These commentaries by John Macgill represent his opinions only and not those of any Ettrickburn client.

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Montgomery’s Review – Dr Brian Montgomery answers questions on access to new medicines in Scotland

An afternoon with SMC

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Reviewing the Review: Access to New Medicines in Scotland

A day of psephology and kidology

Insulting the Lifesavers

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Monday, January 04, 2016: Insulting the Lifesavers

The sophistication and skills of Scotland's ambulance crews have increased beyond recognition in the last 25 years – so why can't we match this as a society in the way we treat them?

There's a video produced in the early 1980s by the police in Londoni about the work of one of their traffic cars. For me the most notable thing about the film is a sequence filmed in an ambulance transferring a patient between hospitals.

The blue-uniformed ambulance attendant, complete with peaked cap, has little to do during the journey beyond adjusting the patient's oxygen mask and feeling his pulse. The ambulance is little more than a van and the equipment seems limited to a spinal board and some spare stretchers.

The contrast with today's green-clad ambulance crews in their fully kitted out £250,000 vehicles could not be more stark.

As a reporter, 27 years ago I made a radio documentary about the new breed of extended-trained ambulance “paramedics”. I spent a shift with a paramedic in a response car in Leeds. The enthusiasm of the ambulance man star of my report was tempered by the incredulity of the local people about a car with the word 'ambulance' on the side: “where does the patient go?”; and the scepticism of some doctors who felt the only job of the ambulance service was to scoop up casualties and waste no time getting them into hospital.

Now, as a Community First Responder, I have seen at first hand the extent of the skills and training that allows a battery of tests and interventions to take place in people's homes, in the back of the well-equipped ambulance or, in one case, a roadside pavement. The Emergency Medicine Specialists I have met are now unstinting in their praise of ambulance crews.

Back in 1988 during my mid-week evening shift with the Leeds paramedic half the calls were related to drink and drugs.

In a recent report just before Christmas, BBC Scotland's Health Correspondent Eleanor Bradfordii told how three out of four calls she attended while shadowing an ambulance crew on a Friday night were alcohol or drug related.

It has since been reported that the Scottish Ambulance Service took 400 calls in the hour between 2am and 3am on New Year's Dayii. It's safe to assume that this was not caused by a sudden spike in medical emergencies.

Even away from the festive season, some 50 per cent of calls at weekends are related to drink and drugs.

The NHS in England says each 'inappropriate' call-out costs them between £80 and £115iv . A call out in the Highlands costs some £300v.

One MSP, Marlyn Glen, has calculated that the cost to NHS Tayside alone of alcohol related ambulance call-outs was £1.66 millionvi and that was on the basis of assuming 25 per cent of all call-outs were alcohol related.

It is a statement of the blindingly obvious that every ambulance sent to a person who has made themselves dangerously ill through drink or drugs cannot be sent to someone with a medical emergency that was not self-inflicted.

The case for charging people a call-out fee for an 'inappropriate' ambulance call-out, while tempting, is an impossible one for a life-saving organisation like the ambulance service to make. But there are many alternatives to calling 999 for someone who's very drunk such as taking them to a safe place and staying with them. It also helps if the intervention takes place before they fall over and hurt themselves rather than afterwards.

Ultimately we have to respect ambulance crews by not getting ourselves so pissed that we need them to rescue us from ourselves.


iYouTube

iiBBC

iiiScotsman

ivBBC

vMSP News Release

viHighlands and Islands Labour Group of MSPs