London's Pulse: Medical Officer of Health reports 1848-1972

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London County Council 1901

[Report of the Medical Officer of Health for London County Council]

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21
(4.)—AS TO THE ESTABLISHMENT OF A HORSE AMBULANCE SERVICE for EMERGENCY CASES IN LONDON.
Tlio fact that in many towns both in the provinces and in other countries it has been considered
advisable to establish and to maintain a horse ambulance service for emergency cases may be taken as
evidence that such a service is of use and supplies a want which is not fulfilled by a hand ambulance
service alone, at least so far as the more busy centres of population are concerned. If this is so as
regards provincial towns it is to be expected that the same would apply to London, or at least to some
portions of it. The County of London may, however, be regarded as containing districts comparable
both to the busy industrial provincial town with considerable traffic in the streets, and to the quieter
town such as those in which a hand ambulance service is still considered to meet the requirements of
the district, and it is possible, therefore, that the provision of a horse ambulance service for the whole
area of the county need not be considered, at all events in the first instance. It might be well in
the first instance to initiate such a service tentatively in one part of London. In any case it is highly
probable that a complete ambulance service for London would be found to be one which comprised
both horse and hand ambulances in each ambulance district, that is to say the horse ambulance would
be supplemented by hand ambulances. I believe this is the case in Buda-Pesth, and that it is proposed
to add hand ambulances to the existing service in Paris. One or more ambulance districts
might be established, and the number of these could afterwards be extended if found necessary.
If it were decided to establish such a service, the points which would present themselves for
consideration include the following—
1. What part of London should be taken for ambulance districts ?
2. What should be the area of the districts ?
3. Where should the ambulance station be established ?
4. What would be the best means for readily summoning the ambulauce ?
5. How should it be staffed ?
6. What kind of horse ambulance should be provided ?
Considering these headings in detail—
(1.) Ambulance districts.—The parts of London where it would be well to first form tin
ambulance district or districts would be those where during the daytime traffic is greatest aiid
accidents are most likely to occur. With a view to gaining information on this latter point the
annual report of the Commissioner of the Metropolitan Police has been studied, and from the report for
1899 the following table as to accidents coming to the knowledge of the police has been taken.
This table refers to police districts and therefore includes areas part of which are without the county
boundary. But for the purpose in view this is not of much moment. Two districts with the highest
number of accidents, viz., Holborn and Whitechapel, are entirely within the county.

Return of accidents known to the police which occurred in the sheets during the year 1899.

Accidents by which persons were killed.Accidents by which persons were injured.Order in relation to frequency of accidents.
Police Division.By day.By night.By day.By night.Total.
A.—Whitehall2...1993523620
B.—Chelsea613156138314
C.—St'. James's4...4361225626
D.— St. Marylebone61415835059
E.—Holborn326541087672
F.—Paddington2...1812921221
G.—Finsbury14...3916446912
H.—Whitechapel151627727153
J.—Bethnal-green5...2342926819
K.—Bow17l542606204
L.—Lambeth13l6561538251
M.—Southwark143509685945
N.—Islington*15...2485131417
P.—Camberwell533374539013
R.—Greenwich6...2986036415
S.—Hamptead.......2563429018
T.—Hammersmith....34225447911
Y.—Wandsworth8...490505487
W.—Clapham1633878849410
X.—Kilbnrn1212823933416
Y.—Highgate151436645168
Total186218,3151,3699,891

2. Areas of ambulance districts.—As regards the area for which one ambulance station would
serve, no precise statement can well be made. The area would depend on circumstances, such as the
number of accidents during one day, the distance from hospitals, and the unequal distribution of
the latter in relation to the area of London.
The information bearing on this point in the replies received from provincial towns, shows that
the area for which one ambulance serves varies considerably, viz., from an area of about 2,050 acres