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LONDON AMBULANCE SERVICE
London had a comprehensive ambulance service even before the coming into effect of
the National Health Service Act on 5 July 1948. The London County Council had itself
instituted an accident ambulance service in 1915 under powers secured by a private Act of
Parliament introduced by Sir William Collins. At first this Service operated from one
station only but by the end of 1915 five additional stations had been opened and by 1930
there were 14 stations with 20 vehicles and a staff of 165. In 1930, under the Local Government
Act of 1929, the Council took over the ambulance services previously provided by the
Metropolitan Asylums Board and Boards of Guardians. The former operated from six
large stations attached to infectious diseases hospitals and the Boards of Guardians
operated ambulances from certain general hospitals and infirmaries. These services for
general sick removals and the accident section were placed under the direction of the
Medical Officer of Health. For reasons of operational and administrative convenience, the
London Ambulance Service has continued to operate an emergency section and a general
service section although vehicles and men are interchangeable. At the outbreak of war in
1939, the Council had a fleet of some 200 vehicles and a staff of 422 operating from 22
stations.
When the National Health Service Act became effective in 1948 the ambulance service
had still not fully recovered from the effects of the war; enemy air attack had destroyed
the Western ambulance station and the Battersea accident station and much damage had
been sustained to other ambulance buildings; in addition the vehicle fleet was obsolescent.
Plans had been prepared during 1947 for the expansion of the service to meet the expected
needs arising from the new Act as well as to repair the war damage. Provision for an
additional 25 ambulances was planned by extending the South Eastern and South Western
ambulance stations and building a new accident station in Hampstead. A second stage
provided for the extension of the Brook and the Eastern ambulance stations, the provision
of accident services from a station in the City of London (where the service had previously
been provided by the City itself) and the building of accident ambulance stations in
Mottingham and Putney—providing in all for a further 36 ambulances.
The impact of the National Health Service Act on the ambulance service of London
was immediate. During the first year in which the Act was in operation the number of
patients conveyed to and from hospital rose by 35 per cent. The number of patients
continued to rise year by year until 1960 and has since remained about constant.
It may be argued, however, that the statistics represent the maximum number of patients
who can be carried without intolerable delays occurring rather than the maximum potential
demand on the service. An increasing number of old people are now able to live in their
own homes or with relatives because ambulance transport is made available to take them
for regular visits to the physiotherapist or to geriatric day hospitals. A particular and an
increasing problem for the service is the transport of patients for deep-ray therapy and to
some of the highly specialised clinics where patients are treated with isotopes and premedication
is necessary. Such journeys assume a high degree of priority, because in the one
case the treatment is so debilitating for the patient that any delay is a serious matter and
in the other because of the narrow time limits within which certain procedures must be
carried out. Reference must also be made to the intention of the Minister of Health* to
provide for out-patient surgery and day wards on an increasing scale, which will undoubtedly
lead to increased demands on the ambulance service.
* A Hospital Plan for England and Wales (Cmd. 1604).
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