Community Relations

Cover of Community Handbook

(WARNING:  It has been a while since I was in education, so I don’t know the current ideas on political correctness, so if the post below is insulting, I’m sorry.  You should know by now that I treat everyone the same.  If you think I’m racist, then check out my archives.  However, it’s not against the law (yet) for me to say that I think religion is a generally silly idea).

Written by the Ambulance Service Association, the Community Handbook (Pocket edition) is an easy reference guide to many of the ethnic groups that we may come across.

Of course, in London there are around 200 different ethnic groups, so any ‘comprehensive’ handbook would weigh a ton.

So we get a two page spread of some of the commoner ethnic groups in the UK.

You can take a look at a sample of the book.

It’s very pretty, and I can imagine it possible being useful for ambulance trusts who do not have a large ‘ethnic’ population.  But I work in Newham, where the ‘ethnics’ outnumber the WASPs, and I’ve found that you tend to pick up on other peoples culture pretty quickly, as in a week or two on the job.

One amusing point of the book is that for a lot of cultures, it says that you should remove your shoes on entering the house.  Yet one of the main things we were told in ambulance school, was that you never take your boots off, as it’s just too dangerous.  I’ve only been asked to remove my boots once before, when I was entering a Mosque.  I explained that I couldn’t and the head bloke there told me not to worry, as the sick person was more important (he was as well, he was having a heart attack).

For a number of cultures, the book tells us that we should speak via the head male family member.  Again, in practice I’ve never come across this.  What I do tend to come across is a seven year old girl doing the translating for the whole family, which is why I think you have a lot of very ‘grown-up’ Asian girls.  Language is always a problem, but I’ve found that although people tell me that they can’t speak English, it is more probable that they don’t have the confidence to try.  So I always try to talk to the patient, and then the relatives will translate the odd tricky word.

Various cultures also apparently have a taboo about men dealing with women.  Again, something I have very little trouble with, as I’m not about to perform gynecological examinations on my patients.  The only time I’ve found that it might be an issue is with delivering babies, but if there isn’t a woman around then I’ve found that people are just plain happy that there is someone around who knows what to do.

Although, having seen some of the ethnic grannies, and their attitudes to their granddaughter having a baby (something along the lines of, ‘Stop being a wimp, and push it out’), I suspect they have as much an idea about delivering babies as I do.

And I can’t see any culture being happy about having their women undress alone in front of strange men.

The book also has little sections on ‘Customs around Death’.  I’d like to think that we are so successful at treating people that we don’t have to deal with it that often…

To be honest, a lot of the book is trying to teach us to suck eggs.  As long as you have some semblance of common sense, and are polite and respectful to everyone (except maybe drunks…), then you shouldn’t have any problems.  If in doubt ask is my motto, and I’ve learned quite a bit about other cultures just by asking the patient.  I’m guessing that a lot of ethnic people have come across a fair bit of unconscious culture clash, and have developed their own strategies for dealing with it.

Please note how Reynolds has made special effort to make everything positive in the above post.  Note how he hasn’t mentioned that some people have a huge chip on their shoulder about their culture, or how one culture seeks to emulate the worst qualities of another culture, or how a lot of non-drunken violence seems to be ‘ethnic’ vs ‘ethnic’ violence.  Just remember, I dislike everyone equally, I’m an equal opportunities cynic.

33 thoughts on “Community Relations”

  1. i love the line “Im an equal opportunities cynic.” it sound like something you find printed on the bottom of a headed letter.

  2. When I used to work in retail, there was an Asian family that came in regularly, and it was there young daughter (no more than 7 or 8) that I spoke to. And she did come across as being very grown-up for her age a lot more than most to the teenagers Ive dealt with.

  3. “if in doubt ask” seems fair enough – everyone must be aware that theirs isn't the only culture you deal with, especially somewhere as ethnically diverse as Newham. Expecting you to identify, know about and adhere to every aspect of every patient's religion is as non-viable as expecting you to speak every patient's language.What you're trained for is the medical stuff, and in a medical emergency (which is supposed to be the only thing you're called out for) everything else is just trimmings.

  4. I expect so he doesn't tread on broken glass, used needles or bits of patients or their bodily fluids that may contain disease (he might have broken skin on his feet, and nasties could easily get in).It could also be so he doesn't increase the casualty rate by knocking people out with foot pong.

    🙂

  5. I'm sure this will sound nasty, but frankly “Stop whining & push” sounds like excellent advice. & yes I've three children & this is basically what my physician told me.

  6. “And I cant see any culture being happy about having their women undress alone in front of strange men.”But if you do find one Tom, for the love of Jebus, let us know!!!!

  7. “And I cant see any culture being happy about having their women undress alone in front of strange men.”But if you do find one Tom, for the love of Jebus, let us know!!!!

  8. Non-specific deity-or-similar preserve us, are they not allowed to use captial letters and complete sentences in their booklets in case this offends someone? Excuse me while I have a 'Greengrocer's apostrophe'-related apoplexy…

  9. Tom, you're living proof that sensible people don't need booklets.That said, may I make a suggestion? What's this “their women” business? If they belong to someone, tell us how much they paid. (Yes, I know everyone talks that way. Interesting, isn't it?) You don't need it. The sentence would be fine without it: “I cant see any culture being happy about women undressing alone in front of strange men.”

  10. Good point, but I'd have said the same thing about the men as well.I suppose the women (and men) belong to the culture, so I suppose it is easy to consider the people of a culture being a possession of the culture.

    That and I suppose that I'm talking about that culture's women (or men) as opposed to women (or men) in general.

    Oh…I dunno, I never not done much English at skool.

  11. …And yet you can stand to read this Blog?I know I'm not the most grammatically correct person on this planet myself. But I agree that if a book is professionally produced, then it should be properly proofread.

  12. That and when you are wheeling people around in a chair/trolley, it would hurt a bit if you ran over your own foot.It's why we have steel toe-capped boots – because they can't trust us with a trolley.

    😉

  13. Well, there are pages on 'Christian' and 'Catholic'.Apparently Catholics don't like their relatives going up in smoke…

    Oh…And for South Americans, under family it says…

    “Domestic violence common”.

    Oh dear…

  14. Oh, it's all so that the Lord High Mucky-mucks have a defence when they get sued. You can't teach sensitivity if it's not there, and anyone with common sense and an ounce of respect will be insulted by these booklets. But the Management has to prove they Did their Bit, so those of us on the ground have to put up with this drivel and sign off having read the crap.Can you tell I've done my yearly training recently?

  15. “I dislike everyone equally, Im an equal opportunities cynic.” Sounds a bit like the late great Bill Hicks. I say exactly the same to the students I teach when they venture opinions about who may be my 'favourite' in the classroom.

  16. Od Dear,dear dear!If one were South American and one was very PC about these maters,( what evactly does PC mean?) could one not take offence at this remark! and printed in an ASA document. naughty naughty! To make the statement that domestic violence is comon without any qualification is tantramount to a rasis coment. The sort of thing that might prejudice a inexperience medic to misinterpret a females black eye and bruising as posible abuse, even though the woman tells them that she sustained said injury falling over. This sort of prejudiced interpretation would lead to the police being called and possibly social pressure being put on the “wife” to press charges against her inoccent husband. And all for the want of more careful editing of an ASA booklet! Sorry this sounds like a synopsis for and episode of casualty!

    What a bunch of wa——

  17. Tom you are causing me sleepless nights, your profile is bloody horrendous! I'm surprised you have not been directed to Occupational Health for an interview with a shrink. Its 0300hrs but I dont mind, on the road I was always up for it, until about 4-5, then it became a right slog. To matters in hand or even better, the hand of god!The Community Hand book is as you say trying to teach emergency ambulance personnel how to suck eggs. In that case it must have been written for the benefit you describe, or as an AS training manual for basic training. Many years ago a leading academic commenting on the Services proposal to encourage the recruitment of more academically orientated people, to fulfil the requirement for additional paramedics, stated that he believed that this was a mistake. What was required of an emergency ambulance person was a large supply of common sense and experience. Of course no one took any notice of the common sense approach to the work. The majority of people who live and work in London and particularly East London are not racists! Any one, who has passed through the local schooling systems, has been taught about other pupils cultures. Children celebrate all the main cultural festival such as Christmas, Divali and Ramadan also Guru Narks' Birthday. Students do cultural studies as part of the curriculum. Who needs this hand book? Oh yes Maybe the training school clique who are currently in all the top uniformed jobs within the LAS (they think they are running the show —-ha,ha,ha! That lot were the first to escape off the front line when London really became multi-ethnic back in the eighties. Before that people were called English, niggers or pakis and that was on their own ambulance stations. In those days a common comment at Newham was, Yeah make the tea, its only a packi with a belly ache!

    Your comment about having some semblance of common sense and being polite and respectful is a very clear interpretation of LAS protocols which used to be designed to be guidelines, which if disregarded would require justification but only if there was an official complaint. You go on to say, if in doubt ask! Although the booklet may say that one should speak to the head, of say a Bangladeshi family its the patient that you really need to speak to. As you know one listens to a history of the event as described by the most competent English speaker (unless you are one of the tiny number of multi-Asian language speakers in the LAS). You then ask the patient to describe their symptoms. If the patient dose not answer or looks towards her family then the next logical question must be, dose the patient (name) speak English? Yes! Well no actually.

    About this time last year one of my ex-colleagues attended a family in the east-end and on attempting to communicate with the patient was met with sullen silence. The medic turned to the family and asked, Dose the patient speak English? This patient was later taken to the London Hospital by another ambulance after the family followed the practical advice offered by the first crew to respond. (Refused to travel)

    Three weeks later, on Christmas Eve to be precise, a letter was dispatched by the Independent Complaints Advocacy Service, which I have been led to believe is an arm of the Mare Street Citizens Advice Bureau. They had been authorised to write on behalf of the patients father and misused this authority to ensure that no member of the Services Complaints Investigation Team, ( a right bunch of wankers at the best of times.) was ever permitted to interview the family. Although there were serious structural problems in the way the Service had dealt with the whole incident, (all unknown to the CAB) that is in the Control/ Incident Reporter Interface, the whole direction of the complaint was directed in one single trajectory. The cascading shit syndrome was in full flow, and right onto the heads of the first crew to respond. A complete fiction was developed by the NE, ICAS and this piece of creative writing caused the two crew members to be awarded a final written warning and a written warning as punishment for bringing the Service into disrepute. In order to make sure this happened, the head of the LAS Public Safety Committee Mr Robespierre Selby decided to have a little fixing meeting, to which he invited various members of the prosecution team. The consensus was that the Crew were guilty, and this decision completely ignored the fact that what really upset the family was the attitude and behaviour and error of at least one of the Control Call Takers. When the family called the Service the second time and as per the advice given to them earlier, the control assistant systematically abused the patients Sister and put her through the wringer. The Sister was so shocked by the verbal bullying she was receiving , that she disconnected the telephone. From reading the transcript of this call I believe that this ghoul, this spectre of the Ivory Tower Control Room put the Sister through a double and some-times triple interrogation to access the necessary information. According to Mr Clinton Beale, the LAS Quality Assurance Advisor , the Emergency Medical Dispatcher had breached AMPDS protocols and told her that the service was to busy and she should phone her doctor. If only that had been all that he/she had done! If he or she had previously dealt with calls from this address, it would make the offence painful in the extreme and the subject of a disciplinary enquiry which if found guilty, should have resulted in dismissal . So what happened to the EMD? As far as I am aware nothing! He/she caused the delay in the transportation of a possibly seriously ill patient to hospital, at best treated the family as if they were pests and possibly with deep rooted racist overtones.

    All these documents were made available through the offices of Josef Kane (Crappy) Investigating Officer, Professional Standards Unit. The third Blind Mouse was of course, the head guillotiner, Mr Selby late of the Metropolitan Police. I knew he was a senior control officer, but I didnt know he was previously in the Traffic Division or was it dogs or more likely horses. Mr Selby is definitely the type of man to ends up with his head stuck up a horses arse, which I think he certainly did in this case. Thats three officers involved in this case are a bit word blind! I myself am a bit dyslexic, but these three gentlemen, scrub that, pounces are way out of my league, definitely Ferengi. Not only did they ignore the truth during the investigation phases, the crew was suspended and when they eventually were invited to a disciplinary hearing guess who turned out to be the Chairman, Mr Selby. Naughty, naughty! Now this is a perfect example of why such things should never happen. The Chairman of a disciplinary panel is supposed to be impartial, he is not supposed to get involved in the investigatory process, let alone decide that the accused are guilty prior to hearing both sides of the case. But then there never was a case in the first place! The condemned crew behaved correctly, as ambulance personnel we have no right to take anyone anywhere without their permition or consent. This consent can be real or implied i.e. the unconscious or imposed by statute, a prisoner or those detained under the appropriate Mental Health Act. When the patient supposedly changed her mind the family followed professional advice and once again calling the Service. Unfortunately their call to Control was picked up by a possible racist, EMD. The EMD responsible, was of course a ghost! An ethereal voice at the other end of the telephone! The EMD caused the patients family to become so angry that they took their complaint to the, NE ICAS. Once they got there and told their rather confused tale the good people at the CAB helped them straighten things out, or did they? I spent years In the Royal Military Police as an investigator and I know that the further one gets from an event the less clear becomes the memory of it. When gaps or inconsistencies develop in the memory people have a tendency to be creative and fill-in and that is when the tale or complaint becomes a fiction. So what was it that set the crew up for this trial? On the initial call, when they couldnt get any verbal response from the patient they innocently asked, Dose she speak English? or Cant she speak English? Standard question of a verbally, non responsive Asian patient! To assume that because her Sister spoke the Queens English or some variety of it, is no guarantee that the patient dose or even that the patient is a blood relative. In different cultures Sister can mean different things. That is Cultural Awareness through empirical experience, in other words common sense!

    A few years ago I found it necessary to write to the chief Executive Officer asking him to remind some of his officers of their responsibilities under the Officer Code of Conduct, this was concerning a previous manager of Newham Complex. He had misappropriated (stolen) about 1000 of amenitys money and wouldnt give it back when asked to do so. Senior Officers all the way up from the Divisional Officer Mr Steve Sale and up to and including Mr Flaherty, (the chief Executive Officer must have also been aware of this) attempted to bully one of my colleagues into dropping the matter. After I stuck my oar in they had a slight change of attitude and the station manager concerned, a Mr Wicks was allowed to quietly resign and slip away from both disciplinary action and a criminal record. He also managed to hold on to his pension rights and even got a good work reference from some-one, because he was quickly taken into employment by the Docklands Light Railway as a junior manager.

    Its amazing how well these people take care of their own! I sometimes wonder if they are not all members of a certain secret society, of the short legged trouser variety! I think its all the fault of Mrs Wendy Foers, the Director of Human Recourses. Ever since she arrived at the LAS, as Don Pages gopher and Central Divisional Executive Officer, she has had a view of operational staff which is generally erroneous. People dont join the LAS or any other ambulance service because they want to abuse or be cruel to sick and injured patients,( at least not the operational staff. The Officers and the Human Recourses department now I could tell you a few good stories about what they have got up to ? Another day perhaps!

  18. I really enjoyed this article and thought it was spot-on. I do cultural awareness training for staff who deal with people from other cultures and the biggest problem we face is that the staff want basically an 'A-Z of other cultures', ie 'OK – you're Chinese – this is what you think – this is what you believe'. We don't do that, as we find that it leads to stereotyping- they see the nationality, not the individual. The bottom line is that we are all coming from our own culture(s), from where we grew up, how things are done in our family, what we eat, if/where we worship, where we work – it's not just 'they're different'. In fact, most cultures have an awful lot of fundamental values in common, around respectful treatment of others. As you said, if you're not sure, just ask. But I must admit, this handbook worries me! – I suppose knowing a bit is better than nothing, but also 'a little knowledge is a dangerous thing'! People are just people, take us all as individuals.

  19. That might be the case among the older islanders, but not among the young ones. Unless “yo mufo” is short for “Mr. Smith”, anyway…

  20. My generation hav tended to get by on kindness, consideration and common sense and -speaking personally – you can stuff PC. No offence!Pat

  21. I need steel toed boots, I run over my own feet with my own wheelchair…don't feel it until its to late usually…lol…

  22. I was just about to write a comment about Kims' post of 1231BST yesterday, when I thought it might be best to check my email first. I needed to know it my comments of yesterday, which I felt it was only fair that I should email a copy to Mr Peter Bradley; the Chief Executive of the London Ambulance Service, had provoked any comment.I told this story to you and your readers in the hope of some personal insight and advice. The sort of advice one might get, from an adult person who has taken the trouble to fulfil their duty as a citizen by registering to vote. This person might also travel about London sitting atop an omnibus. This is a description of a typical juror as afforded by The Master of the Rolls, Lord Denning some years ago. Your readers might also be the sort of person who would dearly like to sit on an employment appeal-board, in the hope of lending some “Common sense” to the proceedings. The sort of person, who my colleague might have had to tell her story to, had Mr Selby gone through with his threat to dismiss. I had never heard of anyone being disciplined for being sensible before. I mean in the sense of applying common sense.

    Low and behold, there was an email sent by the Chief Executives Secretary, which included a read receipt saying that my email sent on Friday the 28 Oct 2005 at 09:29:39, was read at 09:11:39. That was quick!

    The receipt didnt say who had read my email or how they had managed to perform a quantum leap in order to do so at 09:11:39. There was also another little surprise!

    Someone In Waterloo Ivory Towers has thought it a good idea to attempt to gag me in this matter. What? I as the recipient of the email, which contained a standard read receipt was being regarded by the London Ambulance Service as confidential information. This means that I have breeched confidentiality by bringing said email to you and your readers attention, or at least thats my interpretation. Here is a copy, see what you think and let me know:

    Your message

    To: Peter Bradley

    Subject: Community Relations

    Sent: Fri, 28 Oct 2005 09:29:39 +0100

    was read on Fri, 28 Oct 2005 09:11:39 +0100

    ====================== IMPORTANT NOTICE ================

    The content of this e-mail and any attachments are confidential and may be legally privileged and are intended only to be seen and used by the named addressee(s). If you are not a named addressee, any use, disclosure, alteration, copying or forwarding of this e-mail and any attachments is unauthorised.

    If you have received this e-mail in error, please notify the IM&T Service Desk immediately by e-mail (IM&TServiceDesk@lond-amb.nhs.uk) or telephone on +44 (0) 2079215181, and permanently delete this e-mail and any attachments. Thank you for your co-operation.

    Unless expressly stated to the contrary, the sender of this e-mail is not authorised by the London Ambulance Service NHS Trust to make any representations in relation to, nor to negotiate or enter into, any agreement on behalf of the London Ambulance Service NHS Trust. Any views expressed in this e-mail and any attachments are those of the individual sender, and may not necessarily be those of the London Ambulance Service NHS Trust.

    Please check for viruses before accessing this e-mail and any attachments. Except as required by law, we shall not be responsible for any damage, loss or liability of any kind suffered in connection with this e-mail and any attachments, or which may result from reliance on the contents of this e-mail and any attachments.

    Make my day! Sue me.

    I have sent a number of emails to the Chief Executive in the past and had a few replies, none of which contained a qualifying gag. My previous email, sent last week, was to warn him of a possible booby trap situation, laid for him at Newham Ambulance Station.

    Mr Bradley is due to visit Newham early in November as part of his annual Placate the Troops tour. I think he must have upset some influential people at Newham in his stewardship of the Service. Some people are obviously out to get him. Because of the sophistication of this particular booby trap, I suspect there might well have been a conspiracy to do him serious damage. Some idiot or co-conspirator, had allowed or and encouraged the building contractor to install a non-standard doorway into the stations new, ready-room/kitchen complex. The new doorway to the kitchen is only about six feet four in height and last week when making a casual visit to see some of my old colleagues, I managed to blow the booby-trap surprise. I walked through the doorway and the top of my head collided with the top of the door-frame. Lucky Peter and unlucky me! The blow nearly knocked me senseless, but at least I had inadvertently sprung the trap. I took the issue up with two of the station officers, but they were keeping stoom! They knew nothing about it and had noticed nothing on the post construction, health and safety check. Both under six feet and who ever looks up! And that is the point, perfect booby-trap! When operational staff members of Newham Complex take against you had better look out! Unfortunately they have a historical bad habit, that when under unfair pressure from senior management to improve their response times, sickness levels etc, etc. some members have a tendency to become a bit hysterical and miss-direct in their anger onto the wrong person. It only takes one person to start the ball rolling; often a lay trade union representative (The last one to do this was Gordon Ballard, TGWU and he personally had a solid on-the-road reputation for sorting out unruly drunks with the offer and occasional application of some painful retribution) and witch hunt season is opened.

    Senior managers are supposed to prevent this type of aberrant behaviour, but all too often the internal political climate of the day dictates otherwise and they become active participants, in the entertainments… The boys and girls (for that is usually who indulges in this type of behaviour, sometimes called Girls at play) start a mini avalanche of usually old accusations. Sometimes so old one is left wondering why they didnt have the balls to bring the issue up when the alleged incident happened. The female complainants at least have an excuse; they definitely dont have any balls.

    Mr Bradley is the same height as my-self, about six feet six inches tall. We are both what is termed 99th + percentile, adult males, with regard to stature. This means that if one was able to gather one thousand, adult male members of the general population in one room or stadium, there should only be a few people and non more than ten men at most who could look us both in the eye. Everyone else would be too small! (this would not be so in the LAS or any other ambulance service, because tall men like to do action man type jobs. i.e. The Brigade of Guards. We are the lucky or in my particular case unlucky, recipients of a genetic trait for increased height. With regard to my past employment with the LAS, very unlucky indeed! I was dismissed from the Service a couple of years ago due to incapacity. That is, I had become, too tall to safely drive or attend in LAS Emergency Ambulances. Today, ambulances which of course started out life as big white vans are designed around people of average height, and we lanky buggers have to squeeze in as best we can. It causes ones driving geometry to be seriously compromised, which can lead to long term musculo-skeletal injury from vibration due to one knees being endlessly in contact with the vehicle components and pooling of blood in the extremities. It can also cause spots on the bum and seriously aggravate haemorrhoids, and this can lead to emergency surgery due to the risk of systemic infection. Such cramped driving conditions can and does lead to the development of a condition called, cyclonical cyst and sinus the cause of over 50,000 soldiers being discharged from active duty during the Second World War. This dangerous cabin geometry could well lead to serious injury should one be unfortunate and be involved in a relatively minor road traffic accident. Ones femurs could easily be crushed or even smashed through ones pelvis. One might think that in an organisation which attracts a disproportionate number of tall action men and women, would take these facts into consideration prior to awarding a 50 million contract, to Mercedize Benz to supply Emergency Ambulances. One would expect that such a problem would be presented to the supplier as something to be solved, prior to the contact being awarded, especially if a certain tall staff representative had been pointing this out during the previous thirteen years, both this and other ergonomic disasters associated with the previous contract, with Leyland Daf. Just common sense you would think! No, no, no. Not to the LAS vehicle and equipment group. As consequence of this management and trade union error, (of course little eric couldnt understand what the fuss was about. Hes only five feet six inches tall and below average height.) I was eventually injured in a rather embarrassing location and after my station manager, (he of the missing 1,000) and the Occupational Health Department of Kings College Hospital had made a horses arse of my post operative medical assessment, the whole thing happened again. My light fingered manager had eventually, (nearly six weeks after I returned to work on the offending ambulances) sent off a managers referral stating that I had returned to duty, after having had to have emergency surgery for haemorrhoids. The doctor believing this to be the case replied in the negative, when asked if my ergonomic problem could have led to the condition. No. she had never seen any evidence to support this suggestion. It was a pity that the doctor was not aware of the Services treatment protocols, in regard to Primary and secondary survey. If that had been the case, then after she had completed her primary questioning of me as the patient she might well have said drop your trousers and lets have a look. I wouldnt have minded! Ill show my perfectly clean arse-hole to any doctor. Of course she didnt and went on to tell me that I could go back to active duty, (which if youll remember I had been doing for the previous six weeks). The doctor did recognise that there was a serious ergonomic problem and wrote to the station manager, advising that something had to be done about the situation before I did become injured. Over the next eighteen months my life was made very uncomfortable, painful, and mentally debilitating. My light fingered manager, was always reminding me, when I asked what was being done about the problem, that the doctor had only advised that action be taken to rectify that problem. When I took the issue up with the Services Health and Safety Advisors, they attempted to intimidate me into silence, telling me in front of my crewmate that if I persisted in my complaint, the Service would eventually get rid off me. I didnt believe him.

    You cant behave like that, I told him, and this is the twenty first century! Not as far as the LAS is concerned. The advisors were quite correct, they got rid of me!

    Not just like that of course, it took quite a bit of time and a lot of negative effort on the Services part. This was the second point of last weeks letter to Mr Bradley. You may as well read it yourself. Im sill waiting for a sensible reply:

    Dear Sir,

    May I first of all congratulate you on the positive changes which you have brought about during your tenure as Chief Executive of the London Ambulance Service.

    Yesterday afternoon I made a casual visit to Newham ambulance station in order to speak to the secretary of the TGWU branch, the branch which I remain as the official chairman.

    The Branch Secretary, Mr Brian Douglas invited me into the ready room, where after a period of service related conversation I asked Brian if I could have a cup of tea. As he needed to conduct some administrative business upstairs, Brian suggested that I go through to the kitchen and make use of the facilities.

    As I walked from the ready room into the kitchen I felt a blow to the top of my head and for the next few minutes experienced quite a bit of pain. The blow was stunning and I saw stars.

    Once I had sufficiently recovered from the blow, I examine the situation of the kitchen doorway. It then became clear what had occurred. I as you may remember, am of similar height to your-self and the top of my head had collided with the door frame as I had attempted to pass through. When I compared the height of the doorway in the ready room, I was surprised to find that there was a significant discrepancy. The main doorway of the ready room is the regulation height but the doorway leading to the kitchen is at least two inches smaller.

    The reason I am writing to you today, is due to my concern that a similar accident could affect yourself on your next visit to Newham and the consequences could be a lot more serious. How would it look if the chief executive of the Service was rendered unconscious, necessitating immediate transportation to Newham General Hospital and all due to a breach of planning regulation brought about by bad design and improper supervision and evaluation of the building contact?

    Later I pointed out the discrepancy and its consequence to one of the station officers, Mr Mark Summerville. He was very surprised and couldnt understand why he hadnt noticed this flaw and its related health and safety risk before. I explained to him why this is so. Mark is not a 95th+ percentile adult male, with regard to his stature. He is of average height; therefore the problem was until that moment, invisible to him!

    I then took the opportunity to remind Mark that I had had to live with this phenomenon throughout my service within the LAS. I would point out ergonomic problems which tall employees had with both service vehicles and equipment, to both junior and senior officers and they would display a total lack of understanding of the problem. Over time I had brought these problems to the attention of such persons as Mr John Willby, Mr D Page, Mrs Wendy Foers, and of course yourself.

    In fact the first person I had ever spoken to about this issue was many years ago and to a officer driving instructor, who offered a minor criticism as he was about to sign me off as safe to drive and operate as an emergency ambulance person. He suggested that I was just a bit heavy footed when operating the accelerator of the training ambulance and I pointed out to him that the problem was not my heavy foot but the fact that because of my height I was forced to drive in an awkward position. The driving environment was badly designed and not really suitable for someone of my height. The officers attitude was rather negative, Have you got an attitude problem? he asked. Well no I did not have an attitude problem, I was only pointing out once again, that as per the health and safety regulations it was my duty to inform a training officer that there was a problem. He decided to leave well alone. What a pity! If Mr Flaherty had behaved towards me as he did towards any of the other and much younger and inexperienced trainees I would have had his balls.

    As I say, Pity. Mr Flaherty would not have had the opportunity and corrupt power to dismiss me on the grounds of incapacity, just because I had complained about this issue after it had caused me serious injury and a number of sessions under the surgeons knife. Neither would I have been the subject of a failure of the duty of care by the Occupational Health Department of Kings College Hospital, nor would my medical file have had to be corruptly altered in an attempt to cover up the fact. Who knows, maybe I would not have ended up having an nervous breakdown post dismissal and the consequent treatment sessions at the Newham Day Centre for mental health.

    I have provided this warning to you as one very tall man to another very tall man. I hope I have been of assistance and hope that no harm comes to you when you next visit Newham. The pity is that three years ago when I begged your assistance, as a tall man in trouble, you denied me. You sat back at the top of the services ivory tower and hid your head in the sand. Shame on you! I would have sent this or a similar letter to you last year. Unfortunately, when I mentioned the fact that I was about to raise complaint about my treatment by both the LAS and Kings College Hospital, my doctors thought I had become manic. I was placed on a new medication regime and I soon became very ill again and it took another nine months to get better again. Manic, my arse! Angry? There is rage in my soul and I will excise it.

    In closing I would like to put one question to you.

    Where is my fucking pension?

    We await a proper response!

    Anyway, I am sorry, yet again I digress from original the point of my post They can always sue and Ill just keep taking the antidepressant and Lithium tablets until these problems are all sorted out. Then I will really be able to start getting better! Ghosts in the machine.

  23. I work in the Highlands (last census: 98% White), and the cluelessness of some people amazes me.”Oh, she won't want to do that, she's an Asian woman and she won't want to go places without her husband.”

    “Have you asked her?”

    “X says she doesn't speak English.”

    “Have you checked? Or have you asked her husband, who certainly does speak English?”

    “No.”

    *bangs head on desk*

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