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(4) The police—The metropolitan police possess both liand ambulances and wheeled litters
for use in cases of emergency, and members of the force receive on joining, instruction in ambulance
and first aid work as part of their ordinary training. In addition to this a large number of policemen
have voluntarily attended courses of instruction given by the St. John Ambulance Association and have
received certificates of efficiency.
One or more ambulances or litters are kept at all police stations, but in the absence of any
means of telephonic communication with the police station, by which the ambulance can be readily
obtained, their use must be largely restricted, in cases requiring prompt action, to such accidents as
occur in the immediate vicinity of the police stations. The custom of the police is not to leave the
sufferer, and the course taken in any given case depends largely upon the circumstances of the accident,
the place where it occurs and the presence in the crowd of persons ready and capable of giving
assistance to the police. Thus if it occurs near a police station, or a place where an ambulance has
been deposited by the St. John Ambulance Association, or the Hospitals Ambulance Association,
the ambulance would be used; if however these be at some distance and a cab is readily available,
its services would be requisitioned, or before resorting to a cab, if there be a doctor living near at
hand, he may be called out to see the injured person before removing him to hospital or to his
private abode.
The police also possess three horse ambulances, but these are not equipped and staffed, nor are
they in direct telephonic communication, so as to be available for use at a moment's notice. On each
occasion, when required, horses are obtained from a contractor.
On occasions of great public gathering the police largely, if not entirely, depend upon the
voluntary organisation provided for the occasion by the St. John Ambulance Association, the work
being carried out by the two bodies in conjunction. On such occasion the service is organised on a
military model, viz., a base hospital (one of the general hospitals), a field tent, with a horse ambulance,
at which first aid can be given in the neighbourhood of the crowd, and in connection with this, bearer
parties with hand ambulances amongst the crowd.
From what has been said in the foregoing account of ambulance service in London it will be
seen that there does not exist a service, fully equipped, adequately staffed, and connected by means of
a system of communication with different parts of London as to ensure speedy removal to hospital in
the best available manner of all persons who may meet with accidents or bo overtaken with illness.
Such means as exist at the present time, together with the fact that a large number of persons are
trained by the St. John Ambulance Association in first aid and ambulance work must do much good
in alleviating suffering in the removal of persons to hospital. Owing, however, to the absence of any
system of communication the use of the ambulance stations which do exist must be largely limited to
their own immediate neighbourhood, and in view of the fact that the ambulances are all hand
ambulances, considerable loss of important time must often occur in getting cases to hospital.
(2.) The arrangements in provincial towns for ambulance services, so far as relates
to accidents or cases of emergency.
With a view to obtaining information as to what, if any, provision has been made in provincial
towns in regard to an ambulance service for use in cases of accidents or sudden emergency as distinct
from ambulance services for the transport of cases of infectious disease, I addressed a circular letter
to the medical officers of health of the chief provincial towns, taking for this purpose the 32 large
towns included in the list of the Registrar-General.
The information which they have been good enough to send me I have set out in tabular form.
From this it appears that in 16 towns a horse ambulance service has been provided, while in
12 towns only hand ambulances are used.
Regarding those towns where a horse ambulance service has been established, it will be
observed that it has been provided in many cases by the local authority, in some by private
subscriptions, and afterwards taken over for maintenance and control by the local authority, and in
one case by the local hospital.
A special staff is not provided, but the services are worked by means of the police force or the
fire-brigade staff, and in nearly all cases the horse ambulances are kept ready for use at either police
or fire-brigade stations. In the case of the service at Liverpool—which appears to be the one most
systematically worked out—the ambulances are kept at the chief hospitals and at a police station.
The means of communication depended upon in these towns for summoning the ambulance are largely
street telephonic call-boxes.
In the information obtained from Sheffield reference is made to the increasing number of calls
received since the service was organised.

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