Hillsborough

Hillsborough was not a subject I really intended to write about; mainly because it was something I haven't really formed an opinion on it. When it happened, I was barely able to walk so it didn't register much on my consciousness. Since then I have become aware of it from my legal studies - it is the source of a lot of case law which may now need to be re-thought - but again, I didn't think about the event itself too much.

However my mind changed this morning when I heard an interview with Tony Edwards. Mr Edwards was part of the ambulance crew that drove on to the pitch. It was one of the most moving pieces of radio I have heard in a long time and has made me think quite a lot.

Before I go any further, let me make it clear I haven't read any of the reports published on the events that occurred that day nor have I read the newspaper reports in any great detail. My sole knowledge comes from what I have hear/seen in news bulletins.

My first thoughts go out to Mr Edwards who has been badly traumatised by the events of that day. It's not something that has occurred much in the news coverage but it must have been dreadful for those involved professionally. We assume that emergency service personnel will cope with whatever is thrown at them. That their uniform provides some sort of armour against the terrible things that they see however this is simply not true. In this instance, it has cost someone that was passionate and proud to be a paramedic their job and more than that their vocation.

I have some very modest experience of providing pre-hospital care through St. John Ambulance and I can say with some confidence that most people, when they put on the uniform, put on a bit of a mentality. A carapace to make the role easier. In our case, hopefully the worst we will see is blood and other body fluids but it is a similar mentality. However the interview has also reminded me of a few incidents that have left me a bit shaken. There have been a couple of times I have been left shaking after treating someone. During the treatment, the training kicked in and I dealt with the situation. It was the reflection afterwards that I got scared. I was lucky, a cup of tea and chat with colleagues was all it took to evaluate the events, decide that I acted appropriately and be reassured by others that they would have done the same. That reassurance was hugely valuable. For smaller duties and for volunteers who offer assistance off duty, St. John have an on call duty officer who can be called upon at any time to offer a debriefing on events and, if necessary, organise further support. Again a valuable system.

My father wasn't quite as lucky. He came out on duty with my unit at a large London event. It was hugely busy and he ended up in the major injury section of the mobile treatment centre dealing with some very poorly people. He came down reasonably fresh out of basic training from St. Andrews First Aid (the Scottish equivalent) and was expecting to do no more than watch all of us in action. I think he also was under the impression that the most we would be doing was doling out plasters and ice packs. To keep a short story short, he did have quite a tough time afterwards. Despite having a debriefing from me and my commanding officer, he spent quite a lot of time analysing what he did and questioning if he couldn't have done more (his treatment was textbook but it's not always easy to see that from the inside). He also had a couple of flashbacks and bad dreams about the events. Now neither my father and I are uncommonly sensitive. In fact, I would say that we are both fairly resilient but these events affected us.

Therefore it comes as no surprise that Mr Edwards and no doubt a fair few of his colleagues have suffered long lasting effects of that day. He alluded to frustration and guilt about being prevented from getting properly stuck in and about the horror of people literally piling bodies on to his vehicle. He described having to live with the certain knowledge that, if things had been done differently, more people would have survived.

In the interview Mr Edwards talked candidly about mismanagement of the whole process by senior officers at the scene. On the one hand this is shocking and appalling. If people are appointed to strategic roles then they should have received appropriate training for the job and be able to cope with what it throws at them. That's well and good but how exactly does one train for something like this? Simulations are good but, in the back of one's mind, there is always the knowledge that it's a simulation so the adrenaline doesn't start pumping quite as much. Beyond that, they are expensive and complicated to organise so any one officer will have limited exposure to them. I suspect that most training will be done on paper in a classroom. Although this is valuable in giving individuals the opportunity to think through events and come to logical conclusions, the fact that it doesn't mirror the fear and the adrenaline of real life means that there's no guarantee the same thought process will be applied in action. It also raises the question of how senior officers are selected for promotion. I will refrain from saying any more because anything I do say will be nothing more than speculation and I don't particularly want to add to the conspiracy theories floating about on the net.

It has made me wonder how I would have reacted in similar circumstances. On duty, I have spent more hours than I would really care to count both at football matches and at large-scale public events. Some of this time has been spent not just as a first aider but as various levels of duty officer. Therefore there have been times that, if it all went wrong, it would have been up to me to run things until further help arrived. Although this help would never have been far away (both senior St. John and London Ambulance officers) there would have still been a short period where my choices could have had a potentially huge impact. I have never really thought about it in these terms before. I have always been buffered by the thought that back up would be on the scene quickly and that, in the mean time, I would be surrounded by an excellent team who not only had good ability as first aiders but also a lot of operational experience they could share with me if needed. More to the point I, as well as many others undoubtedly, was aware how vanishing small the possibilities of the worst case scenario actually happening were. No doubt that's what those of the scene of Hillsborough also thought. It certainly isn't an excuse for poor conduct at the scene, nor any subsequent cover-ups but it certainly offers a measure of explanation.

Before I sound like an apologist for bad management let me clarify; I am certainly not. Those that were at the scene should have been capable of managing it or at least of taking the advice of others. Even if they haven't had experience of events such as this (and let's hope they don't for obvious reasons) then they should at least be able to keep a level head and make rational choices.

Hopefully the recent revelations about Hillsborough will provide a degree of closure and comfort for the victims, the families of the victims and those that attended the scene and have suffered as a result. Now one of the most important things we can do is look at what happened and learn from it. Use the experience to develop better systems for dealing with events like this and for training those that will have to manage them on the ground. If we do this then hopefully, if the worst should happen again, the human tragedy can be significantly reduced.

JR