The information in this section is a chronological account of the events since 1985. It will hopefully assist the reader in gaining a broader understanding of our aims, objectives and ideology as well as getting to know a little more background information on the author of this site.

Picture of Tim

My name is Tim Hoy. In March 1989, I was diagnosed with insulin treated diabetes at the age of 29. At that time I was serving in my fourth year of a hitherto promising career in the London Fire Brigade. I was about to accept the brigade's decision to medically retire me when I learnt of another firefighter, Terry Adams, who in 1985 had appealed against a similar ruling and retained his employment, albeit from behind a desk at the brigade training centre.

For the next two years I was to discover that my greatest suffering was not to be from any complications of the medical condition, but from the out of date and misinformed attitude from people who were in a position to offer me support in retaining my employment. Some personnel officers did not let their complete lack of clinical knowledge of diabetes deter them from making career decisions on my behalf. One of my Regional Fire Brigades Union representative was more concerned about the constitutional implications of the union's rule book than of seeing a fair result for one of his members.

What was clear at that time was the fact that if I was to remain in gainful employment in a career which I loved, then I would have to establish who my allies were, and then prepare my own case for reinstatement. I spent the 24 months after diagnosis proving my ability to work under stressful and unpredictable conditions. The first set back had been the unexpected diagnosis with the condition. This discovery however was to pale into insignificance exactly five months later. Chrissy, then my fiancée, was the person who encouraged me to join the fire service in 1985. Her uncle and two cousins were already established as professional firefighters in London and I was keen to try and follow in their footsteps. My first 3� years in the service had been spent studying for the statutory promotion examinations as well as anything remotely brigade connected so that I could discharge my duties professionally.

Chrissy and I married in 1987 and the studying continued. She and her family were always great supporters of what I was doing and this backing allowed me to flourish during these first few years. On 15th August 1989 whilst on holiday in Tenerife, in the Canary Islands, Chrissy suffered a fatal accident. Her demise was to have the most profound influence on how my life was to develop. The first five months after my diagnosis with diabetes, had largely been spent wallowing in my own self pious misery with a permanent "why me" expression on my face. After the passing of those five short months I now really had nothing to lose. Chrissy and the job had been the two most important things in my world and I knew that I would now need to fight hard if anything was to change.

In retrospect, I feel that there is nothing like bereavement to put things in perspective. Issues which would have formerly had me ranting and raving now left me thinking - so what, it could be so much worse. I was aware that Terry Adams, the firefighter who won his appeal in 1985, was supremely fit and each year he ran the London marathon in very respectable times.

On 27th September 1989 I was presented with my Graduate of the Institution of Fire Engineers certificate. It would have been Chrissy's 25th birthday. Her uncle, a former fire officer, attended the presentation to support me as I accepted the award. Whilst there, I learnt that had also won the Institute's Award for the top marks in the London branch examinations. I had taken the exams in early March with acute polyuria and polydipsia due to (my then) undiagnosed diabetes. I know that I would have not done nearly as well without the support of Chrissy.

For the first five months with diabetes, I increased the level of physical activity I undertook, especially running, in anticipation of competing in the London Marathon. I hated running, but this was, I believed, how Terry had won his case. After Chrissy died, I decided that I still wanted to do something impressive and which lay people would believe was "impossible for someone with diabetes". In May 1989 I had completed a couple of Outward Bound � courses and during these events, I was introduced to rock climbing for the first time. Although I was a complete novice in this sport, I thoroughly enjoyed it, as I felt there were similarities between rock climbing and firefighting. It remains the only sport I know where one team member regularly saves the life of another.

On my second Outward Bound � course, I was introduced to Peter Whillance, an Internationally acclaimed climber who was now a teacher at Outward Bound Eskdale in the Lake District. Being unaware of Peter's track record, but knowing that he was an established climber, I asked him if he had any experience of climbing on or near the "Old Man of Hoy" in Scotland's Orkney Islands. Another Outward Bound tutor overheard my query and responded "Does he know about the Old Man of Hoy? - Peter Whillance is the Old Man of Hoy" Pete had climbed every route on the Old Man, Britain's tallest sea stack.

The reason for my choice is that I wanted to ascend a fairly famous route and one which other people would know (as well as the connection with my surname). Two ascents on the sea stack have been televised in Britain, the first in 1967 by a team including Chris Bonington and Joe Brown and a later event in 1984 where Joe revisited with his daughter Zo� and climbed one established face with a pair of professional climbers pioneering a harder (E3) route at the same time. The "other" two climbers were Pete Whillance and Murray Hamilton. After my embarrassment had passed, I asked Pete if he thought it a viable proposition for me to climb the Old Man within a year. He stated that it was possible. That was enough for me. I would not be running any marathons, but I would strive to be the first person with insulin treated diabetes to reach the top of this remote and famous climb.

In October 1989 in St Vincent, Italy, a committee jointly commissioned by the World Heath Organisation and the Juvenile Diabetes Foundation was set up. The St Vincent's Declaration was borne from the inaugural meeting of this task force whose role was to set the European standards of diabetes care and research. The British Diabetic Association (BDA) was one of the signatories of the declaration and from the start was actively involved with the process of debate to ensure that the strategies that followed would be the best available to those people in Europe who live with diabetes.

Chrissy worked for the National Westminster Bank prior to her death and a memorial fund account was set up in her name. This account was unused until I eventually decided where any proceeds should go to. Hillingdon Hospital, where I was first diagnosed, provided me with a first rate service at the clinic with a highly professional and motivated team of doctors, nurses, chiropodists, dieticians and receptionists. Despite the high standard of the service there, the team leader and consultant physician, Dr Rowan Hillson MD, wanted a purpose-built clinic for all aspects of diabetes care. This was her dream, and now mine was to climb the Old Man of Hoy.

I decided that the Diabeticare Centre (as it was later to be named) would be the recipient of any money raised in the name of the Christine Hoy Memorial Fund in sponsorship for my climb. On the August Bank Holiday of 1990 we set off and climbed the five pitched E1 (Extremely Severe) route to the summit of the Old Man of Hoy in just 3� hours. The team of three consisted of myself, Adele Phemister a firefighter also based in London and Pete Whillance in his capacity of advisor, motivator, safety officer, mentor, photographer and Icon. On our return to London following the climb, I learn that I had again won the Institution of Fire Engineers award - this time as a result of the Membership examinations of the IFE. The next goal to focus on would now be my reinstatement to operational duties.

When the insulin dependent diagnosis was made known to me on the afternoon of 15 April 1989, it seemed to herald the end of my career. Like every other professional firefighter, I had completed first aid training. This was my only knowledge of diabetes. Of course all one needs to know about the condition for first aid training is the identification and treatment of problems i.e. hypoglycaemia and, to a lesser degree, hyperglycaemia. Now I was "one of those diabetics" I felt that I would not be able to walk down the street without being followed closely by an ambulance. This level of ignorance is sadly commonplace, and in the employment world does a great disservice to highly motivated and capable people who are merely different.

Although I was removed from operational firefighting the moment my diagnosis was known, I did not lose a single day's work in the brigade. I was transferred to the Authority's recruitment section for six months and then, after a change in category of light duties, was successfully interviewed for the job as a recruit firefighter training officer.

In Nov 1990, another precedent transpired in East Sussex Fire Brigade. Prior to this date, there were only a few brigades who'd challenged the national guidance and allowed their firefighters with diabetes to return to full duties following a successful medical appraisal via a local arrangement. Firefighter John Bradford however, based in East Sussex had to go through the lengthy Home Office appeal system, like four other firefighters before him. When the independently appointed medical advisor ruled that he was fit for duty however, his brigade returned him to full duties. This case was the first in the United Kingdom, and therefore another hurdle had been successfully negotiated.

On 2 April 1991, the Doctors at St Thomas' Hospital who advised the London Fire Brigade re-instated me to full operational duties. I won against considerable odds, but there was still a huge amount of work to be done nationally.

At about the same time in Canada, a young man was fighting the Toronto City Fire Department's ruling that diabetes should preclude someone from being recruited into the fire service. In the U.K. we were just starting to win the right for serving members and here was a member of the public in Canada, challenging established rules. Mr Peter Atkins was not someone who accepted that he should be barred from an occupation because of perceived medical problems. He argued that Toronto should give him bona fide clinical arguments as to why he was unsuitable. On realising that they didn't have any, he was subsequently recruited and has now served with the department as a firefighter ever since. When he started at his first fire station in Canada, other serving firefighters around the globe learnt of Peter's case and gradually came out of the woodwork, admitting that they too had the condition.

By applying a blanket ban in the interest of safety, those who would be automatically dismissed by the rules, chose not to disclose their condition. Whilst I cannot support that sort of dishonesty which contravenes a safe system of work, it does illustrate that in the absence of a fair right to a clinical assessment, people will fail to disclose their condition. In some cases, the secretive firefighters had to go to the toilet to check blood glucose levels and inject insulin - Neither hygienic nor safe in terms of glucose management.

Back in Britain in May 1991, the Fire Brigades Union (FBU) annual conference took place in Bridlington. The blanket stance taken by the Executive Committee (EC) of the Union was that no one with insulin treated diabetes should be allowed to work in the operational environment. This policy conflicted with the trades union constitution on two counts; Firstly, if this bar were applied rigidly there would be no point of appeal as there would be no automatic right of return to operational work after a successful hearing. Secondly, for people like me, who had won the right to return and were now riding in charge of fire engines, there could be no support from my union which I was still paying dues to on the grounds that they believed I should not be working in the operational environment.

The benefits of trades union membership far outweigh any arguments I may have had with regard to constitution and semantics from petty-minded officials, and so I attempted to get things moving within the FBU. One London Regional Official, Mr Ross Neal, took a statement from me and used it at the Bridlington conference. Representatives from other regions of the FBU also took the time to debate the issue so that by the time the East Sussex Diabetes Resolution (No 73) was on the agenda, there was a formidable discussion in progress. The E.C. were overturned and from that moment, it became Fire Brigades Union policy that we should be entitled to an individual assessment rather than subjected to blanket bans. Ross Neal's outstanding contribution, along with that of Fire Brigades Union Representatives from South Wales, Avon, and Merseyside had saved the day.

By the end of the Summer of 1991, I was aware of 10 other firefighters around the United Kingdom diagnosed with insulin treated diabetes. The rules of each brigade varied with the stance taken by their medical advisor or Chief Fire Officer. The differences of policy from one brigade to another was about as arbitrary and extreme as it could be. In one Scottish brigade, two firefighters who developed diabetes were instructed to keep quiet about it to anyone outside of the fire authority for fear that being identified would bring about their immediate dismissal. This was despite the firefighter's demonstration to a qualified diabetologist that they were in control of the condition. In another brigade in the north west of England, one firefighter Kenny Williams, had been dismissed after his diagnosis and had successfully appealed against the decision to retire him.

At that time, the Home Office in London was the department responsible for the administration of fire brigades in England and Wales. The Home Office appointed a consultant endocrinologist who made the decision to allow Kenny back to work, but this was overruled by a Chief Fire Office with an out of date first aid certificate. Kenny was made to appeal again, this time with National Officers of the Health & Safety Executive supervising the procedure. Their ruling was that the endocrinologist had been suitably qualified and that his recommendation should stand. Shortly after this ruling, it became clear that the Chief Fire Officer regarded any decisions that contradicted his own were to be dismissed as unqualified, regardless of the professional standing of the referee.

Kenny effectively had to undertake a total of five hearings before he was allowed back onto fire engines. It took him over two years to win his case, but in one of the brigades in South Wales, two firefighters had taken over 7 years to achieve the same result. My own case, and that of Terry Adams, provided evidence to use for the national arguments, but we were still effectively a tiny voice in a large auditorium. As I learnt of more isolated firefighters in the UK, our collective cases would prove an impressive aggregate and source of anecdotal information about insulin dependence and firefighting.

This networking was proving a valuable asset in working towards continuity of standards around the UK, although like Rome, a definitive and fair structure for individual appraisals was not going to be built in a day. In October 1991 I formally set up the National Register of Firefighters with Diabetes (NRFD). The intention of the group was to continue networking between all firefighters and keep one another informed as to progress with Government departments etc. The register was also designed to have an educational role, giving a comprehensive set of guidelines and advice to newly diagnosed firefighters.

A newsletter was written on 27 October with the intention of making this a six monthly publication, but within a few weeks, there was so much information to disseminate that this plan was changed to the production of a quarterly newsletter instead. The action of starting such a group is actually very commonplace in the UK. When governments, employers or society are unwilling or unable to take action over an issue which some people feel strongly about, then they have very often set up their own support or pressure group. These activities are very often the embryonic stage of many registered charities.

To achieve success in setting up any small organisation, I believe that you initially need to keep it very basic and merely network with other like-minded people so that you are not doing it all by yourself. Costs for me were kept small by keeping things simple. I saw no need for a constitution or registration fees as we were a relatively small group of people with common aims. I used a very basic word processor to produce the newsletters and only invested in a large memory personal computer when the membership expanded and I needed the services on offer from the Internet such as Email.

Time is the one thing however that is at a premium for me. My fire service work at that time took up 42 hours per week (it has on occasions increased by 50% due to the flexible duty system) plus overtime and other meetings. Committee work, attendance at tribunals and law courts and writing the newsletter averaged another 10 to 20 hours each week. Prioritising work was therefore essential to ensure that the important issues were addressed quickly and those less urgent, postponed or delegated. After several years of activity, it seems to have worked well this way. Although back in 1991, there were an endless string of meetings to be attended just to keep in touch.

Having the right of individual assessment as national Union policy in 1991 was just the start of the negotiating process. All national conditions of service have to be ratified by a selection of committees which make up the Central Fire Brigades Advisory Council (CFBAC). The FBU was just one representative body within the CFBAC and so I canvassed the other groups which make up the overall committee. Most of them didn't have a clue about the issues and were prepared to agree with anything a doctor told them on matters medical. This however, was where other, more serious hurdles occurred.

Most occupational health units attached to the United Kingdom fire brigades were represented by a group called ALAMA. ALAMA stands for the Association of Local Authority Medical Advisors and made up of doctors around the U.K. Most of them have been general practitioners before becoming more involved in occupational health. Some of them are trained specialists in all aspects of occupational medicine. Sadly, many other are not, and have sometimes attended as little as a one week seminar in occupational health before they refer to themselves as occupational health "specialists". This latter category proved to be a substantial obstacle for us, as senior uniformed officers of the fire service with nothing more than basic first aid training would assume that people with the title "Doctor" would know exactly what they were talking about.

In January 1992, I was invited to the Home Office to add my arguments to the employment debate. This was the first time that the NRFD was recognised as an advisory body, albeit an informal one and without the voting rights of CFBAC committee members. The meeting had been instigated by the Liberal Democrat Member of Parliament, Mr Alan Beith. Lord Ferrers chaired the meeting. I was accompanied by the Director of Services from the British Diabetic Association, Susan Knibbs and Dr Rowan Hillson MD.

Susan Knibbs lived with diabetes since her early childhood and her formative management of the condition through the years without blood glucose meters and the other associated modern paraphernalia was impressive. Susan subsequently earned her status as "living legend" during her active involvement with our campaigns. She remains the brightest of stars in our often dimly lit journey. Lord Ferrers was extremely convivial to the entourage and seemed genuinely interested in the arguments made by us. The other Home Office representative present was Mr Ed Cook, a progressive thinking Civil Servant with an important role advising the UK fire services about employment and promotions issues.

At the end of the meeting, we had all been given the opportunity to make our case and left feeling that we had been listened to. At that time, Gary Mabbutt was one of the best known people with diabetes in the United Kingdom. He had represented his country as a professional soccer player and been the captain of a Premier league team for longer than many people last in the sport. Professional soccer players are required to maintain an extremely high level of athletic fitness and with the protracted length of the football season, this energy is required to be sustained every day of the year. Gary Mabbutt therefore is justifiably held up as a great role model for people with diabetes.

A month after our meeting at the Home Office, Gary allegedly fell out of his hotel bed following a non-league soccer match. Without any access to medical information or confirmation of the facts, several newspapers ran a story that Gary had been suffering from hypoglycaemia at the time of his accident. The backlash for the fire service was that a prominent Chief Fire Officer immediately circulated a message on the Fire Information National Data System (FINDS) computer that all firefighters with diabetes should be suspended from operational employment.

In response to this transmission, four operational firefighters were removed from their place of duty. Eventually, all of them were returned to work, one within a few hours and another two within the week, but the fourth remained off duty for 3 months, effectively having to re-appeal against the decision - he was obviously responsible for Gary Mabbutt's alleged hypo!

This event again highlighted the nonsense of blanket statements. All four firefighters had been afforded the right to demonstrate their ability to control their diabetes shortly after diagnosis, and for the years that followed continued to work in the unpredictable operational environment with often sustained periods of hard physical activity. Another person (Gary Mabbutt) had difficulties, in another environment, not at work, not even remotely connected with the fire service and judgements were made on those firefighter's ability to look after their own condition. At no time did any personnel officer from the fire service bother to find out the circumstances of Gary's difficulty and those of us who did, were soon to realise that there was a perfectly understandable explanation for what happened - which would not have been replicated by an on-duty firefighter.

Almost immediately after this event, we were granted a meeting with the Chief and Assistant Chief Fire Officer's Association (CACFOA) at their headquarters in the West Midlands. CACFOA were represented on the CFBAC and so this opportunity was a valuable one to enter into dialogue. This was the first time I had met both Dr Geoff Gill and Kenny Williams although I had written and telephoned both many times over the preceding two years. At that time Geoff Gill was already one of the leading endocrinologists within the United Kingdom and held a long track record of challenging unfairness in employment caused by ignorance about diabetes.

At that time, Geoff was also an advisor to the BDA. The other person present that day was the now legendary Susan Knibbs. The meeting didn't commission any overnight changes, but the Chief Fire Officer who chaired the event had once been based at North Kensington Fire Station where I was employed at the time of the meeting and he acknowledged that it was a very busy workplace where someone would soon come unstuck if the diabetes was not properly managed. He also revealed that he had a newly diagnosed firefighter within his own brigade and that we had helped him plan the process of evaluation so that the appeal would be heard fairly.

On 14 February 1992 I married Sian Griffiths, also a London firefighter, at the now defunct Willesden Register Office. To challenge tradition, I had four groomsmen, and Sian procured a best women. Despite our ridiculed and unorthodox approach, it didn't stop three hundred guests at the evening reception drinking all the free booze we had provided for them. Another wonderful benefit of my official union with Sian was the fact that I inherited a ten year old son Lance. I had known Lance since he was 8, but now I had official responsibility for him as a bone fide step father.

Just after Lance's 9th birthday I had taken him out for a pizza when his mum was on night duty at the fire station. As we left the restaurant, I noticed a vehicle alight and went to the assistance of the driver and a passer-by who were both having difficulty using a water extinguisher correctly. I extinguished the vehicle's engine fire and gave the driver some information that he would require for an insurance claim before returning to Lance who had been waiting patiently for me on the pavement (sidewalk). "That didn't send you hypo - did it?" he said. If only the national fire service had shared his quality of common sense reasoning. That nine year old boy knew more than he realised!

In May 1992, an Australian in-flight attendant who had been dismissed from his job after diagnosis by his employers, QANTAS Airlines, won his case to be re-instated to cabin crew duties. In January the following year I was asked to appear on national TV on a programme called The time the place. For the US readers, this programme is a current affairs/human relationships/news show run in a similar format to Oprah Winfrey although without the charismatic presenter. The show hosts had been given my name by the BDA and I was more than happy to attend, thinking that we could raise public awareness of discrimination issues and of the achievements of people with diabetes.

What I had missed however was the fact that the week before, the show had been pitched asking for people who had experienced difficulties with diabetes or if their children had the condition. The result of this sort of approach is that anyone with a horror story to tell about diabetes is likely to want to do just that. The resultant show was a collection of yarns such as "how I beat up my children when I was hypo" and "how I have become useless since diagnosis". The show provided such a diabolical image of diabetes that my co-workers subsequently questioned my ability to fight fires. Prior to the programme they had been happy to ride with me in charge of their fire engines at North Kensington, one of London's busiest fire stations. It took several days explaining the fact that the group who appeared on TV were not representative of most people in the UK with diabetes.

In February 1993, I was contacted by an occupational health doctor from Australia and a firefighter from New South Wales who both informed me of the similarities in their country with regard to the absence of any form of individual assessment. The Australian firefighter, Robert McGregor subsequently became the Australian Secretary of the register thus creating an International status.

In March 1993 an All Party Working Group on diabetes was set up in the House of Commons at Westminster. The Secretary was Ms Theresa Gorman (Conservative) and the Chair Mr Colin Pickthall (Labour). Colin has diabetes himself and has been a staunch supporter of our aims and objectives. He later became the Secretary of the parliamentary group.

Later that month, the IRFD and the BDA were afforded a meeting with another group who made up the CFBAC - The National Association of Fire Officers (NAFO). This was now our third meeting with CFBAC committee members, but this one proved to be a waste of time. The NAFO members chose not to speak to anyone who was not a doctor, and even then showed scant regard for any MD who was not an advisor to a fire authority. Specialist diabetes knowledge seemed to count for nothing, unless it was accompanied by occupational knowledge of the fire service. The irony of this, is that Dr Gill had visited the Fire Services College in Moreton in the Marsh and witnessed first hand, the extreme conditions that firefighters are put under at the fire house (breathing apparatus training school). On return to his hospital, Dr Gill started to work on a risk assessment project for people with diabetes in potentially hazardous employment.

In April 1993 the name of the register was changed to the International Register of Firefighters with Diabetes (IRFD) due to the work done by the Australian Secretary Robert McGregor. Shortly after this transition, the Diabetes Associations of New Zealand, Canada and the USA were approached to see if these other countries presented similar restrictive practices which denied their employees a right of appeal or assessment. The situation in the USA was very different to our own UK policy. The Americans with Disabilities Act afforded each citizen the right to be treated fairly as part of the US constitution.

Although I believe that truly egalitarian cultures are only ever achieved by the commitment and motivation from the society within, the fact that such civil rights legislation existed in the USA made the activities of the IRFD largely redundant. After all, what was the point of US firefighters affiliating with a group which campaigned for something that was already in place within the country's legal framework? Or so we thought...

In July 1993 I learnt of the existence of Bill Pratt, a Sub Officer serving with Avon Fire Brigade in the South West of England. Bill was diagnosed after just five years service, but the news that this diagnosis had been in September 1973 caused us great excitement. 20 years trouble-free firefighting with diabetes. This was the sort of evidence we had been dreaming of, never believing that such a case actually existed in the UK. Apart from the worry of unexpected hypoglycaemia at work, the other main reason for opposition from our senior personnel officers and medical advisors was the assumption that a] There was no long term data about firefighting and diabetes and b] people who have had diabetes for a long time suffer from complications and loss of hypoglycaemia warning signs.

To say to people who are newly diagnosed with diabetes that this or that is likely to happen to them in 30 years time, based on the available data of those who have had the condition for the last 30 years, is very misleading. The available 30 year data in 1993, by definition, would be of people who were diagnosed in 1963. In the early 1960's there were no personal blood glucose meters, insulin was very unrefined and animal based; smoking, especially in public places was the norm, food labelling and nutritional advice was almost non existent. Someone diagnosed in 1993 would have to wait until 2023 before similar data was available as long term evidence of diabetes complications.

It is clear that as each year passes, the amount of people suffering from nephropathy, retinopathy, amputations, blindness, neuropathy and renal failure caused by diabetes diminishes. Although extrapolation of the current figures is unlikely to produce an exact prediction of the data for 2023, the trend towards improved controls and health is clearly evident. The news of Bill Pratt now gave us even more ammunition to take to the various medical appeals going on around the UK.

In the same month, I was to learn of a 17 year old Australian man who secured his (non commercial) pilots licence from the CAA despite his diabetes being controlled with insulin. I was now being contacted by people from other occupations who had heard of the IRFD and wanted more information. In most circumstances, we were able to give the person making the enquiries sufficient material to fight their own case.

In September 1993, I received a letter from Mr Tim Savage, a Police Constable with the London's Metropolitan Police Service. Tim was subjected to a reduction in overtime and specialist duty opportunities since his own diagnosis, but the rules seemed to have been applied very haphazardly in lieu of any definitive advice from the Home Office. Tim's situation and that of other police officers was so similar to that which firefighters were experiencing that he too decided to set up a networking/self help group. The Metropolitan Police Diabetic Association was borne and within only a few weeks had become a national group following Tim's publicity, predominantly in the national Police Review magazine.

Details of the National Police Diabetic Association can be found at the end of this section of the web site. In October 1993 the United Kingdom's contribution to the St Vincent's Declaration became more tangible as several committees were set up by the BDA. I was invited to sit on the Patients and carers sub committee and readily agreed. The role of this group was as follows;

• Consider public, professional, and institutional awareness of diabetes and make proposals for its enhancement.
• Consider self care and the promotion of fuller awareness of patients' needs by health care professionals.
• Define areas of prejudice and discrimination as they affect people with diabetes and propose methods to reduce them.

This third remit was, I felt, right up my street and I set about gaining as much evidence from people in occupations far removed from firefighting so that my contributions were not too narrow in subject matter. The more I learnt of the other rather dynamic members of this group, the more honoured I felt to have been selected onto it. Other aspects of discrimination came to light during our meetings, in particular the difficulty that a person could have in gaining insurance at a reasonable premium due to the medical condition itself rather than his or her own unique way of dealing with it.

In January 1994 the full St Vincent's report was written, including a pr�cis of the debates that had taken place and a full set of recommendations. All the reports from each of the separate St Vincent's sub committees have subsequently been published in Diabetic Medicine - The Journal of the British Diabetic Association - Supplement 4 to volume 13 (1996). After the final meeting of the task group, I was a little saddened by the void which it left behind. It had been another opportunity to work with the legendary Susan Knibbs and the topic we debated was the one closest to my heart.

It felt as though we had made great progress, and yet now it was all over. I would clearly need some other activity in this vein to keep me going at full pace. In February 1994 that opportunity arrived when I was asked to sit on the BDA's Driving and Employment Working Party. I learnt that I was to be the only layperson on the group, all others being medical practitioners - mainly but not exclusively endocrinologists. Dr Geoff Gill was to chair these meetings and the inaugural gathering took place on 24 February 1994 at the BDA.

I had never considered my diabetes to be a disability, notwithstanding some people with long term complications sometimes have to live with severe impairments that are directly caused by the condition. What I did find disabling however, was other people's attitude towards my wholly controllable medical condition. It was after all, other people's beliefs rather than any difficulty I experienced with my diabetes that precluded me from doing my operational job for 2 years.

In March 1994 I learnt of the existence of a UK group called Voluntary Organisations Against Discriminatory Legislation (VOADL). With a name like that, I had to find out about them and discovered that they were a body of activists who were busily challenging any legislation or practices in society which presented a discriminatory and punitive affect on people with disabilities. VOADL, along with other affiliated pressure groups were trying to highlight a private members bill which afforded a full and enforceable bill of civil rights to UK citizens. VOADL eventually changed its name to Rights Now! and the IRFD became one of the numerous groups to affiliate with them.

In May 1994, I was asked to appear on regional TV for a programme called Your Shout. This five minute slot, shown after the evening news bulletin was designed to afford a platform to members of the public to voice their opinions - most commonly their dissent - at issues which affect them. I am always happy to undertake anything which adds to the public awareness of diabetes and discrimination and set about gaining approval from the London Fire Brigade to allow cameras and crew into Chiswick Fire Station whilst I was on duty. I was given full editorial control over the show, and all the narration was left up to me. The final cuts were out of my control however.

Little did I know that when the show went on air one month later, a more noteworthy event would also be filmed. It was the recording of the British Diabetic Association's 60th anniversary celebrations during a huge event organised in conjunction with the Outward Bound Trust. Called the "60 up Diamond Ascent" the event consisted of 20 people with diabetes ascending each of the three highest peaks in England Scotland and Wales, making a total of 60 people at the summits of Great Britain's highest mountains to commemorate 60 years of achievements for the BDA.

On 14th December 1994, our most significant goal was achieved. The previously applied blanket bar policy was overturned in place of the right to an individual and qualitative assessment by specialists in both occupational medicine and diabetes/endocrinology. We had taken on the Home Office and won. This right of individual assessment would now be employment policy for the entire United Kingdom fire service.

In same month, I was contacted by a Royal Naval firefighting instructor who had just been diagnosed. His treatment by the Ministry of Defence (MOD) was fairly predictable, based on our other experiences from the Royal Air Force and the Army. When someone develops a condition that they did not join the service with, if it is not in any way disabling, the MOD tends to return the employee to work on some form of reduced medical category. In many instances, the soldier, sailor or air force employee has been allowed to continue doing the job they were doing immediately prior to diagnosis. This employment has in some cases been allowed to continue for as long as four years, but when the employees contract of employment is up for renewal, the MOD policy is to then to medically retire them.

The reason given by the defence ministry for this action is because "the employees need to be ready for immediate transition to war". We argued against this statement on the ground that if war were declared on the UK, there would still be a need for specialist service employees who did not need to travel to foreign locales or war zones. This was particularly true of ground based RAF firefighters and Royal Naval firefighter trainers. Despite our arguments, the MOD have not moved away from this stance, and continue to dismiss personnel whose contract of employment comes up for renewal.

In March 1995 a British Airways engineer was suddenly given a reduced responsibility job description which precluded him from wearing breathing apparatus (a necessity when working inside a wing's fuel tank). As the change did not reduce the employee's pay scale and actually prohibited him from an inherently unpleasant job, one would think that this was actually not a bad deal. In reality however, he rightly saw this as the thin edge of the wedge with the possibility of reduced pay or promotion opportunities in the future because he had been classified as unfit to carry out certain tasks.

In August 1995, the former Irish National Hunt jockey Mr Pat McWilliams got in touch with the register. Pat lost his racing licence after diagnosis, despite an excellent control of the condition. I travelled to the Republic of Ireland to defend him at the Irish Turf Club headquarters with his solicitor and partner. The Turf Club consisted of a panel of thirteen men and one General Practitioner who took on the occupational health role for the club.

In October 1995, the IRFD celebrated its fourth birthday. In an expanded 55 page newsletter the stories of several offshore workers were covered. At the start of the newsletter writing four years beforehand there had been 17 recipients and 10 fully operational firefighters. On this anniversary edition there were 78 recipients and 38 operational members. Fighting against the same old ignorance, using the same old arguments had been a tiring task, but we were proving that with determination that it could all be worthwhile.

On 8 November 1995 the Disability Discrimination Act became law in Britain. This was sadly to prove a watered down UK statutory instrument which paid little more than lip service to disability rights pressure groups. Without a commission similar to the Equal Opportunities Commission or the Commission for Racial Equality, the facility for people with disabilities to challenge unfairness would rely solely on charitable groups with limited funds. The best that could be said of the new act was that it was better than nothing, although for my colleagues in the fire service, it provided no protection as they were exempt.

Another case emerged this year which did not involve firefighters. A social worker based in Oxfordshire was told that her licence as a registered child minder would be revoked due to her diabetes. Another case where a Royal National Lifeboat Institution crew member lost his licence for seagoing activities also came to light. I felt it was time to raise public awareness via the media. On 22th November 1995, the Independent Television company produced a follow up programme The time the place on diabetes, this time in Bristol.

After the horror stories of the previous show, I wanted to ensure that a repeat of the negative images did not arise. The opening statement from the audience came from the legendary Susan Knibbs and she set the standard which was followed by nearly all the people there. YES, diabetes can do awful damage. YES, people who are insulin treated need regular injections. On the positive side however there were a huge number of people who lived active and complete lives - compromised only by the discriminatory actions of a few. This was more like it. The sort of televised publicity that we had needed for so long.

1995 had been a positive year on the whole with some great victories under our collective belts. On 12th December however, one of the most important and long winded cases reached the High Court. In June 1993 a Dorset firefighter Gary Cooper had been diagnosed. He was dismissed in the usual arbitrary fashion and appealed against that decision. I had been optimistic that he would succeed at the appeal as he was an extremely fit and well managed person, and one of the most articulate people that I knew. This latter quality, would, I was sure, enable him to present his own arguments in a clear and concise manner. Another bonus was the fact that the consultant physician appointed to hear Gary's case had already returned one retained (part time) firefighter in Hampshire County.

When the appeal took place, the consultant physician merely endorsed the brigade statement and ruled that diabetes was incompatible with firefighting. This was a great shock to us all and seemed incredible in light of the previous appeal at which the same doctor had allowed the Hampshire employee to return to full duties. In lieu of any clear guidelines for where we should proceed, we contacted a host of legal advisors including the law firm employed by the Fire Brigades Union. Most however were just not interested and eventually Gary had to pay for an independent firm to represent him. He applied for, and got, legal aid and the matter was referred to a judicial review.

The process and bureaucracy were completely alien to us both and we merely wanted to state the medical facts to an independent consultant who could make a reasoned assessment. Sadly, the legal world does not work like that and the case ended up 2� years later at the Courts of Justice in London. We were starting to have an inkling about how Helen Steel and David Morris must have felt during the McLibel trial as everything but justice evolved over the two day hearing. The first draft of this web site was being written as the McLibel verdict was announced. The fact that Morris and Steel lost their case had so little to do with any sort of real justice.

At Gary's case there were two barristers, neither of whom confessed more than an even basic understanding of diabetes. Both of these QC's (Queens Council Barristers) were addressing the judge who knew even less than they did about the condition - It was so unfair, and we were not permitted to talk. In his summing up, the judge made 15 basic errors relating to diabetes, illustrating his ignorance of the condition, but when he ruled against Gary, it was the final straw of nearly three very long and arduous years. He decided not to appeal - Gary called it a day.

It took another three months before some really good news took the depression out of Gary's High Court fiasco. In March 1996, I received a letter from the solicitors of Pat McWilliams in Eire - we had won and Pat was to regain his racing licence. By the time I heard of this victory, Pat had already raced a few times. On his first race after being given his license back, Pat's family and friends turned up to support him. Without having raced for the two years prior to his return, Pat was without "form" for the bookmakers to set the odds and so he was a 20:1 outsider. With his supportive audience on the site and the euphoria of returning to work, Pat put the icing on the cake by finishing in first place. Not only had he proven his ability to race horses, he was again showing the world that he could win as well.

On 30th April 1996, my daughter Cydney was born, underwater, at home and without any form of obstetric intervention. She weighed 8lb 7oz and both Cyd and her mother had a near perfect delivery, assisted by yours truly. I had not anticipated the amount of time that a new baby would take in our already hectic lives. Whilst this new set of chores were ones which I relished, each day we became more exhausted than we had been on the day before.

In May 1996, the topic of taxi drivers and ambulance workers came to the fore. The DEWP meetings were still debating issues such as this, but we were becoming increasingly frustrated by the inconsistent way that medical employment laws and criterion were being applied. Each ambulance service in the UK has its own unique way of applying medical criteria for their employees fitness to drive. This is also true of the authorities that licence taxis around the UK.

The disparity is so extreme that in some counties or health authorities, personnel are recruited with pre-existing diabetes. In others, they are dismissed from service after diagnosis regardless of their ability to look after themselves. As ambulance workers were not exempted from the Disability Discrimination Act, we eventually gained another employment precedent to shout about (more about that later).

Despite the new laws however, it seems that various sections in society will continue to make things up as they go along, discriminating against people without the clinical know-how to justify their punitive rules. Again the babies were being thrown out with the bath water.

In July 1996 Ms Margaret Wright set up the Canadian branch of the IRFD. Although not employed by the fire service, Margaret has followed our progress since the start of the register and has regularly assisted us in updating information from Canada where new medical research or breakthroughs have occurred. Canada, was of course, where Banting and Best first evolved the life-saving concept of injecting insulin.

Almost immediately after the production of every quarterly newsletter by the IRFD, some major news would break, thus ensuring that another three months would lapse before the material was disseminated to the registered members. In July 1996, just after the completion of the newsletter we heard of the successful completion of another long-winded case, setting another UK precedent. This was Station Officer Alexander Sinuks, dismissed from the West Midland Fire and Civil Defence Authority some 2� years before due to "fragile" diabetes. He accepted the medical dismissal not understanding that the fragility of his condition was not a permanent situation.

We had learnt from the Gary Cooper case that once dismissed, an appeal was much harder to win than it was for members who were still employed, but as with our successes in London, the egalitarian stance taken by the fire Authority facilitated a second hearing by their occupational health team which Alex subsequently won.

On 12thMarch 1997 I was presented with the British Diabetic Association's HG Wells Award, given annually to the layperson who has "made the most outstanding contribution to people with diabetes". The award accompanied a cheque for �2,000 paid for by the pharmaceutical company Boheringer Mannheim which I, in turn, donated to the Care and Information Services Dept at the BDA. This department partially funded the cost of the computer which I subsequently wrote the first draft of this web site on. The addition of a fax and Email facility made communications with other international organisations much cheaper and quicker.

On 11thJune 1997, Avon's Sub Officer Bill Pratt started a walk from John O'Groats to Lands End. For our overseas readers, the walk is the total length of Britain from the Northernmost point of mainland Scotland to the most Southern point of the most Southern County - some 930 miles (over 30 per day for a full month). To make things more difficult, the team of three firefighters were wearing full fire kit, tunic, helmets and leggings, although training shoes replaced their normal fire boots. The walk was successfully completed by all three firefighters a month later. The final sum raised for charity was over �15,000.

On 28th July I was elected onto the Board of Trustees at the British Diabetic Association. I was nominated by the legendary Susan Knibbs. It was a three year appointment and I had hoped to be able to dedicate as much time as possible to this work to ensure that their excellent service was maintained and, where possible, improved.

In October 1997, the Department of Transport informed the British Diabetic Association that from 1 January 1998, anyone in the UK who treated their diabetes with insulin would be barred from driving vehicles in the C1 and D1 category. This was relatively old news for those of us who had been campaigning for individual assessment rights, but what had not been declared prior to the October missive was that there would be no "grandfather rights" extended to existing drivers. This ruling would mean that as each person with insulin treated diabetes renewed their three year licenses, they would immediately be excluded from driving trucks of between 3.5 and 7.5 tonnes (C1) and minibuses with between 9 and 16 seats (D1).

As more and more people learnt of these punitive changes, there was a huge outrage that such discriminatory legislation was being applied unilaterally by the UK Government without considering any form of clinical assessment for each driver. The originating legislation was a European Community Directive (No 91/439) which in general terms states that insulin treated diabetes is incompatible with driving such vehicles, but that each person should have the right of review, assessment and most importantly, appeal in exceptional circumstances. The interpretation of this rule in other European countries varies greatly with the stance being taken by the United Kingdom.

Rules constructed by the European driving legislation are there in theory to ensure a consistent standard is applied across the entire European Community. Such legislation can be compared to the USA's Federal laws which cover every state, regardless of the wildly varying and autonomous state laws which are confined to the boundaries of each state border/County line. In reality, each EC country is allowed to apply these laws with a certain amount of flexibility or interpretation, provided that human rights and free trade with other EC countries are not compromised. This, in turn means that if say, France allows individual assessments which are not facilitated in the UK, then a French driver could retain a large good vehicle license which would not be entertained by the UK regulating authority under their own interpretation of the same European law. Because both France and the UK are bound by EC directives and laws however, the French driver with diabetes must be allowed to drive in the UK on his or her French license without being hindered by the UK authorities.

In 1997, in anticipation of implementation of the EC Directive the following year, the Department of Transport had decided that there were NO exceptional circumstances that would allow an appeal. Regardless of any good intentions the department may have had, having no direct access to the millions of clinical records of every driver in the UK with diabetes in order to make such a qualified sweeping judgement, they went ahead with their implementation. The right of appeal was therefore initially denied to every driver with diabetes from 1st January 1998.

As a result of our high profile campaigning, especially the activities of the BDA, I was asked to appear on a BBC television programme called The E Files. The show went out in January 1998 and the driving issues were debated at length in a very well balanced and informative programme. Radio programs followed, one of which featured an impressive and empowering interview with Avon Fire Brigade's Bill Pratt.

In the same month, I changed my fast acting medication to Lispro analogue insulin, marketed as Humalog, by its creators Eli Lilly. Despite already being confident in managing my condition to a sufficiently high standard to remain on unrestricted operational duties, I found that Humalog made the management regime even easier for me. The new medication seemed unaffected by extremes of heat and humidity on the body, notwithstanding, I am still not fireproof yet! I took leave from work to ensure that any unexpected or spectacular differences between my old medication and the Humalog occurred in a safe and supervised environment. As it transpired, all of my anxieties were unfounded and I continued to discover even more benefits of Humalog as time passed.

My 28 day trial was recorded in a 40 page report which I submitted to the Diabeticare Centre in Hillingdon. Whilst I was extremely impressed by the benefits of Humalog, if any readers of this site are interested in changing their own medication for whatever reason, please ensure that appropriate medical advice is sought before embarking on any deviations from current regimes. The main positive difference for me between the analogue insulin and its predecessors, was that because of the increased speed of release, it was licensed for post prandial (after meal) injections. This is, of course, what emergency service workers should all do on duty where the time of our next call out is unpredictable.

Because of the huge interest shown in the changed driving license regulations, the BDA set up a parliamentary liaison (lobbying) group in late January to meet with the Transport Minister and other key government officials. The BDA's entourage were selected because of past successes in campaigning or for their knowledge of the complex medical issues. When I was asked to contribute to the group, I accepted immediately. Being in the company of Professor George Alberti, the President of the Royal College of Physicians and Dr Geoff Gill was an immensely empowering experience (plus it gave me the opportunity to do a bit of name dropping too!).

Trades Unions and driving campaigns organisations were also represented on the group as well as primary care doctors and nurses. The first of the two meetings was held in March to ratify our agenda and debate what we hoped to achieve and the time scale in which we anticipated the changes to happen. In April we conducted a presentation at the House of Commons in front of many Ministers and politicians. There was adequate time for dialogue and the exchanges seemed to be well balanced from the politicians, trades unionists and other representative bodies alike.

I was pleasantly surprised at how little ignorance and opposition we encountered. The lobbying brought about a meeting of the "Expert Panel on Diabetes" at the Department of Transport, who had not originally been given any opportunity to contribute to the implementation of the EC directive. In my opinion, it was a classic case of locking the stable door after the horse had bolted and I am still sceptical that the talents of the expert panel were never adequately utilised during this time.

In the middle of all the activities surrounding the driving issue, I contacted a US firefighter, based at Colorado Springs called Paula Heule. Paula had joined her fire department with pre-existing diabetes and was just the sort of person I was looking for to take up the mettle of setting up and running a US office. Paula agreed and in September 1998, another country was added to our international list of offices. As well as her firefighting activities, Paula possessed a substantial record of achievement in equestrian events within the USA.

On Wednesday 16th September 1998, The Times newspaper ran a front page article about David Parker, a bookkeeper from Buckinghamshire, England, who had just broken the world record by a whole week for walking across Australia. David achieved this 2,600 mile walk from Perth to Sydney in just 69 days, 11 hours and 28 minutes (therefore averaging over 37 miles every day). The mammoth trek involved ten months of training to achieve. A huge irony of David's success is that if he applied to be recruited into his local fire brigade, he would be barred. This is because as a person with insulin treated diabetes, he would be regarded as medically unfit!

Also in September 1998, I was invited by Anne Felton, the Chair of FEND to Barcelona in Spain as a keynote speaker for their annual conference. FEND stands for the Federation of European Nurses in Diabetes and represents the group of professional health carers with the greatest ability to bring about changes in standards across Europe.

Standards may be set by the St Vincent's declaration, medication provided by the pharmaceutical companies, clinics led by the consultant physicians and overall control and standards maintained by the patients themselves, but specialist diabetes nurses seem to be the group that hold it all together. The award winning diabetes clinics around the UK usually attribute their success to good communications and teamwork. I agree wholeheartedly with this concept and feel that no one element can take the credit.

I always return to the fact that it is the nurses who have the most intimate contact with patients at any clinic appointment. They also have the most holistic view of the team and patients combined. I am sure many a nurse has been taken into the confidence of a patient who wouldn't dare to admit to the clinic's consultant that s/he was smoking or running excessively high glucose levels. I hope this is not seen as being critical of physicians in general, because I am not. My address in Barcelona lasted 40 minutes and I spoke on the topic of patient empowerment.

By mid September I was beginning to feel a bit like "diabetes - rent a quote" because on the day of my return to the UK, I appeared again on national TV on the Esther show talking about diabetes discrimination (just for a change). Esther is another audience participation programme similar to the Oprah show but not quite as slick as its US counterpart. The programme was one of the most positive shows I have seen on diabetes, despite one or two of the contributors having very sad and negative experiences.

In October 1998, nearly two years after the start of my campaign for the recruitment of firefighters with pre-existing diabetes, I was contacted by a firefighter in Devon who had already been allowed into the brigade with insulin treated diabetes. The firefighter had been completely honest about his condition at the time of being recruited in 1996. Although this set a precedent, I realised that it would be some time before we could ensure that individual assessment rights exist for people attempting to join us.

On 1st December 1998, I was promoted to the rank of Station Officer in London. I had been doing the job on a "temporary" basis for an aggregate of 8-9 years and so, this advancement was of no great magnitude. It did make my position a little more secure however, as well as transfer me to another watch and give me a white shirt to keep clean. Within a few hours of being in charge of the new watch I discovered in conversation that many of them played musical instruments or sang, and were prepared to perform in their own time to raise some money for charity. As none of them had any preferences for a suitably good cause, I suggested the BDA as the recipient for any funds raised, which they agreed.

The band's intention was to record an album of our own songs that had been written and played by the members. With so little access to a decent venue to rehearse, compounded by the fact that most of the members were spread widely about London, the progress with the album looked likely to be very slow however. The first gig was eventually planned for the Donnington Primary School's annual barbecue in Willesden on 15th July 2000.

Cydney had started at Donnington Primary School in a full time nursery placement in 1999, and the planned gig would hopefully come to fruition just as she finished her first full year there. All proceeds of the live event were to be evenly divided between the school's PTA (Friends of Donnington School) fund and the UK Brain Tumour Society (UKBTS).

In February 1999 I attended the 8th International Women in the Fire Service Conference in Los Angeles, USA with Sian and Cydney. I presented two workshops, one on Diabetes Discrimination in Employment, called Divide and Rule which was co-presented by Paula Heule US Secretary of the IRFD. The workshop opened up dialogue with some of the fire chiefs who had been unaware of the requirements of the Americans with Disabilities Act. As a result of the workshop, on our return to the United Kingdom, I received two emails from US firefighters who had experienced similar opposition to that which we had been fighting in the UK. I was now able to pass the baton to Paula Heule for her to do the ground work and write to them personally.

Because of the vastness of the USA geographically, compounded by a myriad of varying employment policies and practices, it became quickly apparent that there were hugely different rules from fire department to department. Some of these rules discriminated against people with diabetes, despite federal laws which prohibit such arbitrary treatment. The raised awareness by the US fire department administrators and policy makers following the conference went some way to breaking down the barriers that we had been unaware of prior to the trip.

In October and November 1999, there were another two ground breaking cases where a Hackney cab (London taxi) driver and an amateur jockey were granted their licences after previously being banned due to their diagnosis with diabetes. At the time of the Hackney cab driver's successful appeal there were another 16 outstanding cases in London at varying stages within the appeals process.

The UK driving issue continued to be a very slow and difficult one to overcome. The Drivers Vehicle Licensing Authority and Department of the Environment, Transport and the Regions both asserted that their rules were designed to put safety above any other concern, including civil rights. I am inclined to agree with that philosophy in that I would clearly not want to campaign for the right to endanger anyone's life. To suggest that every one of the growing number of people with insulin treated diabetes in the UK (500,000 people in 1999) were all the same however is complete nonsense. I know of no other group within society where such highly discriminatory (supposedly clinically sound) statements are issued without even affording the person a medical examination.

So let's assume that the primary motivation of the government departments was safety. After all, the government in place in 1999 pledged to outlaw discrimination, so it couldn't be fairly argued that a blanket ban is merely a cheaper and simpler system to apply. As I have already alluded, the overall safety issue MUST be held in a higher regard that a person's right to drive from a known higher-risk group. Insurance companies and their underwriters employ actuaries to calculate the likelihood of someone having an accident. So finely tuned are their skills that they are paid excellent salaries to ensure that their data is right. The actuarial data can assist them in presenting a reliable prediction of the amount of accidents and theft and the likely costs to settle claims in the forthcoming financial year so that the company can set the premiums to be paid by the customers.

Age, gender, postal district, previous claims, medical conditions, the type of vehicle and a host of other variables contribute to the equation that calculates the premium, so that the policy holder pays a sum commensurate with the risk they present. Sorry if this is giving egg sucking instructions to any of you grandmothers out there, but stay with me on this one please! So, with the government departments having access to national road accident statistics and actuarial data, they could make a clear appraisal of the dangers that a variety of groups present to the safety on our roads. It is not likely to surprise many of the readers of this web site that one group of road users is statistically most likely to be involved in an accident involving death or serious injury.

Yes, drunken drivers are a huge problem, but the second anyone drives a vehicle with an excess of alcohol in their blood, they are breaking the law - and technically anyone can get drunk of course. The group to which I am referring is men under the age of 25. The statistics indicate that there is a substantially higher (over 1000 times more likely) number of injurious road accidents involving this group than there are from the population with diabetes. So why do the government departments not apply the same blanket bars to this group as they do to people with diabetes? Apparently it's because it would be an infringement upon their civil rights.

This blatant discrimination actually sends out a very clear message that if you have insulin treated diabetes you will not be able to retain some of the basic civil rights that are afforded to the rest of society. I cannot and will not accept that this is fair and will continue to fight any form of bigotry that arbitrarily and punitively prevents me and people like me from undertaking tasks that we are capable of performing safely.

In March and April 2000, a series meetings between the BDA, a group of specialist lawyers, Lord Whitty and the Government were held. The topic centred on the diabetes and driving issue and followed the publication of the Government's (Science & Technology) Select Committee report "Scientific Advisory System: Diabetes and Driving Licences" The publication is available from Her Majesty's Stationery Office (HMSO)and costs less than �10. The report outlines many of the concerns voiced within this web site and asserts that there needs to be a fairer system of rules applied. There is some concern that European Law has been enforced without using a suitable model to evaluate the relative risk. This, in turn, has led to people losing their jobs without any change to their condition and without even having been afforded a medical examination.

In June 2000, the British Diabetic Association (BDA) changed its name to Diabetes UK. In July 2000, after a long-winded series of delays, Paul Zapletal, a London Underground Emergency Response Manager was finally told during his Employment Tribunal in Croydon that he had been unfairly dismissed. His insulin treated diabetes had been the sole reason for his dismissal, but despite the ruling and compensatory award for the maximum sum possible under law,the Tribunal also decided that he couldn't be reinstated to his previous job.

On 15th July 2000, the last of my (almost) lifelong ambitions was realised when the band played at Donnington Primary School in front of about 150 guests. By the time of our inaugural performance, we were a 9 piece group, plus another three exceptionally talented guests musicians to add to our performance. The two sets lasted just under an hour and there were 12 offers of future work on the evening of the show. It made such a lovely change for me, having an event that didn't have a single thing to do with challenging diabetes discrimination.

Despite my break from the soap box on the 15th August, at that time there remained a substantial number of UK cases of diabetes discrimination in employment being challenged by the IRFD. Drivers of medium weight goods vehicles, two stevedores and several drivers of passenger carrying vehicles had lodged their respective cases for Judicial review, Industrial Tribunal or at an advanced stage of their internal appeals procedure. Ambulance workers and Paramedics too were challenging this blatant unfairness at work.

The appeals process is painfully slow and expensive; not just in terms of financial cost, but also due to the huge amount of one's personal life that is taken up writing letters and attending meetings. When the alternative is accepting that people with diabetes are second rate citizens, then usually the people that we defend are prepared to become the political footballs they need to be in order to succeed.

In August 2000, my three year tenure as a trustee of the BDA/Diabetes UK came to an end. I had wanted to change the world, but after 36 months of meetings and letter writing, changing a light bulb would have achieved more than I did in my capacity as a trustee. I continued to rely heavily on support from Diabetes UK to produce newsletters and some of their achievements have been superb in terms of public awareness and political movement on campaigning issues that I feel strongly about. My own contribution as a trustee however, was so insignificant it was (in my somewhat less than humble opinion) worthless. It took so much of my time and achieved nothing that wouldn't have been apparent had I missed every single meeting.

One absolutely brilliant moment in world history occurred this year and that was Steve Redgrave winning his fifth consecutive gold medal for rowing (one at every Olympic games since 1984) at the Sydney Olympics. This was a unique achievement in Olympic history and had a profound effect on my whole attitude to life. Not only was he from the United Kingdom, helping us Brits feel better about our national sporting achievements, but of course he was also someone with insulin-treated diabetes.

By the New Year he would be Sir Steve Redgrave, but no Knighthood, Royal Pardon or Special Dispensation would change the fact at that time he would be prevented from joining the Army, Navy, Air Force, Police, Fire Brigade or RNLI. Nor would he be able to drive a bus, minibus, lorry or train. Nor would he be able to be a croupier, toilet cleaner, gym instructor, ticket collector or cut anyone's hair professionally on a cross channel ferry. As unlikely as it is that he would choose any of these occupations, the fact that he was considered medically unfit to do them indicates the fact that even the most successful Olympian ever is denied the right to work in even low risk occupations because there were NO special circumstances.

In the final three months of 2000, I attended three weddings, but these positive events were completely eclipsed by the seven funerals of colleagues, friends or relatives in just 8 weeks. Each one of the people who died, left behind at least one surviving parent. It all seemed so unfair. One of these people was a firefighter on my watch at Acton Fire Station aged 39 when he suffered a heart attack, leaving his wife to bring up their three children. His youngest was under 2 years old. The band decided to donate the proceeds of the next year's gigs to a memorial fund set up after his death. After a full year of fundraising for this fund, the account changed its name to the "Acton Red Watch Charity Fund" but the band continued to perform for nominated charities each time.

Medical researchers continue to try and find a cure for diabetes. I would be happy for the IRFD to become defunct as a result of this discovery or invention. I suspect however, that diabetes will be around for a lot longer than I will. As my paternal grandfather once said "You can always live in hope, even if you do die in despair!"

In April 2001, after a long and hard-fought campaign, people with diabetes who drive the category C1 vehicles (3.5 to 7 tonnes) were again permitted to do so after a medical assessment. The changes to the law regarding this category of vehicle were a significant victory for all concerned, particularly Diabetes UK and their active members who had spent a great deal of time attending lobbies and writing letters. The drivers would be subjected to extremely stringent medical assessments, the criterion of which were largely drawn up by consultant diabetologists.

In late 2001, I learnt of yet another Hackney Cab (Taxi) driver who lost his license solely on the grounds of his insulin-treated diabetes. Mohammed Malik lived and worked in Shropshire and was something of a celebrity when he discovered that a drunken passenger had paid him �50 and not �10 as he had originally thought. Most other people would have considered the unexpected cash excess to be a fringe benefit of picking up an inebriated passenger, but Mohammed went to the police in order to trace the whereabouts of the customer so he could give him the correct change. His honesty gained him substantial coverage in the local press, but this would be of no consequence once he developed diabetes. His diagnosis, like so many before him, would herald the end of his driving career.

He appealed unsuccessfully at a judicial review at Telford Magistrates Court, but then the case progressed to the Shrewsbury Crown Court where I was asked to attend to support him. The case finally came to court in the longest day of 2002 - the same day that England were knocked out of the world cup. The latter event allowed me to leave London significantly later than normal as the roads were completely empty with the majority of the UK public staying in to watch the match. The Crown Court ruled that Mohammed had been discriminated against and awarded him costs too. This was to be of small consolation as he had already sold his car to pay the day-to-day bills that would have been covered by his earnings before he lost his license.

The award of costs came as a great relief to him as the lawyers had been charging him �425 ($670 US) per hour for their services. They admitted that the case would have been much more difficult without my evidence and assistance, yet I waited over 6 months to get the reimbursement for my travelling expenses of �50 for fuel. As usual, the cost of my telephone calls, facsimiles, emails, paper, stamps, envelopes, inkjet printer cartridges etc was met from my brigade salary. Whilst I consider it my duty to support Mohammed Malik and people like him (ie people who are in the predicament I had been in 12 years beforehand) I do have difficulty in accepting the huge disparity between what lawyers can make, and what I manage to secure for my efforts. I have never sought remuneration for my vocational work outside of firefighting, but to be out of pocket when there are people charging over 30 times my hourly rate of pay does cause me considerable anguish.

In the firefighters strike of 1977, I had been drafted into a Royal Naval breathing apparatus search and rescue team during my time in the submarine service. I was quickly aware back then that we were wholly under qualified to do the job properly and I am thankful to this day that we were bailed out at every life-threatening event by the striking firefighters who left their own picket lines to protect the public. I had hoped that history would not repeat itself, but in November 2002, we were on strike ourselves.

There were three things I had completely underestimated about us being on strike. Firstly, no one ever prepares you for how much work it involves in the process of withdrawing your labour. Secondly, I could never have imagined just how wonderful the public support would be. There we were, standing outside the fire station on picket duty and we were being treated by the public as if we were the greatest thing on earth - If any readers of this site stopped and supported their local fire station crews during this time, please accept my most sincere thanks for giving us the chance to state our case and live with dignity during an extremely harrowing time for us all. Thirdly, no one could have ever convinced me before the strike that the level of demonisation and lies about us could ever be so very high. The scant regard the majority of the tabloid press barons have for facts in preference for sensational titillation and salacious mythology is hardly a state secret, but new depths were reached during the first few months of the industrial action.

My fire station's band (now called No Bitchin') performed again on 15th November 2002, this time in aid of the firefighter's and control officer's hardship fund. No Bitchin' shared the stage with the FBU's General Secretary Andy Gilchrist, Comedian and Journalist Mark Steel and Joe Strummer and the Mescaleros. Joe, the former front man with The Clash had been offered over a million dollars by a multi-national company to perform again with another Clash icon, Mick Jones. Both had refused the offer, but on 15th November they got back together without any fees for a jam on our stage, for the benefit of the FBU members on strike.

The event took our band's total charitable takings so far just past the �50,000 mark. It was lots of hard work for the many people who organised it, but it was undoubtedly one of the highlights of the year for me. The MC for the night was Geoff Martin, Director of the Charity Ethical Threads and Unison London Convenor. Velvet Fist, the socialist, feminist a cappella soul sisters also shared the stage with us and performed the opening act that night thanks to our previous collaboration with one of their singers, Tara Tierney.

Five weeks after the November gig, Joe Strummer died of a heart attack. His funeral took place in the Kensal Green Crematorium and crews from the surrounding fire stations made up a guard of honour. A few weeks later, it was announced that a book of the Acton Town Hall gig titled "The Last Night London Burned" by George Binette was to be produced with all proceeds to the hardship fund. Just three months into 2003, the wonderful singer, friend, artist and angel from Velvet Fist Tara Tierney lost her battle against cervical cancer. I decided to get a tree planted for her and used a charity I had been supporting for years called "Future Forests".

I hadn't realised until Tara's death that the charity was also supported significantly during its time by Joe Strummer. After going on-line to make my donation and get a tree and dedication sorted, I discovered that "Future Forests" started to plant a Forest in Scotland to the memory of Joe. Details about the activities of Future Forests (now called "The Carbon Neutral Company") can be found on their web site. Carbon Neutral Com

2003 had been a pretty uneventful year in terms of successful appeals or progress for people with diabetes. There were lots of fine words from politicians and executives of NHS trusts, but these were rarely supported by any tangible evidence that the words were matched by their actions. This made their words worthless. This lack of integrity is not exclusive to politicians and executive officers of course, but these are the people who are usually in a position to make the changes that would ensure equality for everyone.

One significant case of the year was that of taxi driver Pat Flynn. Her case against West Berkshire Council who issue the cab drivers licences was one of sustained nonsense. This did not deter Pat from fighting however. She took up the mettle and made sure petitions were signed, magazine articles written, politicians lobbied and a huge effort on Pat and her supporters part was made to try and secure something akin to justice. At the end of 2003, she had been unsuccessful in gaining her licence back, but had rattled all the right cages and upset all the right people.

I had absolute faith that she would eventually win, because people like her refuse to give up. She gave me an assurance that when she did overcome the nonsense from her licensing authority, she would be actively involved in setting up an association of Diabetic Taxi Drivers in the UK. I promised to hold her to it.

There were two exceptions to this negative profile - both in late 2003. The first was the case of a track worker for Network Rail called Martin Harkin. Earlier in the year I had gained the honour of being an accredited expert witness for the Disability Rights Commission and travelled to Cardiff in Wales to support Martin. Network Rail (formerly called Railtrack) asserted that their concerns were for safety first. For me, this was about as credible as Adolf Hitler claiming that his prime political motivation was the eradication of anti-semitism. My colleagues had been directly involved with the Ladbroke Grove and Southall Rail crashes. In fact, Divisional Officer Terry Adams - another dodgy old diabetic - had been the Incident Commander of the former event.

The media routinely refer to these events as accidents or tragedies. Corporate murder is a more accurate description as I feel these were not accidents, but legacies of sloppy safety management within a company that puts the interests of shareholders before safety. Very few people who travel on trains have ever argued against this assertion, particularly the families of those who died. Network Rail's legal team were unarmed for a battle of wits and called for an adjournment. The tribunal team ruled that the case could be adjourned, but that Network Rail would be liable for the costs as many of us had travelled a considerable distance to attend that day. The case was finally settled out of court and Martin was awarded compensation and his old job back.

The second bit of really good news of the year was the story of Stephen C Steele, a Canadian pilot. Stephen was diagnosed with insulin-treated diabetes in 1986, immediately terminating his 11 year commercial aviators career. He was grounded and considered unfit to continue in the job which he loved (sounds familiar). He maintained his flying skills however after being allowed to work as a flight simulator instructor. (also sounds familiar) His extensive background in airline flight training development and human factors in aviation, combined with his exemplary personal diabetes management, assisted in his campaign for individual assessments (very familiar). In November 2002 he was allowed to return to flying airliners, albeit with stringent conditions attached to the rules, some of which he assisted in writing (very very familiar).

At the end of 2003 in Canada there were 54 people with insulin-treated diabetes who were medically certified to fly. Five of these pilots flew commercial airlines. One in the Canadian military and the others recreational pilots. The regulatory authorities in Australia and South Africa also adopted policies which are similar to those implemented in Canada, although at that time none were being issued within the US or the UK. (source Diabetes Voice Magazine September 2003 Volume 48 Issue 3)

On 1st October 2004, the exemptions from the Disability Discrimination Act previously applied to the Fire, Police and Prison Services were lifted. From this time, blanket bans for potential applicants with pre-existing disabilities/impairments such as diabetes would be unlawful. There had been a time of almost 3 years set by Maria Eagle, the Disability Minister for each service to get their act together. On the go-live date, most of them were still playing catch up, but it would undoubtedly have been much worse had it not been for the leadership, training and commitment of Michelle Valentine of the Disability Rights Commission, who took the emergency and prison services in hand at the highest level and showed them the way. Thanks Michelle.

For Christmas 2004, my wife Sian had organised a round the world family trip lasting 6 weeks, taking in 6 countries and meeting up with loads of old friends. We left the UK on Christmas Eve and two days later the tsunami hit with devastating consequences. We were in Singapore at the time and protected from the carnage by the land mass to our north. The quake and resultant tidal wave went almost unnoticed where we were. Countries much further from the epicentre of the earthquake than we were lost everything.

My cousin John, his wife Nim and their three beautiful children Rob, Kate and Dave were all hit by the tsunami at Khao Lak in Thailand. Only Nim survived, although she was badly injured. Emails, text messages and phone calls flooded in as others learnt of the disaster and latterly of our family's personal loss. A group of firefighters (both men and women) in london shaved their heads to raise money for the disaster fund. As time progressed, Nim stated that she wanted to set up a school in Thailand for the orphans of the disaster to give the children the chance of a future. When my colleagues and friends found out about this plan, the money started to appear without any coercion from me. A number of other events were also planned to raise money.

On 31st May 2005 I flew to South Africa to act as a witness in a Cape Town Labour Court for the applicant Mr Stuart Murdoch. Stuart had been refused employment as a firefighter for all the same reasons used to bar UK, US, Australian and Canadian firefighters in the past. I have to confess a prejudice and fear of going to court in South Africa. The country's appalling history of human rights violations - apartheid in particular - left me with grave concerns about the potential for his case to be heard fairly The lawyers for his case showed me the Employment Equity Act 55 of 1998 and my prejudices started to wane however.

Less than a decade after the release of Nelson Mandela from prison, the laws in place to ensure equitable treatment for all in South Africa eclipsed anything I had seen in the UK. Upon my arrival at the courtroom, the cross examination of Stuart's consultant was in full swing. Professor Francois Benici is something of an icon in the diabetes world. He is multi lingual, has a CV thick enough to prop open the doors to the Bank of England (it's got lots of pages and is laden with qualifications) and his sense of fair play is matched only buy his sharp sense of humour.

At one point during the proceedings, the respondent's (City of Cape Town Fire Department) lawyers asked Professor Bonici if he was aware of the work of an eminent diabetes physician. His response was that the diabetologist was one of his own students! Sometimes being in court can be fun after all. The lawyer went on to highlight one of the diabetologist's papers with text that they were using to justify their blanket ban. Professor Bonici's response was that he was so aware of the paper in question, he could quote it chapter and verse, including the parts that the lawyers had selectively left out that made better arguments to employ Stuart than prevent him from being a firefighter.

I have to say that in 16 years of courtroom activity, I have never seen more thorough legal teams on both sides of the bench. The respondent's questions and line of attack were well researched and meticulously comprehensive. Thankfully, they were matched by the expertise of Stuart's own legal team, leaving the Judge's decision based solely on the merits of the case rather than the competence of the lawyers being employed. Where there was uncertainty, the judge asked some really exacting questions and wasn't satisfied until the response had been clarified to the most finite detail. After presenting my evidence I had just 24 hours before returning to the UK. The court's decision took another 5 weeks, but it was worth the wait. We had made case law and added another country to the list of those who do not accept arbitrary diabetes discrimination. Stuart is now the Secretary of IRFD (South Africa) who will be able to advise those who follow him into the profession, albeit with significantly less ridiculous hurdles than the ones he had to jump before being accepted.

Prior to the October 2004 changes to the Disability Discrimination Act, I was told by more than one person that they thought the changes would open the floodgates for anyone (regardless of capability) to join the fire service. A year after the DDA exemptions were lifted, London had not yet recruited a single firefighter with pre-existing diabetes, although there were two in training by that time in other UK brigades. Some flood that was then! The UK ambulance service personnel at this time were still being subjected to an absolute bar to operational employment. Each time an employee won an internal appeal or tribunal, someone else would step in to place another barrier in the way of them being employed. I always found this issue to have so many ironies.

Ambulance workers must be near the top of the list of professions most likely to come into contact with doctors specialising in diabetes on a regular basis. They are also trained to an extremely high standard in the methods of overcoming hypoglycaemia. Paramedics and Emergency Medical Technicians work in vehicles containing numerous products for increasing one's blood sugars and finally (unlike fire and police officers) they were never exempted from the Disability Discrimination Act. Since October 2004, the UK fire service and more so the police have actively recruited people with insulin-treated diabetes into their ranks. The ambulance service seems very much to be the poor cousin of the emergency services when it comes to matters of employment discrimination.

Pat Flynn's taxi driving issue continued to gather momentum throughout 2005. Part of this was undoubtedly due to the growing number of people being discriminated against who wouldn't just roll over and accept blanket bans. Chris Bell, a private hire driver from Kent was one of these people, but his wife Lindy, in collaboration with Pat, really started to make a difference. Lindy set up a website, secured thousands of signatures on petitions with Pat that were handed over to the Department for Transport and held pressure group meetings with anyone who had even the vaguest responsibility for issuing public carriage licences

The previous stance taken by the Drivers Vehicle Licensing Authority, The public Carriage Office in London and the Secretary of State's expert Panel on diabetes was eventually reviewed and revised. By September 2005, news of one driver after another being reinstated became the norm as each case went back for review - this time with a proper medical assessment to replace the previous blanket ban. By January 2006, more and more taxi and private hire drivers were being allowed to work alongside their non-diabetic peers after a suitable evidence-based assessment. Pat and Lindy's tireless campaigning had now paid off.

On Sunday 12 February, The legendary Susan Knibbs died after 6 weeks as an in-patient in the Chelsea and Westminster Hospital in London. For some time she had suffered neurological (cerebrovascular) disability, initially affecting mostly her power of speech, and for several months she bravely bore the increased progress of this trouble. It pained me greatly to see her in hospital just before she died. Susan retained that immensely sharp brain and wit I loved so much. With her speech so badly impaired however, she was denied the opportunity to actively contribute to the dialogue in her usual way. This must have been so very frustrating to one of the most articulate and dynamic women I have ever met.

Despite this obvious despair and the concerns she must have had for her own well being, she expressed more interest in how my family were and how the campaigns for the ambulance and taxi drivers were going. The term "legend" is always over-used and frequently inappropriate in the media, but in the case of Susan Elizabeth Knibbs BEM, friend and inspiration, to refer to her as such was an understatement. For 17 years, her support for the activities of the IRFD was unwavering. She offered advice without criticism, helped to champion our cases vehemently and was an inspiration to anyone who wanted to campaign for a fairer world.

At times in the past I have felt that the struggle to secure something akin to justice had been thankless and exhausting. Just when I would start to think "what's the point?" a letter, card or email would arrive from Susan that would re-light the flame and get me back onto the campaign trail. Anyone with a heart who met Susan couldn't fail to love and admire her. She is irreplaceable and will be missed every single day for the rest of my life. Because of Susan's impassioned crusade to ensure that children with diabetes were educated about their condition, a charity was set up after her death by her partner Terry. The Susan Knibbs Charitable Trust (registered Charity No 1115397) is now in place to provide funds for children with diabetes to participate in events such as educational trips and holidays similar to the way I learnt about my own condition with the BDA's Outward Bound event in 1989. For more information about the trust and its work, please contact me directly.

In late 2006, the DVLA's Working Group on Diabetes and Driving in Europe published their recommendations on the DVLA web site. There were a number of changes suggested by the working group, but one of the most distressing was the creation of a blanket ban against any insulin treated personnel in the emergency services from driving on "blue light" conditions. Blue light driving refers to emergency response vehicles on their way to incidents. This suggested ban effectively brought the job descriptions of most police officers, ambulance workers and senior fire officers into question.

As usual with the arbitrary "one size fits all" knee jerking such as this, the decision was not based on a single accident or near miss event, nor on any evidence-based assessment. Unreferenced stereotyping would clearly suffice for this government department. Whatever happened to their passion for equality? It appears to be as absent as their accountability for their actions. No surprises there then.

The ongoing battle for ambulance workers started to gain impetus as a number of paramedics, Emergency Medical Technicians (EMT) and ambulance drivers started to get more angered and even more organised. Craig McDermott, a paramedic in Scotland decided that after fighting his own appeal, enough was enough and that the service needed to get more active in challenging the DVLA's prejudice. Craig founded the International Ambulance Diabetes Association (IADA) shortly after the DVLA's Web publication of their blue light blanket ban. There was no obvious press release with the DVLA's working group changes, so if it hadn't been for the eagle-eyed Lindy Bell, the recommendations may have been translated into policy without anyone being aware that they were coming.

After the news had been disseminated amongst the other campaigners, a series of written responses were submitted to the DVLA. These came from The Disability Rights Commission, Lindy and Pat's Taxi and Private Hire campaign group, Tim Savage's National Police Diabetic Association, the Royal College of Physicians, Craig McDermott's IADA, Diabetes UK, Brendan Barber the General Secretary of the Trades Union Congress (TUC) and of course yours truly at the IRFD. At the next All Party Parliamentary Working Group on Diabetes meeting at Westminster, I was invited by Claire Francis, head of public affairs at Diabetes UK to address the group. I was accompanied by Tim Savage and Craig McDermott.

With so much momentum gathering amongst the ambulance worker's in their efforts to gain a fair system of individual assessment, I was hopeful that the Westminster meeting may have been the catalyst for some more high powered meetings with all interested parties. We followed up the meeting with a letter jointly written by the three emergency service participants.

In the USA in November 2006, the National Fire Protection Association (NFPA) revised standards were published. NFPA 1582 Standard on Comprehensive Occupational Medical program for Fire Departments 2007 Edition was sent to me by the former head of advocacy at the American Diabetes Association. The good news was that blanket bans were to be replaced with individual assessments, but the American Diabetes Association were very concerned that one of the recommendations was an HbA1C of less than 8% which they thought may conflict with the absolute need to avoid hypoglycaemia at work.

I discussed this 8% issue with a number of consultant diabetologists and the consensus was that it was an appropriate requirement. Stuart Murdoch in South Africa finally started at the fire brigade training centre in December 2006. It was whilst he was still in training school that we were both invited as guest speakers at the International Diabetes Federation's Congress in Cape Town. 13,000 delegates attended (not all at our presentation thankfully) and the event took over the city for 5 days. Our presentation was titled "Tackling discrimination head on".

After almost 18 years of doing this stuff, I was sorely disappointed with the many stories coming back from the audience about workplace discrimination so similar to our own ones. Equally frustrating was the fact that these stories were still so commonplace. Also in 2006, Diabetes UK published their report based on feedback from police officers with diabetes in the UK taken from a national survey. The success of the survey and quality of the data received allowed it to become the catalyst for a similar survey of the UK fire service.

Each fire brigade and rescue service was solicited for feedback. Two separate surveys were used, the first for all the personnel employed with diabetes, the second from the employer's perspective. From the start, all the identified "stakeholders" were approached to ensure that all their differing agendas and particular levels of expertise were given due consideration. Representatives from each of the following groups were present at the inaugural meeting at Diabetes UK: IRFD (of course), Diabetes UK, the Fire Brigades Union, Chief Fire Officer's Association, the Disability Rights Commission, the Retained Firefighters Union and the Association of Fire Officers. It was the first time I'd ever witnessed representatives of all these groups having a civil discussion at the same table although I could see a number of people found it deeply uncomfortable.

The debate remained professional though and the survey that followed was advertised by all the attending parties. The survey results confirmed the success of the IRFD's work over the previous 17 years. A number of names of serving firefighters and control officers with diabetes came to light that we didn't know about. These people were diagnosed after the bulk of our campaigning work took effect and instead of facing an immediate medical dismissal, they had been afforded an individualised medical assessment. The survey indicated that there were about 20% more firefighters and control officers with diabetes that we knew about.

The response from individual employees was impressive. It is common to get less than 50% of people surveyed to respond to questions. The feedback appeared to have come from almost all of the target group, although some fire brigades didn't bother to reply for the second survey - somewhat highlighting our concerns that disability inclusion and equality was off the radar (AKA something they didn't care about) for many organisations.

The information gleamed from the two fire brigade surveys created a report - written in the main by Michelle Valentine at the DRC - similar to that used by the UK Police Service earlier in the year. The report was launched in October 2006 at the House of Commons. The Fire Service Minister attended as did Tim Savage from the National Police Diabetes Association and Craig McDermott, a paramedic working for the Scottish Ambulance Service who had been making the same arguments as me and Tim since his own diagnosis with diabetes. Craig was so fired up from the meeting (and the accumulated stress and annoyance that dealing with jobsworths causes) that he decided to formalise his campaigning and inaugurate the International Ambulance Diabetes Association (IADA).

In January 2007 I learnt of two bits of great news. Firstly Dr Rowan Hillson, the leadership behind Hillingdon Hospital's excellent Diabeticare Centre, was awarded an MBE. I don't normally get excited about awards with the word "Empire" in them, but when the recipient is so deserving, I'm inclined to set aside my prejudices. Benjamin Zephaniah was right though - the "E" should stand for Excellence. The second bit of news was that Geoff Gill (the other remaining legend and advisor to the IRFD) became a Professor of Diabetes in the new year. Geoff was very dismissive of the title in his own modest way, but it looks good on our documents that a real Professor is advising us.

By the start of 2007 a number of personnel had been recruited into the UK fire and Police services with pre-existing diabetes. What came to light at a number of locales where they would be trained and employed was the lack of awareness of the line managers and training staff. A number of Dr Hillson's informative books assisted in getting some of the straining staff up to speed, but it soon became clear there was a need to procure something more focussed on the line manager's role. I set about drafting up the IRFD Line Manager's Handbook (sub title - Balancing Rights with Responsibilities). I was ably assisted by Diabetes UK, Professor Gill, Michelle Valentine at the Disability Rights Commission, Frances McAndrew at the London Development Agency, Tim Savage at the National Police Diabetes Association and Crag McDermott at the International Ambulance Diabetes Association. The content was ratified in the spring of 2007 and is now available from the IRFD office.

On 20 September 2007, I received a call from Peter Hannell, a Paramedic in the London Ambulance Service (LAS). Peter is also a lay official within the largest NHS/Ambulance Services Trades Union Unison and thankfully another one of those people whose words are matched by his actions. The call was to tell me that the 8 LAS members who had been suspended from driving duties were now back on unrestricted attendance duties (including blue light driving) following appropriate assessments. Peter had worked tirelessly to get some case law for the national campaign, but the employers eventually settled out of court with re-instatement and punitive damages compensation paid to the 8 workers.

I was under the impression that Peter had diabetes, given his well informed and impassioned delivery of the requisite subject matter. There was however no self interest to satisfy save that of doing the right thing as a trades unionist and making a difference. Within minutes of the news, my phone starting ringing as other people around the UK heard the news and wanted to get their own employers to act similarly to the LAS. Craig McDermott had already approached his line managers and shown them the LAS letter. The response, he said, was worth the effort. This landmark decision was a culmination of 18 and a half year's work for the IRFD and others like us and ensured a broad smile was maintained on my face for the rest of the day.

The ambulance service driving issue was always the one I saw as my final goal before I hung my gloves up. It now looked as though we had finally succeeded. A host of unpaid David's against a significant number of well financed Goliath's with their own legal departments, making the justice all that more sweet. I do love a happy ending, but it wasn't over yet..

On 1st October 2007, the Commission for Racial Equality (CRE), Disability Rights Commission (DRC) and the Equal Opportunities Commission (EOC) were modernised (government speak for "cut") and merged into one organisation - the Equalities and Human Rights Commission (E&HRC). A number of dynamic and talented people lost their jobs at the former commissions, including Michelle Valentine, but many brilliant people were also retained for the newly merged E&HRC. I was hopeful that these key players would still be able to make a difference and do the right thing, but these things always take time and the history written by human rights activists will indicate how effective the changes were. Watch this space.

Also in October 2007, I was contacted by Malcolm Knowles, a commercial pilot who worked for BA until his diagnosis with diabetes. He asked for information about the possibility of challenging the very strict rules applied by the Civil Aviation Authority (CAA) and the Federal Aviation Authority (FAA) medical requirements. I sent malcolm a copy of the last IRFD newsletter that had the Stephen Steele article in it from 2002. Martin got in touch with Stephen - who was regularly flying in and out of Heathrow for Air Canada - and the blue touch paper was lit for yet another campaign group.

The inaugural meeting of the Pilots with diabetes group was held on 13th December 2007 at the RAF Club in Piccadilly, London. I was invited to the meeting to talk about effective campaigning, although this group of inspired and hopeful people seemed suitably talented to make the difference required. All 8 attendees had insulin-treated diabetes but I was the only one who had never learnt to fly. One of the active and highly articulate attendees was Douglas Cairns, a pilot and author of the book "Dare to Dream - Flying Solo with Diabetes (Around the world in 159 days) ISBN 0-9549929-0-3.

Douglas already had a web site titled Pilots With Diabetes so the name of the group suited this existing label. The web site can be found at Pilots with Diabetes Within a day, a forum was set up to network other pilots who were in the same or similar situation. If any readers of this site are pilots - commercial or otherwise with an interest in flying safely after diagnosis, then it's easy to register.

Further meetings took place and when the group is successful in getting the blanket bans replaced with individual qualitative medical assessments, then it is possible that the DVLA and DfT might also have to review their arbitrary stance on LGV, bus and train drivers - and of course hairdressers on cross channel ferries!

So what's next? There is still plenty of diabetes and other disability discrimination apparent from employers to keep us in work for the foreseeable future. On average I receive a couple of emails or telephone calls each month from someone else who has suffered arbitrary and punitive discrimination, usually solely on the grounds that they have diabetes. The IRFD continues to extend its service beyond the employment of firefighters and is supported by some eminent consultant physicians who specialise in diabetes and endocrine disorders.

My last remaining goal will be to find that cure - but Diabetes UK's web site has the virtual monopoly on that topic. They can be found via the links section of this site. If you have managed to read all of this section then you have already proven to be a most patient person. Thank you for the interest shown in the IRFD. If you wish to communicate with me, my E-mail address is diabetesed@irfduk.net

Key to brigade & other jargon and initials used.

I must stress that the UK English spelling of words has been used in this web site. I am sure that there are still going to be some errors contained within it and would welcome any additions or corrections via E-mail for the next revision.

• CACFOA Chief and Assistant Chief Fire Officer's Association
• CAA Civil Aviation Authority
• CFBAC Central Fire Brigades Advisory Committee
• CFOA Chief Fire Officer's Association (formerly CACFOA)
• CLG Department for Communities and Local Government (formerly ODPM)
• CRE Commission for Racial Equality
• DDA Disability Discrimination Act
• DETR Department of the Environment, Transport and the Regions
• DEWP Driving and Employment Working Party
• DfT Department for Transport
• Diabetes UK (Formerly the British Diabetic Association - BDA)
• DRC Disability Rights Commission
• E&HRC Equalities and Human Rights Commission
• EOC Equal Opportunities Commission
• FAA Federal Aviation Authority
• FBU The Fire Brigades Union
• FOA Fire Officers Association
• HMSO Her Majesty's Stationery Office
• IADA The International Ambulance Diabetes Association
• IDF The International Diabetes Federation
• IFE The Institution of Fire Engineers
• MOD Ministry of Defence
• NAFO National Association of Fire Officers
• NPDA National Police Diabetes Association
• ODPM Officer of the Deputy Pie Minister
• RFU Retained Firefighters Union
• TUC Trades Union Congress
• VOADL Voluntary Organisations Against Discriminatory Legislation

• The Home Office - This was the UK's government department that set the rules for the employment of firefighters, police officers, prison officers and civil servants in England and Wales. In Scotland the Scottish Home & Health Department and in Northern Ireland, their Department of the Environment, based in Stourmont served much the same function. After government department changes the department that became "responsible" for the UK Fire Service was the Office of the Deputy Pie Minister (ODPM) later replaced by the Department for Communities and Local Government (CLG)

• Private Members Bill - Before laws are enacted by UK parliament they are referred to as "bills". A private member's bill is one which is written and put forward by ordinary members. Unless these bills are adopted by government they seldom pass as laws due to the inherent bureaucracy required to allow each separate reading of the bill at each stage of the process.

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