AMBULANCE crews' attempts to save lives and tackle real emergencies are being hampered by too many "stupid and unnecessary" calls from the public, and by poor management, a Gwent paramedic claims.
Painting a stark picture of life on the frontline of emergency healthcare, he also warns that unless crews are enabled to spend more time on the road, by speeding up handovers at hospitals, and unless bureaucracy is reduced, the service will continue to struggle to meet the expectations of patients, paymasters and politicians.
The paramedic, who does not wish to be named, likened "demoralised" crews to "piggies in the middle" whose difficult, lifesaving work is often overlooked amid an "obsession" with response time targets.
And he believes a concerted campaign to educate people about when it is appropriate to call for an ambulance, is long overdue.
"I've had calls to people who have turned out to have toothache, or earache, and colleagues will tell you the same. Some of the calls we get are frankly stupid, unnecessary cases that do not warrant us going out," he said.
"The public's idea, or understanding, of what an emergency is - what is and what is not serious - is low. There needs to be more advertising on radio, TV, in print, to educate the public on medical risks.
""But there are instances when people could help themselves. For instance, if an elderly lady has broken her wrist. If she is mobile, has relatives on the scene, and there is transport, they could take her to hospital.
"The main focus seems to be on response times and it is important, but I could get to a job in four minutes and lose someone, or get to a patient in 12 minutes and that patient make a fantastic recovery.
"Our job is to get there as quickly as we possibly can."
Inappropriate demands on frontline ambulances contribute, he said, to difficulties at the hospital doors, where thousands of hours are lost every year because the handover of patients is too slow.
"In a 12-hour shift, it's not uncommon to lose three hours waiting to hand over patients," said the paramedic.
"They say a happy workforce is an efficient workforce, but morale is rock bottom."
"When I first started I couldn't wait to get into work. All that has gone and a lot of us feel that way.
"We look forward to helping people, but we don't look forward to the prospect of a metaphorical beating up in terms of workload.
Holding wards staffed by nurses and doctors would be an ideal way help speed up handover times at A&E departments, said the paramedic.
"Ambulances could come in, crews give the patient and the information over, and leave," he said.
"There are at best 14 emergency ambulances in the whole of Gwent which is a scarily small number, and it can vary day-to-day.
"If half of them are backed up at the hospital, it's no wonder other patients are waiting far too long.
"Rapid Response Vehicles are brilliant if you have the same number of ambulances to back them up."
Handover times - defined as the period when a patient taken in by ambualnce is handed over the the hospital - are proving a particularly stubborn problem to solve. The Assembly target is a maximum 15 minutes.
Last December, when the worst ever response times were recorded in parts of Gwent, more than 1,000 crew hours were lost at the Royal Gwent alone.
Many frontline ambulance crew perceive Welsh ambulance top brass to be "at loggerheads' with the Assembly over the running of the service, said the paramedic, and believe there are too many managers.
"There are too many managers who cannot manage and a lot of officers who have had no managerial experience. We need more team captains rather than coaches."
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