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Emergency cases, other than maternity patients, are normally taken to the nearest
casualty receiving hospital. There are 51 hospitals in the metropolitan area prepared to
admit casualties of any kind at any time of the day or night and a further 10 hospitals
accepting child casualties only. St. James' Hospital, Balham, received the highest number
of patients, 4,255.
Eighteen major incidents occurred during the year. There were 5 fires involving
39 casualties, 6 major road accidents involving 61 casualties, 3 relatively small
railway incidents involving 26 casualties and 3 miscellaneous incidents involving
11 casualties. The remaining incident was the tragic Lewisham railway disaster from
which 223 persons including 85 dead, were removed by the ambulance service. This
accident occurred at about 6.20 p.m. on 4 December, 1957, in dense fog near St. John's
Station, Lewisham, when a steam train collided with the rear of a ten-coach electric
train which was stationary at a signal. A number of carriages in each train telescoped
and carried away one of the pillars supporting a fly-over railway bridge which partially
collapsed on to the wreckage. Vehicles and men were quickly deployed and, within
half an hour of the initial call for assistance, 12 ambulances were at, or on their way to,
the scene. A further 19 ambulances were dispatched during the succeeding half hour and
ultimately, 37 ambulances and crews were in attendance. Ambulances were sent to the
scene by the Kent Ambulance Service and the Essex and Surrey Ambulance Services
undertook to respond, if necessary, to calls in East and South West London, respectively,
where London ambulances had been depleted. The last injured person was taken to
hospital by about 10.30 p.m. but the work of locating and removing bodies continued
and the last ambulance was withdrawn some 60 hours after the occurrence of the
disaster.
During the year there were 3,639 calls describing emergencies in which medical
assistance rather than ambulance transport was required and callers were advised to
summon the patients' doctors or were given particulars of other doctors who could be
called upon locally.
The work of the general section of the Service, concerned mainly with the removal
of sick persons to and from hospitals, clinics, railway stations, etc., continues to grow
(table (i)), in spite of the very slight reduction in the total number of patients dealt
with by the combined general and ancillary services. The bulk of this work is the
conveyance of out-patients to and from hospitals and clinics and no less than 83 per cent.
of the 886,839 patients dealt with by the general section came within this category.
Vehicles to meet this considerable transport problem are housed mainly at six large
ambulance stations which together accommodate some 280 ambulances and cars.
About 100 of these vehicles are stationed at the larger hospitals daily, or as often as
required, to work from these hospitals under the direction of the hospital transport
officers.
General
section
The conveyance of about 1,100,000 patients each year over a distance of about
6,000,000 miles without incurring some delay in dealing with the less urgent cases is a
problem which requires for its solution the most careful use of available resources.
Table (iv), shows the improvements which have been achieved by the general
section of the Service. By the careful planning and co-ordination of journeys and by
the increasing co-operation of hospital authorities, lost journeys have been considerably
reduced, delays in the ' turn-round ' of ambulances at hospitals are now relatively
infrequent and there has been a steady improvement in patient/mileage ratios.
Despite these improvements, however, delays in the conveyance of out-patients do
still sometimes occur. Moreover, it is evident that the present-day tendency to treat
more and more patients as out-patients and the schemes which several London hospitals
already have in hand for the very considerable extension of out-patient treatment of
all kinds, will entail still further increases in the demand for ambulance transport.
It is likely, therefore, that while emphasis must continue to be laid on the importance,
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