HC Deb 16 July 1875 vol 225 cc1617-29
DR. LUSH

, in rising to move, That, in the opinion of this House, the positions of the Medical Officers of the Army with respect to their honours, pay, and relative rank, is not in a satisfactory state, and that a revision thereof is desirable, said: Mr. Speaker, in rising to call the attention of the House to the subject of which I have given Notice, I feel that I have considerable difficulty to contend with. First, from the natural dislike of hon. Members—in which I myself share—to listen to the details of any grievance at all; and, secondly, from my own want of a personal claim to be listened to as a medical officer of the Army. But if the House will bear with me for a short time, I think I shall be enabled to show that the condition of the Army in respect of its medical Staff is not sound, and that whatever may be the personal desire of the right hon. Gentleman at the head of the War Office to effect a satisfactory reform, he will be comparatively powerless unless aided by a Resolution of this House, that such a reform is needed. And at the outset let me say that nothing is farther from my intention than to do, or to ask for, anything tending to deteriorate the discipline of the Army, or to encourage the parade in this House of grievances inalienable from military service, and which are always to be taken into account when gentlemen accept commissions either as scientific or as combatant officers of Her Majesty's Army. But the matters to which I have to refer cannot be said to arise naturally from the Service, and the complaints of the medical officers are that a systematic and unexpected deviation from the Regulations, and a practical repudiation of Royal Warrants have resulted to the prejudice of one branch of the Service, without any great or striking advantage to the other, except in the matter of honours and decorations. And if it may be considered that some of these results are more of a sentimental than solid injury, I would remind the House that the medical profession is a peculiarly sensitive one, and that much of their influence for the good of the Army and of the nation depends upon the position they assert, and the estimation they hold in public opinion. When, therefore—though habits of discipline keep them silent—they find themselves, as it were, treated as a separate class, and in the large majority of cases placed in a position subordinate to the combatant officers, they feel themselves, and I feel also, that with the great reluctance of the War Office to relieve them from their irksome position hitherto evinced, they have a reasonable justification for coming to this honourable House. And, Sir, the matter is, for another reason, become a pressing and growing one. An important deputation of teachers from the licensing bodies of Dublin which lately waited upon the right hon. Gentleman, authoritatively assured him that the supply of candidates for the future medical service of the British Army is decreasing, and the probable quality deteriorating, solely from the unpopularity engendered by the official treatment of the gentlemen who now hold commissions. I shall not attempt to weary the House by reciting all the vexations that have been communicated to me; but will in a few words endeavour succinctly to state the salient points, just premising that by Royal Warrant of 1873, the old system of regimental medical officers was superseded, and the whole body converted into a medical Staff. Though it struck a vital blow at the old regimental system described by Lord Herbert as the backbone of the British Army, which had the advantage of permanently associating the medical officer with his patients; yet it has passed into history, and the medical officers, as a whole, are content with the change; their real complaint being that the terms of the Warrant are either evaded or not complied with; and that by a caprice of the War Office, all that they have been led to consider the securities of their rank and position, may at any moment be cut from under them. Take the matter of pay—and this is the least of their grievances. Though the pay of an Army surgeon commences only at the same rate as in 1793—namely, 10s. per day, yet the rise of 2s. 6d. per day every five years to 17s. 6d. per day would not be unsatisfactory, if the promotion to a higher grade could be relied upon; but for want of a good system of retirement there is a block of promotion steadily increasing, so that though in 1859 the average service in the junior rank was seven years, in 1875 it exceeds 15 years. This stagnation naturally sours the Service, and is a fruitful source of discontent. I am assured also that although there is under the new system an apparent increase of a little over £30 a-year in the pay of the surgeon, his liability to be removed suddenly from one station to another, often with a family, really renders this addition an illusory boon. There is the vexed question of forage. The Royal Warrant places surgeon majors in the position of field officers, and as a consequence they wear spurs, and have the rank of such officers, but by a refinement of absurdity the War Office denies them forage for their horses! So with regard to absence and sick leave, a combatant officer gets leave of absence free of charge or responsibility, the doctor must provide a substitute at his own cost! And if sick leave is granted to him, after six months from India he is put upon half-pay. The hon. and gallant Gentleman opposite says that adjutants are in a similiar position with respect to substitutes; but an adjutancy is an appointment paid for in addition to his status as a regimental combatant officer. No doubt the value thus set upon the personal service of the medical officer is complimentary to the profession; but it is a heavy premium to have to pay for a doubtful compliment. It should be considered, also, that even before Purchase was abolished and now, the medical officer enters the service as a means of livelihood by the exercise of his skill. He has not the Peerage—glory, and possibly Westminster Abbey, in view. The highest position he can attain in the Service gives him only £3,000 a-year, while an ordinary general of division gets £4,000 a-year. These higher things are limited to combatant officers; and one of them, the distinguished Sir James Outram, on his death bed, is reported to have said—"It pains me to think that the services rendered by medical officers to the public have been so ill-requited, and that my efforts to obtain justice for them have been attended with so little effect." I trust these emphatic words of the dying hero may sink deeply into the minds of hon. Members. That distinguished officer, Sir Garnet Wolseley, also, at the Mansion House, said with regard to the Ashantee Campaign, "that the services of the medical Staff were beyond all praise." So in the matter of pensions. A medical officer on the Indian Staff informs me that after 28 years' full service he retired with the rank of major-general with 20s. per diem. The combatant officer in the same rank getting £500 a-year, with the possible chance of re-appointment on full pay—but the doctor is shelved for life. The right to exchange, and the losses sustained by the medical officers, are matters on which I do not like to dwell; the only point I would insist upon is, that an exchange should be bonâ fide, as promised in the other branch, and should be placed upon solid and unmistakable grounds. At present this is not so—and medical officers who have given quite £600 for their position have never been recouped one penny. A more grievous complaint is with regard to the honours bestowed upon the medical officers. Anticipating a recent brevet of honours, I ventured to ask a Question of the right hon. Gentleman in this House, whether in any future general distribution of Army honours, the medical service would be more equitably considered? Indisposition kept the right hon. Gentleman from his place. If he had been present, I do not think I should have got the curt and somewhat flippant answer that I did from the hon. and gallant Captain by his side (Captain Stanley)— It is considered that the medical officers engaged in the Ashantee Expedition have received their full proportion of the honours and rewards bestowed on that occasion."—[3 Hansard, ccxxiii. 1509.] But in that campaign out of 230 combatant officers, many of whom stayed on board ship, 78 were either promoted or decorated, and out of 81 medical officers only 9 got the same reward meted out to them. The volunteers to the Gold Coast were not sufficient; so that the medical officers on the rota went in the ordinary course of duty, and so much the more were entitled to a higher share of the rewards. As the Ashantee Expedition was more a war against climate than any other force, I venture to suggest that its success was in no slight degree owing to the science of the medical officers. If, therefore, in such a war, the relation of honours bestowed in one case is as 1 in 3, and in the other as 1 in 9, what hope is there for medical officers that in any future campaigns, without, possibly, the special conditions of the West Coast of Africa, they may escape the disdain that appears to actuate the Advisers of the Crown? Sir, as if to quench for ever any hope that the agitation of this question may have given rise to, a Birthday distribution of the honours of the Bath has since taken place, and amongst a wholesale creation of G.C.B.s, K.C.B.s, and C.B.s, amongst generals, colonels, majors, and captains, amounting to 80 or 90 in all, only one medical officer of the Army was allowed to creep in, who, though a very distinguished officer, had no special claims above numbers of his brethren. Sir, the medical officers naturally ponder upon these inequalities; they do not, in their private relations, hesitate to speak of them, and the result will be fatal to the future sanitary condition of the Army, if the right hon. Gentleman hesitates at once to take the matter in hand. The problem of future rapid military movements practically devolves upon the medical Staff for very much of its solution; and this is the time considered by the War Office suitable for a general snubbing of this important branch of the Service of Her Majesty, I venture to ask the House to take a different view, and that this course of injustice will no longer be tolerated. Sir, the third point referred to in the Resolution I propose to move relates to relative rank. It is one of much importance to the comfort and dignity of the medical profession, which is a branch, let the House recollect, of a profession in which honour is punctilious, and necessarily so. The right. hon. Gentleman at the War Office and in this House denied the grievances and also scarcity of applicants. His statement that there was no lack of medical officers is to be explained by wholesale reductions, so as to keep demand and supply equal. Isolated cases of numbers of marks do not disprove the fact that the Indian Service does really get all the best students. And there is no doubt the discontent in the Army discourages the admission to Her Majesty's Service of the alumni of some of the best medical schools in the world. I have purposely avoided obtruding my own advice in the various matters complained of. I think the relief sought for should spontaneously be afforded by the Administration, and not in its details be forced upon it. Respect to Her Majesty's Prerogative and the discipline of the Army forbid any other course. What the medical officers desire is that relative rank should be a reality and not a sham, and that it should date from The Gazette. That it should hold in hospitals and barracks, as well as in a regiment, and that none of its advantages should be withheld from the profession. The subordination of the medical to the combatant branch in hospitals is, upon the face of it, a peculiar injustice. A distinguished medical officer formerly at Netley told me, that if, on entering one of the wards of that noble monument of Sidney Herbert, he found the atmosphere impure, he was not entitled to order a window to be opened, but had to send a hospital orderly to the captain of the orderlies for his authority to do so! The House will see by this example how sedulously the doctor, even in his own peculiar sphere, is taught to humble himself and to be humbled, whenever there is an opportunity. In the United Kingdom it may be that the disadvantages resulting to the medical officers are comparatively slight and limited to choice of quarters, as the right hon. Gentleman asserted lately: but abroad it is a serious matter. In India the question of relative rank is stereotyped on the official mind and pervades society. A ease is known to me where at an official reception, a young civilian, just after getting relative rank of lieutenant-colonel, took precedence of a surgeon-major after 27 years' service. The medical officers serving in India in 1873 were ignominiously turned out of their regiments, and ever since no surgeon can be really considered as belonging to any mess. He is simply tolerated—that is all. True they have been allowed to wear out their old regimental uniforms; and the anomaly may be witnessed of, for instance, a medical officer attached to an Infantry regiment wearing the uniform of the Royal Horse Artillery. The injustice of placing a medical officer on half-pay, after a short sick leave, is manifest. If restored on recovery to full-pay he finds that his juniors have in the meanwhile passed over his head; and more than one of such cases have been certified to me. In fact, the system is gradually separating the medical branch of the Service from their brother officers, and it is felt, and strongly felt too, that though liable to mess charges, they no longer belong to the regimental fellowship, and the effect, though possibly slow in its operation, by reason of the past associations, cannot fail to be permanently injurious to Her Majesty's service. It should be recollected, also, that the two classes of officers start already clearly handicapped by the difference of age and education. An officer may enter the Service at 16. The medical officer, only at full manhood, after years of study, and a considerable outlay, can receive his commission, and then finds that he is classed and treated permanently as of an inferior grade, his age, instead of ensuring a certain respect, actually in the race for promotion and rank, telling against him. Sir, I do not feel myself justified in further trespassing upon the time of the House. I have endeavoured, though very imperfectly, to give expression to the sense of injustice pervading the entire executive branch of the medical Service. The administrative officers, so far as I can gather, have less reason to be dissatisfied, and are indeed somewhat favourably treated in comparison with the other class whom they elbow out in a measure; and I assure the House that I have purposely understated my case, in order not to be compelled to introduce cases of individual hardship. I shall be glad if what I have said may have the effect of convincing the House that the case of the medical officers of the Army is not an imaginary grievance, but one of reality and importance, not only to themselves, but to the Army and to the country, and that a full and generous consideration of their claims is imperatively demanded of the right hon. Gentleman and the Government. Sir, I wish very strongly to impress upon the right hon. Gentleman the urgency of the case and the necessity of immediate action in the matter, and beg to move the Resolution of which I have given Notice.

Amendment proposed, To leave out from the word "That" to the end of the Question, in order to add the words "in the opinion of this House, the position of the Medical Officers of the Army with respect to their honours, pay, and relative rank is not in a satisfactory state, and that a revision thereof is desirable,"—(Dr. Lush,)

—instead thereof.

Question proposed, "That the words proposed to be left out stand part of the Question."

SIR WALTER BARTTELOT

expressed his satisfaction that the hon. Member for Salisbury (Dr. Lush) had brought forward that subject in behalf of a most deserving body of men, who had always done their duty. Still, had the hon. Member known the position of those gentlemen when he (Sir Walter Barttelot) entered the Service he would have had a very different tale to tell, for there was no body of men who in that respect had been more cared for of late years than the surgeons of the Army, seeing that a physician-general now ranked with a major-general, and a surgeon-general ranked with a colonel. Upon that score, therefore, he did not think that they had much to complain of, while great injury had, he believed, been done them, so far as the position which they held in their regiments was concerned. The aspiration of the medical officers was that they should be considered part and parcel of the regiment, and that the regiment should be their home; but the regiment was their home no longer. Surely it was a monstrous thing that a man should be called upon to find regimentals for a particular regiment and then be transferred nobody knew when and nobody knew where. That was not so in former times; and he was of opinion that the hon. Gentleman had made out that part of his case, and it was a point which should be impressed upon the attention of the right hon. Gentleman the Secretary of State for War.

MR. CAMPBELL-BANNERMAN

, having had some degree of responsibility in the issue of the Royal Warrant of 1873, which had been so much referred to by his hon. Friend the Member for Salisbury (Dr. Lush), desired to say a few words in explanation of its object and intention. That Warrant was not issued without full inquiry into the subject. A Committee had sat upon the whole question of medical organization in the Army, and that Committee consisted of officers specially competent to deal with the question. Sir Henry Storks and Sir Garnet Wolseley, two distinguished officers who had both had a peculiar degree of experience in the working of the medical service, were on the Committee; so was Sir Galbraith Logan, at that time Director General of the Army Medical Department; and the very able officer who now filled that position, Sir William Muir, either was a member of the Committee, or, at least, was constantly consulted by its Members, and entirely agreed in their Report. The principal recommendation which the Committee made was the unification of the department, and the establishment of a consolidated Staff service instead of the regimental service which had up to that time prevailed. The House would bear in mind that, while it was very necessary to consider the interests of the medical officers—and he (Mr. Campbell-Bannerman) would yield to no one in his desire to do so—it was still more necessary to consult the interests of the Army itself, and to secure for it the services of efficient medical officers. Now, they might have stringent entrance examinations and thus provide that when he joined the service, an officer should be well qualified; but if that officer was confined to a particular regiment, the experience gained in the course of his service must be small, he would see no variety of disease, his acquaintance with the higher branches of his duty must be limited, and it was found that he was very apt to grow rusty, and to fail to keep abreast of the progress of medical science. One advantage of the unified system was that it gave medical officers the wider experience which they thus required, and the House would see, notwithstanding what had been said in favour of the strict regimental system, that that was a good reason for abandoning it. Another very important advantage was, that the consolidation of the service enabled them to have, as was so desirable, the same system in peace that they should be obliged to have in war. The system, therefore, introduced by the Warrant was that a medical officer should not be appointed to a regiment, but should be attached to it for five years; and it was not intended that their change from one regiment to another should involve any expense for regimentals, as it was proposed that there should be one uniform for all medical officers. His hon. Friend the Member for Salisbury (Dr. Lush) had made a complaint that officers removed, under the Warrant, from regiments had received no compensation for the payments they had made for their appointments, at a time when combatant officers were receiving such large compensation on the abolition of purchase. But the cases were entirely different. The combatant officer had paid a certain sum under regulation; and his over-regulation payments had been inquired into by a Royal Commission, which decided that though illegal, they could not be ignored; Parliament, therefore, could not avoid acknowledging those claims. But if any payments were made by medical officers they were unknown to the military authorities, and they were quite beyond the cognizance of the War Department. It might be that in carrying out this great change hardships had been unintentionally inflicted upon individual officers, but he hoped these would be mitigated as much as possible. The other great object of the Warrant was to facilitate promotion. Owing to the large increase made to the department at the time of the Crimean and Indian Wars there existed, two years ago, the near and certain prospect of an absolute block in the lower ranks. The medical officers then desired, and he believed this was still one of their proposals, that promotion from surgeon to surgeon major should of necessity occur after a fixed period of service. His noble Friend, however, the late Secretary of State, was very averse from fixing by Royal Warrant any positive period for promotion, being aware how unfortunately such an arrangement had worked in other cases; but he thought it would meet the case, and satisfy the officers, if he stated that it was the intention of the Secretary of State that promotion should, on the average, be made after a certain period, without laying it down in explicit terms that that should in all cases occur. He (Mr. Campbell-Bannerman) had not followed the course of events for the last year, but he presumed that the standard of promotion was still not far from from that which the medical officers wished.

Notice taken, that 40 Members were not present; House counted, and 40 Members being found present,

MR. CAMPBELL-BANNERMAN

resumed: There was every desire on the part of the late Government to meet the wishes of the medical officers, and they were under the impression, and, indeed, had good reason to believe, at the time the Warrant was issued, that its general principle was agreeable to the department. If there were any minor points, such as relative rank, choice of quarters, and others, in which the medical officers felt themselves aggrieved, he had no doubt the right hon. Gentleman opposite would as far as was in his power relieve them of any just grievance of which they complained.

DR. WARD

, in supporting the Motion, said, he had no doubt great discontent was felt upon this subject, and that the most prominent grievance amongst the older members of the Army medical officers was the removing them from their regiments, and placing them on the staff by the late Government in a very harassing fashion indeed. This, however, was a wise measure so far as the Army was concerned, because it kept up a knowledge of the profession. But the most important of all their grievances was in connection with promotion. In Lord Herbert's time a medical officer was sure of promotion after serving seven years; now he must serve 15 years. That was a great hardship, and there was only one remedy for it, by providing a compulsory retirement for the older officers after they reached a certain age. After all, the slowness of promotion was the great grievance, and he strongly urged the right hon. Gentleman (Mr. Hardy) to lessen that evil by fixing the age of retirement at 60 instead of 65, as was the case in the Navy. A medical officer had to look mainly to his pay, and on a comparison of years he received less money now, when everything was dearer, than he did 15 or 20 years ago.

MR. GATHORNE HARDY

said, that the hon. Member for Salisbury (Dr. Lush) and the hon. Member who had just spoken had taken up very different positions, the one dealing with the sentimental and the other with the pecuniary aspect of the question. He (Mr. Hardy) would be the last man to deny the great merits of the Medical department of the Army, and their title to share in the honour and dignity which naturally accrued to men who served their country under circumstances of great danger, but the honour he was called upon to give to the medical officers of the Army did not emanate from him, but from the military authorities. On the whole, the medical officers of the Army had not much to complain of. Their relative rank had become very high, and with regard to soldiers in hospital it was necessary to maintain discipline, which could only be effected by the combatant officers, who, however, never interfered with the medical officers in the discharge of their professional duties. Moreover, it would disturb the sound rule which had always existed, that the military authority should deal with the discipline, and the medical authority with the health of the Army. As for the proposal to make retirement at 60 compulsory, he believed the great evil was the dearth of medical men for the Army, both with regard to the Army and Navy, as well as the other public Departments, but he had no doubt it would remedy itself before long. He had had the question of rapidity of promotion examined into and actuarial calculations made in reference to it; and if adopted, a greater injustice might be inflicted by it than was now the case under the present system. Before changes like those proposed were adopted they required to be very carefully looked into, and before any alteration was made, he desired that it should be one that would be likely to last. All those matters had to be carefully considered, and he could assure the hon. Member for Salisbury that he was not losing sight of the subject. It was the fact, he believed, that promotion was slowest in some of the best regiments in the country, and practically, he might add, medical officers had become now staff officers, would be treated as such, and would have their own uniform. As to relative rank he could assure the hon. Member that, although there were great difficulties in the way of altering the position which they had always held as juniors of their rank, yet that, believing it to be of the greatest importance that they should have suitable quarters, he had directed that such quarters should, as far as practicable, be assigned to them. He hoped under the circumstances the hon. Gentleman would not deem it to be his duty to press his Motion to a division, but would rest satisfied with the assurance that he was looking into the question in the same temperate spirit as that in which it had been brought under his notice. We must have medical officers, and good medical officers, and if we could not get them without change that change should be made.

DR. C. CAMERON

thought the statement of the right hon. Gentleman would give considerable satisfaction to those to whom it related. He might add that the death rate among medical officers was very-high—30 per 1,000—while that in the case of the combatant officers was only 15 per 1,000; and would suggest that a thorough alteration should be made in the present system with regard to granting sick leave. The loss of forage was also a practical grievance, involving a pecuniary loss of £30 a-year.

DR. LUSH

said, that after the very courteous statement of the right hon. Gentleman he should not press the Motion. He hoped, however, that the changes to which the Secretary for War had alluded would speedily be carried into effect.

Amendment, by leave, withdrawn.

Question again proposed, "That Mr. Speaker do now leave the Chair."