I often joke with parents that their children enjoy scaring them.
When they are a few weeks old, they hold their breath and go blue.
When they are a year old they get high temperatures and have febrile convulsions.
When they are two years old they fall over and cut their head.
When they are seven they fall and break a bone.
When they are fourteen they either get pregnant, or make someone pregnant.
One of our commonest calls for children is the 'traditional', two year old who has fallen over and cut their head on a wall/radiator/stone/passing dog. The mother is often panicking because 'it's a lot of blood!' (even though it isn't) and we pop them down the hospital for patching up.
Sometimes a child will fall over and get a bump on the head. I take them to hospital because it's an easy job and they get to sit there for a few hours before being sent home by the A&E doctor. Simple.
Sometimes however the parents just want the child 'checked out', they don't want to wait at the hospital so they will call an ambulance and not go to hospital.
Occasionally the ambulance crew will feel kind to the parents and child and suggest that they don't need to go to hospital.
I have no details of this job, or what happened – but I can talk in generalities.
If, on examining a child, they are happy, alert and interested in what is going on around them and there is no history of a loss of consciousness, then they are almost certainly going to be fine. If you take them to hospital they will be sent home most likely without an x-ray or CT scan.
I can imagine that in this instance, even if the ambulance crew had taken the child to hospital the outcome would have been the same. Only the headline would be 'Hospital in probe over boy's death'. I don't think that the child would have been examined differently by a hospital doctor than by the ambulance crew.
There is a saying among those of us at the bottom of the medical hierarchy – 'always leave another medical professional between you and the patient', or 'don't be the last medical professional to see the patient alive'. If I take a patient to the hospital, then it's the hospital's fault if something goes wrong. If the patient wants to stay at home, then I'l try and arrange the GP – so if something goes wrong it's the GP's fault.
It's medical arse covering at it's worst.
In part it's due to the media – in this story above, do you imagine that the BBC would print a story following the investigation where the ambulance staff are found to be without fault? I doubt it.
We ambulance folk are being subtly encouraged to leave people at home, and most of us are blatantly ignoring this hinting for the exact reason above. We don't want to be the last people to see a patient alive.
If I go to a patient with a sore toe I'll still take them to hospital – because if they die of an unconnected heart attack, I'll be the one to blame.
And soon, with the 'front end' model, solo responders will be expected to leave patients at home, somewhere in the vicinity of 60% of patients should be left at home, or have 'alternate pathways' for care.
I can't see many ambulance people being happy doing that.