My Thoughts On The 7/7 Report

As always, the thoughts on this blog are my own, and have nothing to do with my employer, the London Ambulance Service.  I do not represent them in any official capacity and the views here are how I see things and I may have incorrect information.  Also while I’ve read the report, my sinuses are blocked and my head feels like it’s going to explode.

The report on the 7/7 bombings makes interesting reading and despite what some of the media may have you believe it is not ‘slamming’ the response of the emergency services.  (I could mention all the ways in which ‘The Sun’ report is inaccurate, but I can’t be bothered wasting my breath).

Personally I agree with a lot of what it suggests.  In the whole I think that it is a reasonably balanced report and that a lot of the changes it suggests are reasonable ones.

However there are a few points that I believe are misinformed.

The people making up the review take on the role of ‘informed layperson’ – looking at the backgrounds of the people involved in the review, one is a barrister specialising in employment law, one has a degree in economics, one is a solicitor, one a business trainer and one has a BA in politics and economics (and incidentally studied where I trained to be a teacher).

My concerns about the report is that I believe none of them have any experience in emergency situations.  It is very easy to look back and criticise the actions on the day – but the ‘fog of war’ is a very serious obstacle.  Much like you, dear reader, perhaps had little idea of what ambulance work was like until you read this blog – I think that some of the reports recommendations show a lack of understanding of what a major incident is really like.

The main finding and recommendation of the report is that the communication network was inadequate, and that more should be done to improve communication between staff on the ground and Gold Control, who’s job it is to coordinate our response.  Eighteen years after the Kings Cross fire and the emergency services still needed to rely on ‘runners’ for communication as the radios we have don’t work underground.  With this I recommendation I agree completely, our communication needs to be upgraded – unfortunately, from what I hear the TETRA airwave system that we will be getting in the start of 2008 is not going to solve many problems.  It simply isn’t as good a system as people would have you believe.  (But this is a topic for another post).

There are some recommendations which are a little strange, such as allowing medical staff who are untrained in pre-hospital care to start setting up field hospitals and the like.  While medical knowledge is incredibly useful, it’s also very useful to not have people who may be unaware of all the dangers on scene wandering around explosion sites in nothing more than theatre scrubs.

I understand the urge to help, I would have done the same when I was working in A&E and I don’t want you to think that I’m degrading the work that these volunteers did on the day – but the risk of creating more casualties is just too high.

One thing that the report does is to record the accounts of members of the public caught up in the explosions – unfortunately the report does not mention that in such times of trauma the brain can easily become mistaken with what is happening.    Perception of time can become altered – two minutes can easily feel like ten.  Also there can be a misperception of what the first ambulance on scene does – on arrival the driver should stay in the ambulance and provide communication with Control, while the attendant makes a survey of the scene in order to report on what additional resources are needed.  The first ambulance on scene does not treat any patients until the scene management is taken over by an officer.  Add in that the first person needs to be sure that the track current is off, and then needs to walk fifteen minutes to get to the train – spend a couple of minutes assessing what has happened and then walk another fifteen minutes to get back to the ambulance, and it is unsurprising that a lot of the injured felt that the ambulances took a long time to arrive.

While the evidence from the public should be gathered, I think that by publishing emotive eyewitness reports on what they believed happened is a poor idea.  In some places the report reads more like a disaster movie rather than a report on how to better improve our response.

Some mention is made of the lack of equipment, unfortunately in the first response to a major incident you are going to get ambulances, and not the ‘bigfoot’ support vehicles – we can only carry a limited amount of equipment in an ambulance, and to be honest it’s not unusual to only need to use an oxygen mask or two in the course of a normal twelve hour shift – so while we are equipped to deal with a patient or two, we simply do not have enough room in our ambulances to stock for major incidents.

As I said at the start – the report makes a number of excellent points, and at no time does it criticise the actions of those ‘on the ground’ who did an excellent job under difficult circumstances.

I know that the LAS has already made improvements, such as reinstating the ‘obsolete’ paging technology for it’s managers – something that came in extremely useful two weeks later with the failed second attacks.  I do have the LAS’ news release concerning this report sitting on my computer, I just need to OK to post it here…

7 thoughts on “My Thoughts On The 7/7 Report”

  1. The comms working throughout the tunnels thing is going to be a real problem – and TETRA won't even touch that.Getting comms working through the tunnels, in conditions where there are obviously already serious problems is going to be even tougher. Frankly they might do better to have a TETRA relay box in each station which someone grabs and pushes into the tunnel – hooking it to the tunnel comms wires (pair of wires that runs along the tunnels for emergency use) – that would also knock out the power should someone try and restore it.

  2. Yes – part of the report mentions that at one of the scenes those wires were damaged by the explosion.There is some mention of military grade radios, but I'm afraid I don't know enough about radios to offer a reasoned reply.

  3. Out of curiosity, does anyone know why communications don't work on the london underground? In Newcastle upon Tyne we have a light rail system called the metro. parts of it are overground, but in the cities (Newcastel and Sunderland) it's an underground system. I can get a clear mobile signal underground on the metro, although I've got to admit I don't know off the top of my head if emergency services radios work down there. I would expect so though. Surely it wouldn't be that difficult to invent a way to make underground comms possible? Where are all the techs whose job it is to invent these things?

  4. Basic fact of physics, radio waves do not like to go through the ground, and they especially don't do so well with getting into metal tubes under the ground. Many metro systems do have cell service, generally through repeaters. Sometimes if a tunnel is shallow enough, the signal can get through anyway, or find its way in via ventilation ducts. Generally, the radios that the train drivers use (where they have them anyway) work by picking up a signal from a “leaky coax” antenna stung along the tunnel wall.

  5. the fog of war is a very serious obstacleYes. Very much so. I didn't know what had happened until I finally made it to work at 10.10am, having been thrown off the tube at Baker Street at 9.20am. I obviously wasn't involved in any of the incidents and on hearing 'there have been massive power surges' I immediately went into 'Londoner-needs-to-get-to-work' mode. I spent the morning feeling vulnerable because of the lack of information available to me.

    our communication needs to be upgraded unfortunately, from what I hear the TETRA airwave system that we will be getting in the start of 2008 is not going to solve many problems.

    There's a part of me that things the best solution is the simplest one that relies on as little and as tested technology as possible. When things get blown up, the technologically best solution may cease working and we need a fail-safe fall back. There's a reason I carry a whistle on my key ring….

    There are some recommendations which are a little strange, such as allowing medical staff who are untrained in pre-hospital care to start setting up field hospitals and the like. While medical knowledge is incredibly useful, its also very useful to not have people who may be unaware of all the dangers on scene wandering around explosion sites in nothing more than theatre scrubs.

    I understand the urge to help, I would have done the same when I was working in A&E and I dont want you to think that Im degrading the work that these volunteers did on the day but the risk of creating more casualties is just too high.

    I think the point is more that you can't *stop* people helping, so you might as well bring them within the overall command structure and use them ie. allocate them to provide TLC + care for minor injuries and not to deal with those with more serious injuries.

    There'd also be some merit in requiring medical staff to be trained regularly in the principles of pre-hospital care to help prevent them doing something stupid. It's only a matter of time before another incident like this ones happens again.

    spend a couple of minutes assessing what has happened and then walk another fifteen minutes to get back to the ambulance, and it is unsurprising that a lot of the injured felt that the ambulances took a long time to arrive.

    It's the communications thing again. How long would it take for the attendant to leave a message with a responsible person (say a member of LUL staff) explaining what he was doing and saying that help is on its way and that it'll take approximately 1/2 an hour for that person to rely to the passengers?

    we simply do not have enough room in our ambulances to stock for major incidents.

    And it would be unreasonable to expect you to. I think the report suggests that caches of stock be kept in tube stations/other large public venues and I think this is a good idea, providing there's some system of rotation so that it's replaced and doesn't sit around for years going out of date, ending up non-functional when it's actually needed.

  6. Why does there need to be blame?Your people, along with the Police and Fire were magic. I know things could be better, but isn't this down to public funding?

  7. I have real problems with these sorts of reports. Of course we should look back at what happened and see if we could do better. Well, of course we can. No response to an unexpected emergency will be perfect.”It is very easy to look back and criticise the actions on the day but the fog of war is a very serious obstacle. “

    How do you avoid the confusion caused by the “fog of war”. There is one easy way. I am surprised no one has mentioned it. Peter Cook did years ago. It is surprisingly simple:

    Jonathan Miller and Peter Cook in the “Beyond the Fringe” piss take of the Civil Defence instructions on “what do do in the event of nuclear war”.

    Cook said:

    “The first thing to remember is to be out of the area where the bombs are dropping.”

    Quite.

    The retrospectascope is an infallible instrument. We can always look back and say this ambulance should have got there quicker, and that hospital should have…. and so on.

    I hate the sub-text of “blame” in which the Red Tops love to indulge.

    The only way to have a perfect response to an unexpected terrorist outrage is to have the whole country on red alert. And if we do that, the terrorists have won. Ordinary life will be impossible. Are we to assume that every 1st division football match is to be bombed? Every theatre? Every rock concert? Should we search everyone as they go in?

    There is no end to it.

    We just need to get on with our lives. The emergency services perform pretty well by and large. By all means, lets learn some gentle lessons, but I don't want the whole ambulance service sitting there 24 hours a day on red-alert wearing gas masks. Who is going to take my little old ladies with fractured hips to hospital.

    John

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