Understand this: I, or a colleague, will put a tube down your throat to breathe for you. I will make decisions that mean the difference between life and death for you. This will happen in your bedroom, in the street, your workplace, at hospital or in the back of an ambulance. It happens every time my dispatcher passes me another 999 call.

I was paid £18,500 a year when I started making these decisions. Several years on, I still earn less than £20,000.

The media focuses on hospital waiting times and the plight of nurses and junior doctors. Yet so often, the first contact a patient has with the NHS – and sometimes the last – is with ambulance crews.

These crews are exhausted. We work 10 hours a day, often without a break. I’m told there are committees looking into this, that further recruitment has been made, but nothing has changed. We are not infallible. We get tired and mistakes can happen; mistakes have happened.

Were you aware that the government doesn’t class the ambulance service as an emergency service, but only as essential? The difference may not be immediately obvious but it means my colleagues and I will not retire at 55 or 60 like our peers in the police or fire service. We will retire at state pension age, and this could mean older and older paramedics trying to carry you out to an ambulance. It also means that while a firefighter or police officer has the training pay of a junior doctor, your friendly neighbourhood ambulance crew is paid significantly less.

We are exhausted because of cuts. I’ve been sent on a non-emergency job at 3am for a patient who had been waiting 12 hours for an ambulance, simply because there are not enough ambulances on the road. I have colleagues who work alone, waiting for over an hour with patients who need critical hospital care, unable to get them to hospital because there are not enough ambulances on the road. I have been with a patient who was in cardiac arrest and waited over 10 minutes for back up.

We are not the people to fight for more money for ourselves but more money for better patient equipment and more staff

Next year, the Scottish ambulance service budget will be significantly lower than that of the fire and rescue service – about £232m compared with £285m [pdfs]. The ambulance service attended 600,000 emergency calls last year, while the fire service attended 90,000 incidents. We also transport 1.3 million patients a year to routine appointments – within the same budget. This isn’t an argument against the excellent and vital work of the fire service, but I want to point out the limited funding for my service, the one that will restart your heart and put a tube in your throat.

In recent years we have been given briefings and training regarding lone wolf terrorist attacks or marauding gunmen. I worry more about this than you can imagine. I worry because, depending on how the first 999 call is made, it will be an ambulance crew that gets there first and we don’t have the safety equipment for this. Our control staff have 60 seconds to dispatch an ambulance after a call and often we are at scene before we are told the scenario.

The police at least have body armour and means to defend themselves, and fire and rescue have sheer numbers. We work as a pair at best, and have just a fleece. We do have specialist teams with ballistic body armour and helmets, but they will not be first on the scene. We accept that each and every job may be our last, and I’m told daily by my wife to “keep safe” as I head to work. I accept this, even for a meagre salary.

Most of my colleagues have been assaulted. I have. A lot. I’ve come home with bruised ribs, fingers that have had to be returned to their sockets, limping and sore. Some of my colleagues have been bitten and spat on. Some have been held with a knife to their throat, or had shotguns meeting them as they step through a door. They’ve had to attend counselling. This isn’t just where I work: every ambulance crew in the UK faces these challenges. The police are absolutely incredible in getting to us quickly, but a lot can happen in the four or five minutes it takes. But I still come into work, now for just £19,500 a year.

I think that’s the issue. To be in this job, to do this work, we look beyond ourselves. We are the people who willingly help the 90-year-old lady off the floor who has laid so long she has become incontinent; we clean and change her before taking her to hospital.

We care more about the job than the money, but we have been taken advantage of. We are not the people to fight for more money for ourselves but more money for better patient equipment and more staff to see patients quicker. This is not just us, it’s the whole NHS. I’ve known nurses to come in sick and broken, with problems in their personal lives that would floor most people, to ensure safe staffing levels.

So to Jeremy Hunt and his colleagues, to health secretaries past, present and future, to the prime minister, I implore you to find the money to squeeze in the budget to give us extra ambulances and a decent wage. Invest in me and my colleagues. It might just save you one day.

This series aims to give a voice to the staff behind the public services that are hit by mounting cuts and rising demand, and so often denigrated by the press, politicians and public. If you would like to write an article for the series, contact tamsin.rutter@theguardian.com



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