The Helicopter Is Paid For by a Charity Shop — Epoche B1
The air ambulance that lands beside a motorway crash in England is owned and paid for by a charity, not by the National Health Service. The paramedics and doctors on board are usually NHS staff, and their drugs come from the NHS; the aircraft, the fuel, the pilots and the engineering are funded by shop donations, weekly lotteries and cake sales. Most people assume the opposite, and the assumption is worth correcting. The split has a simple cause. The NHS was built around road ambulances. When doctors first began flying to patients in England in the late 1980s, local charities bought the helicopters, because no national budget existed for them. What began as a local solution hardened into the normal arrangement, and it stayed that way even as the service became central to serious trauma care. Scotland took the other road, and funds its air ambulance through the state ambulance service, which shows the split was a choice rather than a law of nature. The effects follow. Each charity must raise millions of pounds a year, because a single mission costs a few thousand once the aircraft, crew and maintenance are counted. Crews now carry red blood cells and plasma on board, since a patient bleeding at the roadside cannot wait for a hospital, and that costs money too. So should this rest on fundraising? Supporters say charity brings freedom: a night-flying aircraft can be bought when donors agree, without waiting years for a committee. Critics say no emergency service should depend on whether a shop sells enough second-hand coats in February. Both arguments are honest. The one thing no donor should think is that they are giving to something optional. References Lyon, R. M., de Sausmarez, E., McWhirter, E., et al. (2017). Pre-hospital transfusion of packed red blood cells in 147 patients from a UK helicopter emergency medical service. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 25(1), 12. House of Commons Library (2019). Air ambulance services in England. UK Parliament, London. Charity Commission for England and Wales (n.d.). Register of Charities. Charity Commission, London.