By Jenny Randerson
Western Mail
Copyright 2008 Western Mail
SOUTH EAST WALES, UK — Just before Christmas the overtime ban by ambulance staff in South East Wales hit the headlines.
To many it came as a surprise, because, after a couple of traumatic years, it seemed that the ambulance service was at least on the path to success.
We have had several months of steadily improving target response times and news stories featuring the new fleet of ambulances suggested the equipment problems were being solved.
I was forewarned of the impending overtime ban when a paramedic came in to talk to me in the Assembly. As an AM my diary is full of meetings with chairs and chief executives of the many health-related organisations in Wales.
These meetings are very useful but often it is only by talking to the people who actually do the job, that I find out what is really going on.
My paramedic visitor painted a picture of a service which still appears to be drastically over-stretched and is dependent on regular overtime by ambulance staff.
The day-to-day management appears to operate on a hand-to- mouth basis. For example, long-standing annual leave requests can be turned down at the very last minute and staff can be called in to cover on pre-arranged days off.
My visitor informed me that this approach encouraged “pulling a sickie” as the primary means of obtaining some time off.
This obviously causes further problems. One recent evening in Mid Glamorgan only five out of the designated 13 ambulances were on duty.
Response times have improved because of the now widespread use of rapid response vehicles — cars staffed by a single paramedic. The idea is to get immediate aid to the patient, followed quickly by an ambulance where needed.
But improved response times still mask deep-seated problems. I was quoted several examples where no ambulance was available to assist the first responder.
Recent publicity has cast doubt on whether this system is really best for the safety of the patient, but I would like to speak up for the safety of first responder paramedics.
My visitor has been attacked three times in one day by angry or drunken patients or their families and friends. In my view the number of attacks on ambulance staff suggests they now should all be issued with stab-proof vests. It is time we took the safety of ambulance staff seriously.
Long-term staffing problems in the 999 control room mean that it is often difficult for ambulance staff to get through. The long awaited Tetra radio system has still not been rolled out throughout Wales.
Staff have welcomed the well-equipped new ambulances, but it is clear that their potential is not being maximised.
The recent queues of ambulances once again outside the University Hospital of Wales, in Cardiff, underlined the need for paramedics to be allowed to sign off patients — I would argue they need to able to triage patients as well so that unnecessary ambulance journeys to hospital are avoided.
My paramedic visitor was, of course, looking at this from a paramedic point of view. Management would undoubtedly have an alterative perspective. What the overtime ban has emphasised is the human cost of the considerable improvement we have seen in our ambulances service.
If we are to have a truly excellent service there has to be a more sustainable approach to change. You cannot have a dependable service based on excessive overtime and forfeited annual leave.
Excellent services are only delivered when talented and motivated people feel their efforts are appreciated and rewarded.
Only when they feel valued — by a public that doesn’t attack or abuse them, as much as by management — will they be able to produce the kind of services we all want to see.