A plea to all employed in the public sector

A comment in a recent blog post got me thinking.  The conservative party is promoting infighting between each sector of those in public service, and as a result sniping and bickering is readily happening as to ‘who has it worse’.  This bickering is allowing the cuts imposed on the public sector to go unnoticed and remain ignored while each group fights with each other.

It’s time to fight back.  I implore all those who read this blog to contact me with examples of how the cuts in their sector is harming those who use their sector and how the cuts are reducing the level of service the public are getting.  Only by doing this can we show the voting public the harm that these cuts are causing and exposing the falsehoods planted in the media.  This invitation goes out to everyone in the public sector, armed forces, emergency services, healthcare, social services, council staff etc.

For the love of whatever deity you pray to, DO NOT contact me via your work email, nor log in to your private email through your work intranet.  Hotmail accounts can be set up in a disposable way (takes about 10 minutes), as can yahoo etc.  It goes without saying, don’t give dates, person identifiable information nor anything else that can be tracked back to you.  I will of course remove all names.

If you don’t contact me then when the public remain uninformed you can’t really complain that there’s no balance in the media nor how your point never gets across.  So please, get in touch and share the damage being done that’s being imposed by these cuts.

I can be reached via twitter – @NTDailyMail or via Facebook or via email adifferentviewpoint@hotmail dot com (replace the ‘dot’ with . and take out the spaces folks – I have to type it like that to prevent automated spam).

The Daily Mail show their colours

The recent offence taken by Ed Milliband over the Daily Mail article written about his Father has shown the political elite what I, and many others, have known for some time.  That the Daily Mail is a paper that happily distorts whatever it wants.  The Daily Mail, among others, have written these types of articles about public servants for years and have suffered no ill effects for any of them.  

It is only now that politicians are coming under this vitriolic attack that Mr. Milliband questions the “morality and boundaries” of the media however he has remained silent after every misleading and hateful article written previously written.

While I would not want the Mail to write this type of article about any parent I do hope it shows people how the Mail happily twists small snippets of information to their own end and the slant they put on articles.  I also hope that it causes real change to be put into place, although I know that is highly unlikely.

Unfortunately the only way that the paper will change is if people no longer buy their physical paper nor visit their website.  If these two things were to happen they would cease to be of any importance whatsoever.  

Why talking about Winsor’s uniform is important.

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As of a few moments ago that’s how many hits “How can Tom Winsor look at himself in the mirror?“.  That’s one blog, started around 2 weeks ago with a post dedicated to one civilian and his ridiculous decision to wear a full ceremonial uniform to a memorial event.

Some have questioned whether it is appropriate to divert attention from National Police Memorial Day and whether this should have been discussed on another day.  Unfortunately there was little to no publicity in the media about this important remembrance service.  The BBC hid their story within the ‘Wales’ sub-section of the UK news, the Daily Mail hid the story as simply part of HRH Prince Charles day to day activities and a Google search for NPMD brings up a mere two stories in papers.

Police officers up and down the land have shared their horror and revulsion at this man, over 6,000 shares on FB and Twitter.  This means that even though media up and down the land have attempted to manipulate public opinion in such a transparent manner you have all ensured the public are aware of the event and the strength of feeling towards it.  All this work was done by you and I really can’t thank you enough.  It’s only with individual police officers spreading this news that allows for balance and replies and there must be a continuation of this to stop the police being constantly derided in the press.

 

How can Tom Winsor look at himself in the mirror?

Tom Winsor, responsible for reducing the starting wage for the Police to £19,000 pa, while at the same time increasing the entry qualifications; who decided that direct entry to the significant rank of Superintendent was a good idea as well as being able to make Police officers redundant; who increased the age at which Police officers can draw their pension; who decided that Police officers must have mandatory fitness tests, but not give them any time within work to keep their fitness levels to that standard (unlike Fire & Rescue and Ambulance HART), has decided that wearing this uniform to the National Police Memorial Day is appropriate.

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Apparently this is the ‘ceremonial uniform’ of the Chief Inspector of Constabulary, which Tom Winsor now is.  To me, and to many others, this is the uniform of a Chief Officer of a UK Police Force.  

How dare he.  How dare he believe he is in any way entitled to wear a uniform in which men and women far braver than he have died in.  Men and women who gave their lives in service to this country, protecting the public, the vulnerable and the most needy of our society.  How dare he have the temerity to meet the families of dead officers while wearing this uniform, look them in the eye and tell them he is sorry for their loss.  Not only has he never served a single day in any police force in the country but has also destroyed the terms and conditions of officers up and down the land.  

I hope Winsor looks at the families of the dead, sees the quiet dignity mixed with the total sadness in their eyes and realises he isn’t fit to wear that uniform and never does so again.  It would have been far more respectful to the fallen to wear a somber suit and black tie but then that wouldn’t have given him the opportunity to play dress up.

A desperate state of affairs

Today I read the incredibly sad story of Bella Hellings.  Bella was a three month baby who died after suffering a seizure in March.

Unfortunately it took 26 minutes for paramedics to arrive on scene due to a number of wholly preventable issues.  The fault of these issues lies squarely at the feet of the trust rather than the individual paramedics.

The first issue is that Bella lived on a new build estate, so new in fact that her address didn’t feature on trust vehicles sat navs. Unfortunately for Bella, as is so very common, the houses all look so very similar so the detail her fraught parents gave as a distinguishing feature wasn’t unusual.  What I ask of you the reader is tonight, when it’s dusk, step outside your house.  Go to the side of the road and see if you can clearly see your house number?  I can pretty much guarantee that it’s not clearly visible.  For your own sake please find a much larger house number than the one you have and make sure it can be seen from the road.  Yes I know you know where you live, as does the postman but the emergency services don’t and unless it’s clearly visible from the road there will be a completely preventable delay in finding you when you need help at your most vulnerable time.  I have no idea if this was the case at Bella’s house but it is at pretty much every other house I’ve ever had to visit and is a point worth mentioning.

The next issue was that an ambulance had to stop for fuel.  How have we got to the state that we run our ambulances so ragged that there is insufficient time to refuel them other than when they’re on an emergency call? Now I don’t know what vehicles East of England run and I don’t know their range but I’m pretty sure, like everywhere else in the country, the crews get called out seconds after they log on and are constantly run until they finish.  I also know that WMAS has staff called Ambulance Fleet Assistants.  Their job essentially consists of ensuring the vehicles are ready to go out at the start of each shift, part of this is to refuel them from their own diesel tanks they have at some of their ambulance hubs.  I would suggest that East of England need to do similar to ensure their vehicles start the shift fully fueled.  While this wont fix the problem of having ambulances run constantly it will prevent issues like this from happening again, additionally it will deliver cost savings which will enable more money to be put into frontline vehicles and crews.

The key issue on the refueling of the double crewed ambulance (DCA) is there isn’t enough of them.  There simply aren’t enough DCAs to go around.  Any paramedic who crews a car will be able to tell you of horrendous waits for very sick patients, I’m personally aware that in at least one county the amount of DCAs available on a Friday/Saturday night is regularly less than the digits on one hand.  This leads to delays, the DCAs are constantly working their entire shift and their journey times are now longer as EDs have been shut and downgraded.  Unfortunately this means there is no resilience within the system and it’s not beyond the realm of imagination to imagine that one day, somewhere in the country all the ambulances will be held up outside one hospital and something terrible happen leading to a horrendous wait for DCAs to arrive on scene.

I’m very suprised that no-one has every submitted an FOI request for one specific night and asked for DCA crewing levels across the country – I would be astounded if there wasn’t a sea change after if this is undertaken.  Cars have their place in the ambulance service but with services chasing a government imposed arbitrary target of 8 minutes, with their entire worth measured on this one target, it appears services are crewing more and more cars at the expense of DCAs.

There shouldn’t be a choice between DCAs and cars, there needs to be a dramatic uplift in funding for ambulance services across the country, until this happens there will be incidents like this up and down the land and more people will die.  I implore the government to give ambulance services more cash for vehicles and crews as they are so desperately needed.

Let’s straighten a few things out

While perusing various media outlets looking for stories that may be of interest I’ve noticed a few wild inaccuracies that I desperately want to correct.  Some of these examples aren’t really appropriate to critique each article but as concepts I’m happy to correct as you’ll see further down the page.  However if the media can’t report  basic things correctly how can we have confidence in their ability to report larger issues well?

If you’re a medical professional, please be kind.  I’ve tried to keep things as simple as possible and remove as much medical jargon as I can – this may have led to a little over simplification in places but is necessary.

The first thing I’ve noticed is that some papers think that the terms ‘cardiac arrest’ and ‘heart attack’ are interchangeable.  This is blatantly incorrect.  

A heart attack is where one of the arteries supplying the muscle of the heart becomes blocked.  This blockage is when a plaque breaks off from fatty deposits lining the blood vessels and then blocks smaller vessels further along.  Depending on where the blockage is will determine how much heart muscle is damaged.  If sufficient damage is caused then cardiac arrest will follow, conversely if the blockage is small enough then the patient may not even be away that damage has occurred.  

Cardiac arrest is where the heart ceases beating entirely or beats in such an erratic way as to prevent blood from being pumped around the body.  

As you can now see these two terms are clearly not the same thing.  While a heart attack can lead to cardiac arrest not every one will, additionally not every cardiac arrest is caused by a heart attack – a cardiac arrest can be reversible which is why it’s so important to start CPR as soon as a cardiac arrest is evident.  The reversible causes of cardiac arrest are a lack of oxygen, a significant loss of blood, hypothermia, extreme low blood sugar and issues with salts and minerals in the blood.  Additional reversible causes are collapsed lungs, fluid around the heart, some poisons and blood clots that have blocked blood flow to vital organs.  This doesn’t mean that every case of these is absolutely reversible, in some cases the damage is too great too quickly or because of the distances involved it just takes too long to get the patient to the help required by which point it is too late and the patient unfortunately dies.

Obviously not every cardiac arrest is reversible, I’m sure you don’t need me to run through that particular list.

Talking about cardiac arrest leads me nicely onto my next topic, defibrillators.

Here’s something that will suprise an awful lot of people, a defibrillator does not restart a heart, it stops it.  Before I get rotten tomatoes thrown at me, here’s the explanation, starting with some basic physiology.

As I’m sure you’re aware the heart pumps blood to the lungs so that it can pick up oxygen, once the blood is oxygen rich it returns to the heart so that it can be pumped to the body so that this oxygen can be used by the body.  To do this the heart needs to beat in a very organised way and in the human four chambered heart the top two chambers beat first then the bottom two beat.  The top two chambers job is essentially to properly fill the bottom two chambers and it’s the bottom chambers that push the blood to either the lungs or to the rest of the body.  Because of an inbuilt electrical system in the heart this process, when working properly, follows a nice steady rhythm and this gives you the nice regular trace you see on an ECG.  Should the inbuilt electrical system of the heart fail then what can happen (not every time, depends on the problem) is that each cell starts to beat independently of each other.  This process is called fibrillation and if it effects the bottom two chambers of the heart then the heart will no longer pump blood around the body.  It is possible to attempt to reset the heart into a normal rhythm by passing electricity across the heart with a defibrillator.  The hope is that by stopping the heart it will allow the normal electrical system to regain control and for a normal heartbeat to resume.

There is another rhythm that can be successfully shocked called ventricular tachycardia, while a different disease process it can also be shocked – for the purposes of using a defibrillator they’re treated in the same way.

As you can see there are only two heart rhythms that can be shocked with a defibrillator, this means that when someone is ‘flat lining‘ there is already no electrical activity in the heart, so trying to stop the heart with a defibrillator has no benefit and no shock will be given.  There is another heart rhythm called ‘pulseless electrical activity‘ this is where essentially the electrical system is already working properly but for whatever reason the muscle of the heart isn’t responding.  It’s common sense to not pass electricity across this rhythm as the electrical system is already working so stopping that will bring no benefit to the patient.

The final inaccuracy I want to work on today is as follows, I see time and again various articles where the reporter triumphantly reports that a person ‘died of a cardiac arrest’.  Everyone dies of a cardiac arrest, it’s what caused the arrest that needs to be explained: merely stating a person died of a cardiac arrest is like saying your car stopped because it broke down rather than saying the alternator broke, it ran out of fuel or an oil leak caused the engine to seize.

I think that’s all the pedantry anyone can take for today.  As and when other things annoy me there may be more ‘media corrections’ coming out.

It appears some journalists don’t know what they want.

I’m writing today about an article in Saturdays Daily Express, “Health and safety rules have turned into a sick joke”.  It’s confusing as it appears that the Stephen Pollard, who wrote the article, isn’t really sure about what he’s writing about nor what he actually wants.

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The article starts with a mention to an unrelated case of which I have no knowledge nor expertise so cannot comment with any authority – however to ensure that you can read the entire article I’ve copied it, you also know I haven’t missed anything out.

 

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The article talks about Godfrey Smith, a former Community First Responder who broke the law while responding in a service marked vehicle responding to a call.  The marked vehicle is pictured here, in an article published on 11th September in the Metro.  You will note that although it has green and yellow retro-reflective ‘battenburg’ markings it possesses neither blue lights and therefore it will also not have a siren.  The Daily Express article concentrates on the fact that Mr. Smith exceeded the speed limit by 50% as the sole factor, whereas the Metro article shows that Mr. Smith not only exceeded the speed limit, but also ignored a ‘keep left’ bollard in order to circumvent a red traffic light.  It is worth repeating that Mr. Smith did not, as he had neither, activate blue lights and sirens both of which are essential equipment for claiming those exemptions, exemptions he is not entitled to.  

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The article then states that no-one was injured as a result of Mr. Smiths actions, this is irrelevant.  He broke the law, and according to the Metro article he broke the law three times (excess speed, fail to obey keep left bollard, crossing a stop line when a red light is shown).  Apparently the SatNav on the vehicle required updating, again this is irrelevant.  Anyone who has done any further driver training knows that observation of road conditions and signs trumps whatever the little plastic box tells you, if the road sign says 20 then that is the maximum permissible speed by law.

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The article then moves onto the tragic case of Mr. Simon Burgess who the coroner recorded died in accidental circumstances.  It is factually incorrect to suggest, as this article does, that a delay in sending in help to Mr. Burgess directly caused his death as the coroner informed the court that the delay in waiting for specialist teams “was not a significant factor in his death”.

The article then moves onto the tragic event of Shannon Powell.  A young girl who first had a seizure and then went into respiratory arrest.  This article fails to mention the fact that Miss Powell was having a seizure, this makes carrying her virtually impossible for any length of time and depending on the method used it can be impossible to manage a persons airway – without this airway management death would have been inevitable.  

As a quick breakdown I’ll list the available options to carrying a person so you, the reader can establish why Miss Powell would have been left on the ground until the ambulance could be brought closer

  • Carry chair – only possible to use with someone who is conscious enough to protect their own airway.  Carrying over rough ground is possible, but only if the patient remains still
  • Longboard – Requires the patient to be strapped onto the board, depending on the nature of the seizure this would be impossible, furthermore movement dramatically changes the center of gravity which makes carrying a seizing patient virtually impossible
  • Scoop – see longboard for explanation
  • Carry sheet (only some ambulance trusts carry these) it is impossible to manage a persons airway when in a carry sheet, meaning your patient may asphyxiate prior to reaching the ambulance

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This article then moves onto what can only be described as a rant.  Furthermore it incorrectly describes Mr. Smith as an ‘ambulance driver’.  This ambiguous term means nothing in law – does the journalist mean paramedic? Or does he mean someone who, as in this case, drives a vehicle provided by the ambulance service?  I’ve yet to meet an ‘ambulance driver’ anyone who is ambulance crew, regardless of their training, does far more than just drive the ambulance.  It is worth remembering that Mr. Smith is not ambulance crew.  He has training only slightly above that of a first aider and is limited on his treatment options, especially when compared to a paramedic or an ambulance technician. 

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What really bugs me about this article, and I mean really bugs me is that the journalist links to one of his previous articles, titled ‘Too many people killed by speeding emergency vehicles’ an ill informed article describing paramedics as ‘stretcher bearers’.  The opening paragraph of this linked article is as follows

“Those at the wheel of emergency response vehicles can never be excused from driving responsibly.  After all, far too many people are injured and killed on the roads by police cars, ambulances or fire engines going at breakneck speed.”

This is incredibly hypocrisy, in one article he defends a volunteer driver, who has no exemptions under the Road Traffic Regulation Act 1984 or the Traffic Signs Regulations & General Directions 2002 , who failed to adhere to basic driving standards.  In the other he calls for a reduction in road traffic casualties from irresponsible driving by emergency service vehicles, which it is worth remembering Mr. Smiths vehicle was not.

Unfortunately for Mr. Smith, as he has admitted to driving past stationary vehicles in excess of the speed limit and failed to obey traffic signs while in a marked service vehicle when not entitled to do so, I have no sympathy for him.  It was his choice to break the law and he must accept the consequences.  He placed significant numbers of the public at risk and that is indefensible.