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66
Extension
of free
facilities
It had been the Council's policy, over a period of years, to extend from time
to time the range of facilities which were provided by the ambulance service
without charge to the public. For example, the free conveyance of patients to
hospital was at first available only in respect of the Council's own hospitals and a
small charge was made for removals to voluntary hospitals. From 1st April, 1946,
however, the latter, also, were carried out free of charge except where the patient
was being admitted to a private ward. There remained some purposes, not covered
by these free facilities, for which ambulances could be hired but the Council was
always ready to consider sympathetically any case in which payment of a hire
charge would result in financial hardship and in no circumstances was an
ambulance ever withheld through doubt as to whether or not the fee would be
paid. Ninety-five per cent. of all journeys undertaken during 1947 were carried
out free of charge and it will be seen, therefore, that the Council at that time had
already gone a long way towards the provision of the free service which, on 5th July,
1948, became available to all under the provisions of the National Health Service
Act, 1946.
Present Organisation
Accident
Section
For accident and other emergency calls there are now 18 ambulance stations,
so situated that no part of the Administrative County of London is more than
about 2 miles from one of them, and the average time taken to reach a street
accident is a fraction over seven minutes from the time the call is first received in
the Control Room.
The ambulances attached to these accident stations carry, in addition to the
normal first-aid equipment, a comprehensive range of special equipment and
appliances including oxygen-CO2 apparatus, sterile surgical instruments, drugs,
carrying chairs, hacksaws, rope and special apparatus for raising or lowering the
injured from positions otherwise difficult of access.
General
Section
For the removal of sick persons there are the six large "general" ambulance
stations geographically placed so as to provide equal facilities throughout the
county. Each of these stations has a fleet of about 30 ambulances supplemented by
a small number of cars for the conveyance of sitting cases. Some of the stations
have, in addition, a number of ambulance-buses capable of carrying a large
number of patients, either sitting or recumbent or some of each. The ambulances
operating from these stations are provided with first-aid kit to enable their crews
to treat any injured persons they may encounter while engaged on their duties.
Infectious
cases
The removal of patients suffering from infectious diseases is undertaken by
vehicles from the "general" stations and special apparatus is provided for the
cleansing and disinfecting of the vehicles and their equipment.
Method of
dealing
with calls
Normally, calls lor ambulances are received centrally in the Control Room at
the Headquarters at County Hall. Here a specially designed telephone switchboard
is installed and gives direct communication with each ambulance station. The calls
either come in directly, from hospitals, doctors, midwives, the police, etc., or are
relayed to the Control Room by telephone exchanges which have received them as
emergency "999" calls. This central system of control enables the resources of
the entire service to be used to the best advantage by the diversion of work from
one station to another according to the fluctuating pressure. The Control Room is
in the immediate charge of a Supervisor and an Assistant Supervisor and is manned
throughout the day and night by a clerical staff totalling about 30 working on a
shift rota.
The daily number of calls for ambulances received in the Control Room is
about 250 for accidents or other emergencies and about 600 for general removals.
Decentralisation
Other calls for general ambulances for the conveyance of out-patients are made
directly to the ambulance stations by certain hospitals which have a large volume