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83
in out-county establishments had been vaccinated. Parental consents were being
obtained for the remainder.
Discussions have been held with the Ministry of Health, the County Councils
Association and the Association of Municipal Corporations on, among other matters,
the necessity for maintaining records of vaccination of adults, particularly those who are
vaccinated before leaving the country. Although the Ministry did not consider it essential
to maintain records of the latter category, they wished to have full statistical information
of all other vaccination and it was decided to continue to keep records in London of
both infant and adult vaccinations, including those performed on persons going overseas.
Vaccination of staff and patients in hospital was considered to be a hospital responsibility
and the Ministry have arranged for local health authorities to obtain, without charge,
information of the extent of such vaccination.
LONDON AMBULANCE SERVICE
as in every previous year since the inception of the National Health Service there
was during 1952 a substantial increase in the demand for ambulance transport, the number
of patients conveyed by the General section of the service being 660,206 compared
with 550,621 in 1951, an increase of 20 per cent. The increases in the number ofjourneys
made and in the mileage run in dealing with this increased demand, 13 and 12 per cent.
respectively, are appreciably lower than the increase in the number of patients carried
and this is due to the additions made during the year to the list of hospitals to which some
degree of decentralisation is applied and, so far as the road mileage is concerned, to the
still increasing number of 'ambulance-train-ambulance' removals which, though
adding considerably to the administrative work of the headquarters staff, result in very
appreciable reductions in road mileage run and in vehicle and man hours occupied and
hence in an increased availability of ambulance vehicles within the area of the county,
besides effecting a considerable financial saving. In 1952, a total of 4,759 patients,
travelling a total of 377,501 miles by rail, were conveyed by this means compared with
3,998 patients, travelling approximately 302,000 miles by rail, in 1951.
Railway
stretchers
In collaboration with the chief officer of supplies and with a firm of manufacturers,
modifications were made in the design of the special stretcher used in the Service for the
conveyance of immovable recumbent patients by rail and 51 stretchers of this latest
design were added to the existing stock.
Decentralisation—ambulance vehicles stationed at hospitals, etc.
As mentioned above, the arrangements under which ambulance vehicles are stationed at
hospitals, etc., for varying periods on weekdays to convey patients to and from these
hospitals on the instructions of the hospital Transport Officers were extended during
1952 and more hospitals, etc., were brought into the scheme, bringing the total to 43.
Review of administrative organisation and of methods of operational control
The ever growing demands upon the service have led to very severe pressure upon the
central control room and upon the administrative and control staff both at headquarters
and at the general ambulance stations as well as upon the operative staff and vehicles. A
comprehensive review of the various clerical and operational procedures employed in the
service was accordingly undertaken with a view to the elimination of outmoded
practices and the promotion of greater service efficiency. This review was conducted in
close collaboration with officers of the organisation and methods section of the department
of the clerk of the Council, to whom I am greatly indebted for much expert
advice and practical assistance. As a result a number of changes in procedure have already
been adopted and others are in contemplation, designed to reduce the pressure upon the
central control room, to simplify the control work at the general ambulance stations and
at the same time to promote still closer association between the hospitals and their local
ambulance stations.