On 28th February 1975, at 8.46 in the morning, a tube train failed to stop at Moorgate station and ploughed on into a brick wall, compacting the first three coaches into a tangle of metal. Just why the driver did not stop was never fully understood; there seemed to be nothing wrong with the train.

At 9 a.m. St. Bartholomew’s Hospital was asked by the London Ambulance Service to send one doctor to the site. A casualty officer left almost immediately in an ambulance with a medical student and a small first-aid bag. On arrival he called for a resuscitation team.

From the outset it was hard to know the magnitude of the disaster or to reach the casualties. Death was difficult to diagnose. Though many patients were pulseless, heart sounds were inaudible because of the noise of pneumatic drills close by. Cutting equipment, lighting and ventilation were needed in the confined area of the rescue; but 74 live patients were evacuated in 13 hours, including one who required an on-site amputation to effect her release. Because of the problem of getting to the wounded it was 24 hours before it was clear that no one else was living.

Forty three people died from head injuries and traumatic asphyxia, and two later in hospital from crush syndrome. Forty one were admitted and the slow but steady arrival of the injured meant that the small accident department at St Bartholomew’s Hospital was not overwhelmed by the injured. Barts was flooded with people wishing to give blood as a result of appeals on the radio, and while the hospital’s accident plan worked well, it was apparent that disaster planning should cover more than a single hospital.

It was clear that there was no national system of approaching major accidents, or of giving the recently developed specialty of accident and emergency surgeons a centre place in disaster planning. Even a system of clearly marking dead victims was missing, to avoid time being wasted by the rescuers on repeatedly confirming death. Moorgate brought the need for wider planning for disaster in to focus.

For a fuller account of the events, see www.nhshistory.net