Ambulance

Some thoughts from EMS2016 keynote speaker Professor Douglas Chamberlain
Our European
Ambulance Services:
We Can Learn so much
from Each Other
By Professor Douglas Chamberlain, leading pioneer
of paramedic practice
The wish to assist the sick and wounded goes back millennia in our history. Possibly the first wellorganised
attempts came in the 18th century with the formation of the Humane Societies, set up
principally to save victims from drowning. The first was in Holland, but this development influenced
other countries to develop similar schemes. In the 19th century, the Order of St John spread from
France to many parts of the world ‘to relieve sickness and injury.’ Progressively through the 20th century,
statutory ambulance services were set up wherever a sound civic structure exists. But have we continued
adequately to learn from each other in our own era when communication can be rapid and effective?
Systems have evolved or been developed
purposefully in countries, or not infrequently
in smaller areas, that vary in structure,
in types of organisation, and in efficiency.
Perceived local needs are generally the
driving force, but other influences are
sometimes powerful. Emergency services
may depend on unpaid volunteers, but within
professional organisations the educational
background and required academic levels at
entry vary widely, as do the complexity of
service that can be provided. One major
difference depends on whether or not
physicians play a leading role, either in an
advisory capacity or as active responders.
Of course, there is room for variation within
a service but it is likely that some structures
match local requirements better than others.
Few even in Europe would claim that they
have the best possible system. Deficiencies
may arise partly from financial constraints
but there are other impediments to possible
improvements. Managers, for example,
may have personal reasons for accepting
the status quo or simply be unaware of
unnecessary shortcomings. Such problems
are commonplace in all organisations, but
progress within healthcare impinges strongly
on the well-being and lives of individuals,
and so demands our close attention.
Many of us who have lived through decades
of evolution in medical provision can take
lessons from recent history. Knowledge
within my own specialty of cardiology 50
years ago was circumscribed by geography
and more particularly by language. We did
not dwell on the fact that progress in some
areas may be well in advance of our own
even in closely neighbouring countries, yet
Book your place at EMS2016 now at: www.ems2016.org
Spring 2016 | Ambulancetoday
Winter 2014 | Ambulancetoday37