Sir, – I took an elderly friend of mine for a pub lunch in Thirsk on December 30.

While my friend and I were enjoying a pint and a meal in the Thirsk pub. I noticed an elderly couple who evidently visit the pub frequently and witnessed the lady attempting to stand up.

She was unsteady and I commented to my friend that I was concerned about her stature. There was a loud thud and the lady had collapsed on the floor. I dashed over to her and looked for signs of heart failure etc. She was still breathing but perspiring profusely. I propped her up and her airway was clear.

The landlord asked if we should phone for an ambulance and I said yes. I am not familiar with the internal workings of the NHS A&E call routing procedures, ie whether 111 and 999 share the same call-handling and queuing priorities. But upon reflection I recall that I was experiencing a worrying sense of frustration as I, on all fours,relayed back to the call handler via the landlord, answers to what seemed a long list of questions.

My friend in West Yorkshire is a paramedic dispatcher at the incident HQ in Wakefield. He is clinically trained but now civilian non-medical call centre staff are asking questions and reading from a script comprising of a set of questions. I worry that depending on which box they tick the computer software algorithm assesses the situation and the decision making process is electronic. This is rather like when one applies for a mortgage.

Nevertheless, I am pleased to report that in less than ten minutes an ambulance arrived with two female paramedics based at the Friarage Hospital. I informed them of what I had learned from the lady's husband. They checked her sugar levels first, requested a lemonade from the bar and within 20 minutes after being checked out in the ambulance the grateful couple were back in the pub thanking the pub's concerned clientele who raised their glasses and continued to enjoy their Christmas fayre.

I was on the march to save the Friarage – primarily the maternity unit – but having witnessed the efficiency and professionalism residing in our midst we must be vigilant and make a stand against any steps which may well, by stealth, bring about the hospital's demise.

KEN WALSH

Tunstall, Richmond.