You’re reading my newsletter, Terra Nullius, on the weird and interesting intricacies of the countries and places that make up our world. It currently goes out to over 1,000 people every week. You can subscribe by clicking below:
Why do fire departments exist? It’s a relatively simple question you might assume: something catches fire, and the firefighters come and put it out within minutes of you dialling 999/112/911/111/or in the out-of-sequence place that is Guinea 442-020. The problem is that things don’t catch fire anymore.
Last week I was in New York, one of the most exciting places on the planet. Over the few days I was there, I heard a lot of sirens and saw a lot of fire engines zooming off to emergencies. Curious if this was because New York is inherently more flammable than other places, I looked up the New York City Fire Department (FDNY) statistics. They surprised me
According to the 2021 statistics of the FDNY, they attended 1,213,750 incidents. That’s a lot of fires. But when you take those incidents apart, it emerges that ‘Fire Incidents’ make up less than 25 per cent of those 1,213,750 total calls. Even then, the 290,643 ‘Fire Incidents’ cover things from actual fires to malicious false calls, with structural fires being 10,639 – the vast majority are more medical incidents. In much of America, the fire departments often take up the role that ambulance services would in Europe. For example, 65 per cent of ambulances in New York are run by the fire department, with the remainder from hospitals.
The disparity wasn’t always so vast. In 1980, fire departments in the United States attended almost 3 million fires. In 2020 that had halved to 1.4 million. The reason is simple, with the proliferation of smoke/fire alarms, reduction in smoking and the increase in fire safety for buildings and things like furniture. Similarly, in 1980 fire departments in the US attended 5 million calls for medical aid, but in 2020 attended 24 million. There are now so few fires that there is double the number of false alarms each year in the US than genuine fires. The number of firefighters, however, has skyrocketed – primarily to meet medical demand.
The trend in fire emergencies doesn’t change across OECD nations. The only difference is that fire departments outside the US tend to do much less medical work. Following the heatwave last week, the London Fire Brigade reported they had the busiest day since the London Blitz in the Second World War. The Brigade said they had received 2,600 calls, five times a usually busy day. Not every call was its own incident, with many calls generally being made for each fire. Extrapolating the Brigade’s statement, it means that on an average day, they get 520 calls. In contrast, the London Ambulance Service receive around 8,500 calls daily. London’s Metropolitan Police Service receive a similar number. Curiously, the disparity in calls is not reflected in the respective budgets.
The London Ambulance Service have an annual budget of around £160 million, while the London Fire Brigade receive almost £400 million. Recent years have taken a toll on the former. The NHS targets immediate medical emergencies in London, such as cardiac and respiratory arrest, with 7-minute ambulance response times. These are mostly met, but as the call volume has risen, so has the response time. Where things get dangerous is in Category 2 calls, where patients are experiencing severe issues like a heart attack or stroke, which the NHS believes require a response within 18 minutes. In data from 2022, the average response time for a Category 2 medical emergency was 52 minutes. This is shocking, but it’s hard to blame the Ambulance Service. They simply don’t have the resources.
The London Fire Brigade, meanwhile, have no such issues. The average response time from call to the first fire engine’s arrival is 5 minutes and 10 seconds (the target is 6 minutes), a response time unchanged in almost 20 years despite the closure of many fire stations and budget cuts in the millions of pounds during the same period.
You might be starting to see where I am going with this.
The need for fire departments will never go away. But as trends have shown, the fire risk faced in the UK is not what it was and is projected to continue to drop even with the increased fire risk from climate change. Conversely, emergency medical and mental health needs in the UK are trending upwards, with some NHS regions seeing 25 per cent increases on pre-pandemic levels. So, where does that leave our established, respected, brave fire brigades? In my mind, the answer is obvious: to upskill and give them the equipment to dual-role as a reserve medical emergency service as has been done in the United States.
Firefighters are already instructed in emergency first aid and trained in the use of defibrillators as well as oxygen. These skills would allow existing firefighters to assist as first responders, as the overburdened police in London do for cardiac arrest, while others could be trained with more advanced medical skills. For instance, in London, if fire stations were each given an ambulance or hybrid fire-medical vehicle, it could be put to use to relieve the NHS and would also be helpful if there was a fire that needed medical assistance. The London Fire Brigade is paid to be on call at all times; this could be used to help the surge in medical needs across the capital without impacting response times and, when necessary, prioritise fire emergencies.
Not a single part of this blog is to criticise the phenomenal work done by firefighters and the rest of the emergency services. The problem is firefighters are too good at their jobs. Not many professions have managed to put themselves out of business in the way fire departments have through their advocacy for fire safety, but maybe there could be some use in a broader focus on their future. It feels like a waste of valuable resources and skilled firefighters when there is low-hanging fruit waiting to be plucked at little cost to the public and with potential to continue their tradition of saving lives.
If you’re enjoying this newsletter, please share it:
When I first began this blog in 2020, it was a combination of immense boredom with being stuck inside and the idea that it would not be long before regular international travel restarted and I could write about my adventures. Before the Pandemic, I travelled a lot. After the Pandemic, not so much. It has meant most of these (irregular) posts have been journeys from my desk at home.
However, over the last few months, I’ve got back into travelling and once again started to think about the places I visit and hope to continue this as time goes on.
Interestingly even 50 years ago in UK it was always wise to ask for Fire emergency as the Crewe’s were always trained in first aid & resuscitation and much speedier to the scene.
It makes a great deal of sense to integrate the emergency services more closely.
Very interesting. Also when you said “Not many professions have managed to put themselves out of business in the way fire departments have through their advocacy for fire safe,” it made me wonder whether the medical industry could do the same for health safety!