View report page

27
(iv.) Notes of evidence given before the Sub-Committee.
(1.) Sir Henry Burdetfc, K.C.B., Chairman of Council of the Hospitals Association and
of the Committee of the Street Ambulance Branch.
(2.) Air. Thomas Ryan, Hon. Sec. of the Bischoffsheim Ambulance Service.
(3.) Dr. Danford Thomas, Coroner.
(4.) Dr. E. C. Perry, Superintendent of Guy's Hospital.
(5.) The late Admiral Adeane, formerly Chairman of the Ambulance Committee of the
Metropolitan Asylums Board.
(6.) Dr. R. J. Collie, the Council's Medical Examiner.
(7.) Police Superintendents.
(8.) Dr. Nachtel.
(1.) Sir Henry Burdett, K.C.B. (Chairman of Council of the Hospitals Association and of the Committee
of the Street Ambulance Branch).
Sir Henry Burdett explained the establishment of the Bischoffsheim Ambulance Service,
particulars of which are given in the medical officer's report, and stated his views on the subject of the
relative advantages of hand and horsed ambulances. His experience is that it is very doubtful
whether a system of horsed ambulances would justify the cost, and he thinks the Paris system is a
very extravagant service and not as efficient as the street ambulance service which exists in London at
the present time. If it can be shown that there is any useful purpose to be served by the introduction
of horsed ambulances or by motor ambulances which are much preferable, the money will
be given. It has been offered over and over again.
The great object of an ambulance should be to bring an ambulance litter to an injured person
at once, and the less he is moved the better. He said that while he was not opposed to horse or motor
ambulances he was strongly of opinion that they did not afford a panacea for street accidents. It
would be impossible to cover the whole of London with such an ambulance service, and the provision
of an elaborate system-on these lines would not be justifiable until it was found where they could
be most usefully employed. It would, moreover, be very difficult to get stations. A hand ambulance
6ervice can be supplemented by these means, but to substitute horse and motor ambulances for hand
litters would be a misfortune.
With regard to the police, Sir Henry Burdett stated that their co-operation is essential. But
the police already have as much as they can do, and it is unreasonable to expect them to undertake
elaborate arrangements for the removal of injured persons. At the same time the police should be
afforded greater facilities for acquiring first-aid knowledge, and they should not be expected as at
present to undergo a course of training in their own time, for in practice the majority of police have
to find their own time to attend first-aid lectures. The City police co-operate heartily with the system.
The service has instructed them in first-aid, and they use the ambulances more than the metropolitan
police.
He suggests that some reward should be given to the police, say half-a-crown, for every
accident case, removed to a hospital on an ambulance, in which they render assistance.
Sir Henry said that the present ambulance provision is no doubt inadequate, and that the existing
voluntary efforts do not cover the whole ground required. The people he represents would be willing to
disappear in a moment if they could get the system taken over by the Council. He thinks it is properly
part of the work of the Council to organise a proper service for London, and if the Council did nothing
more it could afford the existing service sites for other stations.
The Council could also help in inspiring enthusiasm amongst its large staff for first-aid and
ambulance work.
Sir Henry Burdett would like to see a trust fund organised by the Council, to which he was
sure Mr. Bischoffsheim and other people would contribute.
The Bischoffsheim service has no telephones at its disposal. Telephones might be useful.
The stations on cab ranks are most useful.
(2.) Mr. Thomas Ryan, Secretary of St. Mary's Hospital, and Hon. Secretary of the Bischoffsheim
Ambulance Service.
Mr. Ryan expressed the opinion that the existing provision is not adequate but that it is on
the right lines, and that the way to improve it is by developing what we have and not by discarding
it in favour of something else. There are at present a large number of hand ambulances distributed
over the metropolitan area. In his opinion this system is what the conditions prevailing in London
require and not four or six horsed ambulances.
If the object were to make a brave show which would appeal to " the man in the street" then
four or six fire-engine-like horsed ambulances are just the thing, but if we want an effective service
adapted to the conditions which prevail in London, a large number of light litters to be wheeled by
hand is what is required.
Among the reasons for this are—
1. That in at least 75 out of 100 cases a horsed ambulance and surgeon are simply not
wanted. The great majority of accidents, etc., are happily comparatively slight, and firstaid
and a well constructed hand ambulance are the desiderata.
2. That the 10,000 or 12,000 accidents that happen every year in London do not occur
regularly, about one per hour, throughout the day and night. No doubt if they did it would
be an ideal condition for 4 horsed ambulances to cope with. But no, these accidents are
intermittent and erratic. On a foggy day for instance, or when frost succeeds to a light rain,
they occur in scores at the same time all over London. It is certain that 4 or 6 or even
10 horsed ambulances are not calculated to successfully deal with a situation such as that.