Letters - Ambulance services

Published: 21/03/2002, Volume II2, No. 5797 Page 21

Ray Shannon's apparent Damascus experience is not the first in the history of the ambulance service ('Get your kit off ', 28 February). Serving career ambulance managers will have survived three major NHS reorganisations, and led the way in change management and performance.

They will also recall the 1970s, when they were denied access to NHS managers' development training programmes. As predicted, this limited future career prospects and resulted in the one-way transfer from other disciplines we see today.

'Those whom the gods would destroy' clearly do not understand the process which led to the deep-seated culture still evident in some ambulance services. The 1948 service recruited from St John and Red Cross volunteers and from local authority manual workers. The resulting dichotomy - the former largely seeking professional representation, the latter retaining their manual worker trade union membership - partly explains both the hard-won battle for paramedic status and past resistance to change.

Dress uniform, appropriately worn, acknowledges the service's unique public nature, its frontline operational alliance and equality of status with the other emergency services. To suggest that uniform creates 'a less caring image' is to cast doubts on the integrity of organisations such as St John, Red Cross and St Andrews.

In the year of the Queen's golden jubilee one also questions the motivation for the ultimate insult - that of removing the crown badge.

John Wilby Former chief executive Scottish and London Ambulance Services Lanarkshire