Select Committee on Defence Minutes of Evidence

Examination of Witnesses (Questions 960 - 979)



  960. But you would have to make a decision because people would be ailing considerably. You would have to make a decision half an hour, one hour, two hours, three hours, before the specialist military units arrived to tell you what you were dealing with.
  (Mr Roberts) Yes, but we do have some intelligence on what the most likely things which might be used are. We have some kind of information about some of the signs and symptoms, if you like, which might be produced by one type of agent. In the beginning we are going to be dealing with things in that kind of generic way. Our experience after the white powder incidents was that it was sometime before you could get confirmation or otherwise of what you had been dealing with, and that led us to over-react on many occasions.

Mr Howarth

  961. May I pursue this question of the potential co-operation of the armed forces which you described as being a bonus, and suggest that there is no kind of formal arrangement in place. Are you undertaking any exercise with the military in particular in relation to detection, decontamination and cleansing in respect of chemical warfare?
  (Mr Roberts) We are actively working with the military at places like Winterbourne Gunner and using their experience and their equipment. Detection is not generally something that the Ambulance Service would tend to get involved in, quite frankly. I am not aware there are any formal agreements. I think you would have to address that question probably to the Department of Health. That is where I would expect those agreements to come from.

  Basically, at a local level, we tend to rely very much on the common sense of the first responding crews and that gives us real worries, and secondly, on the arrival of police or fire to give us a first line. The first question is do we go in or not and it is how do we stop the first attending crews who will naturally want to go in from not going in because we cannot drive around every day going to every incident that might be a chemical or biological one in full PPE even if we had it on every vehicle.

  962. The point is there is an arrangement which you have with the army which is more co-operative than the concept of a bonus which is that they might pitch up in extremis.
  (Mr Roberts) I think if they pitch up it will be a bonus. We have got arrangements with them for training and other things and, of course, if we request military assistance it may arrive. Personally I am not clear about any time that has happened and I know London have had a bit more experience in terms of working with the military in exercises.
  (Mr Bradley) Yes. The police have got arrangements to be able to activate the military in certain circumstances. Certainly over sustained incidents the military would be used.

  963. On police initiative not on yours?
  (Mr Bradley) Absolutely.

  964. Do you exercise with the joint NBC regiment?
  (Mr Bradley) No.

  Patrick Mercer: It is not available. It is deployed.


  965. If you can get to Kabul they will be able to help you.
  (Mr Roberts) I am not an expert on much of anything but the advice we have been given is that the military NBC is perhaps a little bit different from the type of situation that we would be trying to deal with in many significant respects. We are trying to learn from them those parts which might be relevant to us.

Syd Rapson

  966. On 11 September many brave people in the emergency services rushed to the World Trade Centre and did what you were saying, straight in to save lives. In doing so they were subsequently killed when the building collapsed which nobody foresaw. Has there been any re-evaluation of slowing down the response time? It sounds very odd but somebody has to consider that the danger they put themselves in if the building collapses is enormous, not least the loss of life, the loss of the facility to carry on afterwards. The question is whether or not a hesitation should be brought in to be careful that they do not get killed if a building collapses before they have had a chance to save lives.
  (Mr Roberts) I think there has been a lot of thinking about this. The reality is that fundamentally protecting yourself is an ingrained bit of your training. You should be making that assessment every time you answer an emergency call. It might be as simple as whether you are going to get some kind of blood borne contamination or much more dramatic. At the end of the day though when the adrenalin is running and you see those things happening, it is very, very difficult to prevent the crews following their instinct basically. Very often the first arriving officer in many incidents has to pull them back, that is probably his first job.


  967. How much was finally collected by the ambulance services throughout the country? I know the West Midlands was truly incredible. Several hundred thousand pounds was raised for their colleagues in New York.
  (Mr Roberts) I do not think we have a figure for the Ambulance Service as a whole. Most ambulance services worked with their local fire services to raise money and then sent it across to their colleagues. It was a significant figure.

  Chairman: It was truly amazing.

Patrick Mercer

  968. Gentlemen, a few technical questions on protective equipment. We have covered some already but if you do not mind I am going to go into it in a bit more detail. Asking a general question: what types of protective equipment does the Ambulance Service have, not necessarily just nuclear, biological and chemical but what types of protective equipment do you have?
  (Mr Roberts) Do you want to answer the general bit?
  (Mr Bradley) Apart from the CBRN type of equipment which is only issued to the specialist staff who attend the incidents, we just have the normal infection control equipment which you would expect to find in a hospital coupled with normal hard hats, radio, telephone and reflectorised jackets and things like that.

  969. The general protective equipment is held by everybody?
  (Mr Bradley) Yes.

  970. The specialist stuff, where is that located exactly, the nuclear, biological, chemical, CBRN stuff, where is that?
  (Mr Bradley) In London it is personally issued to those people so they carry it themselves.

  971. It is not a central store?
  (Mr Bradley) No.

  972. The equipment that you have got, the CBRN equipment you have got, presumably it is designed primarily to deal with an accidental chemical spill. How suitable is it for the wider protective role for perhaps biological attack or a more complex biological attack?
  (Mr Roberts) I think the specification for the equipment, it is not the gas tight suits, it is meant to be for working in the warm zone rather than the hot zone. As you know, when we are dealing with an incident, the seat of the incident, the highly contaminated bit would be dealt with by the fire service and that is the hot zone and there would be a cordon around that. In the warm zone, that is where we do the decontamination and that is where this equipment is intended for people to work. It is not the gas tight army or fire service type suits. We have had a working party for two years basically looking at what kind of level of protection you should offer, what will protect against what and for how long and what filters to use. Some of that discussion is still ongoing. The equipment which has been issued currently affords general protection against most of what could be commonly used, so contaminants, but not biological.

  973. Yes.
  (Mr Roberts) As I say, the biological issues, in a way that is a health surveillance a week down the line issue rather than for ambulance services answering 999 calls except, of course, for the white powder: "what are we dealing with here". The national working party on that is still sitting because the police and fire have not decided what equipment they are going to wear in the warm zone either or what specification they will use. We do have this Department of Health national committee still sitting and it has decided now that another set of personal protective equipment will be available from this March, so that is just about coming through, which offers greater protection against a wider range of things and for longer periods. The doctrine I think we are adopting currently is that nothing offers complete protection against everything for always.

  974. How much interface has there been with the Ministry of Defence for the national specification?
  (Mr Roberts) I could not really answer with any degree of certainty because the working party is a Department of Health one and it is one of the working parties where we feel we need more representation on because it is our people who have to wear these suits so confidence in them is a big issue for us.

  975. From a relative layman's point of view, it strikes me that the armed forces have gas proof suits. Interestingly, you mentioned earlier on that you reckoned there is only 30 minutes durability of working in the equipment that you have currently. The standard Ministry of Defence suit has got much greater durability, they will be in that suit for a much greater period of time although there will be a degree of degradation. It would seem sensible, I would have thought, to purchase and perhaps adapt or just a straight purchase from MoD stocks. Has that been looked at?
  (Mr Roberts) I think it has been considered. As I say, I am not an expert in the matters. My understanding is that the military protective equipment is basically designed to protect the soldier so he can continue to fight so it is a bit about weathering the storm whereas I think there is a balance somewhere between equipment that you can work in, from a health care point of view you cannot do much in a gas tight suit. You cannot even talk to the patient.

  976. That is true.
  (Mr Roberts) There are differing operational needs, if you like. I am fairly certain—you could certainly check it out with the Department of Health who run this Committee—that the military experience has been captured by this organisation called the National Focus who look at chemical incidents.

  977. Moving on, if I may, it has been said there has been a lack of involvement in this process by those who are going to be most at risk, ie the front line staff, in these discussions in the choice of equipment and consequently there is a lack of operational confidence amongst the staff. You have talked already about confidence and the lack thereof. Could the staff have been more involved in this process? Does it help to improve confidence?
  (Mr Roberts) Very personally I think it would, yes. I think the Ambulance Service involvement, that is one of the issues we have had about not being involved. If we are expected to put people in there, they have to be pretty confident about the decisions which have been made and simple things, the military in particular and the police as well, they expect people to wear suits and work in them, they have usually gone through a process probably at Winterbourne or somewhere where you can wear the suit and test it and be confident in it, and those facilities are things which we are only now starting to access. We put this kit out there and we have said to people "This is how you put it on. This is what you do with it" but at the end of the day they have never been in a situation where they know it works.

  978. Is the lack of confidence in the process of making decisions or in the equipment itself when it turns up on the ground?
  (Mr Roberts) It is probably in the fact the decisions have been made without involvement and therefore we do not really understand basically. You cannot involve all the 17,000 ambulance people around the country in the decision, but as the managing authorities we have to find a way of making them confident in the use of the thing in case they have to do it for real.

  979. Presumably an increase in confidence will come with an increase in familiarity, which means a higher degree of training?
  (Mr Roberts) Yes.

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