1990’s  INTO THE CAULDRON

 The first two months of the nineties was taken up with the strike started in the previous decade, but as soon as it was over the crews set to with a new heart. The service was in good shape, with a new completely refurbished Control, and a Regional Training School covering a wide range of courses.  Most of the twenty stations in Surrey were in good condition, having been gradually renewed since the start of the service, and with the crews willing to put the immediate past behind and make a fresh start.  

However, strikes  unfortunately always leave an aftermath, and this one left a certain amount of bitterness towards  Mr Foy,  who from then on appeared to lose all the confidence of his personnel, mainly as a result of threats he had issued during the strike, but also for cuts he was to make in the service. Although his actions were considered politically correct at the time it was to affect the service for many years to come.

 It takes a lot of finance and a good many years to fully establish an ambulance station, yet one of the  most radical of the cuts saw the closure of three stations. Banstead where the site was retained, Cobham, and  Egham, whose sites were sold off.  

Although the press was full of reports of under manning, and the closure of certain stations at night,  the qualified crews were cut  by 16. This does not sound a lot, but in reality it was the equivalent of two 24 hr vehicles.  

 As always, there appeared to be a natural built in resilience within the service, which was much in evidence in the early nineties. On top of all the cuts the service was going through a complete metamorphosis, from which it would emerge unrecognisable to the people who had brought the service into being.  In line with the rest of the country the service had become  two tiered, with the general work being completely separated from emergency work. This in itself was a major operational change, as staff engaged on general work would not now require the qualification that was essential for those serving on front line vehicles.   It was the plan to have one advanced trained person on each emergency vehicle within two years, the title of ambulance man/woman would be dropped in favour of the now familiar title paramedic, their crew mates would be known as technicians.

Just as the service was beginning to move forwards another political intervention occurred. It was proposed that along with Hospitals, Ambulance Services would be allowed to establish self governing trusts.   The Surrey Ambulance Service decided they would seek trust status,  which yet again would involve another big change in administration, and as ever such changes, big or small, always cause a certain amount of disruption.

On top of trying to introduce new working and training methods, there was now the added task of working towards becoming self-governing.  Mr M Foy decided to depart before these changes took place.  Mr Lyn Samuel who came from without the service, was appointed as the first Chief Executive, his task was to take the service into the new form of administration.  

The Surrey Ambulance Trust came into being in 1994, with the appointment of a Board of non-executive Directors, and a Chief Executive. Lady Helen Gardiner was installed as the first Chairperson.  Although he quickly integrated himself into the service, and saw it through to its new status,  Mr Samuel decided to leave shortly afterwards.  Lady Helen took over the reins until a replacement was found.    Mr Alan Murray was chosen to follow  Mr Samuel, he came from the Belfast Ambulance Service, but again his appointment with the Trust was also to be short lived.    Mr Alan Kennedy, a former member of the London Ambulance Service who had been Mr Murray’s deputy,  was promoted to Chief Executive at the beginning of 1997.  Not an easy task to take on, having three changes of chief within six years does little to help staff moral, and there were still more changes  to be brought about within the service.

The years from 1990 leading up to the 50th anniversary will probably go down as the most changeable and stressful the service has seen. The Trust took over just as the cuts instigated by  Mr Foy were beginning to be felt, their terms of reference vastly different to anything that had gone before generating a complete new beginning.  Every aspect would be carefully scrutinised, and changes introduced to bring it in line with the latest developments. All departments and staff, from the top to the bottom, would be assessed and evaluated.  Once again the personnel proved their resilience in accepting alterations whatever reluctance they felt. Even before all the changes were in place a completely different service emerged to the one initiated in 1948.

 One of the first noticeable changes was the introduction of two shifts of twelve hours, replacing the old eight hour three shift system.   The role of the traditional Station Officer also disappeared as the new structure began to take place.

 Looking at the outside of a modern ambulance one could be forgiven in thinking it was not so very different from early models, but looking inside, the picture changes immediately.   Gone are the two trolley beds either side, now replaced by one central trolley bed. Blood pressure monitors, defibrillators, intubation and infusion kits, and certain drugs, special splints and portable stretchers, and much much more, all go to make up the back of a modern ambulance turning it into a mini casualty department on wheels.     In the cab an up- to-date radio  and data track system.  As gradual replacement to the Fords, a number of LDV ambulances were purchased, but they did not come up to expectation.  Negotiation are taking place to lease Chevrolet ambulances, and if successful have some in service in time for the fiftieth anniversary, thus cutting down on cost and maintenance, and reducing the need for fitters and workshops.  The original Bedford and Ford vehicles used by patient transport were replaced by Peugeot  Boxers,  these are now about to be replaced by Fiat Ducato's.   

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Another change was to effect crews and vehicles, under new regulations most stations had their petrol pumps sealed, and now vehicles fill up at private garages using agency cards, one of the benefits of this is the flexibility it gives.

 To keep abreast of an increased population with the same number of emergency vehicles,  (one of the disadvantages with the new ambulances they carry less patients), and the ever present need for a rapid response; plus the fact modern technology was advancing so  rapidly, control soon found it was in  need of an urgent up dating. Towards the end of 1987 a complete make over of the main control room was commenced.  A temporary control was set up on the top floor of the main building at Banstead. Unfortunately problems with a new computer system delayed the opening of the up-graded control room.

Although other than training incidents, there has not been a large major emergency, thankfully, for many years, however, this does not mean the service has been complacent.  Building on past experience, a comprehensive mobile unit has been established, consisting of a Land Rover which tows a caravan, housing an independent control, a kitchen, and crew quarters.  Three Vauxhall Monterays are stationed at various points around the county,  each with large trailer tents on tow.  All the vehicles are four wheel drive, and carry a vast range of equipment, which in a very short time can be turned into a sheltered rendezvous where treatment and clearance of casualties can take place under cover.

Recruitment to the service has changed immensely. Under the 1998 criterion,  candidates must hold a clean driving licence, and are required to have at least three GSCE's, preferably in Maths, English and Science, or they must sit an entrance examination.  A series of tests are given, including a driving assessment.  A three week Induction Course follows, one week of which involves driving.  Successful candidates are then appointed, initially, working with Patient Transport as Patient Care Assistants.  After a short period they can apply to become Ambulance Technicians, this would involve a further six week residential course, and if successful they would pass out as Assistant Ambulance Technicians.  Three monthly assessments follow, culminating in a final test after one year promoting them to Ambulance Technicians.  A further year must be worked before they can apply to become a Paramedic.  Selection for this progression is by interview, written and practical tests, successful candidates then undergo an intense residential course at Banstead taken in two stages of two and three weeks, and finally a months training in hospital.

The Training School felt the wind of change, as other authorities were beginning to run their own training programmes, leaving the School committed to their own in-service training, but open to other Health Authorities who still wished to participate. However a complete restructuring followed, residential courses for new entrants, technicians and paramedics would take place at Banstead, but refresher courses and ongoing training carried out at local level.   To this end instructors are now posted to various stations around the county as Clinical Team Managers, for the continual assessment and upgrading of crews.   

A new commitment for the Service was income generation. Health Service Trusts are expected to enerate a certain amount of their own income and, therefore, a new department dealing with the commercial side has been set up.

Private ambulances were becoming more and more to the fore, it seemed only natural, therefore, that the service should want to run one of their own.   Starting at Banstead with one vehicle and crewed by on-call personnel, a new successful arm of the service is now beginning to take root and grow.  In the short time it has been running it has expanded to four Industry of  First Aid Courses and equipment, and the covering of public events with ambulances and medical teams. Contracts to move repatriated patients from airports within the country, and to provide emergency cover at many of the racing meetings in the south, have just been signed.  All of which has contributed to the success of their entry into the commercial field.       

 Other services are still not forgotten in all this, The Hospital Car Service continue to play an important role. The British Red Cross and the St John Ambulance Brigade, also give very valuable service, albeit mainly at week ends.

1993  saw the setting up of a Retirement Association (SARA), under the chairmanship of   Mr Len Davis.  This organisation has gone from strength to strength, and meet at regular intervals, it runs various activities for its members, a Bowls Match and Golf Tournament annually,  a yearly Reunion, (the 5th coinciding with the 50th Anniversary of the Service), organised by the Association, and a Christmas Buffet by the Service at Banstead; all of which are open to both past and present members  of staff.    A Mobile Museum has been set up and members attend many functions with it during the year.  Lady Helen Gardiner has graciously been Patron for the past four years, and Mr Alan Kennedy is the current President.  However, it must be said,  the co-operation that is given by the present full-time staff, goes a long way in achieving the success of this organisation.     

 What of the future? Unfortunately changes are very often up to the whim of an individual politician.  After helping to guide the Trust through what will probably be its most difficult period, Lady Helen Gardiner, in all probability, will relinquish her role on the Board.  Talks are at present taking place with regard to a merge between the Surrey, Kent and Sussex Trusts.   The Fire Service still keep trying to get involved, and have in some parts of the country already combined, station wise, with the Ambulance Service.  But whatever happens, and whatever changes follow, one thing is certain there will always be an Ambulance Service with men and women loyal and fully committed to it.   For myself I would like to see the Surrey Ambulance Service continue for another 50 years, but then again I am biased.

            Bits & Pieces