Simple is best

I draw attention to this story from France with a heavy heart since it also shows that it it is not only the the NHS that has problems.

In Britain, 999 is the oldest emergency telephone number in the world having been launched in 1937. In France there are also emergency numbers – but four of them: no 17 for the Police, no 18 for the Fire Service (who can also send emergency ambulances) and no 15 for the SAMU (Service d’Aide Médicale Urgente) which, in effect, is a sort of triage service for emergency medical response – or not, as we shall see.  The fourth is 112 – and where this European standard number is directed in France nobody seems entirely sure but it seems to be the police. In Britain of course, dialling 112 is the exactly the same as dialling 999.

On December 29th last year a caller (one Naomi Musenga) rang the fire service number, who, confusingly (for me at least,) also supply ambulances, especially for major emergencies, and including natural disasters or road accidents where injury is involved. The fire service operator transferred the call to the SAMU but in doing so informed the SAMU that the woman thought she was going to die. The fire service operator had already remarked to the caller that we all going to die.

During the Christmas/New Year period it is claimed that these fire service operators deal with about 2000-3000 calls per day although that must be an aggregate figure because otherwise it amounts to little more than 28 seconds for a complete call. The Mainstream media is little better than our own at really describing the problem.  I suspect this figure is in fact a call centre rate and as these call centres are in fact based around a French department (roughly our county) with about 3 or 4 call handlers it is likely to mean an average call duration of about 3 or so minutes, which seems much more probable.

The caller had, it seems mistakenly, rung the fire service number saying, amoungst other things that she felt she was going to die. The operator responded, as we have seen, that that’s what we all do and, in due course transferred the call to the SAMU. The SAMU call handler was overly influenced by the fire service description and responded poorly to the call suggesting again that we are all going to die and in due course asking the caller to telephone instead SOS Médecins, which is the equivalent of the UK out of hours doctor service. This, Naomi Musenga, in her parlous state, duly did and was in turn transferred back to another operator of the SAMU who sent out the ambulance of the fire service. Which is of course where she first started. Naomi Musenga, sadly died six and a half hours after her original call, as the mother of a child of 2, and at the age of 22. Her body has been reported as suffering some decay before the autopsy took place, though perhaps that is because the death verdict is, initially, multiple organ failure.

Even the En Marche (Macroniste) health minister, Agnès Buzyn, is shocked at the catalogue of events (and this same link is where there is the rather shocking transcript of the actual call.)

It transpires that this is not the first time this has happened. There was a similar reported instance 10 years ago where there was not even a reply when a complaint was made to the health minister. This at least suggests that Macron’s party is a considerable improvement on the old school of Sarkozy’s presidency, a decade ago. It is more responsive and not afraid of radical reform. The government suggest they are likely to create one emergency number within months. That is the conclusion, and an encouraging one, for France.

What of Britain?

Britain has an emergency healthcare response SYSTEM that is still outstanding, although often general French health care is more highly rated. But it is a great pity that the British government is doing its best to make our simple system considerably more complicated. This cannot ever, be advantageous. Just look at the result of Cameron’s health ‘reforms’, which in his manifesto, he promised not to meddle with. This was what he inherited:


and this is what he created:



(Both planograms courtesy of Alyson Pollock, Director of the Institute of Health and Society, Newcastle University)

I think there is just one conclusion – for both Britain and France.

Complexity never works as well as simplicity.

Pretty simple really. And something, it seems, that Macron can grasp but the British government cannot.