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Commentary

Reflections from my Armchair

Having spent most of my professional life dealing with preparation and contingency planning for dramatic events and disasters as well as Royal and State occasions I have followed the events since Her Majesty’s death with considerable interest and more than a little sadness, that having retired, I would no longer be involved but could sit back and watch along with millions of others.


I am old enough to clearly remember the death of King George V1. He died just a few days before my birthday. As part of the national mourning my planned birthday party had to be cancelled. I did not understand this at the time and was really angry for a while. My father who was serving in the Royal Navy at the hospital in Chatham Kent was very distressed at the loss of the Boss.


In 1953 came the Coronation of her Majesty Queen Elizabeth, A grey and rather wet day. I travelled from Chatham to London to watch it on my grandparents 12” black and white television. They were some of only a few who had a television. My mother put me on the train under the care of the guard in the guards-van. I remember sitting on his seat and watching the progress of the train through a periscope device. At Victoria Station my grandmother collected me from the guard and took me home. I cannot imagine a child travelling alone like that today.


During the service I was packed into the living room with about 30 neighbours and friends watching the very dramatic service. It left a marked impression on me. I did quite well financially as many of the neighbours gave me a penny or even a threepenny bit!


Fast forward to 1965, by now I was a medical student in London, Sir Winston Churchill died, and I went with a group of fellow students to walk past the catafalque in Westminster Hall. I think I was in the queue for about 6 hours. For the funeral, we were in place the night before, and had a good view from the pavement near to the steps of St Paul's Cathedral.


After qualifying I became part of an immediate care scheme providing medical support and advice at major incidents. For over 30 years I attended road traffic collisions, train crashes, air crashes, IRA terrorist attacks, fires, explosions and civil disorders. After many of these events Her Majesty attended to pay her respects and thank the emergency services for their efforts.


Wearing the uniform of St John Ambulance, as an Area Surgeon, I was part of the team providing medical services at several Buckingham Palace Garden parties and a reception inside the Palace.


May 1995 brought the 50th anniversary of VE day. Widespread celebrations were planned in Hyde Park over 3 days. It was anticipated that up to two million people would be there each day. As Secretary and coordinator of BASICS London it fell to me to bring a medical plan together that would work in conjunction with the London Ambulance Service. There was considerable concern about extraction of casualties from the park to get them to hospital. The plan provided a central Field hospital with an adjacent helicopter landing pad. This was the hub, surrounding it were about 10 first aid posts, all around Hyde Park staffed by St John and British Red Cross and supported by LAS paramedics and a doctor and nurse. Each unit was manned for 2 shifts; 8am to 4pm and 3pm till close at about 1am. About 50 Heads of State and all the British Royal Family were there. Several of us slept in the Field Hospital at night to keep secure all the equipment. It was by far the best staffed Accident and Emergency department in London that weekend. Consultants in A and E, Consultant anaesthetists and a consultant cardiologist all available on the ground. We recruited all available BASICS doctors from London and the Home counties as well as St John Ambulance surgeons and A and E staff from many hospitals. Planning assumptions suggest that for people treated at first aid posts only ten percent would need onward referral to a field hospital and of those only 10 percent would need transfer to a main hospital. The system worked well with. 386 casualties were sent from the first Aid posts to the Field Hospital, but did not need further treatment in a hospital away from the Park. A total of 33 patients were referred to main hospitals including 2 with broken necks who had foolishly dived into the Serpentine.


For me, this event was of special significance. I knew my parents had both been there in the Mall in 1945. My father was on 48 hours leave from the navy. It has been an open secret in my family that I was almost certainly conceived that night, as my parents were apart again immediately afterwards. The then Princess Elizabeth and her sister Princess Margaret were allowed to go out of the Palace incognito as teenagers to experience the crowds.


The sudden and unexpected death of Princess Diana in 1997 threw London into turmoil. I was informed by the London Ambulance Service about 6 30am in the morning. The next week we worked up to 18 or more hours in the days hastily putting plans together to provide medical cover for the vast crowds that amassed outside the palace and in the park. On the day of the funeral, I remained at the LAS headquarters as Gold Doctor coordinating the use of the medical resources which came from BASICS London and surrounding schemes in the way we had used for both VE and VJ days


With virtually all of London watching the service the number of 999 calls into the control dropped to just a trickle during the actual service.


The death of the Queen Mother brought the many medical agencies together again coordinated by the London Ambulance Service for the funeral on 9th April 2002. On this occasion I assumed the role of Silver Doctor with responsibility for the footprint area of the event. I think this was the first time the LAS deployed decontamination teams on standby for a Royal event.


The template for state events has been similar for many years. It has frequently been refined and updated. It was an active document, often reviewed, parts rewritten, and new technology introduced. There were regular exercises. I wondered about how comms. were managed before the advent of radio and telephone and when I researched back to see, the answer was flag messages sent line of sight from one point to another to summon Ambulances.


On September 8th came the message that The Queen was ill and that members of the family were rushing to Windsor. It was immediately apparent that this was for real and not an exercise. Her death was announced in the planned way some two hours later. I took to my armchair to watch and listen for the next 10 days. I spoke to my son, who was a senior manager at LAS and warned him just how busy the service would be in the next 10 days. I realised that only a handful of staff would remember being on duty for an event like this. I was very confident that they would make an excellent job of it with their partner agencies. There were detailed procedures and protocols in place.


The media literally ran out of superlatives to describe the service our Queen had given in the last 70 years, the many people interviewed had the same problem Amazing, remarkable, extraordinary just were not adequate to express their feelings of deep affection and gratitude the world had for Elizabeth II. She was just THE queen to millions throughout the world.


Great Britain has a reputation for doing pageantry well and this time it just exceeded all perfection. The military bands, the sailor pulling the gun carriage, the guards carrying the coffin were more than perfect in their precision timings. We were not allowed to forget that through all of this was her own family deeply moved by the loss of a mother, grandmother and great grandmother. Grief was seen but not over played. The media kept us in touch with the family aspects and allowed sufficient privacy when needed. I was struck by how emotional I felt at times, more than I expected, but it reflected the high esteem in which our beloved Queen had been held.


When providing medical cover for events like this the requirement is to be as low key as possible, to be readily available whilst being inconspicuous, then if required to provide the highest standard of care. In today’s world there is always the possibility of terrorism, but a loan madman is just as big a threat. It was all there ready yet out of sight. Thankfully there were no significant incidents.


The Elizabethan era is now over. The new Carolean era begins. King Charles 111 has a very hard act to follow I am sure he will ensure our monarchy thrives, we own him a duty of support. God save the King.


Dr Ken Hines MBBS, FICPEM,MRCGP

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