§ DR. LUSHrose to call attention to the condition of the Medical Department of the Army, many of whose members, he urged, were dissatisfied with the present Regulations. A few years ago the same complaint arose from the Medical department of the Sister Service, where there was a chronic state of discontent. But the Naval authorities put their shoulders to the wheel, and now they never heard one word of open discontent amongst the Naval surgeons. Under our new system of military tactics, it was necessary to move large bodies of troops with celerity, and it was only by the skilled and anxious supervision of the Army Medical department that they could be kept in fighting health, whether on rapid marches, or in the trenches. The number of officers in 610 that department had been gradually diminishing since the year 1869. In 1871–2, when the effective strength of the Army was 132,000, there were 613 medical officers. In 1877–8, when the numerical strength of the British Army was 131,000 of all ranks, the number of medical officers had fallen to 531. In 1868–9, in the whole of the British Army, there were 43 administrative and 1,039 executive medical officers. In 1877 the administrative medical officers were 42 and the executive 870. That he regarded as very unsatisfactory. If the British Army was to be maintained in efficiency, the Medical department ought not to bear such a reduction as that which had taken place. The regulations with respect to the Veterinary department were also, he understood, in an unsatisfactory state. The right hon. Gentleman opposite (Mr. Hardy) had expressed his surprise that at a time when a number of medical appointments were to be given away, comparatively few candidates applied for them, and said it seemed to him to be discouraging. The clear inference from that was that the right hon. Gentleman had not made the inducements sufficiently attractive for medical men to enter the Services. It might be said that the grievances complained of were not of a serious character, but some of them were of a serious character, and they all tended to render the Service generally less popular than it might otherwise be. The right hon. Gentleman issued a Circular last year in which he did endeavour somewhat to remedy the evils complained of with respect to promotion and retirement, by paying off those gentlemen who were not efficient, thus retaining the best men in the Service; and if the effort had proved successful, some of the complaints might have been removed; but it appeared that it had not been successful, being only a limited and partial remedy, and that the complaints of those who were in the Service were such as to deter men from entering it. In Ireland the examining and teaching authorities had in consequence expressly discouraged their pupils from entering the Army Medical Service. Now, that was a very serious thing. It might be said also that the grievances in question were of a sentimental rather than of a practical nature; but even so far as they might 611 be called sentimental, they were not of a character to be overlooked, and some of them were really practical grievances. One thing of which they complained was the shifting and arbitrary character of their appointments, which placed them in a much less favourable position in many respects as compared with combatant officers of the Army. They were frequently shifted from one regiment to another, had to purchase horses for short service, and suffered losses for which they received no compensation. Another ground of complaint had reference to the matter of leave. They were not in the same favourable position with respect to leave as the combatant officers, who, under the Regulations, could obtain 61 days' leave of absence unconditionally, whereas medical officers had to pay for substitutes during their absence. They were at a great disadvantage also with regard to position when compared with the combatant officers, the medical officer becoming junior in the rank to which he belonged. These things tended to produce an uncomfortable feeling among the medical officers in the Army. Then there was a more important matter with regard to the right of exchange. The War Office, it had been said, proceeded in that matter upon the principle of dealing with each case on its merits as it arose, but the system did not appear to work well. One disadvantage in regard to exchanges was that whereas the combatant officer after three years' residence in England on leave from India was readily granted an exchange on applying for it, the medical officer's application was refused, and after his three years in England he was sent back to India peremptorily. That was a matter which affected the Army medical officers seriously; and there was nothing in their position which appeared to justify such a distinction, as compared with the case of the combatant officers. Another complaint on the part of the medical officer was that, by the rules of the Service, whatever outfit he might have, he was compelled, when attached to any branch of the Service, to purchase at his own expense a case of instruments he did not want. That was not, perhaps, a great grievance in itself, but it added one more straw to the weight which pressed on the medical officers of the Army. Instances could easily be cited to show that there was a 612 good deal of oppressive injustice in the way in which they were dealt with, and a good deal of indifference as to their claims which ought not to exist. With regard to one of their grounds of complaint, the case might be mentioned of a surgeon-major who entered 28 years ago into the old Ordnance department, who was a man of eminent ability and might have risen to some important position in his own department, but who, although he had served in the Crimea and elsewhere abroad, was excluded from promotion by the arbitrary rule which prevented a man joining the Ordnance department rising above the rank of surgeon-major, unless he had served for a certain time in India. The same feeling of injustice existed among the Army medical officers in India as prevailed amongst those at home; and the effect generally of the administration of the War Office with respect to that Service was prejudicial and injurious. There was a feeling amongst the officers of that Service that their claims did not meet with the recognition and attention which they had a right to assume was due to them. If that was the opinion of the House, he trusted they would support him on behalf of those men who were members of an honourable Profession, and who were always ready to do their duty, even in spite of this systematic withholding and invasion of their rights by the War Office. The importance of the Medical Staff of the Army was such that no statesman or patriot could wisely overlook their claims. There might be occasions when the want of a thorough Medical Staff would convert what might otherwise be success into irremediable disaster. Another matter of which these officers had reason to complain was the niggardly way in which honours, such as were conferred on combatant men for distinguished services, were distributed to them. And in that, as in other matters, he trusted that their claims would receive proper recognition.
§ COLONEL NORTHregretted that there was now great difficulty in obtaining candidates for the vacancies in the Army Medical department, which young medical men were solicited to enter. In the last Army Appropriation Account some observations were made by the Auditor General which showed the present condition of our Army Medical de- 613 partment. They first showed that the number of medical officers was below the efficient strength; and next, that owing to the falling off in the number of those officers, the employment of private medical practitioners became necessary. The Returns on the Table of the House too stated that, though the number of the Army had been increased, the number of medical officers had from time to time been reduced. They were now almost on the brink of war. It was impossible to know whether we might not be sending troops abroad in the course of a very few weeks, and he asked was that a time to have the medical Staff below its full strength? Surely, it was not. He moved for Returns, and he found that the whole medical system of the Army had been changed. It was of the greatest consequence to the men that they should have their regimental medical officers, who were known to them, and in whom they had confidence, to attend to them. In private life men did not change their medical men, whom they knew, and in whom they had confidence every week, and yet instead of having medical officers attached to regiments as of old, they were subject to be changed under the new system Only the other day he heard of a medical officer, being attached to a regiment for a particular march. He had read, too, in a newspaper of a medical officer being placed in charge of a regiment for the voyage to the Cape, where he handed over his charge and returned home. He thought it a serious thing that medical officers going out on these responsible duties in charge of troops, perhaps, with serious cases under treatment—cases in which they might feel deep interest—should, on arrival at their destination, find that their duties ceased, and that they would have to transfer their patients to other medical men. A case had come to his knowledge of an officer in Ireland having been attended in an illness by five different medical officers, and at last employing a civil medical man. In his day no men used to be more welcomed than the medical officers of a regiment. They were the private friends of many of the officers, and the friend of every man in the regiment, and were always treated with respect and attention. At present, however, there were no medical officers who did not find fault with the present treatment of that 614 department by the War Office. He had heard a remark made in 1856, that "the reputation of the Army was at stake, and in any change they ought to have what would command the assent of the great body of the Profession." Now this had not the assent of the great body of the Profession, and they must all feel that the Medical Service was one which ought to be in the best possible condition of order.
MR. GATHORNE HARDYsaid, it would almost seem from the speeches which had been made, that previous to the time when the recent changes had been made in the Medical department, there had been no grievances, and that there had been no demand for changes. His Predecessors, however, could have told a very different story. So far from that being the case, from the year 1858, when the Warrant was issued, on which they relied, medical officers continually asked more and more, until in 1873 another Warrant was issued. They came to him in 1874 and presented their grievances, every one of which had been met, and yet that evening the hon. Member for Salisbury (Dr. Lush) had put forth new grievances, some of which seemed to him to be wholly unworthy of a great Profession. His (Mr. Gathorne Hardy's) great desire had been to put the Medical department of the Army on a footing satisfactory to themselves; but in this, as in every other Service, there always would be discontents. The agitation in this case might be traced to one or two individuals. There had been a surgeon-major or surgeon in London who had, he believed, spent his whole time in dissuading young men from joining the Service. He trusted, however, that the Medical department would hold its own, and that these complaints would pass away. Allusion had been made to the system of three years' service in India. That was rendered necessary by the exigencies of climate, and the Indian Government would not take any one for an administrative Department who had not served three years there. If an officer had not complied with this rule, he had brought this bar upon himself, and was sent out to fill up the number of months or years which made up his term. It was, no doubt, a War Office rule; but it was rendered necessary by the rule of the Indian Government. His hon. and gallant Friend (Colonel 615 North) had gone back to the regimental system; but it had practically passed away by the Warrant of 1873, which was before his (Mr. Hardy's) period of office. With regard to the unification system, the hon. Member for Salisbury did not take exception to it, when it was brought forward, but the reverse, and the higher classes of the Department were uniformly in favour of that system. In time of war, the War Office was driven into the unification system. It could not be resisted, because you could not get on with regimental hospitals, and were obliged to have general hospitals. Having that day consulted the Director General of the Army Medical department, he had been assured that we had never gone to war with a medical system organized upon so good a footing as that which now existed, and that it could be put into the field and brought into operation at a moment's notice. If the Director General were deceiving him (Mr. Hardy) on that point, upon him or those who instructed him the blame must rest. He was steadily working to this end—that when the medical system was put in action in the field, it should be able to do the work and answer the purpose for which it was designed, so that all might fall into their places in time of war. With regard to the orderlies, they had been substituted for medical men at the instance of the medical officers themselves. The latter said they were not meant to take charge of certain matters belonging to the hospitals, and it was to relieve them of these medical duties that the medical orderlies had been introduced. He quite admitted that there had not been so large a number of applications to enter the medical Service as could have been desired; but there was not that number of vacancies which might have been supposed. In 1877–8 the department nominally consisted of 885 medical officers; its actual effective strength was 842, so that there were only 43 vacancies. There were, however, 17 candidates at Netley almost ready to join, which reduced the number of vacancies to 26. For these vacancies there would be an examination in August. There had been 80 applications for the Schedule of Instructions, and these persons might enter for competition when the time came. The hon. Member for Salisbury had used some 616 language hardly, he thought, deserved; he had spoken of the "systematic invasion of the rights of medical officers by the War Office." One complaint was as to medical honours. Would it be believed that these medical men had obtained a larger proportion of the honours than they were strictly entitled to? The reason why they would obtain no more honours was that they had absorbed them already. The War Department was advised on the whole question by medical men, and if the Medical Profession in the Army were crushed it was under the weight of the Medical department. Did not the hon. Member for Salisbury think that these gentleman had the interest of the Medical Profession at heart? The eminent men who had successively administered the department had had no other object than to give it a high tone and character, and, therefore, while they had urged on increased pay and rank—[DR. LUSH: I said nothing about pay.] He was aware of that, but the hon. Member had said that they had received no compensation for promotion. But they had had an opportunity of pressing out at the top those who had been stopping promotion. The assistant surgeon had become a surgeon with increased pay. The surgeon of 12 years' standing had become a surgeon-major with increased pay; and was this nothing? Could there be no compensation, except in the shape of a lump sum paid down into the hands of these officers? They received compensation when they were put in a higher position to which they had become entitled after a certain length of service. The War Office did not wish to encourage a system of perquisites, and if a medical officer had a horse, he received forage, but not otherwise. It was a wrong system to pay officers indirectly by means of allowances; if they were to be paid, let them be paid directly, and not by making allowances for forage. As to leave, it was obvious that arrangements could not be made for granting medical officers leave in the same way as other officers, without an enormous addition to our expenditure. They could not supply their places as they could those of other officers. He had done his best to obtain new quarters for medical officers. Notwithstanding the great number of grievances that had been pressed upon his attention, 617 the demand now made for instruments was altogether new. There was now a strict roster by which men took their share of foreign service; and though he should be glad to meet the demand for exchanges if he could, he did not see how it was possible under the unification system. Was it fair that the new system, in the first year of its operation, should be charged with all the difficulties attributed to it? If it were allowed a fair trial, the heads of the departments believed that it would work well, and they said they were prepared to go into the field with it, in firm reliance that it would answer the purposes for which it was designed. With respect to the complaint of the Militia surgeons, they had formerly their pay and certain payments for work done—he might call it piece-work. They were paid for examination of recruits, had allowances for attendance on the permanent Staff and their families, and for the preliminary training. Complaints had been made, however, that attendance on the permanent Staff and at preliminary drill was unremunerative; and, as to the recruits they had examined, the interval between examination and preliminary drill was sometimes so long that when they came up they were found to be unfit for the Service. It was difficult to find fault with those who examined them, for the recruits might have been in a fit condition at the time they were examined; but still the facts led to the inference, that there was on the part of the Militia surgeons less ability to examine properly than was possessed by Army surgeons with greater practice. There was a particular mode of payment under which it did not answer a man's purpose to get more than five recruits in a day, and such anomalies occurred as 68 recruits being brought in at a charge of £166, while 77 were obtained for £7. Under all the circumstances it was thought best to commit the work to Army surgeons. If he were to make application to the Treasury, he did not see on what principle he could propose to give compensation for taking away the work which had been done as piece-work, especially as the ordinary pay and allowances of Militia surgeons had been largely increased, the ordinary pay being now £1 6s. 6d., whereas it was formerly 14s. 4d. a-day. He thought they had done very well. He would 618 admit they had satisfactorily performed their duties; but when it was said they were taken away from private practice, it must be remembered that a Militia appointment was often an introduction to private practice. He had now to deal with the subject of the Hampshire Yeomanry. He had read some letters in which the system had been very much praised. The officers had spoken favourably of it; but with the greatest possible respect for Colonel Power, who had done admirable work in his time, he could not think it right to make the sacrifice required for the purpose of retaining the services of that officer at the age of 67, and maintaining the Hampshire Mounted Rifles, which had never numbered more than 24 efficients, and were now reduced to 20. He did not think he should be called upon to set up a regiment which had failed, and he must decline to do so. It did not seem to him desirable to have two kinds of Cavalry drill going on at the same time, and he was not prepared to give up that which he thought the better for the worse. He hoped the House would now go into Committee and allow him to take the remaining Army Votes, after more than three and a-half nights of preliminary discussion.
§ CAPTAIN NOLANreminded the right hon. Gentleman that the emoluments of Militia surgeons had been derived practically from the allowances which had been abolished. In fact, that abolition amounted to depriving them of a great part of their income. He knew one case in which the allowances amounted to £150 a-year, and it was unjust to take that away from him, while his regular salary was only increased by £40 or £50. As one of those, he might add, who had advocated the claims of the combatant officers to have permission to make exchanges, he thought that it was hard that any surgeon should not be allowed a similar privilege.