During the Second World War doctors became trained in emergency care, and were involved professionally with the rescue services both with the civilian population and armed forces alike. After the War there was a substantial increase in road traffic, although the roads were inadequate, and road traffic accidents accounted for more deaths and disabilities than had resulted from the previous armed conflicts. Dr Kenneth Easton first became aware of the problems in 1949, when as Senior Medical Officer to the RAF Regiment Depot, Catterick, North Yorkshire, he was allowed to organise on-site medical care for the victims of road traffic accidents on the 15 mile stretch of the A1, a long way from the nearest hospital and where accidents occurred with monotonous regularity. He entered general practice at Catterick in 1950, and after meeting several farseeing colleagues including Dr William Pickles, Dr Ekke Kuenssberg, Dr John Hunt, and Dr Ken Pickworth, who were later instrumental in forming the College of General Practitioners, he was invited to give lectures on Immediate Care at road accidents to groups of enthusiasts. 

Deaths and injuries from road traffic accidents reached a peak in 1965, when it was obvious that ad hoc rescue units needed improved co-ordination and co-operation between the statutory emergency services and general practitioners and hospital doctors, if unnecessary deaths and disabilities were to be prevented. Contact was made with Professor Eberhard Goegler of Heidelberg who had just published the results of a highly organised and funded scheme based on his University Surgical Clinic. By filling the “Therapeutic vacuum” between the occurrence of the accident and hospital admission. Goegler had reduced the mortality and morbidity following serious injury by 20% within a radius of 20 miles of his hospital. There seemed to be no reason why this “Therapeutic vacuum” should not be filled in the United Kingdom by forming “Immediate Care Schemes”, utilising the nearest general practitioners to provide this specialised medical care. 

An approach made to Parliament asking both for the integration of the rescue services, and for better rescue equipment for the fire services, met with a surprising reply. Not only were fire services not obliged to attend persons trapped in road accidents, but any improvements in rescue procedures would necessarily depend upon local voluntary action. Thus the ground was prepared for the starting of the pilot Immediate Care scheme: “The Road Accident After Care Scheme (RAAC)” of the North Riding of Yorkshire, which covered 1,000 square miles and utilised the voluntary services of 34 doctors The RAAC went into operation in December 1967, and although its main concern was to be with road traffic accidents, all types of sudden illness and accidents were to be attended. Dr Ken Easton and the late Dr E.L.R. McCallum addressed the BMA Annual Scientific Conference in July 1967, calling upon the profession to study the needs for establishing similar schemes in their own localities 

The Chairman of the BMA Scientific Conference of 1967, the late Mr Norman Capener, CBE, FRCS, was also Chairman of the Medical Commission on Accident Prevention, and he invited representation from the RAAC on that commission, their aims being mutual 

This relationship gave rise to the far ranging associations of the parent body, under the auspices of the Royal Colleges, many eminent members of which joined in the First International Conference on Immediate Care held at Scotch Corner in May 1969. One of the general practitioners who attended that Conference was Martin Cottier, a general practitioner in Bamber Bridge, near Preston. It was as a result of his efforts, and the public concern arising from the death of a young man employed at a local factory that led to the formation of the Lives in Danger Organisation (LIDO) some six years later. This charity provided a vehicle equipped with full resuscitation equipment that the local doctors took turns at driving. Whilst having radio communication with Lancashire Ambulance control room the idea of doctors attending accidents was alien to the ambulance personnel, and the limited area that the scheme covered meant that the doctors soon lost their confidence and withdrew from the scheme.  

Little more was to occur until 1988 when the Consultant in charge of the Accident Department of the Royal Preston Hospital decided that as part of the hospitals Major Incident plan the Medical Incident Officer on scene was to be drawn from the general practitioner Clinical Assistants who worked in the department at that time. The general practitioners involved met together and agreed that though they would undertake the responsibility they felt it necessary to be adequately trained and equipped. The hospital rapidly pointed out that no funding would be available. It was then that Dr Vic Calland recruited one of his patients, Mrs Barbara McDougall, to act as Charity Organiser, and in the December of that year Med-ALERT was formed. 

Whilst Med-ALERT originally intended just to serve the catchment area of the Royal Preston Hospital it was not long before another doctor in Ormskirk, Lancashire appealed for support and so the organisation decided that it would offer a Lancashire wide service. When the Ambulance Service was pushed into the concept of paramedic training by the Department of Health it seemed logical that Martin Cottier and Vic Calland were appointed to the Paramedic Steering Committee and were responsible for initiating many of the improvements in equipment and training the crews were to receive in the next few years. In 1993 the chairman of LIDO decided that the charity no longer met its objectives and £67 000 of its wealth was transferred to Med-ALERT. 

With the formation of the Lancashire Ambulance Trust a significant improvement in the working relationship between the two organisations took place. With money from the Family Health Services Authority the Med-ALERT doctors cars were fitted with the same vehicle location system the emergency ambulances used. Lancashire was the first county to have their Immediate Care doctors location displayed on the computer maps in Ambulance control. 

New radiocommunications equipment enabled the doctors to use same computer logging system as the ambulances, automatically recording on scene & left scene times. Unfortunately as the technology used in ambulance control moved forwards the administration failed to recognise our contribution and we were never included in the bid for the next upgrade. Data tracking of vehicles ceased, as did the automatic call logging. We faced another challenge too, for as the General Practitioner out of hours services sprang up we discovered more and more cars using green lights for what were clearly not emergencies of the nature we responded to. It was time to move into blue lights to enable us to take full benefit of the Road Traffic Act provisions. It was a long battle to win but we eventually succeeded. It was a retrograde step in one respect however as we now blended with all the other Emergency Service vehicles and thus became "the Invisible Charity". 

Med-ALERT had now reached the strength that it could provide a rota of Major Incident Management trained doctors to act as Medical Incident Officers at any incident in Lancashire. Thus eight years after the initial concept the organisation had achieved its goal. Events have continued to move on however and the Charity has continues to meet the challenges before it.

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Last modified: 01/13/07