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The question of an ambulance service for street accident cases was first debated by the Council in 1901 but it was not until 1905 that application was made to Parliament for powers to provide such a service. The Bill was rejected by a Committee of the House of Lords but a Metropolitan Ambulances Act was passed in 1909. This Act was permissive only and a long period of debate ensued as to whether the existing services provided by the Metropolitan Asylums Board, the Boards of Guardians and the Metropolitan Police were adequate. Finally, in March 1914, the Council decided to provide a street accident Ambulance Service which was placed under the command of the Chief Officer of the London Fire Brigade. The first station was opened in February 1915 and, by October of that year, the service was in operation in all parts of the County.
On 1 April 1930, when the Council took over the functions of the Metropolitan Asylums Board and the Boards of Guardians it also took over their ambulance services. A unified London Ambulance Service under the supervision of the Medical Officer of Health was then formed from the combination of these services with the Accident Section previously administered by the Chief Officer of the London Fire Brigade.