Pre-war planning for a national hospital service

The creation of the Air Raid Precautions Department

In 1935, the government established the Air Raid Precautions (ARP) Department to supervise civil defence measures. As part of this function, it became responsible for the planning and organisation of a national hospital service, which could deal with air raid casualties in the event of another war.

The ARP suggested that local authorities should begin preparatory work to plan first aid, hospital and ambulance schemes at a local level.

Two types of hospital administration and funding emerged:

• casualty 'clearing' hospitals in more dangerous areas would be part-funded by local authorities under the direction of the ARP Department
• base hospitals in safe areas would be the responsibility of the Ministry of Health, with the costs being borne by the Treasury.

This meant that both the Ministry of Health and the ARP Department had an interest in the development of health infrastructure and different hospitals were under different funding arrangements.

The Ministry of Health becomes responsible for planning

On 1 June 1938, the government made the Ministry of Health responsible for the organisation of a national hospital service for civilian casualties following an air attack. However, first aid posts and the ambulance service were still carried out by local authorities, under direction of the Home Office. In December 1938, the Ministry of Health took over those functions from the Home Office.

By the outbreak of the war, it had become clear that the Ministry of Health would also take control of the administration of the treatment of air raid casualties, rather than delegating that responsibility to local authorities.