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whom died, were taken to hospital and very many more were given first-aid treatment
in the standing-by ambulances, after which they were able to resume their
duties. In his report to the Council on this disaster, the Chief Officer of the London
Fire Brigade paid generous tribute to the efficient co-operation of the London
Ambulance Service personnel.
The other major incidents were:—
On 19th January—Omnibus in collision at Rotherhithe with a lorry laden
with timber. Ten injured persons were conveyed to hospital.
On 24th July—Train smash at London Bridge Station; seven casualties were
dealt with.
On 6th August—Train smash at Euston Station; 32 casualties were removed
to hospital.
National agreement on ambulance charges and new legislation
In February and April, 1949, conferences were held of representatives of the
County Councils Association, the Association of Municipal Corporations and the
London County Council to consider the incidence of the cost of, and the rates of
charge made for, ambulances required for the removal of patients by one local
health authority on behalf of another. The published reports of these conferences
included recommendations as to the basis on which such charges should be made
and the rates of charge. These were adopted by the Council and, with minor
individual qualifications, by local health authorities throughout the country with
effect from 1st October, 1949.
It was also agreed at the conferences that representations should be made to
the Minister of Health recommending that, when opportunity occurred, Section 27
of the National Health Service Act, 1946, should be amended to provide that where
a person had travelled from the area of one local health authority to that of another
for the purpose of attending at, or being admitted to, hospital and, immediately
after such attendance or on the termination of his period of accommodation in the
hospital, returned to an address in the area from which he was admitted, the local
health authority for that area should repay to the local health authority in which
the hospital was situated the cost of ambulance or other means of transport
provided under Section 27 of the Act of 1946, provided that the date of the patient's
return was not more than three months after the date of his admission. A section
to this effect was subsequently included in the National Health Service (Amendment)
Act, 1949 (Section 24), which received the Royal Assent on 16th December,
1949, but a sub-section added the proviso that "any local health authority may
agree to waive their rights under this section against any other local health
authority, either in consideration of a periodical payment or without consideration."
As the number of patients removed by the London Ambulance Service from
London hospitals to out-county addresses is approximately 3,000 a month, this new
legislation has added a considerable burden to the administrative work of the
Service, since the cost of all such journeys is potentially recoverable and in order to
determine liability the date of the patient's admission and the address from which
admitted has to be ascertained in every case. Further enquiry is, of course,
necessary in the case of those journeys where it is established that the cost is
recoverable, as to the mileage run and type of vehicle used. It is hoped, however,
that when experience of the financial implications has been gained—say, at the
end of 12 months—it may be found possible, by agreement with other local
health authorities concerned, to minimise the amount of detailed accounting
involved.
Smallpox
Miscellaneous
The special arrangements for the removal to hospital of patients suffering from
smallpox, which are made available on request to other authorities within a