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LONDON'S
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Page 105
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Remarkably Efficient
AMBULANCE SERVICE
THE London area has a remarkable ambulance service, one that is kept in readiness for any unexpected rush of calls, such as may arise in an epidemic, a great fire, or any, similar disaster. From one office of the London County Council an ambulance may be summoned by telephone, night or day, at any part of -the area and will, if necessary, be on the way in a few minutes.
Until April 1st of la,5t year the ambulance arrangements of the Metro
politan Asylums Board, Metropolitan Boards of Guardia)* and the London Ambulance Service were operated separately. The Metropolitan Asylums Board dealt mainly with infectious cases, conveying patients to and from its own fever hospitals, convalescent homes, etc, 'also running an ambulance hire service at very reasonable rates. The Boards of Guardians conveyed patients to the Guardians' Institutions; the London Ambulance Service which
was under the L.C.C., attended to street accidents, etc.
All three services have now been merged, the operation being under the control of Dr. Y. N. Kay Menzies, the medical officer of health of the L.C.C., whilst the supply and maintenancelof the fleet and equipment are in the hands of the Chief Officer of Supplies, Mr. F., W. McKinney, C.I3.E., rather in the manner in which the G.P.O. is organized.
The absorption has entailed the taking over by the L.C.C. of 92 ambulances and 15 ambulance-buses from the M.A.B., 21 ambulances and one ambulance tender from the L.A.S. and 46 ambulances from the Boards of Guardians, and the service now operates 160 ambulances, of which 22 are allocated to the Emergency Service and 188 to the General Ambulance Service. The entire resources are thus pooled, the aim being increased efficiency and economy.
The largest of the three organizations, the M.A.B., which was constituted in 1867 and has run ambulances since 1881 (the first self-propelled type being a Thornycroft steamer, put on the
roads in 1902), was dealt with at length in our issue dated May 14th, 1929. It was then pointed out that the Board had always some 19,000 patients receiving treatment, employed a staff of 9,500 and, with its fleet, carried 199,944 persons (of whom 96,787 were patients) in the year 1928, the fleet then comprising 144 vehicles, chiefly ambulances a n d ambulance-buses of ClementTalbot, Crossley and W. and G. du Cros makes.
There were at that time 22 goods vehicles, the makes being Thornycroft, Leyland, Daimler, A.E.C. and S.D. Freighter. The combined fleet now comprises 349 vehicles, consisting of 160 ambulances and ambulancebuses and the rest goods vehicles, private cars, etc.
In the nine months AprilDecember, 1980, this fleet has covered 1,921,381 vehiclemiles. During the whole of 1930 the general ambulance service dealt with 200,481 cases, the London-area accident calls amounting to 43,930.
The reorganization has called for the abolition of 23 ambulance stations of the Boards of Guardians, the vehicles being transferred to the six stations of the original M.A.B., now termed the General Ambulance Stations. Each is adjacent to, yet, of course, quite isolated from, one of the six fever hospitals, and each is in communication by private telephone with the Victoria Embanktuent headquarters. This headquarters has two telephone switchboards, one worked by two clerks dealing with all emergency calls, and the other, requiring a staff of seven clerks, handling all general calls.
In the evening, until 11.30 p.m., four clerks are on duty, and from then until 7 a.m two clerks are retained. This staff, on receiving a call from a doctor or other person, arranges the hospitalbed vacancy and the dispatch of the ambulance, all in the course of a few minutes. The centralization results in a saving of delay when one station is overworked.
In an urgent case, such as acute appendicitis, where a delay of a few minutes may make all the difference between life and death, the 'phone call coming to the G.A.S. will, should that service be unable to call upon an ambulance immediately, be passed in a few seconds to the accident service and treated at Once as an emergency case.
The ambulance work now calls for a staff of 500, and on occasions is taxed practically to the limit of its resources, On January 28th this year, 1,091 passengers were carried by the G.A.S. (including the friends of -patients, etc.), 431 journeys being made, and 6,077 vehicle-miles covered.
The latest type of ambulance employed by this service was dealt with in our issue dated November 11th, 1930, and 14 of the 160 ambulances referred to above are a this new class. It incorporates a chassis made, by Clement Talbot, Ltd., Barlby Road, London, W.10, and has a sixcylindered, side valve engine of 18 hp. (R.A.a rating), with automatic-adeance coil ignition, a four-speed gearbox with silent third speed, and a particularly interesting final drive. The propeller shaft is enclosed in a torque tube and drives the axle shafts by a helical bevel gear with a very small crown wheel. The necessary
reduction is obtained partly by this bevel drive, but mainly by, setting the axle case lower than the roadwheel centre and driving the road wheels through double-helical gears. Without using an offset transmission line, a floor height of only 1 ft. 7 ins, is obtained.
The Mead Works of the old M.A.B., with some reorganization and increase of staff, now handles the entire fleetmaintenance work. The rigid system, that has proved its worth is retained, for mechanical reliability is of vital importance, and vehicles are completely stripped for overhaul every 20,000.miles. Approximately 10 per cent, of the fleet is undergoing repair at Mead Works at any one time.
Every 1,000 miles a formula of 55 items of inspection is gone through, these being listed on a card. Another Set of cards, one relating to each vehicle, shows the date and speedometer reading on every occasion when engine oil has been changed, chassis greasers replenished and the vehicle inspected. There is also a drivers' defect card as well as a tyre-history card.