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

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London County Council 1949

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

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63
the children at five nurseries and ten nursery schools had been vaccinated or were
awaiting vaccination. Of the remainder, parental consent had either been refused
or was awaited.
LONDON AMBULANCE SERVICE
Historical sketch of the Origins, Development and Present Organisation
Origins
Ambulances were originally devised to serve the purposes of a military
campaign and their use in civil life was a secondary development. It was Baron
Larrey who first contrived "ambulances volantes" for the "Grande Armee"
under Napoleon. Originally they were spoken of as "Hospitals Ambulants," thus
indicating the true nature of the service—an extension from a base hospital to
the site of the casualty.
One would assume that most people would value their lives more highly than
their property but it is, nevertheless, true that while for generations the property of
Londoners has been protected it is only comparatively recently that anything
has been done for those who fall ill or meet with accidents in the streets. The early
remedies for dealing with fires were primitive enough and can hardly be compared
with the elaborate modern fire fighting organisation but, whereas the London Fire
Brigade can trace its history back at least to the end of the 17th century, an
ambulance service in London dates only from about the middle of the last century.
Introduction
The need for conveying fever patients expeditiously to hospital from their
homes brought about the first ambulance service in London, that of the Metropolitan
Asylums Board. Sir Allan Powell, C.B.E., the Clerk to the Board, wrote, "After
the opening of the Board's Hospitals, attention was drawn to the defects in the
arrangements for the removal of patients to hospital. This duty still rested with
the Boards of Guardians. In many instances, the vehicles were quite unsuitable in
themselves and were housed in a dangerous way, as, for example, when a carriage
after being used for the removal of a smallpox case was placed in a yard surrounded
by tradesmen's carts. Frequent complaints were made of the carriages conveying
patients to hospital stopping at public houses, into which the driver and the patient's
friends went for refreshment, and difficulty was frequently experienced in obtaining
a carriage when required."
In 1879 the Board obtained powers to provide ambulances and the first
ambulance of the Board was a horsed conveyance containing stretchers for two
patients lying down and a seat for the attendants, generally bearded, who
accompanied them. Horse ambulances were exclusively used until the end of the
19th century and it was a common sight in London to see urchins running behind
them shouting, "Fever!" In 1902 the Board first used a steam ambulance
carrying eight stretchers and attaining a speed of five miles an hour. From 1904,
when a motor ambulance was introduced, horse ambulances were gradually superseded
until the last was abandoned in 1912. From the days when smallpox cases
ware isolated in ships moored in the Thames, the Board had run a river ambulance
service with three wharves and five steamers but this was discontinued in 1932.
Infectious
cases
For non-infectious cases, the earliest attempt to provide an ambulance service
in London appears to have been the foundation of the London Horse Ambulance
Service under the Presidency of the Duke of Cambridge in 1882. This unfortunately
came to an end when the ambulances wore out.
Noninfectious
cases
Provision for dealing with the sick and injured in streets and other public places
was first conceived and undertaken by voluntary philanthropic agencies rather than
as part of municipal administration.
The Order of St. John of Jerusalem afforded first aid instruction and provided
litters and stretchers at certain stations in London. It also co-operated with the
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