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What if? Contingency planning fairy tales

Normally when returning from continuing professional development events, I feel largely unmoved; it’s pretty unlikely that anything dramatic will change in the emergency medicine fishbowl as a result of an afternoon away.

Normally when returning from continuing professional development events, I feel largely unmoved; it’s pretty unlikely that anything dramatic will change in the emergency medicine fishbowl as a result of an afternoon away.

This time was different. In view of the impending summer of excitement, sporting achievement, bunting and cream buns designed to distract from poverty, tax rises, double-dip recessions and pensions theft, I attended a presentation on business continuity.

This is contingency planning to keep the show on the road whatever the circumstances.

It’s about testing planning assumptions by asking the ‘what if’ question. What if the emergency department caught fire, or a high pressure steam pipe in the ceiling burst? What if someone brought weaponry or explosives in and held staff hostage, or mounted an attack on a high-profile patient? What if there was a radiation incident?

What if the building was attacked by a far-right counter-triage faction?

My only previous business continuity discussion involved Chicken Licken. You may recall that the unscrupulous and cunning Foxy Loxy took advantage of the fearful chicken, who had been struck by an acorn, manipulating her anxiety and so led her with her friends Turkey Lurkey and Ducky Lucky to his lair where he ate them for dinner.

During the presentations the man with the military haircut looked quite shifty, although not entirely cunning. When he used the mobilising of troops to maintain fuel deliveries in case of a tanker drivers’ strike as an example of business continuity planning, I felt that his game was up.

Their acorn had been the possibility of widespread disruption and this resulted in the public being panicked into buying fuel it didn’t need so propping up the economy; simultaneously tanker drivers were forced to work harder and made to look uncaring.

I decided to resist his agenda and launch a diversionary counter attack. I proposed that his planning exercise be taken to our financial masters instead of us. In it they could find the much-needed incentive to resurrect the long forgotten plan to build my bigger and safer emergency department, with its cunning inbuilt resilience, rather than to continue to push the impoverished and sick through a series of unsafe buildings.

If they can find £24bn to build a cycle track, a swimming pool and a stadium surrounded by wild flowers, surely they could have spent a little on back-up healthcare rather than depend on a man with a dodgy haircut to provide the necessary cover of ‘a contingency plan’.

So, Mr Foxy, it’s your problem, not mine; I’ll be too busy putting up bunting and eating cream buns to enter your lair.

Charles Lamb, consultant in emergency medicine