§ COLONEL BOLDERO
said, that in moving for a Select Committee to inquire into the state of the medical departments in each of the two services, he felt glad that he had not had a previous opportunity of bringing forward the subject, because the evidence already taken before the Sebastopol Committee had furnished two subjects worthy of remark. It appeared from that evidence that the speeches which had been made in that House by hon. Members who had been eye-witnesses of the state of affairs in the East, and also the graphic, interesting, and intelligent statements of the private correspondents of the London journals, had, so far from being exaggerated, fallen below the actual state of the case. The cause of that state of things and of many of the calamities which had occurred was the deficient state of the medical department, and last year a Cabinet Minister had had the honesty to acknowledge the existence of that deficiency, which he attributed to having commenced a war upon a peace establishment and without a medical staff. The war was commenced by sending a small detachment of 10,000 men to Malta, and the medical department was called upon to furnish the medical assistance requisite for that force, and that task they performed, he believed, without any complaint being made, but when that force was augmented in the first instance to 25,000 men, it was found that, instead of the Government of this country having acted in a manner similar to the Emperor of Russia, and made every preparation for war, the means provided by them in every department were inadequate to meet the emergency, and more especially so in the medical department. When it became necessary to establish a hospital at Scutari, deficiencies were found to exist in every branch of the medical department. There was a deficiency of medical men, of medical stores, of means of transport, of apothecaries, of ambulances, of orderly sergeants — in short of everything that was required. He did not wish the House to be led into a belief that the medical men did not perform their duty, for, on the contrary, there was abundant testi- 1505 mony to prove that, whether in the field or in the hospital, they had done so faithfully and nobly, and that in arduous and dangerous circumstances they had displayed great firmness and determination. They were not accountable for the disasters which occurred, it was the Government who were to blame for the whole mismanagement. With regard to the conveyance of stores, there commendations of Dr. Andrew Smith had not been attended to, and, instead of medical stores being sent in one ship under a supercargo, some were sent in one vessel, some in another, and they were never to be found when wanted. If the description of the manner in which the Prince was laden was a fair criterion of the general management in despatching stores, could any one wonder at the confusion which prevailed at Varna and Scutari? and on account of that confusion and the impossibility of procuring what was requisite, thousands of valuable lives had been lost. Then, with regard to the appointment of a purveyor, a most important officer, it appeared that a medical board had reported that a purveyor had been appointed who was old, incompetent, and obstinate. The apothecaries who were first sent out were quite incompetent to perform their duties, and were also too few in number, as were also the orderly sergeants, a set of men who ought to be chosen from the same class of persons from which schoolmasters wore ordinarily selected. Then, again, pensioners were selected for the ambulance corps in spite of the entreaties of Dr. Andrew Smith, who gave as the result of his experience that these men were worn out by disease, by climate, and dissipation, and that they would be quite incompetent for the duties which would devolve upon them. Dr. Smith stated that he was at the head of an establishment with no actual power, that he had five masters and was interfered with at every turn; and he (Colonel Boldero) maintained, therefore, that no responsibility could rest with the head of a department so constituted. Did not this furnish a sufficient reason why the House should grant a Committee to direct their energies to this subject, receive evidence from persons able to guide their judgment, and see whether they could not propose some remedy for such a state of things? Without going into details, he thought every one would acknowledge that evidence enough had been taken before the Committee now sitting, to show the necessity of a change in the whole medical 1506 department. The medical officers themselves complained that they were not fairly treated; they said neither their pay nor their pensions were equal to those of other branches of the army, while honours and rewards were withheld from them. Now, in proof of this alleged ill-treatment, let them compare the position of a medical officer in the Queen's and Company's service. In the latter, after the expiration of seventeen years, the medical officer was enabled to retire upon 200l. a year, direct pension, with 300l. a year in addition from the medical fund; together an allowance of 500l. a year. On the other hand, the medical officer in the Queen's service, after serving twenty-five years, received but 1l. 5s. per day, while his retiring allowance was only 13s. a day. Again, place his case beside that of an officer in the line. The officer of the line, who might have entered the army a boy of sixteen, was allowed to retire upon full pay after a service of twenty-one years, be his rank what it might. So that, although the medical officer must necessarily join the service at a considerably later period of life on account of the time taken up by his professional studies, his retirement could not take place until four years later than that of the officer of the line, add to which you require twenty-four years' service from the medical officers. With regard to the navy, he had but little to say beyond this, that, bad as was the treatment which the medical officers of the army had received from the hands of the Government, still it differed in a marked manner from that which had been evinced to the officers of the navy. Indeed, towards those gentlemen there had been a display of obstinacy, of prejudice, and of blindness, winch it seemed impossible to exaggerate, and which it seemed useless to remonstrate against. And here let him point the attention of the House to this circumstance, the qualifications for an assistant surgeon in the navy were less than those required in an assistant surgeon in the army. Now he would ask why that should be? Was not the value of the lives of men fighting the battles of the country, the one on land the other on sea equal, and ought not, therefore, the country to have equal care of both? Indeed, if a preference were shown, it ought to be in the direction of the sailor, who was the more skilful of the two, and for whose training a longer time was required. The fact was, there ought to be no difference whatever in the 1507 treatment of the two classes of medical officers, both ought to be under the direction of a general medical board, and on their becoming candidates for employment, they ought to be allowed to choose the service to which they should be attached, either the army or navy. There was, however, no reason why any distinction should exist either in the standard of qualification or in the pay of military and naval surgeons. He saw some time since in the newspapers a list of sixty-three ships deficient in medical men, and he felt justified in saying, that two months ago there were 100 vacancies which they could not fill up. If in a ship destitute of the proper medical attendants the surgeon fell ill, and the ship went into action, might not the result be that a number of men would be wounded without having any person on board who could treat them properly. The gentlemen who were selected in the navy were generally between eighteen and twenty years of age, instead of being between twenty-two and twenty-four, and though they might be theoretically well trained at Edinburgh and Dublin, practically they knew nothing of the duties required of them until they became thoroughly acquainted with the system under which they were called upon to act. With regard to the militia, that might at present be almost said to form part of the regular army, and if a Committee were granted, the medical department connected with that service might perhaps form a subject of inquiry. There was but one objection that could be raised to the motion. He might be told that it was intended to make an alteration, and that a plan had already been proposed. Probably the force of public opinion might have induced the Government to endeavour to effect a change, but had the plan which had been proposed received the sanction of the medical officers of the army? Certainly not, for Dr. Andrew Smith expressly stated in his evidence that he had seen the proposed plan, and he did not hesitate to say, that he for one would not remain one hour in the service if it were carried into execution. It might be said that great improvements had taken place in the hospitals in the East. True, there had been improvements, but to whom were they indebted for those improvements? Not to the Government, but to The Times commissioner, the charity of individuals, and more particularly to the heroic exertions of that amiable woman, Miss Nightingale. He trusted that the Government 1508 would not refuse to accede to his motion, and he could assure the House that in the course he had taken he was actuated solely by the desire of benefiting his fellowmen.
§ SIR JOHN TROLLOPE,
in seconding the Motion, said he had had some experience of medical practice connected with the military service in former years, and he much lamented to see that latterly it had greatly deteriorated. If a Committee were appointed the origin of this deterioration might be traced to the right causes, and he hoped he should not be told by the hon. Gentleman who represented the War Department in that House that the Committee now sitting to inquire into the conduct of the war in the Crimea embraced in their inquiry this branch of the subject. No doubt they did, incidentally; but still he thought that a general Committee appointed to consider how the war had been carried on would not go so fully into the causes of the evils described by his hon. and gallant Friend (Colonel Boldero) as a special Committee appointed solely to inquire into the state of the medical departments of the army and navy. He thought the origin of the evils of which his hon. and gallant Friend complained might be traced to the system which had been pursued of late years. In former years there existed an Army Medical Board, but that board had been abolished in order to save the public money, though assuredly not for the advantage of the public service. The duties of the Army Medical Board had since devolved upon one individual, and in asking for a Committee it behoved his hon. and gallant Friend and himself to show how the power thus vested in a single individual had been exercied. At present the Medical Director General of the army had the absolute power of appointing all the staff surgeons of the army and Ordnance, with the exception of the household troops, and he had the power of placing them in any part of the world where our Colonies were situated, with the single exception of Sierra Leone, to which Colony the medical men were allowed to volunteer. Now, he did not mean to say that favouritism had been shown by Dr. Andrew Smith in the exercise of his patronage or in the selection of the posts to which the medical officers had been appointed, but he thought it ought not to be in the power of any man to say that such a thing was even possible. If an Army Medical Board existed, whose duty it would be to sit upon the appoint- 1509 ments which were made, there could be, at all events, no charge of favouritism or partiality. With regard to the service which had been principally adverted to by his hon. and gallant Friend—namely, the present service in the East—he thought there ought to be an inquiry, first of all, whether the Medical Director General of the army had secured for himself the most adequate and able men upon whom he could lay his hands. He (Sir J. Trollope) happened to hold in his hand some letters addressed to his right hon. Friend the Member for South Wiltshire (Mr. S. Herbert) by a most eminent member of the medical profession, who had been inspector of hospitals, who was a gentleman of great experience, and whose name, he was sure, would be received with the highest respect: he alluded to the brother of the illustrious Sir Humphrey Davy. Dr. John Davy was a retired army medical inspector of hospitals, a man of ample private means, who had seen a great deal of service, and when the expedition to the East was first talked of he wrote to the right hon. Member for South Wiltshire (Mr. S. Herbert) to volunteer his services. In 1839, Dr. Davy was sent out by the present Prime Minister, who was then Foreign Secretary, to establish hospitals at Constantinople, under the orders of the Turkish Government. Dr. Davy remained nearly two years in Turkey, but his mission was unsuccessful, owing to the corruption which prevailed in the Turkish Government. He was, however, enabled to acquire extensive knowledge of Eastern affairs, of the peculiarities of the climate, and of the resources of the country, and he was unquestionably one of the most proper persons to be intrusted with the charge of the medical departments of the army in the East. On the 25th of March last year, Dr. Davy addressed a letter to the Secretary at War, tendering his services. Dr. Davy had served in all parts of the world, and it might be said that he was of too advanced age to be employed, but the Secretary at War never took the slightest notice of his letter. On the 11th of April, Dr. Davy renewed his offer of service to the right hon. Gentleman with a similar result—he received no answer whatever. Time went on; an alteration took place in the War Department; the Duke of Newcastle became Minister of War, and on the 27th of November, Dr. Davy addressed a letter to the noble Duke, tendering his services, mentioning the previous applications 1510 he had made, and stating that no reply had been vouchsafed to him. The following was the answer he received from Dr. Andrew Smith—Sir,—I have to acknowledge the receipt of your letter of the 27th instant, addressed to the Duke of Newcastle, and the copy of a communication to the Secretary at War which accompanied it. In reply, I beg to inform you that I do not feel myself warranted to recommend your being restored to full pay for service with the army in the East.Now, Dr. Davy did not ask to be restored to full pay. He was a man of perfectly independent means; he was residing in happy retirement, after his long professional services, in the lake district of Cumberland; but, feeling that he might be useful, he tendered his services to the Government, and this was the manner in which he was treated. There was, perhaps, a reason for the brusque style in which Dr. Andrew Smith wrote to this gentleman. Dr. Smith was taken from a lower grade of the profession; he was never anything but staff surgeon, and he had been hoisted over the heads of all his seniors, who were men of far greater professional acquirements. Dr. Smith had been at the hospital of Fort Pitt, at Chatham, under the command of Dr. Davy, who bad thought fit to report him for want of attention to his duties, and this was, doubtless, a reason for the animus which Dr. Smith displayed in his letter. There was, therefore, a personal feeling in the matter; but the House would see, from this case, how the public service was conducted when it was left in the hands of individuals. He would ask the House to consider in what manner young men who received medical appointments in the army were treated. The practice fur forty years had been to send them to Fort Pitt, at Chatham, where there were no lectures to which they could have access, but where they might remain for six or nine months before they received regimental appointments, hanging about a mixed garrison and seaport town, and exposed to all the temptations to dissipation which existed in such places. He (Sir J. Trollope) thought it would be greatly conducive to the public interests if the military hospital at Fort Pitt were removed, and were brought within such a distance of the metropolis as would afford the medical officers of the army an opportunity of attending the metropolitan hospitals, lecture rooms, and libraries. His reason for seconding the Motion of his hon. and gallant Friend was, because he thought the deterioration 1511 of the medical service of the army was a subject well worthy of inquiry. When he (Sir J. Trollope) held a commission in the service immediately after the close of the great war, every regimental medical officer was a man of experience with respect to the diseases incidental to camps, and more especially the treatment of the wounded. He believed if they had had men of sufficient experience to choose proper places for hospitals in the East, that the great barrack of Scutari would never have been devoted to that purpose. In a building where such a tainted atmosphere existed, there was little hope of the recovery either of the sick or wounded. He thought sufficient ground had been shown for a special inquiry, with the view of elevating a profession upon which the health and comfort of our brave troops so materially depended. Comparisons had been drawn between our own medical service and that of our gallant Allies, which were not at all favourable to the system adopted in the British army. He could only attribute this difference to the circumstance that the French service was not tied down by such a miserably close system of routine as our own. Since the time of the Emperor Napoleon I., when men of genius and ability had been found they had been brought forward, they had been led to act upon their own responsibility, and they had not been obliged to write to a director-general for everything they wanted. He considered that they ought to follow the example of Napoleon I., who gave Baron Larrey, the distinguished surgeon-general of his forces, power to do anything he pleased for the relief of the army. Baron Larrey created the ambulance system, which we had not only been obliged to imitate, but we had been obliged actually to borrow the ambulances volantes of our Allies to convey our sick and wounded troops. Our own military service, he was happy to say, had already afforded two noble examples of bravery and devotion on the part of medical officers. Assistantsurgeon Wilson, at the battle of Inkerman, went bravely into action like a private soldier; and all would recollect the touching case of Surgeon Thompson, of the 44th Regiment, who remained upon the field of battle, at the hazard of his life, solely to succour and assist the wounded of the enemy. He was sure it would be admitted that men who performed such noble acts deserved every encouragement at the hands of their country. To show 1512 how the medical service of our army was tied down, he would read a few extracts from a work on the subject, which showed the duties of a regimental surgeon:—In addition to the proper duties of attendance upon the sick of his regiment or station, and to the prevention or removal of the causes of disease, the medical officer is also required to act as dispenser of medicines, as hospital steward, and as clerk. In the course of the duties of this latter office he has the charge of at least fourteen sets of elaborate books and forms, the keeping, filling, and transmitting of which would, if accurately done, occupy the greater part of the time of a skilful and laborious accountant. It is prudently provided that, should these archives 'accumulate to an unwieldly bulk'—should they exceed the capabilities of transport by ship or rail—the director general is to be applied to, and he may be expected in the plenitude of his wisdom and power to find a remedy—'he will give orders for their disposal.'The fact was, that entries were required to be made of every case of trifling sickness in huge folio volumes, which could neither be transported by ship nor by rail. He (Sir J. Trollope) thought the best thing that could be done with these useless volumes would be to burn them in the barrack square. So much unnecessary duty was thus thrown upon the regimental surgeons that they were obliged to obtain the assistance of hospital sergeants, who were men taken from the ranks, without any medical knowledge. The article from which he had before quoted said—The hospital sergeant illicitly performs the part of steward and dispenser, while the surgeon devotes his time and thoughts to the prevention and cure of disease, and to the consideration of such necessary measures for the improvement of the health and vigour of the soldiers with whom he is associated as he can recommend to the commanding officer. But why should a snare be laid to entrap him into a technical breach of orders? Throughout, our military surgeon is in all cases bound and trammelled by regulations; he can scarcely stir without a reference to the director general. When he goes forth, and when he returns, he is to report his movements to the director general. If his regiment changes quarters, he is to transmit to the director general a copy of the route. He must not expend more than 5s. in getting his instruments sharpened, without obtaining the director general's leave. He is to perform no capital operation in Great Britain without the previous consent of the director general, who lies perdu in his office in St. James's Place, while the patient may linger in the barracks of Cork.There had been frequent instances of the disadvantages of this system. Every man, medical or non-medical, must know that frequent cases occurred where life or death might depend on the promptitude of operations, and yet he had heard, in reference 1513 to a soldier, that not very long back three weeks elapsed before the order for an amputation was sent. These things ought not to occur, and they only occurred because everything was placed under the control of a director-general sitting in London, who must be referred to for every minute particular, and a great and honourable profession was treated as if it was unworthy of the slightest credit for judgment and capacity. This was a disgrace to the medical profession and to the army, and to render the service what it ought to be they must raise the position of the medical men, and give them something more than the ordinary rewards of their profession, in order to induce individuals who had devoted their time to the acquirement of a proper medical knowledge to enter the service and remain in it. He believed that an inquiry by a Committee of that House into these matters would lead to such a result as would leave no one sceptical as to the justness of the position which his hon. and gallant Friend had taken up.
§ Motion made, and Question proposed, "That a Select Committee be appointed to inquire into the state of the Medical Departments of each of the two Services, Army and Navy."
§ MR. FREDERICK PEEL
said, in reference to what had fallen from the hon. and gallant Gentleman (Colonel Boldero) as to the motives which induced him to bring forward the present Motion, no one could doubt that his only object was to promote the advantage of the service, and to make the military branch of the medical service such as it ought to be, so that the medical men of this country might enter into it with the feeling that it offered prizes and prospects as promising as any that could be contemplated in private practice, or by attendance in the large civil hospitals of this country. He (Mr. Peel) should confine his observations to that portion of the Motion which related to the army, leaving his hon. and gallant Friend near him (Admiral Berkeley) to deal with the naval part of the question. He saw no reason whatever why the medical department of the army should not have advantages and prizes such as would draw into it the ablest of the young medical men of the country, and he quite agreed with his hon. and gallant Friend that the merit of the members of the profession in this country entitled them to the kindest and most liberal treatment from the Government.
1514 It had been said that Dr. Andrew Smith had stated that he had been nursed in the persuasion that it was his duty rather to save money than to spend it, and that medical officers were trammelled by forms, and had duties devolved on them not comprised within their proper sphere of service. He (Mr. Peel) was glad to say that these inconveniences had in a great measure disappeared under the pressure of actual service, and, looking to the great necessity of now obtaining soldiers, and sending them abroad well drilled, and in a state of efficiency, he believed, setting aside every other motive, that it would be both good policy and economy in the end for the Government to bestow every care on the proper treatment of the men; so that they might feel convinced that if they fell sick or received wounds they would be treated in a manner worthy of the advanced state of medical science in this country. He would most heartily join with his hon. and gallant Friend in any measure likely to tend to such a result; but he thought that there were reasons why, at the present time, the proposed inquiry by a Committee would not be desirable or even opportune. His hon. and gallant Friend had laid great stress on the evidence taken before the Sebastopol Committee, but it should be observed that that evidence did not bear so much on the faults of the system followed in our service as on those of individuals, many of whom, as the purveyors, were old men. The disgraceful state of the hospitals, so much complained of at one time, had in a great measure ceased to exist, and the Sebastopol Committee was at the present time inquiring into this very matter. One-half of the evidence contained in the blue book presented to the House had reference to the deficiencies of the medical department; and that very day one of the Commissioners of Inquiry who had been sent to the East had been examined in reference to the state of the hospitals. There would, therefore, be great inconvenience in having another Committee appointed to investigate precisely the same subject. The state of the medical department, if not the special subject of the inquiry of the Sebastopol Committee, was nevertheless embraced within the scope of its investigation, and he had no doubt that the Government would derive great advantage from the conclusions at which that Committee might arrive on the subject. The present Motion had been based on the evidence given before the Se- 1515 bastopol Committee, and it certainly would be somewhat novel and anomalous to appoint the Committee now proposed in order to report what conclusions ought to be drawn from evidence taken before another Committee, whose inquiries were not yet concluded. Let the labours of the Sebastopol Committee be finished, and then, if that inquiry should be found incomplete, it would be time enough to appoint another Committee for the purpose of considering this question. Another reason why he felt that the appointment of the proposed Committee would be inexpedient was, that this subject was not only under the consideration of the Government, but was being dealt with by them at the present moment. The Government were taking steps to reorganise and reconstitute the medical department of the service. The right hon. Baronet (Sir J. Trollope), who seconded the Motion, said that a contrast had been drawn between the French and English medical service, disparaging to the latter; but it should be borne in mind that a Commission, which had been appointed to proceed to Paris to inquire into the constitution of the office of the Minister of War there, had made its Report, and much of that Report was devoted to the state of the constitution of the medical department. He had no doubt that the Government would obtain many valuable hints from that Report. Of course the first subject which the proposed Committee would have to inquire into would be the constitution and direction of the medical department of the army. The right hon. Baronet had found fault with the arbitrary and despotic powers possessed by Dr. Andrew Smith, who, as the head of the medical department, determined the conditions on which medical students should be admitted into the army, the nature and sphere of their duties, and recommended them for advancements and promotions; and yet, on the other hand, Dr. Andrew Smith complained of having five masters, and of being trammelled on all points—on a question of expense being obliged to go to the War Office, to the Horse Guards on a question of promotion, in reference to supplies for the hospitals to the Ordnance, and to the Admiralty in reference to conveyance of stores. The remedy for that was the concentration of the authorities of the army, and that had in a great measure been already effected by the creation of the office of Secretary of State for War. That officer had now a power over all 1516 the other authorities which controlled the movements of the army, not before possessed by any single functionary, and all the evils of division and rivalry of authority were, he hoped, in the course of removal. Then, again, the Government proposed to make further changes with respect to the direction of the medical department itself. The office of Secretary of State for War was brought into more immediate connection with the medical department than any other office hitherto had been, and the Government proposed besides to make changes in the constitution of the medical department itself. Complaint had been made of the large power vested in one officer, particularly in reference to military surgeons, the possession of which subjected that officer to the imputation of such motives as had been mentioned in the case of Dr. Davy. It was, however, the intention of the Government to appoint a civilian as a member of the medical board, who, in conjunction with the person filling the office of Director General, would regulate the operations of the department—an alteration which it was to be hoped would prove satisfactory to the profession and to the country. In addition to that, a change would also be made in the persons to constitute this board. The hon. and gallant mover had supposed that Dr. Andrew Smith retired from the medical department because he disapproved the alterations that were taking place. Now, the truth was, that Dr. Andrew Smith, who deserved to be mentioned with honour, inasmuch as he had performed his duties zealously and with a sense of his responsibility to the public, had now been employed in the medical service for nearly forty years; and it was not to be wondered at that, after such a period, he should be desirous of retiring from active life. But, further than this, he was not unnaturally reluctant to share with others that control over a department which he had so long held undivided. Another subject which would fall under the inquiry of the proposed Committee would be the constitution of the medical staff itself. The hon. and gallant mover complained that the surgeons of our army were denied certain advantages which were enjoyed by the profession in other services; in India, for instance, a surgeon was allowed to retire upon half-pay after seventeen years' service; whereas, in the Queen's service he had to serve twenty-five years before he could do so. Now, it should be remem- 1517 bered that service in India was considered, from the climate or other causes, to be more onerous than it was under other circumstances. However, if there were any injustice done to the surgeons in this matter, as posibly there was, it could easily be redressed, and would indeed probably be dealt with by the new board. The right hon. seconder of this Motion said the system of admission to the medical service was very bad, and objected that surgeons were first required to go through a course of practical training at Chatham, where they had inadequate means for qualifying themselves. Now, here again the measures that had been taken by the Government would supersede the necessity for appointing this Committee, because the House had recently voted a sum for establishing professorships of military surgery at London, Edinburgh, and Dublin; and it would therefore be possible to impose attendance at lectures on candidates as a condition previous to their admission, and also by competition to raise the standard of the acquirements possessed by medical students. With respect to the system of appointing orderlies from the different regiments to perform hospital duty, the effect had been that the discipline of these men as soldiers had been destroyed, while their services as nurses were perfectly useless. But this was another of the evils which the Government were about to remedy, because the sanction of the Crown had already been given to the formation of a regular hospital corps, which was, in fact, now being raised as fast as possible. It was intended that there should be persons employed to act as ward-masters, in maintaining discipline in the hospitals, and seeing that the prescriptions of the doctors were properly made up and administered; there would also be a class of officers to cook the food and take charge of the clothes of the invalids; and thus all the inconveniences which had been complained of in regard to those particulars would be obviated. As to the relations between the purveyor and the chief medical officer, great misconception had existed. Whatever had been the doubts raised by the purveying department, it was clear that the purveyor was under the orders of the medical officer in charge for the time being; and whatever the medical officer required he was authorised by the War Office to obtain from the purveyor, and to insist on his supplying. Then, with regard to transport, the Transport Board that had 1518 been constituted would remove much of the difficulty that existed when the medical department was dependent on the Commissariat for the conveyance of its stores. These, then, were the principal subjects into which the proposed Committee would have to inquire, and it would be seen that in relation to the whole of them the Government were at this moment taking active steps. With regard to the other topics which it was suggested by that Motion to make the subject of investigation, the proposed inquiry would undoubtedly clash with that now being prosecuted by the Sebastopol Committee. The most convenient course would, therefore, be for the House to suspend its judgment until that Committee had concluded its labours. If its Report should be considered incomplete, and the recommendations of Her Majesty's Ministers should also fail to give satisfaction to the House, then they might rely upon it that the Government would make no objection to the fullest investigation of this subject. Under these circumstances, and with this assurance from the Government, it was to be hoped that his hon. and gallant Friend would not deem it necessary to persist in his present Motion.
§ MR. BRADY
said, he thought that, after the able and convincing arguments of the mover and seconder of the Motion, the House must be persuaded of the necessity for speedily settling this important question. Indeed, the admissions just made by the right hon. Gentleman (Mr. Peel) in resisting the Motion, were sufficient of themselves to establish that proposition. At the present moment the public mind was excited, and called loudly for inquiry into the management of all our departments. It was the constitutional right and duty of that House, when a general impression prevailed that great abuses had existed in a department of the State, to have the matter fairly investigated; and this question was not to be restricted to such narrow grounds as the mere advantage or disadvantage of the surgeons of the army and navy. Hitherto this question of the medical department had been considered as if there were only two parties who had anything to say on it—namely, the public medical officers on the one hand, and the Horse Guards and the Admiralty on the other; but he trusted the time was now come when that House would assert its rights, and would institute an inquiry with a view of making the medical institutions connected with the public service 1519 efficient for the great objects for which they were intended. The hon. and gallant Member who had introduced the Motion had shown how inefficient were the medical departments connected with the army, and he (Mr. Brady) would show that this was also the case with respect to the navy. That such was the state of things in the navy was proved by the fact that the Government at the present moment had been compelled to obtain the services of upwards of 100 unqualified young men to act as surgeons on board one of the largest and most powerful fleets which had ever left England. These inexperienced and ignorant young men, who were only hospital dressers, who did not know an artery from a nerve, and who would not be allowed to assist in the most simple operations in the hospitals at home, had been intrusted with the care of the lives of the captains, officers, and men in the naval service. He actually shuddered at the idea of an engagement taking place while these unpractised youths were acting as surgeons. The reason that capable and efficient men would not enter the service was because, if they did so, they became degraded in their social position, and if the present system were continued it would be most injurious to the public service and the nation at large, and would ultimately lead to the most serious consequences to the country. He would call the attention of the hon. and gallant Member (Admiral Berkeley) to what their future prospects were by stating that he (Mr. Brady) had, a short time since, presided over one of the most important meetings—in a medical sense—ever held in the country; deputations were sent to it from the various colleges, and there were upwards of 4,000 medical men and students present. The young men on this occasion came forward and pledged themselves never to enter the service of the navy so long as the present degrading regulations existed. On the 17th of February, 1854, the hon. and gallant Member (Colonel Boldero), brought forward his Motion relative to the assistant surgeons in the navy, and he then asked where the Government would be able to obtain the assistance of surgeons from, when all who entered the service were compelled to remain in the cockpit for three years. He then said that if qualified surgeons could not be obtained, the Admiralty would deteriorate the article, and take surgeons who would act under a boatswain's warrant. There had been no truer prophecy 1520 than this, for the Admiralty had been forced to deteriorate the article, otherwise they would not have been able to obtain a sufficient number of men to act as surgeons. The right hon. Baronet the Member for Carlisle (Sir J. Graham), who, he regretted to see was not in his place, had, in answer to the hon. and gallant Colonel, said—At this moment there is no deficiency in this branch of the service. We have no complaint to make of the want of a sufficient number of assistant surgeons in the navy; and, we have every reason to be satisfied with the competency and the abilities of the Gentlemen selected for the office. I can assure my hon. and gallant Friend that if I had the slightest apprehension that the crews of Her Majesty's ships were exposed to the treatment of ignorant and empirical practitioners, there is no effort that I would not make to remedy so great an evil." [3 Hansard, cxxx. 822.]Such were the words of the right hon. Baronet on the occasion alluded to, and he (Mr. Brady) now called on the hon. and gallant Addmiral to support the words of his former colleague, and to remedy an evil which now undoubtedly existed. He accused the hon. and gallant Admiral of being the chief cause of the degraded position of the surgeons in the navy, and he had been told that the hon. and gallant Admiral had resolved that they should remain in their present position, and that he was a man of firmness, who would not depart from his resolution. If the hon. and gallant Admiral had not been in office two years ago men of inferior education would not have been taken into the service, as there were plenty of able men ready to enter it as soon as the present system was abolished.
said, he should not have risen on the present occasion, had it not been for the unwarranted personal attack which had been made upon him by the hon. Gentleman who had just sat down. He had been charged with being a man of firmness and resolution. These were qualities he hoped he had displayed throughout his life, and had employed them in taking care of the lives of the seamen in Her Majesty's service, and of the credit of the navy. It had been stated that assistant surgeons were unwilling to come forward, and one of the reasons which had been assigned for their unwillingness was, that the necessary qualification was lower than that which was required in the army. The fact was that a higher qualification than that of the army had been demanded, but it was thought right that the standard 1521 of qualification of assistant surgeons should be assimilated to that of the army. The hon. Gentleman who had last spoken had asserted that they were obliged to put up with men who had scarcely any qualitication, and that a set of dressers were employed to perform the duties of assistant surgeons. That was not the fact. He did not think that the resolutions adopted by the meeting to which the hon. Gentleman had referred did any credit to the Gentlemen who had agreed to them; they almost resembled the endeavour which had been made by operatives to dictate to their masters, and exhibited a singular lack of patriotism. If they looked to what had taken place before Sebastopol, they would find that the health of our men had been better looked after than that of almost any other troops in the world, and it had been truly stated that, out of 1,000 seamen, who had been landed, only twelve were on the sick list. It had been asserted that they were unable to obtain assistant surgeons, but only last year forty-nine had entered the navy. He also begged to assure the House that, so far from the ships in the Baltic and Black Sea being deficient in assistant surgeons, there was not one vacancy in them, and, moreover, that every ship in Her Majesty's service was now provided with one-third more medical attendants than had been supplied during the great battles of the last war. The hon. Gentleman said that so degraded were the assistant surgeons by being compelled to serve in the cockpit that properly qualified men would not enter the service, but after the eminent men whom the cockpit had produced he thought they need not be ashamed if they were obliged to live in that place.
said, it was impossible to give too much credit to the medical officers of the army for the kindness and ability with which they discharged their duties. What he wished to call the attention of the house particularly to was, as to the impossibility of the Committee up stairs investigating in a satisfactory manner the working of the general and regimental hospitals in the Crimea. There was one point of great importance connected with this subject. From the deductions which were made from the pay of soldiers confined in hospital for the comforts supplied them, it was at present almost impossible that he could leave it otherwise than in debt. He (Colonel North) also 1522 agreed that the amount of correspondence imposed upon medical officers was too great. He did not think the officers were any better treated. In the West Indies some years since ensigns on 5s. 3d. a day had to pay for leeches themselves, when in yellow fever, when leeches were very dear. He did not consider the removable position of the medical officer a satisfactory one. He would vote for the Motion, because he thought every regiment should have a regular and complete medical establishment, thoroughly trained in all its parts, from the hospital surgeons upward. He thought a system of providing linen and other similar conveniences for the military hospitals should be adopted the same as in the naval hospitals. And he finally begged to call the attention of the Government to the serious condition of officers returned invalided from the Crimea; and would suggest that as they had no allowance, an hospital should be established for their use, or houses should be hired for the same purpose. He would vote for the Motion because, as he had previously stated, he thought the Committee up stairs could not investigate all these points, or inquire into the whole question.
said, he quite agreed with the hon. and gallant Member who had introduced the Motion, that nothing could be more unsatisfactory than the state of the army medical department. The Committee upstairs was doing its best to unravel much of the confusion in which this establishment was at present involved, with a view of enabling the Government and that House to make such reforms as were essentially necessary for the efficiency of the service and the credit of the country, and he would leave it therefore to the discretion of the House whether a second Committee should be appointed to sit at the same time on the same subject. The hon. Gentleman opposite (Mr. Brady) had mixed up the questions of the military and naval establishments, but, so far as the medical establishment of the navy had come before the Committee upstairs, he was bound to say that it afforded a very agreeable contrast as regarded results to the medical service of the army in the East. In the naval hospital in the East there did not appear to have been any want of medical appliances or comforts or of medical assistance, and the naval detachment before Sebastopol appeared to have suffered a very trifling loss in comparison 1523 with the army. The question now under discussion would he thought be found, when examined in all its bearings, to be one very much of the remuneration which ought to be given to medical officers in the army. The Gentleman who preceded Dr. Andrew Smith in the office of Director-General of the Medical Department received a salary of from 2,000l. to 2,500l. a year, but when Dr. Andrew Smith took the office the salary was reduced to 1,200l.—a sum very far inferior to that which a person of eminence could obtain from private practice. In like manner, the superintendent of the hospitals at Scutari, with 5,000 patients to look after, and the labours of Hercules thrown on his shoulders, was paid at the rate of about twenty-two shillings a-day. Certainly some allowance ought to be made for the difficulties in which that Gentleman was involved from the numerous functions which he had to perform. He bad to superintend the hospitals on the spot; to receive all the sick and wounded sent down from the Crimea; to provide accommodation for them; to receive all the reports sent in by the medical staff, and to despach duplicate reports of the condition of the hospital to headquarters in the Crimea and to England; to act as president of the boards before which all officers applying for leave of absence on account of their wounds or of ill health had to pass; and, in addition, he had himself personally to perform some of the most important operations which took place in the hospital. Certainly, these were labours too great for any one man to undertake, and this gentleman would most probably have appeared to better advantage before the Committee and before the public if he had boldly stated so, instead of endeavouring to assign reasons why he had not properly discharged all these various functions. What was wanted was a military commanding officer able to control the whole management of the hospital, and to see that the wants of the patients were properly attended to, with power sufficient to put a stop to all the petty quarrels about conflicting authorities, and summarily to dismiss such medical men as did not perform their own duties and impeded others in the performance of theirs. It was from the want of such an authority, and the attempt to substitute another authority in its place, that the greater part of the evils of which the country had so great a right to complain had arisen.
1524 With regard to the appointment of a Committee, though he should leave it to the discretion of the House to decide upon the question, he was of opinion that, on the whole, it would be better to wait for the termination of the inquiry which was at present going on, and which must soon be brought to a close, when the whole subject would be fully before the House, with the additional advantage of knowing what were the propositions of the Government with reference to it.
§ MR. MUNTZ
said, he was perfectly at a loss to understand either the principle or the policy of the Government in opposing this inquiry, when the public had such strong grounds for believing that all the Government departments were badly managed. It appeared to be only a question of expense; but why should there not be two Committees sitting? The first Committee was a Committee to do everything; the other would be a Committee to do only one thing. He could not help thinking that the Government were showing a great want of discretion in resisting a demand of this sort merely on the ground of expense, when so much had recently occurred to show the absolute necessity of such an inquiry.
§ MR. MONTAGU CHAMBERS
said, he could not help remembering that the public interests had perished through delay and procrastination, and now the Government were about to procrastinate again. He was prepared to vote for this Motion. It was said that there were no complaints from the medical officers of the navy, and the hon. and gallant Member (Admiral Berkeley) told the House that the Admiralty were able to get as many properly qualified medical men as they wanted. But in private society it was well known that the medical officers of the navy were constantly complaining, while the most distinguished members of the medical profession on shore were crying out against the treatment of medical men in the navy. Let the House reflect upon the situation of the Baltic fleet, and the probable number of wounded men if that fleet went into action, and then let them inquire why the Admiralty were sending out pupils to act as surgeons? Now was the time to act, before the mischief occurred. He understood that 100 young men now occupied a subordinate position as dressers in the Baltic fleet, who were simply pupils, and who were consequently quite ignorant of their 1525 profession. There was no doubt an objection on the part of highly qualified medical men to enter the Royal navy. He would give his vote without hesitation for the appointment of another Committee of Inquiry, and the sooner they entered upon their labours the better.
§ SIR GEORGE GREY
said, that the hon. Member for Birmingham (Mr. Muntz) had assumed that the Government opposed any inquiry into the state of the medical departments of the army and navy. But was that a proper explanation of the course taken by the Government? His hon. Friend (Mr. Peel) had stated the reasons which led the Government to the conclusion that it was inexpedient that the Committee now proposed to be appointed should sit while an inquiry was already going on upstairs embracing this among other subjects of inquiry. His hon. Friend had also stated that it was admitted abuses existed, and that the proposal for inquiry by a separate Committee would meet with the willing concurrence of the Government if the House thought it desirable, after the inquiry now going on had been concluded and the Committee had made their Report. A great portion of the time and attention of the Committee now sitting upon the state of the army before Sebastopol, had been devoted to the medical department of the army, and the more useful and proper course, he considered, would be to wait until this subject had been fully inquired into by them. The only Member of the Committee who had addressed the House (Mr. Ellice) had taken this view, and had also stated that very shortly the Report of that Committee would be laid before the House. The Government were anxious that these departments should be placed in an efficient state. Motives of humanity and policy alike guided them in this desire, and the Government would be very thankful for any assistance which a Committee of that House could give them in improving the efficiency of these departments. But the Government thought there ought to be some regularity in the proceedings of the House, and that the House should wait and see what one Committee recommended before they appointed another. If eventually the House should think it desirable to refer this subject to a separate Committee, it would be an advantage to that Committee to have the evidence before them now being taken by the present Committee. The question affecting the naval branch of the profession was a mere ques- 1526 tion of detail as compared with the other. The hon. and learned Member (Mr. M. Chambers) had mentioned as a proof of the indisposition of medical men to enter the navy, that there was now with the Baltic fleet a number of very incompetent men, who were pupils. But the House ought to understand that there had been a certain number of pupils appointed to do duty with that fleet, but that they were supernumeraries, and not subordinates acting as surgeons or assistant surgeons. The full complement of surgeons and assistant surgeons existed in the Baltic fleet, and these dressers who were sent out might hereafter become assistant surgeons, when they had seen sufficient practice and acquired sufficient skill. He trusted the hon. and gallant Member who brought this Motion forward would consent to withdraw it, and bring it forward at a future period.
§ SIR GEORGE PECHELL
said, that if the Motion had been limited to the army he might have been content to wait for the Report of the Sebastopol Committee, but after the speech of the hon. Member for Leitrim (Mr. Brady), as to the treatment of medical men in the navy, he would not refuse to give his vote in favour of this inquiry? He regretted, however, that the hon. Gentleman had thought it necessary to speak with a tone of asperity respecting the conduct of the hon. and gallant Member for Gloucester (Admiral Berkeley), who, it would be found, had made great exertions with regard to the equipment of the navy.
§ COLONEL BOLDERO,
in reply, said, that he had had the honour of a seat in the House of Commons for many years, and that he never remembered a Motion to have been received with so much favour as that which he had had the honour of submitting that evening. It had been supported by both sides of the House, and even Members of the Government had made use of arguments in its favour. The Sebastopol Committee had concluded their evidence upon the medical part of the case, and he saw no reason why the inquiry which he proposed should be put off until their labours were completed, which might not be until the close of the Session. The present, therefore, was the best time for inquiry, and under the circumstances he could not consent to withdraw his Motion.
§ Question put.
§ The House divided:—Ayes 69; Noes 73: Majority 4.