Poor ambulance service alarms London doctors

DOCTORS say that patients' lives are being put in jeopardy daily as the London Ambulance Service (LAS), the largest in the world, founders in the face of emergency calls.

In a week in which two London coroners at separate inquests criticised the LAS for delays in responding to emergencies, evidence mounted of confusion and inefficiency.

Cases include a wait of nearly 24 hours for a man with suspected heart failure - and then two ambulances arriving together; and the ambulance service 'losing' a call, in an emergency in which a man, a banker, died.

The banker, from Putney, had a serious heart attack while playing tennis and lay unconscious for 34 minutes on the court before an ambulance arrived. Passing firemen tried to revive him. The call had not been put into the LAS computer.

Family doctors have become familiar with life-threatening delays as patients are left anxiously waiting, often in pain, for the ambulance to arrive.

In two cases, doctors who had dialled 999 waited nearly an hour with male patients having heart attacks, one at home and one in the surgery, before the ambulance arrived.

A woman with multiple sclerosis was left 'sitting on the floor' at her home when she lost the ability to walk. After waiting all afternoon for an ambulance she was telephoned by ambulance staff to see if the following day 'would be all right'.

A cancer patient for whom a GP had found an acute bed waited from lunchtime to 7pm for the ambulance which arrived only after the doctor had called 999.

In the case of the death of a premature baby, Dr Harold Price, the Walthamstow coronor, said that it was 'astounding' that no ambulance had been available to take the infant, born three months early, to hospital. It was 40 minutes before an ambulance arrived.

Sir Montague Levine, the coroner conducting the inquest on a 44-year-old man who suffered a heart attack in Sydenham, called for an inquiry when he heard that it had taken six minutes for the initial 999 telephone call itself to be answered.

He also critcised ambulance crews for not allowing the man's wife to travel in the ambulance with him.

'Together with inordinate delays, it is inexcusable that she was not allowed to travel with him,' he said.

In response to the barrage of complaints and criticism, the LAS, which takes up to 2,500 emergency calls a day, has promised more staff on the emergency switchboard and an improved system.

'We are introducing a series of new measures to speed up telephone answering,' a spokesman said. 'Firstly, we are replacing an obsolete telephone system in October. This will give operators greater flexibility to swap between the 999 calls and the special telephone lines for calls from doctors.

'Secondly, we are recruiting more staff in the control room. Finally, when commissioned, the computer-aided dispatch system will free another seven staff for call taking.'

One London GP who has complained about the state of the service to LAS headquaters is Gillian Braunold from Kilburn. Her patients have experienced four long ambulance delays in the past three weeks.

'In addition to the difficulties in finding a hospital bed, we now have the worry that that bed might be gone by the time the patient gets to hospital,' she said.

'If it is like this now, what is going to happen in the winter?'

Dr Braunold said that doctors had special telephones to use for ambulances, but now they often resorted to dialling 999 when crews failed to arrive after an earlier request.

The patient with multiple sclerosis is registered with her.

'I was astounded that the ambulance service had telephoned the patient direct to ask if the next day would do. I have never heard of this before,' she said.