Heritage and history

Welcome along here this afternoon. This very important symposium is put together to celebrate the 125 years as we know, so I'm going to run through some of the things. There's so many things, there's so many people, and this afternoon we'll cover various facets of that evolution of our service.

We can be very, very proud. This service is not unique in the world, but it's up there with the best of them, and there's a lot of reasons for that.

So I'd like to acknowledge David here beside me who's going to run the A. V. for us this A. V. and he's graciously given his afternoon to do that. Thanks, Dave. I'll just talk about the first slide before we start.

Now, that is a 50 year point and I'll come back to it. And I apologize to those who've heard this presentation before, but the majority of the room have not. And I thought it was important to you to know that don't ever let a graduate come into your ambulance station and say they didn't know anything about our history.

What I'm going to present to you this afternoon is what we presented at White Island to the graduates. And the messages, I will repeat to you so you know that they've had the particular messages about our culture and our history. Very, very important messages. So we'll just go through that quickly. The MacKay at the starting point we'll come back to.

The logos up this left hand side of that screen are the evolution that we'll talk about later in the day, about the evolution of how those logos come about. And I'll point out some things in the photo as well.

So, if we ignore history, we are highly likely to make the same mistakes. The best industry in learning from history is probably the aircraft industry. We would hope medicine is good at it, and in the majority of cases it is.

We are a bit like the aircraft industry. We can't afford to make the same mistake twice, because it's usually someone we know very well, or a patient, or someone who's entitled to be treated well. The worst thing we can do to our patients is not be current.

And sadly, in places, that was part of the story. We had people who did the same things for many years and never questioned them. But gee, we picked up our game, and we picked it up big time, in recent years. So, for anyone that says to you, Oh, don't worry about that’s old stuff. That's an ignorant statement in the sense that you can learn from this old stuff.

And it's worthwhile knowing that some people did things a particular way and why they did it. And this afternoon will be a little bit about that, but it will also be a lot about some good messages as well.

Warrian's regarded as our founder, and rightly so. He had a few colleagues with him especially a fellow named Tonkins, and he was the shortest of the stayers of the early founders, and there was a few reasons for that.

But the acknowledgement is well deserved, and he was at the Ekka, as we know, and fellow at Ekka had horse racing in those early days, 1892, as one of their future events. And a fellow named Elton fell off the horse, as we know, fractured his leg. Good Samaritans put him in a Mollie brown four wheeled horse drawn cab, took him to the Royal Brisbane, what, 200 yards?

In the old measure, maybe three. And made his simple fracture compound. And that horrified Warrian and the Medical Super Royal Brisbane Hospital of the day. And Warrian decided that we should have a civil ambulance. They'd been talking about it, him and Tomkins and a fellow named Eustace Jack have been talking about that for some time.

But this really, this incident really drove them to do something about it. They had a meeting at Warrian's house at Annerley on the 12th of September, 1892, and formed the City Ambulance Transport Brigade. They had designed the logo behind them that we'll talk about later.

The first case was done from Taringa to the Royal Brisbane.

How far is that? 8K? 6K? Bitumen Road? Nice gutters? Paving? No snakes? No mud? Plenty of bridges? How many creek crossings between Taringa and the Royal Brisbane? We don't know because we drive over and we don't even notice them, do we? What would that trip be like? Surge uniforms? October? Would it be warm?

Would you do it? What was the weight of the patient? 80 kilos? 100 kilos? Is that important? It's bloody important if you're sitting at a Surge Tunic carrying the patient, trying to be careful, trying to get them there without too much jolting. Where was your water supply? You have a nice bottle of water, corner stores you pull up, grab a bottle?

I doubt it. One of the ways they used to overcome that later was to catch a train out to one of the suburbs. And walk to the patient and then walk back to the train and catch it back to the Brunswick Street and then walk to the Royal Brisbane, which is about a mile in the old measure. The lady's carrying the umbrella to keep the sun off the patient.

The artist name's ideal for ambulance sort of topics.

Warrian is the guy with the pipe in the photo here. He's got some colleagues around him. Some well known Brisbane names on that slide for you. And these photos are wonderful. Keep in mind, this is 1892, I think, that photo. And look at the detail we have.

Thank you to Sonia Harvey and her team who've enhanced some of these photos over time for us. And we're digitizing our whole photographic suite and there's about 30 odd thousand we'll be able to, at some point, looking forward to having you be able to access those for your own presentations in the future.

The big myth of the ambulance service is that women came along in the 70s. You can deny that very forcefully. And the women in the audience will help you deny it, I'm sure. This is a photo of Mary Gourlay, who was the second woman. The first woman was appointed in 1895 as a bearer collector.

Now, being a bearer collector, she would have to do both roles. She would be out collecting money, but would have to fill in shifts, would have to probably go to the races and look after people there, because she was a uniformed person. And the collecting duties would be, of course, getting money for the service, but we will find out who that first woman is, because every International Women's Day one of Michael's teams asked me who the first woman was, and we don't know a name yet, because the records used to say one bearer and two collectors, or something like that.

Superintendent, two bearers, and a collector. But, yeah, that's, that's evidence that women were around from day one, and great evidence.

This is a little quick history. And some of those things are important. The incorporated incorporation of the committee that ran the ambulance is important because it took the liability off the individuals.

And this is a very high liability type of service that we do. Dealing with people is about potential mistakes and people wanting to get some compensation for those mistakes. The committee of the day, were volunteers, people giving their own time, and the government saw the value in making them a body corporate or incorporated association just to protect them from the liability.

The government subsidy, you can see there, started early. It's varied over the years from one pound for a pound, dollar for dollar. The recession, I think it got down to fifty cents in the dollar. But it's very important that there's always been, the government's seen the value of helping fund the ambulance services.

It took a while to get the ambulance service away from Brisbane. Gold mining was one of the reasons Charters Towers had plenty of money. The Brisbane people said, we're not going to let you start an ambulance service unless you've got some money to pay wages and get equipment. And they still relied heavily on the community.

So community ownership of the ambulance in Queensland is a message we give to your new graduates. They go into a country town, they need to respect patients, respect the community. And above all, they need to recognize a community really think they own the community and rightly, ah the ambulance service and rightly so, because initially it was a community that provided the funds and probably donated the timber and the labour to build these ambulance stations and provide vehicles.

A very important message. Some other thing there Queensland transitioned from a colony to a state, so the City Ambulance Transport Brigade became the Queensland Ambulance Transport Brigade. And that brought with it the growth around the state. Ipswich is a very early station, Charters Towers, Rocky, Toowoomba, and those sort of places.

And they were places where there was a bit of money to get the ambulance service going. Some other things there it took ages to get the world the first motor vehicle. I'll come back to that. The wars interrupted the service. Where were the men who ran the service? This other gender that's never mentioned as being part of our male dominated service in the early records.

But they were there and they were doing the job, and if you look at our promotional bus, there's a wonderful photo on the side of it, of a team of women doing the ambulance work. Subscription scheme was mooted a few times, as was the dedicated number for ambulance, but they took a while to come in.

And this service operated on that community support for a long time, up until 1991 really, in terms of money. So two way radios, triple O calls, they were all things that came in in the early days, and after, from 1892 to 1970, the first formal recognised training. There was a lot of individual training before that, but it was not universal in quality or in substance.

Toowoomba always had a lot of money. Look at the equipment here from 1902. We've got a centre that looks like a stable. Multi skilling before multi skilling was ever heard of. They'd look after the horse, tend to the garden, treat patients, and maybe do a bit of training, and certainly they would look after their equipment, the wagons and the litters and things like that.

They get a bit of equipment there. The ponies were mostly white. There were plenty of black and brindle ones around to buy, and but white was like a medical color, so dapple gray and white are very common in the photos. There's rarely the black one, but they're there, or the brown one. The horse cart there, the sulky is called a jingle, we believe, because of the backward facing seat.

It was a rapid response vehicle. It was not about transporting patients. This was to get the officers out to the case quickly so they weren't exhausted when they got there from wheeling the litter out. So they'd tow the litter out, drop the two officers off, and the third officer would go and take another litter somewhere else.

And you can see Toowoomba's got a lot of equipment there. A lot of stations only had the one litter and the one sulky.

First motor vehicle is of interest. It's an absolutely WHS nightmare to get in and out of. You can see that, can't you? Do yourself a mischief. That wheel was on both sides.

They had two spares, a solid rubber. It was a French Clement Talbot. And the reason for that, if you think about the time, who were buying all the motor vehicles? It was very, very difficult to get a motor vehicle onto a boat to Australia because the demand was in the UK, France, and Europe and obviously America, US.

So getting a motor vehicle into Australia on a boat was something very challenging. There was a person on the Brisbane Ambulance Committee who had a motor vehicle and thought they should have one again as a rapid response vehicle. So that's why there's three people on it. Two to wheel the litter back, one to take them out there and go and come back and take another litter somewhere else.

The person who took the wheels off the litter and put the stretcher on the deck for the first time got disciplined. New ideas come hard. The other thing about the car, the reason it was a French Clement Talbot, and there were English ones, English Talbots, is that the company who bought this vehicle into Australia was a Canadian bicycle company, had an agency here in Brisbane and had lots of dealings with the, with France and companies in France and in Canada.

Oh, that's Gordonvale and that place was probably, and this is one of the messages for our graduates, that place was probably built by the finest Queensland timber that was probably donated. It would have been volunteer labour that probably built it in the most cases, as a lot of them were, and donated money from the community.

The officers’ wages would be half subsidy and half donated. The officers in Gordonvale, not a very, ool place, Gordonvale, and he's got serge tunic on all year round. You had to wear tunic and cap all year round in those days. That was a discipline coming from out of the military background. Ladies, the phone was in the kitchen, the bathroom, the bedroom and the lounge.

And I say ladies, because it was a male dominated service, the man couldn't get the job unless the woman, the wife, was prepared to be a volunteer for the ambulance. So they take over your kitchen. Cooking for fundraising or rodeos. There's a wonderful book by the women of the ambulance service. And one in particular from Phil Crawford's wife in Aramac.

She was a young woman who'd gone out there. He was a new superintendent. And her first weekend was spent baking for the coming rodeo. In her own kitchen, in the house of the ambulance. So, that's the way it was. We can't rewrite the history, but we can certainly fix those things today. The other things there is he might be away for quite a while, like three or four hours.

The roads weren't that wonderful, so he goes into the bush near Gordonville, especially towards the coast. Warren over here knows very well, and so does Michelle. And the, and suddenly she owns that job, she's got to do it, so they had to be first aid trained as well.

I won't touch this much because Tash is going to talk about this stuff, but we had some quirky things going on with our pharmacology and I'll leave that to Tash and come back to that.

Not all of them were Queensland Ambulance cars. This is a Fiat and a Hospital Ambulance in Maryborough. We've got a few wonderful photographs of the Hospital Ambulances around the state and we've just been able to get The Barcaldine Hospital Ambulance back to its original state. And Gavin Parry, working with Gavin and Doug Merchant, who used to drive that car as the wardsman, the X ray technician, and the ambulance officer for Barcaldine, actually was the driver of the hospital ambulance, who's now seen the car back again, fully restored, so he's absolutely happy about that.

That's a Maryborough one, for Sue, that's for you, for some history for you. We did that before? No, I saw that. This is the one that Natasha will deal with, so I'll gloss over this one. She'll come back to that one. Do these people look happy? They look happy? How many times have they been bogged today?

Did the patient take the photo? Where's the patient? Come on. I don't know the instances. Anyone been to Westwood? Rocky people have been to Westwood, haven't they? Half an hour's drive? Comfortable? How long would these have taken? Two hours? Four hours? Are they coming or going? Did the patient take the photo?

Where is the patient? I don't know, but these cars had on them boxes with shovels and boards and things. Now put the challenge back to you today. How many of you have been bogged? Be honest. Who's been bogged? I've been bloody bogged. Who's been bogged in an ambulance?

Okay. And our young people are going to get bogged, aren't they? So it won't change. You get onto a farm, someone guides you in the night, next minute there's been a bit of a storm and you're in a hole. And there you stay until someone comes to get you out. Do they look happy?

We get a lot of, again, a lot of info from these patients. Look at the vehicle, look at the fittings on the vehicle, the type of roads, this is the main highway, and the, what they're wearing, no shoes, and I wouldn't, I'd always advised it against taking shoes off because people throw stubbies out of cars as we know. And I've seen a few of our own people cut feet.

To get around this problem we had these rail ambulances. There's about 15 of these around the state. Up at Atherton there's one. I think at Herberton there's another. There's one out at Barkie. There was one at Blackall. The council have restored it and put a little station there and they roll it in and out.

And the public take photos of it every day of the week. It's an attraction at Blackall. And Frankie Smith out there is going to do some work and make sure it's kept in good order. So that's the Charters Towers one my recollection of these things is a couple of little lights getting eaten by mosquitos near the Dawson River and hearing the putt putt putt of the little motorcycle engine coming in the distance.

See the configuration, you see it every Friday night, do you recognise it? Tendon seat, stretcher beside it, golf buggies at the footy. Must have been a good idea, we learnt something from our history.

The other way of getting around this problem was aircraft and Qantas was the first provider of air services for ambulance.

It was such a logical thing. Would you rather spend half an hour in a canvas fuselage of an old de Havilland, or would you rather be on the road getting bogged every ten minutes? Which one? Four hours, eight hours, or ten minutes, or a half hour? What's your choice? It's a bit of a no brainer, isn't it? Just let's put something into perspective here.

When Jamie Jackaway got hurt in the Torres Strait, around 4 o'clock, he was in the spinal unit by 10. But the geographic location that he was hurt is equivalent to about 500 to 600 miles south of Tasmania. Come back to that when we talk about the emergency medical system, but it's a huge state. So this is why aircraft was such a logical solution to our distances.

You live in the distances. At Cunnamulla, or whether you're in the Cape, like Warren and those. You know the differences, distances are a big factor in what we do, and time.

This is the Brisbane Communication Centre of the 50s. Now the rumour is, or the, the myth is that Brisbane had the first two way radios.

We all thought that. Now John Stibbs has done some work. His father was the superintendent of Blackhall, and decided that these newfangled radios were a good idea to talk to the station when he, talk to the centre when he's out on the properties. Or to talk to the properties. Now he introduced the two way radios in the Queensland Ambulance.

The Yanks could talk to their subs, their aircraft, their infantry, their artillery. During the Second World War they could talk to anyone, but it took a little while to get it into the Queensland Ambulance. And when they got two way radios in, they were the old valve style. So the range was about three or four miles in the old measure.

And they weren't reliable because the jolting of the cars would blow the valve and then you'd have to go and get a new one. The valve was like a bulb, the radio valve. Nowadays they use transistors. The day we got transistors was the day that radios started to become reliable and the range change immediately extended.

Another quick list here for us the time it took to get a decent analgesic I'll leave to Natasha. It was just a long time, and it was awful, and you had to really tell people that what we had worked. And I'll leave that to Natasha, I won't steal her thunder there. One of the important things is that QASB came into being in 1986.

That was the day that things changed. The State Council was unwieldy, it was about 24 people. They narrowed that State Board down to 12 and immediately started getting effective decisions and less arguments. You put 24 people in a room to run an ambulance service all over the state, suddenly they start arguing about what the best thing is.

And sometimes you don't get a decision for quite a while. There are other things there. The coronary care program, and Tony's going to talk about that. One of the things you might not be aware of is the team we had in the state training center in 1988. Was using satellite technology to distribute both administrative updates, and Robbie's nodding, he'll know.

Administrative updates and training, and they would phone in. That was a way of communicating. The health department had satellite dishes in the grounds of the hospitals, and we were using those. From 1988, Martin Kelly was one of the people who designed the program, and I know Martin up in Bundy. He was very much involved in that as one of the state training officers.

We went from health to emergency services in 89. Now, you will hear people say, we're in health now. The correct language is, we're back in health. We were there from 1892 to 1989, and we came back in 2012, which was logical, but we came back a lot better. It used to take 10 years to get a building. We were dealing with a AO8 level person, nowadays the commissioner only answers to the DG and the minister.

That's a huge difference for us as a service, and a health service. Some other details there, the Associate Diploma was our first registered pass fail, but we had a few, a little program before that, I'll leave time to tell you about that was an unregistered pass fail, but nonetheless, you couldn't practice unless you passed it.

LACs were developed out of the QATB committees, that was a great development for LACs and it kept that community link. Which has been a strength we have that isn't universal. It's fairly unique to this state. Some states have got different things but it provides us with a good community link and a good measure of keeping us focused on communities and our patients.

Entonox, I'll leave a bit for Tash but this is Kevin Heaton for those who know him. It was a bit of a bugger. You had to have the respiratory effort to breathe it through the passive demand valve. But it was a breakthrough in pain relief.

The establishment of the training school in 1970 was not our first training. We had an early photo of Warrian and his crew working on some drills, patient care stretcher drills. But this was a breakthrough that created the model that we now have where the people have a degree before they come to ambulance. So we've gone through a, an evolution of a wonderful evolution of education linked to clinical practice.

We started to get in the, when the board come in, we started to get some specialized ambulances. This work is done now by the helicopters and the fixed wing, but this was a specialized neonatal retrieval car. The range was about 150 K, so it would go down to Coffs Harbour, out to Toowoomba, up to Nambour, places like that.Two officers and a neonatal nurse, and quite often a neonatal specialist.

Some other things in 91 that started to improve, we had the regions. One of the quirky things about the regions was Townsville had the South West, Quilpie, and those places. Neil Kirby used to say to us how far it was to go and check his region out.

It was a long way. I don't think it worked very well for Neil. The assistant commissioners were looking at that. The big thing in those days was had to rationalise the comms room into one. So the, the rationalisation of the comms was a bit of an argument, and it's now history.

We had some other developments as we went through and the higher education and the management of our history, a couple of things there that came into being. And both of those have been, I think, useful in, in part of our retaining our culture and retaining our respect from the community. Very, very, very important ones.

The emergency medical system. Two simple principles prevail, regardless of what we call it, and the principles that started it, get the best care to the patient, upgrade that care as soon as you can, and then retrieve the patient by the best means to the best place. The best performance we had in that is Jackaway.

We did really well with him. We got care to him, we backed that care up, and then we got him into Cairns very quickly and assessed him, then got him down to Brisbane, and that was one of our own, and was a great performance under our principles of best care to the patient, retrieved by the best means to the best place.

Another little list of things there, higher education, we know that pathway, who's lived that pathway from day one, from, from the early days, a few of you in the room have lived that, a few nods, yep, you're grateful for it, probably more confident about your job now than what you were back in those days.

Couple of other little things there, the clinical quality improvement program I think was one of the greater things to come into being. It was about our accountability, about our clinical accountability and registration now will enhance that a lot. It's not about us, it's about public safety. Very important development and very important in our credibility as clinicians.

I won't go through the rest of that, you'll hear some of that, this arvie. We look after our heritage. Couple of photos there, the one I'll point out to the top left, that's how Rocky used to transport patients on a walk cart.

The final message is here, the modern paramedic, the contemporary paramedic is, is essentially young, well educated, and hopefully respectful.

And I say that not guardedly, but with a bit of caution, because not everyone comes into this job respectful. We hope that they gain that and gain it quickly. Respectful of patients, respect for their equipment, respect for their communities, respect for themselves.

Delivery has changed. And the regions you know well you live in, the LASNs. And the final one, we'll come back to Mackay, I think, Dave, the last slide. We've done that, the respectful and young people, thank you. And Mackay, the road is not bitumen. The telegraph pole is telegraph, not electricity. The uniforms are Serge.

This is the 1942, the 50 year mark. The vehicle would have still been used, the 1928 odd, late 20s vehicle. And the guys had to wear their caps. Sulky would not have been used, but the station is as the station was in Mackay, still looking a bit like a stable. Thank you very much.