once all other causes have been ruled out, the nearest relative takes on the responsibility of caring for that person, be that in their own home or by purchasing private healthcare. Either way the state isn’t going to help you.

The Sundin household is not a rich one, Mr Sundin tells me that he has work as a freelance web consultant and Mrs Sundin gave up her work as a secretary when her mother became ill.

The thought of having to look after her mother filled Mrs Sundin with fear, she tells me, she has had no training in how to care for people and hates the thought of having to spend twenty four hours a day looking after a ‘vegetable’.

She says that she tried, her mother was transported home by ambulance only a few hours after the ‘Home Care Advisor’ had left the family home, the advisor had told Mrs Sundin about pressure sores and cleaning incontinent patients as well as how to change the food bag that led directly into her mother’s stomach. She counts herself lucky that she got that advice as soon afterwards the Home Care Advisory Service suffered a number of cutbacks making people rely on advice from the internet.

After one week Mrs Sundin tells me that she had stopped crying, that instead all her emotions left her and she settled into the routine of turning, washing and, after her mother was incontinent, changing the bed.

She tells me that her home used to smell nice, that it was clean and presentable - but that now it only smelt of urine and shit and talcum powder.

She tells me that when she was working she used to spend time socialising with her work-mates, every Friday the staff at the small insurance office where she worked would go out to a local bar for dancing and drinking. Now, as she was not at work, she never went out except to get shopping.

Two months into the care of her mother and she finally snapped. No-one to turn to, no one except her husband to help, no support from the government all wore down her resolve and she started to make plans to run. She tells me that she no longer saw her mother as her mother, instead she saw her as a lump of meat, there was no spark of recognition. Sometimes her mother would open her eyes and Mrs Sundin would stare into them hoping for some spark of intelligence. But it never happened.

Mr Sundin had made a number of contacts in the internet community so when it came time for them to disappear he knew people that could help them. They sold the house, placing Mrs Sundin’s mother in a short term care facility, they then took the money and vanished.

Mr Sundin tells me that they had to make deals with several people from outside the law. Those are his exact words, ‘outside the law’. These people, and he doesn’t elaborate any further, gave them new identities. Now Mr and Mrs Sudin have new names and a new address, the house that they rent is much smaller and Mr Sudin had to give up his job, the web market is too well connected for him to take his new identity anywhere else. Mrs Sundin returned to secretarial work, although she doesn't attend the Friday night drinks at her new workplace.

Mr Sundin now has work in a postal office.

As for Mrs Sundin’s mother, I cannot say. In Sweden they have large warehouses full of comatose patients, stacked away and looked after by minimum wage carers. The death rates are terrible there, but it is all the government can afford.

Mrs Sundin doesn’t know if her mother is still alive, she knows that she’ll never find out.

If the law ever catch up with Mr and Mrs Sundin they could be put in prison for up to ten years. Mrs Sundin tells me that she would rather be in prison than tied to a house looking after someone who doesn’t recognise her any more, feeling the love for her mother, the woman who raised her, slowly ebb away.

I leave Mr and Mrs Sundin at the bar, nursing their drinks, eating their pasta. Judith is still outside, still smoking the same cigar.

We head back to the hotel.

Sweden has long been held as a perfect example of socialised healthcare, that and the UK. I went there to find out how Sweden coped with the first outbreaks of CLBD-7

I’m speaking with a Doctor Anders Kask in a beautiful park. Judith meanwhile is next to some trees aggressively smoking a cigarette while watching some young men play football. She’s got her back to me and I think it’s the first time she hasn’t had her eyes on me. I swear she waits outside the toilet for me to finish, eyeballing the other patrons to see if they are international assassins.

I ask Dr. Kask how the healthcare system of Sweden coped with the early days of CLBD-7.

“Like everywhere else we didn’t know what was happening”, he says in thickly accented English, “People going mad in the streets, emergency rooms filling up with what we thought were psychiatric patients. And of course those who just slipped into unconsciousness.”

For the first time I’ve heard a doctor mention those who died. We are so fixated on those that were left alive we often forget those who died.

“It was the unconscious ones that we tried saving first - it’s all about triage. Triage is this wonderful idea thought up by the French in the first world war. You deal with the most serious life-threatening cases first, then the less serious and finally the walking wounded. We’ve been using it for years and it’s a good way to deal with problems coming in quicker than you can deal with.”

“In an emergency room setting you deal with unconsciousness before you deal with psychiatric problems, the unconscious patient can not wait to be treated. So you put your resources towards helping them while the other patients wait.”

“But there is one part of triage that often doesn’t get spoken about, and that is for the patients for which you can do nothing. You don’t treat them at all. The dead are dead and they remain so.”

“Of course, if we have the resources we attempt to resuscitate the dead - in 2010, the year before CLBD-7 we have a cardica arrest survival rate of 10.7%. Not a good rate, but better than a lot of other places.”

“What we didn’t know was that the unconscious ones were beyond our help. And even if we did know, how could we be sure that it was this new disease and not something that we could assist with?”

“It turns out that of those people showing symptoms of, er, I believe the colloquial is ‘being Clubbed’ around 20-30% would become unconscious, never to re-awaken, another 20-30% would become increasingly violent and the rest would follow normal, if rapid, onset of dementia. Around half of those who became violent, your ‘zombies’ if you will, further progress to a more normal dementia. Those who do not? Well, you have to decide what to do with them.”

But in those early days we didn’t know this, so we would have people brought in by ambulance deeply unconscious, some from stroke, some from diabetes, some from other causes, but a vast majority of them would be due to the disease. We had to treat them all the same, rule out the obvious causes and then find beds for them if they remained unconscious.”

“All the time of course our emergency departments were filling up with deeply psychotic patients”.

“So we were terribly stretched, in a normal week we might deal with three, maybe four or five patients who were persistently unconscious. Those who did remain so would normally go to the intensive care department. The ITU in my hospital has eight beds, and barely enough staff to run those beds. You see, it is not enough to merely have the physical bed, you also need the doctors and nurses and cleaners and all the others to staff that bed. Even working twelve hour shifts you need a minimum of four nurses to look after a bed for a week. And that isn’t counting the cover for annual leave and sickness.”

“And our staff weren’t immune to CLBD-7 themselves.”

I remember when one of our senior nurses was found by his wife unconscious in bed, he was brought in to us and when he was wheeled through the doors it was all we could do not to stop and stare at him. We knew then that the chances of him ever waking up were nearly impossible. We also knew that there were no beds in the hospital, no beds in any hospital.”

“It still shames me that he would be the first person we put on the general wards.”

“Until then, every unconscious patient went to ITU for one on one nursing care, now were were having to use general medical and surgical wards. While the nurses there did their best, they weren’t very well trained in the care of comatose patients. They also didn’t have the staff numbers, one nurse for eight or more patients? How could one person with some untrained helpers look after that many high dependency patients?”

“It started with the sudden deaths of the comatose, we were later to find out that many of these had died from an occluded airway, ‘swallowed their tongue’ if you would. This was because the ward nurses didn’t have the experience of keeping a patient’s airway open, not eight of them at once.”

“Then came the pressure sores, if you cannot move your body then where it touches the mattress, or even another part of the body, the circulation of the blood is restricted and the tissue starts to die. The position of patients should be changed every two hours at a minimum - and it just wasn’t happening, the nurses were too busy. Once a pressure sore happens the skin breaks down and falls away, and then it gets infected and starts to eat away at the patient.”

“I remember one woman who had a tiny spot of a sore on her sacrum, her backside. But the decay went much further, far up along her spine. She had a tunnel, a cavern, running along her back that you couldn’t see. Each day the nursing staff would dress that little spot wound, knowing that there was nothing that they could do for the metre long wound hidden just beneath the skin.”

“The thing I remember most? The terrible smell of infected wounds, Staphylococcus aureus was a big killer in those days and we barely had enough IV antibiotics to give them. After all you can’t give pills to a comatose patient. You would walk onto the ward and the smell would be like a physical wall - I can see why our predecessors thought that disease was carried by smells.”

“So we did our best, until the beds filled up, and then we made more bed, camp beds. Wards that were designed to hold twenty patients would hold twice that number. But the number of staff could not increase, where would they come from? Every country was having the same thing happen. The nurses that we employed from overseas were heading back to their home countries to look after relatives, and that meant our staff numbers dropped even more.”

“And CLBD-7 wasn’t the only disease, we still had people attending hospital with heart attacks, strokes, gall bladder problems - and they all wanted, and needed to be seen.”

“I think the American hospitals had it somewhat easier than us - their insurance companies stopped paying out for CLBD-7 treatment and so the hospitals would discharge them for patients that could pay. I don’t know what they did to those stricken who had no relatives to look after them. I mean, I have heard the stories, the terrible stories of ambulances taking them to places out of the way, under bridges and the like and just leaving them there, but I find it hard to believe that such things really happened.”

“It took us longer. No one in parliament wanted to propose what we knew would have to be done, and sure enough they got voted out the next year - but it saved many lives. The ‘Home Care Plan’ was passed and now anyone stricken who had a family would have to be cared for at home. There were some attempts at training the relatives as to how to look after the sick - but the funding soon ran out and so the information was put on the internet.”

“No one knows how the health service survived. I think that for a little while we just stopped worrying about death, just accepted it and did what we could to prevent it. We aren’t back to pre-outbreak levels, I don’t think that we ever will, but we are slowly recovering.”

I looked over to where Judith and the footballers had been, the field was empty and I couldn’t see Judith at all.

A few minutes later she sends me a text message to tell me to make my own way back to the hotel as she was following a lead.

A short break from the NaNoWriMo posts so that I can tell you about two rumours that I've heard. Note that these are rumours, if I had the time/energy/inclination I'd check them out to see if they are true, instead I'm just relying on the trust I have in the person who told me them.

If anyone knows if these rumours are untrue, feel free to let me know.*

Rumour number one is that a man from the Department of Health visited the ambulance service recently and told people that the moment the government changes (i.e Britain has a collective brain fart and a memory wipe of the last tory government and votes in the Conservatives) the London Ambulance Budget will be cut by £25 million.

This despite hitting our (stupid and clinically irrelevant) targets, despite ever increasing calls and despite the suspected pigocalypse of everyone calling an ambulance when they thing they have swine 'flu.

Additionally, somewhere out there in 'I could find it if I had the energy to Google it-land', is the government plan that a certain percentage of A&E ambulance work should be done by private ambulance firms paid for out of our budget and you can see that we will be going for the cheapest bid, which is never a good sign of quality.

Oh, and I nearly forgot - we have the Olympics coming up soonish.

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The second rumour is to do with a bit of our kit changing. This rumour however has been repeated by several people, including officers. The rumour is that because too many are going missing we will be doing away with our electronic blood sugar machines which are quick, accurate and easy to use in any circumstance. Instead we will be going back to the old chemical dipsticks that you have to wait two minutes for the result, and the result is a range of values that you read by comparing the colour of the stick to a chart.

Which doesn't work all that well, I think, considering half the time we are working in 'less than optimal' lighting conditions.

Also the dipsticks are also apparently far cheaper. And much less accurate.

Instead money is being spent on filter masks to protect me** from a milder, less fatal 'flu than is normally present at this time of the year.

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So, less money, less effective equipment and more calls. Probably less training due to the lack of money (training is normally the first thing to be cut). I can see us going back to being men with vans and bandages. Except of course that someone in government wants us to do the GP role on the cheap, but without the training is that really safe?

Expect deaths.

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To be honest I'm getting past caring. The few improvements that we've had in the service have constantly been overshadowed by new policies and ways of working that seem to exist only to destroy morale and chase unscientific government targets. We are being expected to do more for a frozen pay and with equipment that is falling apart.***

Why should I care any more? I can't do anything to change anything. Instead I should just turn up to work, pick up people who think that they are sick and take them to hospital. Then come home and watch some TV and forget about the feverish children that I couldn't record a temperature on because we didn't have a working thermometer.

Why should I get angry over it when I can't change it?

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*LAS management don't talk to me, they mostly ignore me, so I don't expect any confirmation/denial. Here is a challenge to my management - deny that either of these rumours are going to happen - here and in public. I'd ask you myself, but the organisational chart is so complex I don't know who'd I'd need to talk to.

**Sadly not only is my face such a strange shape that I can't get a mask to properly secure, but in attempting to get it fitted I managed to break my glasses.

*** An example - We drove the newest ambulance in the fleet, around 1,500 miles on the clock. We had to take it off the road twice in two days for various faults and, looking at the logbook, these were not new problems. Thank you Mercedes.