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LONDON AMBULANCE SERVICE
Introduction
Origins and
early
development
A full account of the origins of the London Ambulance Service was given in my
report for 1949 (page 63). Briefly ambulances were originally devised to serve military
purposes and their use in civil life was a later development. An ambulance service as
such in London dates back only to the latter part of the last century when the Metropolitan
Asylums Board in 1879 established the first horse-drawn ambulance service in
London for the purpose of conveying fever patients to hospitals.
The Council s own ambulance service did not begin until 1915 when an accident
ambulance service was introduced under the control of the Chief Officer of the Fire
Brigade. This Service, which, during the first year, established six ambulance stations with
50 men and 9 ambulances, had grown by 1929 to 14 ambulance stations in commission
with 20 ambulances and a total staff of 165.
The Local Government Act, 1929, transferred to the Council the ambulance
services previously maintained by the Metropolitan Asylums Board and the 25 Boards
of Guardians. Six large ambulance stations, 107 vehicles and a staff of about 270 were
taken over by the Council and the general section of the London Ambulance Service,
as distinct from the accident section, came into being, both sections then being administered
through the Public Health department.
At the outbreak of war in 1939 there were 6 general ambulance stations, 16 accident
ambulance stations, some 200 vehicles and a total staff of 422. The London Ambulance
Service formed the nucleus of the London Auxiliary Ambulance Service created to
deal with the conveyance of air-raid casualties, 48,709 of whom were transported to
hospitals or first-aid posts. The six general stations were supplemented by some 112
auxiliary stations and in 1940 there were in commission about 900 ambulances and
700 motor cars for ' sitting' cases with a staff of some 7,000, later to be increased to
8,500.
After the war and the disbanding of the Auxiliary Ambulance Service, developments
in the regular service prior to 1948 included the conveyance of analgesia apparatus
for use by midwives in home confinements, emergency obstetric units to deal with
complications arising during child birth at home and resuscitation (' iron lung ')
apparatus for use in cases of emergency.
National
Health Service
Act, 1946
Section 27 of the National Health Service Act, 1946, made mandatory upon the
Council, as Local Health Authority, the provision of a free ambulance service in London.
It had already been the Council's policy to extend from time to time the range of
facilities which were provided by the ambulance service without charge to the public
and, in fact, in 1947 (the year before the National Health Service came into operation)
no less than 95 per cent, of all removals undertaken were carried out without charge.
The tremendous growth in the demand for ambulance transport since the inception
of the National Health Service is shown in table (i) and is referred to in detail in the
paragraphs which follow. In 1947, 243,342 patients were conveyed over a distance of
2,131,430 miles. Each year since 1948 has shown an increase in the volume of the work
undertaken so that in 1958 the total number of patients had risen to nearly 1,200,000
and the miles travelled to over 6.000.000.
General description of the Service
The Service meets the need for ambulance transport in the Administrative County of
London, which covers 117 square miles, with a day-time population of over four million,
and is controlled and administered from Headquarters at 150 Waterloo Road, S.E.I.
It is under the immediate direction of the Officer-in-Charge, who is responsible to the
Medical Officer of Health, and is divided, for operational purposes, into two sections—
Accident and General. The central control system ensures that each section can assist
the other in times of pressure. The service is supplemented by the assistance of certain
voluntary organisations whose work is described later.
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