Commission report on our prehospital here in Quebec
It's in French ! ?
This the Gvt site
http://www.msss.gouv.qc.ca/f/documentation/publicaune.htm

The Report
334 pages, 1,8 mg ftp://206.167.52.6/acrobat/f/documentation/2000/00-834.pdf
The Resume
64 pages, 918k ftp://206.167.52.6/acrobat/f/documentation/2000/00-834-2.pdf

Now for you UK cowboys
In a realy much less serious line
A bit of slosh journalism...
Bring us back to these Medics ?
And the importance of  Medical Director ?
Wich existance is never mentioned anywhere... ?

And I thought you guys out legislated us by miles !

http://www.bbc.co.uk/scotland/frontline/archive/ambulances.shtml

FRONTLINE SCOTLAND
"AMBULANCE CHASING"
REPORTER: Susan Donald
PRODUCER: Murdoch Rodgers
ASSISTANT PRODUCER: Judith Ahern
SUSAN: Private ambulance services are now big business, but are we safe in
their hands ? We've discovered disturbing evidence of paramedics who are
untrained, unqualified and unsafe. They may look the part but it could be
your life on the line.
ALICE MILLER: Just at the point when we were between a jump and the wall I
came off ... my horse avoided me with three of the feet and the fourth one
just landed in my stomach.
MARGARET TAGGART: I was scared she was dying. I felt there is nobody here
helping me, I have to keep this child together until we get to somebody that
can help.
ALICE MILLER: It's a life and death situation, you're talking about half a
ton of horse maybe landing on top of you.
MARGARET TAGGART: They had no stretcher, they had no ambulance, Northern
Paramedics just literally waved his hands in the air, he was useless.
SUSAN: If you dial 999 after an accident you could have a fully qualified
paramedic at your side in minutes. He will have been trained by the NHS for
a minimum of 3 years and can be trusted to save your life.
But there's a new breed of paramedic on the streets who can't always be
trusted. Increasingly, organisers of privately run events from gymkhanas to
go-kart meetings are hiring the cheaper services of private paramedics.
There's nothing to stop anyone from setting themselves up as a private
ambulance service or calling themselves a paramedic. They need no
qualifications at all. As we've discovered, some people's lives have been
put at risk.

Geoff Young of Northern Paramedicals
This is Geoff Young, director of Glasgow-based Northern Paramedicals
Services Limited. He set the company up with his wife, Catherine in 1992. Mr
Young claims he has a number of medical qualifications, and boasts that his
private ambulance company is the most specialised in Scotland.
He runs a fleet of 6 ambulances which provide equipment and drugs to cater
for any kind of incident from dealing with cuts and bruises to
life-threatening emergencies. Though you could not get a stretcher in this
one. In recent years, Northern Paramedicals have provided medical cover at
hundreds of showjumping events all over the country.
They were on duty at Muirmill International Equestrian Centre in Ayrshire
the day Margaret Taggart had a horse-riding accident in February 1994. Geoff
Young himself dealt with her injuries. Margaret landed on her head and got
the full weight of her horse on the left side of her body.

MARGARET TAGGART: With the speed we were doing she launched me out of the
saddle. I came down over the fence in front of her and she literally landed
almost on top of me, as I was lying on the ground I could see her coming
down on top of me... and the paramedics that were on, one of them came over.
He sat me up and even although I was complaining that my neck was sore, I'd
no feeling in my legs, my arm felt as if it was on fire, I literally thought
I'd broken my arm at the elbow... eh.... he sat me up and I just felt I was
going to be sick and I was going to pass out. My husband kept saying "keep
breathing slowly, slow your breathing down and concentrate, talk to me, keep
speaking to me" to try and stop me from passing out. The paramedic literally
told me just to pass out, he said "it's the best thing you could do just you
go ahead and pass out dear".
After giving completely the wrong advice Geoff Young left the arena to get
something to relieve her pain. He came back with cylinders of gas and air.
MARGARET: He brought his equipment and then said that it wasn't working. So
I was literally still left lying there... oh it must have been in total
fifteen minutes. My husband had to then carry me out of the arena because
there was a competition going on and I think people were getting a wee bit
frustrated at this time because nothing was being done. So my husband
carried me out the arena, I was sat in a chair where the paramedic came up
with a safety pin and said "pin her arm to her .... her coat arm to her
jacket lapel, and never mind about the charge for the safety pin, you can
give me it back another day".
SUSAN: So, Northern Paramedicals had no ambulance, no neck brace, no
stretcher, and not even a sling. Margaret's husband was forced to take
control and drive her to hospital.
MARGARET: The nurses came rushing out, they couldn't get me out the car
because I couldn't move, so they brought a wheelchair and then they took
that away again because they thought there's no way we can get her into a
wheelchair. They then brought out a trolley and had to try and get me out
and ....between four of them out of the car on to this trolley.
SUSAN: Why couldn't they get you out of the car?
MARGARET: I just couldn't move my pelvis or my legs.... em... they had to
X-ray me literally from head to toe.
We asked the Consultant in the Accident and Emergency Unit of Glasgow Royal
Infirmary, who trains NHS paramedics what he thought of Margaret's
treatment.
RUDY CRAWFORD: It is well recognised in emergency medicine that equestrian
injuries if they occur have a potential for very serious and life
threatening injury, so it would be very important in that situation to go
through the simple.... you know... simple A B C's which means airway,
breathing and circulation, and also to be aware of the potential a) for a
serious head injury and b) for a serious neck injury. So the patient would
have to be treated very very carefully and not moved until the neck was
properly immobilised.
SUSAN: So in fact then they should have had some kind of neck brace for this
woman?
RUDY: Yes they should have their neck stabilised at the earliest possible
moment and they shouldn't be moved until the.... until a collar and possibly
sandbags and tape are applied, because in that situation you could sustain a
broken neck and you know.... the golden rule is to assume that that injury
is there until a doctor has excluded that. So they should be treated as if
they have a broken neck in fact.
SUSAN: And would you have expected any paramedic to have a stretcher as
well?
RUDY: Oh absolutely. I mean a patient like that would have to be immobilised
and then carried off on the stretcher, and we would expect on arrival at
hospital that patient to be brought in on a spine board with a collar,
sandbags, tape and eh... being given oxygen.
SUSAN: Alice Miller was 15 when she was thrown from her horse in a
show-jumping competition in March last year. She suffered serious internal
injuries when the horse stepped on her stomach.
Northern Paramedicals were on duty again. The paramedic did nothing at all,
not even basic first-aid, forcing Alice's mother to take charge. Luckily for
Alice, her mother is a qualified doctor.
ALICE MILLER: I remember these was a second when his feet were over me and I
thought he'd gone...... you know I thought it was going to be OK, he was
going to go past... em... and then just the last one came down... down on my
stomach... em... I remember everyone coming, running over, asking me if I
was OK and stuff.
ALICE'S MOTHER: Watching her come off the horse and saying how she fell and
how she landed and the fact she didn't move I knew she was hurt... my first
sort of reaction was hold her hand, feel her pulse which was not easy to
feel at that point.
I wanted her out of there and away to hospital as quickly as possible. There
was no question that she needed to be in hospital quickly and my next sort
of reaction was ... where is the help and... the guy was there beside me but
he was flapping around.... a bit scared himself, ... I felt that he was
scared... I was very scared.
ALICE: I heard her panicking, she said you know... she was screaming for
someone to get an ambulance here now, and that was when I realised it must
be something bad if she was panicking, you know... it must be something
really bad because I hadn't really thought about what it was or anything you
know... I just knew that it was sore and it was there....
SUSAN: Northern Paramedicals did have an ambulance there but the paramedic
refused to use it because he was on his OWN! a 999 call was made, but
precious time had been lost as Alice lay bleeding internally.
RUDY CRAWFORD: As far as I'm concerned that's just complete and utter
incompetence. I mean that's obviously a very serious and potentially life
threatening injury and ... eh... it's very important that people in those
situations get skilled treatment you know... at the earliest possible
moment.
SUSAN: Alice could have bled to death. Surgeons discovered that her liver
had been ruptured by the horse's hoof. She needed 5 litres of blood and
spent 4 days in intensive care. She has now made a full recovery unlike her
riding instructor, former international showjumper Nadine Warwick, who
suffers great pain after a riding accident. She had to rely on Northern
Paramedicals as well. She knew immediately her leg was broken and that the
break was serious but Northern Paramedicals again did everything against the
book, providing no stretcher, no ambulance and no splint. They didn't even
notice her leg was broken.
NADINE WARWICK: The paramedic who was in front me I can remember kept saying
to me "can you move your foot?", and I said "yes I can move my foot, but
there's something wrong, it's just so painful", and he says "well you can't
have broken anything because you can move your foot", and I said "well I
haven't broken anything I have never been in such pain in my life and if you
don't do something very quickly I'm just going to pass out". When they got
me in the upright position I really knew there was something then because it
was like wobbling, it was like jelly the top of it... and I said to them
"there's something wrong, it feels like jelly, it feels as if it's moving".
SUSAN: Once again Geoff Young's paramedics were unable to cope. Nadine was
driven to hospital by her husband where x-rays confirmed her fears. Her leg
was broken in 2 places. The consultant inserted 4 pins and a plate which has
left Nadine with a limp. It's unlikely that she'll ever represent Great
Britain in international show-jumping again.
NADINE: It was pretty awful laying there thinking about how long you were
going to be off, because they said "this take a year to heal"... em... " you
mightn't ride for another two years, it could leave you with a really bad
limp", and this was all too much to take in.
This is the man who treated Nadine. He still works for Northern
Paramedicals. We secretly filmed him at a recent go-kart meeting in
Larkhall. He claims he's a qualified paramedic as well.
NADINE: He just didn't think it was that serious, and he just kept saying to
me "well I don't think anything's broken, I think it's just a really bad
bruise on the muscle"
SUSAN: Have you ever seen him again?
NADINE: Yes I saw him when I did come out of hospital and em... I was at a
horse show watching, I was still on the sticks obviously ... it was about
four weeks later, and he came over to me and he said to me "well how are
you?", and eh... he said "I don't know how I missed that", he said "I just
really don't know how I missed that injury" and I really felt like hitting
him, I felt like grabbing him and punching him or something... because I
kept telling him there was something wrong.
RUDY CRAWFORD: Even a first aider would try to make an assessment of the
injury and eh... if they suspected a fracture they would then immobilise
that leg either by bandaging or by splintage, and then transport the patient
as a stretcher patient.
SUSAN: In this situation the paramedic had no idea that her leg was broken
and this woman had to be transported to hospital in her husband's car.
RUDY: Well... well from what you tell me I mean that's completely
inappropriate and really beggars belief... you know... I think they would
have been far better to have dialled 999 and called an ambulance.
SUSAN: Then at least you know you're getting qualified professional...they
seem to be the only people not taken in by Geoff Young.
Grace Peffers is employed as an occupational health nurse at Glasgow's SECC.
She met Geoff Young at the European International Show-Jumping Championships
held there in 1994 where Northern Paramedicals were providing medical cover.
They discussed how they would deal with any emergency that might arise. She
was alarmed by some of his comments.
GRACE PEFFERS: The first impressions were that he appeared quite confident,
but then he started to talk about what he would do in the event of someone
having a serious injury, in particular a head injury.... and he indicated
that he would em... scramble one of the ambulance services helicopters and
well.... I'm pretty sure you know... that it's only Scottish Ambulance
Service people who can do that, so I thought that that was a bit strange.
All our staff were instructed that if there was any problems at all, if
there was any medical problems that I had to see... see the person or deal
with it and make sure that all our records were kept up to date. And one of
our first aid staff had witnessed Mr Young giving an inhaler to someone, and
I was concerned about this because an inhaler is a prescribed medicine, and
there was no doctor about that had prescribed this medicine so... I asked
him about that.
JUDITH: And what did he say to you?
GRACE: He didn't have any comment to make about it really.
He came at one point and gave me a piece of paper with some details on it...
em... a piece of scrap paper with some details on it, which was not
really... not really professional as far as record keeping's concerned.
SUSAN: But his publicity material seems very professional with lists of
drugs and equipment his ambulance staff carry. But are they entitled to use
them ?
RUDY CRAWFORD: I was very impressed by the comprehensiveness of it, but
unfortunately I felt it was too comprehensive because there are drugs on
that list and equipment on that list that ....that the paramedics in this
area are not allowed to use. The paramedics here, as well as being trained
by us also operate to very strict protocols which are agreed with the
medical profession, with the Health Service and the Ambulance Service...
em... and you know... a lot of the items I saw on that list would not be
available to paramedics in this area.
SUSAN: And why is that?
RUDY: Well because they're very dangerous and they require you know...
additional skill, additional knowledge and training. There's one drug in
particular which can sometimes be given to severe asthmatics by intravenous
injection, and in the wrong hands that could actually kill someone if
inappropriately used. There are items of equipment there such as chest drain
equipment which again involves a surgical procedure to put a drain in to a
chest and I would be very unhappy about any paramedic using that, never mind
an unqualified person.
SUSAN: So how do they get away with it ? Anyone with medical knowledge can
tell the difference between real and bogus paramedics. But most of the
people hiring Northern Paramedicals for public events don't have medical
training. The publicity material that Geoff Young puts out makes them sound
like a well-trained and equipped organisation - and they're considerably
cheaper than NHS- trained paramedics.
What about Mr. Young himself ? He's a member of the Children's Panel in
Glasgow. So well respected is he that he was appointed Chair of the Scottish
Youth Drugs Working Group last summer. His credentials seemed to be so
impressive that on behalf of the Crown Office he carried out Post-mortem
X-rays for a time. And that's not all.
The list of people he's conned is extensive, especially since he's moved
into the film world, 17 film and television productions last year alone. STV
use them and so do the BBC.
On the night they filmed this Northern Paramedics were on duty.
BAD BOYS extract.......
So how does he tout for business?. We wanted to hear his sales pitch for
ourselves and pretended to organise a bungee jump for charity.
Extracts from the telephone call
FRONTLINE: What do you do?
GEOFF YOUNG: We do anything....
FRONTLINE: Right ....
GEOFF YOUNG: Yes absolutely anything from raves through to motorcycling and
showjumping and oh you name it and we get involved with it...
FRONTLINE: Right....
YOUNG: The dafter the better.... we sort of sit around in terms of
qualification and things... a similar level if not higher than the Scottish
Ambulance....
FRONTLINE: Oh right....
YOUNG: em.... we do about six hundred events a year....
FRONTLINE: Oh well that's quite a lot actually isn't it....
YOUNG: Oh it is.... and there's twenty eight of us...
FRONTLINE: Right.... Oh that's quite.....
YOUNG: Four doctors and we.... sort of ... whoever's available will turn
out, but I can certainly put you down on the list and as far as I'm
concerned that's it done.
FRONTLINE: Is it first aid that you have?
YOUNG: There would be at least one paramedic there...
FRONTLINE: Right....
YOUNG: At least one paramedic ... with all the appropriate equipment ....
em... as I say and an ambulance that would use for transporting if
necessary. We carry equipment that Scottish Ambulance don't carry....
because the number of times that they would need it you know... during the
course of a shift are few and far between because most of the stuff that
they do is not sort of specialised injuries like we handle.
SUSAN: So what training does HE have to cope with these specialised
injuries? We hit problems when we started to check out Geoff Young's medical
qualifications. Despite the claims made in his CV that he is a qualified
psychiatric nurse, a State Registered Nurse and a Registered General Nurse,
we checked with the British Register of Nurses, who said they had no record
of Geoff Young. We also found no trace of an ordinary or a Masters degree
with the Open University.
All very curious.
Next stop Mr Young's headquarters in the south side of Glasgow.
SUSAN: This is the address of Northern Paramedical Services Limited and we
believe the home of Geoff Young and his business partner and wife, Catherine
Stevenson. Mr Young has refused to be interviewed by us so we thought we'd
come and ask him in person questions about his medical qualifications.
Expensive nameplate - Northern Paramedical Services and Medical and Forensic
Screening.
SUSAN: That's the company that provided the Crown Office with X-rays. It was
struck off the register of companies in October last year.
We tried several times to contact Mr Young.... There was no answer this
time..
..or the next time...
Well either he's not in or he's not coming to the door.
or the time after that....
What's left? we did have one piece of paper which seemed to show that Mr
Young DID have a medical qualification
Legally, there's nothing to stop you setting up your own private ambulance
service and no organisation you MUST register with, but Geoff Young does use
a certificate of membership of an organisation called Paramedic UK.
This is to signify that Mr G T Young having fulfilled the educational and
clinical standards as required by the Council is duly registered with all
rights and privileges appertaining thereto as a registered emergency medical
technician.
But Paramedic UK doesn't train paramedics. So who checked Mr Young's
qualifications. We asked the man whose signature is on the certificate.
PROF ANTHONY REDMOND: The certificate is not a qualification, it is a
certificate of membership. I was prepared in my capacity you know... to
volunteer and support these people to sign a specimen document, and on trust
and in good faith.. I expected it to be used appropriately.
SUSAN: Who to your knowledge checked that Geoff Young had the qualifications
necessary.
REDMOND: To my knowledge it should have been Sean Ekberg and his staff.
Shaun Ekberg runs the British Association of Emergency Medical Technicians
and ran its fore-runner Paramedic UK. To gain entry proof of medical
competency was required... Had he checked Mr Young's qualifications?
SHAUN EKBERG: We took up the references that he gave em... which was the
nurse who is the senior clinical nurse in em.... in a Lancaster hospital...
and em... I asked him about Geoff Young principally to get him into the
membership and he said "yes this chap's kosher, he's a good egg and he is a
nurse" and has worked he thought at Leeds, and has also worked for the
Manchester Health Authority as a nurse advisor.
I have a copy of the competency certificate that was signed and I'm quite
satisfied that the competency certificate is accurate.
Not according to the man who supposedly signed it: Stuart Westbrook. He's
written to Frontline to tell us that this signature is a forgery and that
Stuart Ekberg never contacted him about Geoff Young's membership in 1992.
EKBERG: Your method of interrogation has obviously got Mr Westbrook
rattled... em.. and I would... I forgive him for the fact that he is
backtracking, but that is Mr Stuart... eh... Mr Westbrook's competency
certificate, that is his printing, that is his handwriting and I did check
with Stuart.
SUSAN: Young submitted a second competency certificate nearly four weeks
later, signed by a Doctor Teanby. Dr Teanby's written to Frontline to say
THIS signature is a forgery. Approached by Geoff Young at the time, he'd
refused to sign it.
EKBERG: I didn't directly check at that time with Dr Teanby because I felt
the signature was a reasonable match, I felt that he had come with a
reasonable reference from his initial referee.
So, first March 1993, Mr Young gets his certificate. Well and good, but to
renew his membership in 1994, he has to submit a new competency certificate.
Now based in Glasgow, Young produces one signed by Charles Allister, a
Consultant at Paisley Royal Infirmary. Mr Allister's written to us to say
his signature is a forgery... Did Mr Ekberg check THIS certificate?
EKBERG: At this instance I personally tried to contact Dr Allister and he
was not available for whatever reason. Part time administration then...
em... all I can say is that eh... I didn't follow it up and neither did my
part time staff follow it up... so.... yes we were at fault.
SUSAN: Did you write Dr Allister a letter?
EKBERG: No we didn't.
And he didn't contact Mr Allister in 1995 either when Young produced another
competency certificate signed by the Paisley Consultant. That is another
forgery. Mr Ekberg cited this certificate in February 1996 as proof that
Geoff Young was a bona fide paramedic in a letter to the Secretary of an
Injured Riders Charity, Jane Pelly. An incredible statement, since Mr Ekberg
claims to have discovered four months earlier that all Young's nursing
qualifications were bogus. We asked Mr Ekberg to explain his letter to Jane
Pelly.
EKBERG: That is my wording.... and I don't believe that is on my headed
notepaper, that is a .... that is eh... not accurate notepaper.
SUSAN: So are you going to tell me this is a forgery too?
EKBERG: Eh... I'm going to tell you that eh.... we wrote that on Paramedic
UK notepaper when we thought it was ... the wording is on Paramedic UK
notepaper I believe.... and I believe... and eh.... and this has been
transposed on to BAEMT notepaper.
SUSAN: And who would have done that?
EKBERG: Eh... well...
SUSAN: Well Jane Pelly wrote the letter to you and I've seen the original...
Mr Ekberg what kind of organisation are you running when there seem to all
these forgeries and all these mysterious bits of paper that you say you know
nothing about.
EKBERG: eh.... no.... not all these mysterious bits of paper... this bit of
paper... em... I have to say that we are running a very small association.
We have a thousand members, em... at the time of all this hasheny going
on... it was a voluntary run association with small.... with a small
turnover and small part time staff... I will admit that we have made a
mistake with Geoff Young, and that is the .... we have not made a mistake
through malicious intent, we've made a simple honest mistake from a man who
was a professional conman.
SUSAN: Three days later in a fax to Frontline Scotland, Mr Ekberg admitted
writing the letter to Jane Pelly confirming Young's qualifications, but said
he had no explanation why... "it was a total error."
SUSAN: So there we are then, four different certificates but no one who'll
actually admit having checked Mr Young's medical capabilities. And this is
precisely what critics say is the problem with private paramedics in Great
Britain today. There are no minimum standards and no proper checks and
qualifications. The British Medical Association is calling for a legal
definition of paramedics. They're deeply concerned by stories of cowboys in
yellow jackets masquerading as paramedics up and down the country. Just how
many Geoff Youngs are there out there?
RUDY CRAWFORD: I think that the National Health Service Training Directorate
should be the standard that everyone should work to as an absolute minimum.
Those are the only paramedics that we would recognise and call paramedics.
I think it's a terrible anomaly that people can take a vehicle and call it
an ambulance and there is no regulation for that sort of thing... Even taxi
drivers have to have a licence.
It's quite clear that these people are in it for one reason and that's
money, and therefore they wouldn't appear to have any ethical principles or
standards that the other professions and people who work in the Health
Service have. When money is the bottom line care goes out the window.
MARGARET TAGGART: Nobody that showjumps has any faith in Northern
Paramedics. There are parents taking their children to pony shows and these
people are dealing... are having to deal with any accidents that happen, and
if my child fell off a pony and it was the Northern Paramedics that were
dealing with it, I would be really really worried.
ALICE MILLER: I feel very very angry that there was someone there that
wasn't properly qualified and it could have been risking my life, that I
could have been em... that I could have bled to death there because they
didn't get an ambulance there quick enough. And that is wrong, and I would
hate to think of that happening to anyone else and I think there should be
something done about it now.
ENDS/



 ------------------------------------------------------------
 Free Web Email & Filter Enhancements.
 http://www.freewebemail.com/filtertools/
 ------------------------------------------------------------