Hello, History: The London (Part 2)

In our Hello, History series, we turn back the clock to look at significant periods for the emergency services.

Laura Blott is an MA student in Public History at Royal Holloway, University of London.

She’s agreed to take us on a whistle-stop tour of The Royal London Hospital during the Second World War, detailing the impact of the Emergency Medical Service from 1939 to 1941.  Catch up on Part 1!

The government, and it’s associated ministries at the time, had failed to consider what might be done about the provision of coordinated emergency services to cope with air-raid casualties until late-1938.

In response, ‘The London’ formed a committee chaired by senior surgeon Russell Howard to undertake localised emergency planning. ‘The London’ was exceptionally close to the industrial East End docks, which meant that it would be under significant threat from the Blitzkrieg.  Fire-fighting squads were organised by this committee, using the medical students and porters.

London was to be divided into ten administrative sectors, radiating from the centre of London, which was estimated to be Charing Cross.  Senior consultants were appointed as group officers who could advise the ministry on the synchronization of all the voluntary and municipal hospitals in their sector.

These consultants were also responsible for the deployment of the staff, from the voluntary hospitals within the sector, into a salaried Emergency Medical Service. The appointment of these group officers meant that, although they had no executive power, panicked minds of London civilians concerned by air-raid casualties were put to rest.

Sir Ralph Wedgwood (chairman of the Formation Committee of the League) in particular called for the speeding-up of air-raid provision measures. In 1939 he suggested in ‘Nursing Illustrated’ that, “Saint Thomas’ and Westminster are close to Battersea Power Station, which will be a target. Others are fatally close to the Thames. It would be much more sensible to establish a ring of casualty stations on the outskirts of London, to which the injured could be quickly transported.”

Administrative Sectors


‘The London’ was entrusted with sectors I and II, which encompassed East London, Essex, along with parts of Middlesex and Hertfordshire. Russell Howard was appointed group officer and, together with the help of A. E. Clark-Kennedy, embarked on the great task of researching the grand list of hospitals presented to them for the area.

These hospitals would provide for air-raid victims and evacuees whilst also being the new workplace of the voluntary staff evacuated from ‘The London’. This was by no means a quick or easy task.  Sectors I and II were the largest sectors and were expected to be covered by one hospital – ‘The London’.

The Emergency Medical Service (EMS) had a dramatic effect on ‘The London’ Hospital.  A. E. Clark-Kennedy spent much of his time vetting the different hospitals in sectors I and II. As a consequence of the introduction of the EMS, ‘The London’ was required to expand into the sector hospitals.

These hospitals were not ready for war and many had previously provided basic local services, or services for the chronically ill. Although many of the voluntary hospitals in the area would continue their work with little alteration, ‘The London’ was presented with the sensitive task of taking over the one time poor-law infirmaries, which included two large fever hospitals that would provide a large reserve of beds for casualties. There were also general and county mental hospitals in Essex and Hertfordshire that were expanded and this new responsibility fell entirely to staff at ‘The London’.

The Ministry provided the funding for EMS beds and other necessary services as well as doctors salaries but ‘Londoners’ themselves carried out the practical planning. These preparations were all made in the early months of 1939. By July 1939, it was documented in the magazine ‘Nursing Illustrated’ that, “with regard to the transport of personnel and equipment, arrangements were being made with the London Passenger Transport Board for the provision of sufficient ‘Green Line’ coaches to convey nurses and other personnel who had to be transferred from central London”.

It was also arranged that each sector would have six five-ton lorries at their disposal throughout the emergency. The EMS would be a necessity to the survival of the medical services throughout the War.

Although war had not struck yet, some began to realise that changes at ‘The London’ made a significant impact on – as Clark-Kennedy said in his prize-giving speech at the college in June 1939 – “the permanent structure of the country, and…in making preparations for war, we are laying the foundation of a more efficient system in place.”

This was something that ‘The London’ proved as the end of the Second World War gave birth to a new Emergency Medical Services system and the establishment of what would be known as the National Health Service.  Perhaps the greatest impact of the EMS on The London Hospital would be in developing a blueprint for health service provision on a national scale.

As soon as a declaration of war seemed imminent, the implementation of the EMS and major evacuation process was underway. Buses and trains were converted into ambulances and there was a real sense of teamwork and professionalism as the dispersal of at least 350 patients a day began at ‘The London’ on 1st September 1939.

Part 3 will be published next week!

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