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On call with the London Ambulance Service
Flashing blue lights, screaming blue murder: 7 days on call with the London Ambulance Service
On
the desk next to me in the London Ambulance Service control room there is
a pile of pink report forms. Each sheet gives the details of an emergency
call. "The caller," says one, "states that he requires a
minicab." The man, it explains, became abusive when the operator told
him she couldn't find him one. "The caller," another form
begins, "rang to say that he does not require an ambulance, but that
he would like to 'deck' me." Contact with the drunk, the malicious
and the criminally insane is routine for control staff at Waterloo. But at
least they're only on the phone.
The
most immediate concern for ambulance crews is not so much those who don't
succeed in summoning an ambulance as those who do. In the capital alone,
an ambulance crew is now physically attacked every day. Hospital workers
can expect a limited degree of protection from closed-circuit cameras,
colleagues and security guards. An ambulance crew is working, for the most
part, alone and without stab vests, tear gas or effective personal radios.
"Assaulting an ambulanceman," one paramedic told me, "has
become our new national sport."
I'm
spending my first night shift with Athar Khan, a Senior Duty Officer in
Central London. An engaging, dedicated man in his early 30s, Athar played
rugby for England's youth team. He drives a rapid response Land Rover,
co-ordinates crews and attends major incidents.
We
are summoned to the ambulance station at the Oval, in South London, where
Athar has to interview a crew who have just been assaulted. Tom and Jackie
were called out to treat an injured drunk. When they arrived they were
spat at, verbally abused and had punches thrown at them. They look more
resigned than shaken: such incidents are commonplace.
I had prepared for my
week with the crews by reading Call An Ambulance, the official
history of the service. Published in 1963, it follows a middle-aged
ambulanceman called Ted, who spends most of the day drinking tea,
listening to grateful ex-patients and "lovingly polishing his creamy
white Daimler". Fending off thanks, with one hand on your PG Tips and
the other on the Silvo, turns out to be something of a dying art.
"The pressure to get to life-threatening calls within eight minutes,
as our charter requires, is immense," Athar says. "The
controllers have to balance safety against speed. The danger is that crews
arrive before they've been told what they are getting into." Lucy
Aidie, a paramedic waiting outside UCH for the next emergency, tells me
how she was recently called to assist a girl who had been beaten up. She
was with her crewmate, Gary, who has since left the service. "We were
attacked by this gang of kids. They had Gary on the floor; I was kicked,
punched and scratched. This continued for 10 minutes. There were about 30
of them. All the time, I was just waiting for the glint of that small
blade."
London
ambulance crews are not helped in such situations by handheld VHF personal
radios that don't work over distances of more than 200 yards, or among
tall buildings. "The police have effective UHF radios," says
Lucy. "They have vests; they can use self-defence. We have
nothing." It won't be long, she believes, before somebody is
critically injured or killed. It takes three to four years to become a
qualified paramedic, at which point, according to a statistic circulated
here, ambulance personnel earn less than a trainee manager at McDonald's.
I'm
becoming familiar with the language of the crews, who radio in from their
"truck" to describe themselves as "blue" (travelling
on lights and siren) or "greened up" (free for the next call).
Athar
is called to a traffic accident where the patient is "suspended"
(or, as we non-paramedics say, "dead"). When we arrive, the body
has just been lifted off the Tarmac, which is streaming with blood. One
ambulanceman told me he can usually get over seeing such things, but adds
that he was once called to a bombing and "I can't forget the body in
the chandelier". Another remembered slipping as he entered a wrecked
train. "When I looked down," he said, "I saw I had my foot
in somebody's rib cage."
Terri,
an ambulancewoman from Shoreditch station in East London, comes over on
the radio. "Priority, priority. I am blue to Homerton [hospital]. My
crewmate has multiple stab wounds." Lucy Aidie's prediction has come
true earlier than she might have liked: Simon Spencer has been knifed in
the arm, chest and head.
I
have come into Waterloo ambulance station to begin a 10-hour shift with a
regular ambulance crew: Mick Pearce, a paramedic in his late 30s, and his
younger colleague, Claire Sanwell. Here in the staff room the distractions
are reassuringly old-fashioned. There are tropical fish. There is a
grotesquely spoilt station cat called Boots. There are sets of dominoes
and draughts. The conversation centres around the stabbing. The crew had
been called out to treat a 26-year-old man stabbed in the face in Stamford
Hill.
As
they entered the address, another man leapt out with a knife and Simon was
attacked while trying to protect his female colleagues. He has survived
and is recovering in hospital. A man has been charged with grievous bodily
harm.
After
a while, the crews relax into their usual banter which, as in many
dangerous occupations, is strongly coloured by graveyard humour. "We
picked up this lady of 79, suspended, in a bingo hall," one woman
recalls. "We lifted the body on to the stretcher, and all these old
dears gathered round; I thought they wanted to help. Then they all sort of
swooped on her blank bingo cards. I heard one of them say, 'Well, she
won't be needing these no more.'" Just before we leave, I pick a crew
at random and ask what injuries they've suffered recently. Russell has
been knocked unconscious; his colleague has been attacked with a meat
cleaver.
Once
we're in our vehicle (call sign November 307), Mick and Claire slip into
another mode: a calm yet determined professionalism. Minor assaults
excepted, they say; nothing significant has happened to them. "Oh,
hang on," says Mick. "There was that woman that held you
hostage."
"Which?
Oh, yes," says Claire. "You mean the one with the knife."
Mick nods.
There
is a silence. "Well," says Claire, "she was a
regular."
It
is a night of mayhem on the streets of Central London. "They are
fighting in the back of the truck," another crew announces over the
radio. "There's blood everywhere." Our nearest hospital, St
Thomas's, has 10 patients brought in on blue lights, of whom two are
suspended and another has knife wounds.
We,
on the other hand, are with Ken in Rotherhithe. A former docker, Ken is 87
and has been married for 63 years; he has slipped and stripped the skin
off his right arm. He apologises profusely for inconveniencing us. We
catch him – apparently heedless of his ugly injury – making
last-minute adjustments to his hair in the bathroom mirror on his way out
to the ambulance. "It's the first time me and the wife have been out
together on a Friday night," he explains, "for 32 years."
Derek,
a drunk in his 60s, is sprawled in a wheelchair at St Thomas's, reeking of
urine, his cheap, grey wig askew. "Are you from Ireland?" he
asks a passing ambulancewoman. To his delight, she is. "I also,"
Derek adds, with a look of tremendous lust, "am from across the
water."
"And
is your name," she replies, "also Gladys?"
"Will
you give me a kiss?" ventures Derek, undeterred.
"I
don't think so," she says. "But," she continues, indicating
a group of us in crew jackets, "try those chaps." I am the last
in a desperate scramble to escape. Derek grabs my hand and, in what is
undoubtedly the worst moment of my week, if not my year, presses my
knuckle to his moist, corroded lips.
"Will
you kiss me now?" he asks the ambulancewoman again.
A
row erupts at the reception desk. "My pulse has stopped,"
insists a middle-aged man. Were his diagnosis accurate, a nurse points
out, he would not be putting his case with such force. "Not that
pulse," he says. "The one in my head."
We
are in Bermondsey, where Drew, a man in his mid-20s who looks like Yosser
Hughes's meaner cockney brother, is standing in the road by some traffic
lights looking for unaccompanied motorists who aren't white. When he finds
one, he shouts obscenities and tries to hit them.
Mick
Pearce motions Drew over to the pavement, and offers to treat his split
lip. "Fuck off," his patient says. "I know what you
do," he tells Pearce, "and I know they pay you fuck all."
It is the one sensible point Drew makes all night. His body language is
intimidating; his eye movements suggest he is about to provide us with our
first thrown punch. Mick and I sit beside him, and Mick tries to talk him
out of his rage. "You two bastards may be the boys tonight,"
Drew continues. "But I am a friend of the [at this point he uses the
name of a notorious local family]. I am gonna call them up tomorrow
morning and then you two are dead. I won't forget your faces. I know
better people," he adds, "than you know. And you two are fucking
dead." Ten minutes later, Drew leaves in a police car.
Even
with Drew in custody, this job is wearing on the nerves. Crews work long
shifts – generally up to 12 hours – and there are no proper meal
breaks. Our next job is a call to a squat in one of the less relaxed areas
of South London where a man is reported as behaving threateningly, drunk
and psychotic on amphetamines.
When
we arrive there is no sign of him. This sort of call is a particular worry
to crews, because ambulances are – unbelievably – not officially
classified as an emergency service. As a result, controllers have no
access to police records listing dangerous addresses.
Our
last job is outside a club in Covent Garden. Two young women, caked in
vomit, are lying on aluminium meat trucks by the entrance. One can't talk
at all. The other, Sarah, is semi-conscious. We load them into the truck,
where their symptoms indicate straightforward alcohol poisoning. As we
arrive at A&E, Sarah sits up, opens her mouth as if to speak, and
vomits. Mick and Claire's last job is to wash down the vehicle.
Paramedics
traditionally judge a potential new crewmate by asking themselves:
"Would you trust this person with your own next of kin?" If I
ever do need an ambulance, these are people, together with Athar Khan,
that I would feel privileged to see on the scene: it seems unbelievable,
given their dedication and expertise, which has taken years to acquire,
that the last time I see them at work they should be on their knees,
wiping up regurgitated pasta and shards of glass from the slammer glasses
Sarah has stuffed in her pocket as mementos.
Watching
an ambulance crew is a bit like observing troops at the front. You see
bodies, gruesome wounds and great courage; all that's missing is the ample
funding for personnel and hardware. There is little doubt that assaults
would be reduced by more satisfactory staffing levels. Additional vehicles
(roughly 250 struggle to serve the whole of London) and more call-takers
would reduce delays for which the crew – who may have raced to the scene
within two minutes of dispatch – can pay the price.
Simon
Spencer, recuperating from his wounds at home in Hertfordshire, told me he
has not decided whether to return to work. "When I was being
stabbed," he said, "I just thought well, that's it – I'm dead.
"The
only defence I had left was to hold on to the blade. I was lucky that I
wasn't killed," he added. "We are such an easy target."
The
London Ambulance Service's current anti-violence campaign "No
Excuse", suggests a range of initiatives; its mission statement,
while admirable, is noticeably dominated by the future tense. Spencer, who
is still heavily bandaged, has already formulated a few proposals in the
simple present. "We need radios that work," he said, "and
we need them now. We should be recognised as a full emergency service. The
police have instant backup, stab vests, the right to use restraint
techniques, and CS gas. We have nice colourful coats.
"These
things need to be changed not by internal initiatives, but by law. I
believe that the crime of an assault on a public servant has to be
introduced, and that it has to carry the same penalty as assault on a
police officer. This has to be dealt with at ministerial level. Because
we've had enough."
Mercifully
untouched by Drew's fatwah, I returned to London ambulance headquarters to
attend a press launch for "No Excuse". The service had tried to
persuade two ministers to attend but was informed that the politicians
were otherwise engaged.
Simon
Spencer is not the first ambulanceman to be stabbed on duty, and yet, for
his colleagues, his name has already acquired a special resonance and
serves as a focus for their anger at the fact that the most vulnerable of
the essential services should also be the most poorly paid, and the least
well defended. The senior politicians, Simon fears, will show up only when
there is a fatality, and possibly not even then. Some crew members aren't
planning to stick around to find out.
One
ambulancewoman, standing outside A&E at St Thomas's in the early
hours, told me she was leaving to spend more time with her son. What, I
asked her, would she like her child to do for a living?
"I
don't know," she said. She paused, thought for a moment, then added:
"Not this."
©
Mail on Sunday Review 
Sunday, 10.30pm
Monday, 11.15pm
Monday, 11.50pm: University College Hospital
Tuesday, 11.30pm: Waterloo
Friday, 3.10am
Friday, 4pm
Friday, 8.30pm
Friday, 10.25pm
Saturday, 9pm
Saturday, 11pm
Saturday, 11.30pm
Sunday,
1.30am
Peter
Bradley
Chief exec. LAS
