Hillsborough: Medic warned not to criticise 999 staff over disaster

The 1989 Hillsborough Disaster
The 1989 Hillsborough Disaster
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A doctor who made sure injured football fans were loaded onto ambulances at the 1989 Hillsborough disaster was later warned by a senior medical official not to publicly criticise the response of emergency services, an inquest jury has been told.

Professor John Ashton today described setting up a triage system on the concourse at Sheffield Wednesday’s home ground as “there was nobody really organising the casualties in a systematic way”.

He made sure casualties injured in the crush were prioritised so those who most needed it were taken to hospital, as at the time police were putting fans with relatively minor injuries onto ambulances.

The Liverpool fan, now the President of the Faculty of Public Health but at the time a senior public health lecturer at Liverpool University, said he went to help after hearing a tannoy appeal at 3.25pm as a “meltdown situation” was developing at the ground.

He told the court that though 999 workers were doing their best, ambulances were slow to arrive and estimated that a steady stream of ambulances only began to arrive at Hillsborough at 3.45pm.

Describing the response of the emergency services today at the inquest, he said: “It was initially chaotic and people didn’t know their role in an emergency.

“From 3.45pm things began to come together but there was a significant delay in that happening.”

Prof Ashton said he gave an interview to a local radio station on the evening of April 15, the day of the tragedy.

He said that on the morning of the Monday after he got a telephone call at his work from someone from the Trent regional health authority.

He told the jury: “I received a phone call from Dr Alderslade, who was the regional medical officer for Trent.

“He told me I should refrain from publicly criticising the emergency services. He told me that there had already been a meeting of the emergency services and they said the ambulances had arrived promptly and that the emergency response had been good and adequate. That is what he told me.

“I was a bit taken aback and I didn’t respond to that. I had my own views on what had happened. I am a doctor, I was there. I saw what happened. I have told the truth about this. I am confident that what I have said is what happened.”

When later questioned, he did not dispute the claim of South Yorkshire’s ambulance service that seven ambulances arrived between 3.30pm and 3.50pm and that three other ambulance arrived before that time.

But he said: “I did not see ambulances arrive in number until 3.45pm or so and that is what I saw.”

He told the jury that despite the phone call, he gave a witness statement two days afterwards describing the response as “woefully inadequate”. He said today: “I knew what I had seen and I knew the emergency response had been poor. I was referring to the way the whole system didn’t work.”

Professor Ashton said he delayed going into the ground before the game because he was worried about the crush outside the turnstiles. He said he warned officers in a police Land Rover of his concerns but received no response.

When he made it into the stand to meet up with his family, he said he witnessed “lifeless bodies being brought out and laid out in the six-yard box” on the pitch.

After going down to the concourse, Professor Ashton, who went to the game with his sons and nephew, said he witnessed “chaos” and “lots of casualties”.

He told the jury: “There was a certain number of police officers, there was no evidence of health service personnel. I asked police officers where to report, they didn’t know.”

He added: “There was nobody really organising the casualties in a systematic way and the police were escorting people with apparently quite minor injuries to the outside area, where subsequently the ambulances were to arrive. But at the time there were no ambulances there.

“The police seemed to be just taking people with all kinds of different things out to be taken away by ambulances.”

Describing the scenes at the ground before going to help casualties, Prof Ashton said: “What had been going on was a progressive escalation of fear and anxiety and later anger as people realised this was a melt-down situation.

“It was minute by minute changing from anxiety to concern, when it began to dawn on people the enormity of what they were looking at in front of them.”

The news comes after a medic described being the only person trained to resuscitate patients at an under-staffed Sheffield A&E as the first casualties of the 1989 Hillsborough disaster were brought in by ambulance.

Dr Edward Walker told the new inquests into the death of 96 Liverpool football fans that he and his colleagues were left without enough staff or equipment to cope at Northern General Hospital.

In the first minutes after young fans began arriving with crush injuries, he said he had to abandon attempts to resuscitate one patient because there weren’t enough staff and on another occasion had to get a police officer to help him.

The court heard that because the hospital’s ‘major accident plan’ was not put in place soon enough, an extra on-call anaesthetist to help him intubate patients did not arrive in the early stages.

Dr Walker, a senior house officer at Rotherham General Hospital trained in anaesthetics at the time of tragedy, drove to Northern General Hospital while off duty after seeing the scenes from the ground on television.

The court heard he arrived at 3.20pm on April 15 and began helping to treat incoming patients by intubating them, meaning their airways were kept open. Extra staff did not arrive until 3.40pm or 3.45pm, the court heard.

The court was told that for 15 minutes after he arrived the senior consultant in charge was not there, leaving only him, an emergency room charge nurse, a junior A&E doctor and a paediatrician. Dr Walker was the only person present with anaesthetics training.

Jonathan Hough QC, counsel to the inquests, asked him if at any time he “detected any sign of the hospital’s major accident procedure having been activated”, and Dr Walker said he didn’t.

The court heard that the delays in implementing the plan meant that in the early period of receiving patients he was the only person in A&E able to intubate patients, placing a tube into the trachea to keep the airway open and help administer drugs. The jury was told that intubation was the “mainstay of resuscitation”.

Dr Walker later agreed that he had no idea what patients would be coming through the door or how to allocate the “scarce resources” at his disposal as there was an “information vacuum”.

The jury was told of the patients Dr Walker saw while in the resuscitation area and later the A&E theatre. He later said he also treated patients in the plaster room of the A&E with no access to drugs or equipment.

The court was shown an earlier report Dr Walker had written about the events of the day at the hospital, which revealed he had to leave a patient in the care of a non-medical member of staff after intubating them.

Jo Delahunty QC, representing ten Hillsborough families, said to Dr Walker: “This is the first consequence of the hospital being placed in a position of not having enough notice to get the staff in the right place to get that patients.”

His report also said that a police officer helped with ventilation and cardiac massage.

Ms Delahunty said: “That is a direct consequence of you being placed in a position where you are literally grabbing whatever staff resources in order to give the best level of care.” Dr Walker replied: “Yes.”

Dr Walker said at one stage he had to abandon resuscitation attempts on a young patient because of a lack of staff.

He told the jury that on young patients, medics would carry on attempts at cardiac resuscitation for a long time, and that he couldn’t recall having to abandon resuscitation at that sort of stage on a young patient.

Ms Delahunty asked him: “Had there been sufficient staff around you, you wouldn’t have had to leave that patient?” He replied: “Yes.”

The jury heard that due to the large numbers of patients in cardiac arrest there were no cardiac monitors available and that he was having to try to resuscitate them “blind”.

Ms Delahunty said to him: “You have the will and the skills but you don’t have the ability to distribute the skills to those that are arriving. You are having to make decisions in a less than optimal state in order to make sure you deliver the greatest care to the largest number of people.” He replied: “Yes.”

Describing his decision to go to the hospital, he said: “I came home from walking the dog and for some reason I am still not clear about I decided to turn on the TV. I saw BBC Grandstand coverage shortly after 3pm.

“I saw pictures of very, very packed football pens. The particular image that stuck in my mind was a fan in the level above reaching down to pick someone up from the overcrowded pen. That made me think something was going seriously wrong.

“I thought that this looked like a situation that would result in casualties. I decided that I might be of some use and decided I might be of more use at the hospital than I would be at the football ground.”

He said he arrived at the Northern General at around 3.20pm and went straight to the resuscitation area, where he got “vague” information about what had happened.

He said: “It was so vague. Hillsborough was also a shopping centre at the time and somebody suggested there might have been an explosion at the shopping centre. That is how vague it was.”

The inquests into the deaths of the 96 Liverpool fans are not expected to finish until next year.

The court heard that many of the patients Dr Walker saw in the first few minutes needed resuscitation and that some had suffered brain injuries caused by a lack of oxygen, after being injured in the crush at the football stadium.

But because the hospital did not initially know the details of the injuries and most major incidents involved surgery and broken bones rather than the need for resuscitation, staff were not geared up to deal with it.

Dr Walker said: “These people needed very simple interventions but they needed it immediately.

“An unusual feature was the age of the patients. They were mostly relatively young and had the chance of making good recoveries from this, were they given prompt, effective treatment.”

Dr Walker said he wrote a statement about what had happened for West Midlands Police on July 20,1989.

He said by then he hadn’t been contacted by anyone from the police but somehow got hold of a West Midlands Police form and wrote his statement from a back office at Rotherham General Hospital.

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