HC Deb 08 June 1910 vol 17 cc837-45

Motion made, and Question proposed, 3. "That a sum, not exceeding £263,900, be granted to His Majesty, to defray the expense of Medical Services, including the cost of Medical Establishments at Home and Abroad, which will come in course of payment during the year ending on the 31st day of March, 1911.


The First Lord, in his statement, mentioned that questions of very great importance and far-reaching scope would be brought before the Committee which the Admiralty very wisely ordered to investigate affairs connected with the Naval Medical Service. The First Lord told us that he would let us have the report of the Committee as soon as possible, and I trust this will be done, as the statement was made last February. I quite agree with him that hardly anything is more important than that the whole of the Medical Service should be organised and ready for war, because you will want an immense amount of reserve both in the surgeons and staff, and unless you have got that reserve properly organised in time of war it would be a matter entailing serious consequences. One shell can kill a great number of people, and wound perhaps sixty or seventy men, so you must have a proper medical staff quite ready to go on duty if war were suddenly declared. Since the South African War the Army have recognised the importance of this point. They have got a school, which the right hon. Gentleman probably knows, at Millbank, which is a most excellent institution, and prepares officers for duties, in which they cannot have too much practice, in case of sudden emergency in war. I hope the right hon. Gentleman will tell us that the Committee will provide some sort of Naval Medical School, something similar to that which has been provided for the Army. I find, according to the peace establishment which is put down in the Navy List, that we ought to have 574 surgeons of all ranks, and, as I make it out, we have got about 60 or 70 short on the peace establishment. That is a very serious position, especially when we consider our requirements in case of war. I hope the right hon. Gentleman will tell us what he intends to do in regard to that. We have got only thirty-four reserve volunteers in the Naval List. I think we might increase those volunteers immensely by inviting the surgeons of mercantile ships to become surgeons for the Royal Navy in reserve. I believe they would be very glad to do so, and there would be this great advantage: that these men are accustomed to be at sea. I must again refer to the craze for economy. There was one year in which they never joined a single surgeon in the Navy. These economies are very bad in their result, and you have always got to pay a great deal more for them after- wards. We can learn a great deal from the other service on the question of the medical officers, because they have had experience in the South African War, and it is owing to that experience that many of the leading reforms in the Army Medical Department have been carried out.

Another point is the status of the sisters. There never was anything that was more to be admired than the attitude of those sisters in the hospitals. They put a stop to swearing. They kept everything clean, and they saw that the men had their medicine at the proper time. Since the advent of the sisters the naval hospitals have been improved enormously. I hope that the right hon. Gentleman will see that our sisters are put on terms similar to those given to the sisters in the Army. Personally I always took a great interest in the hospitals. When in command I used to go to the hospitals every week, and I can testify to the utility of the admirable work and the loyal work that is carried out by the sisters in the hospitals for the Navy. I do not think that they ought to feel that they are underpaid in comparison with their sisters in the sister-service. I am afraid that I should be out of order if I were to touch on pensions, but I hope I may mention incidentally that the whole of the sick-berth staff wants looking into, neither the pay nor the pension being adequate. With reference to "sick-berth staff in the Reserve" perhaps the right hon. Gentleman will tell us, as I would like to know, how many men there are, and if this question has been taken up by the Committee, and, if so, what they intend to do with regard to it? There is another proposal I would like to make. In all the hospitals there are certain civilians, the assistant to the dispenser, storekeepers, butlers, messengers, and receiving men, and they are all civilians. Cannot the right hon. Gentleman see his way to get sick-berth pensioners to take these positions, because if he does he will at once create a reserve of practical men, whereas you cannot send civilians to any other work? The sick-berth staff would appreciate this change, and it would cost the State no more, which is one of those things which we have to consider.

Another point is the necessity of building two hospital ships. This is absolutely essential in these days, when you have the most tremendous sacrifice of life and inflic- tion of wounds with the present modern weapons and high explosives. These ships would perhaps get to the place where they were wanted within a few hours. If these modern hospital ships are properly found with proper stores and a proper staff, and a proper number of surgeons, hundreds and hundreds of men's lives would be saved. They are a necessity in war, and I entreat the right hon. Gentleman not to take up an ordinary merchant ship, and to think that he can make it into a hospital ship. He cannot do it. We tried it with the "Maine." It did very good work, but it never was a proper hospital ship. It was under my orders for five or six years in the Mediterranean, and whenever I had a certain number of men with the fever I used to send this ship home with them. On one occasion I sent home sixty-two cot cases of fever, and when the ship arrived in England there were only sixteen in the cots. It shows that you must get the people away as soon as ever you can when they get the fever. If you do not do that it goes against them very often, and it leads to other complaints. I hope there, will be a hospital ship laid down, and built as soon as possible.

There is one point on which the right hon. Gentleman has given an answer, but I do not think a very satisfactory one. I hope, however, that he will consider it. I refer to the question of hospital stoppages. When a man gets a complaint or a disease, as happens continually, he goes to hospital, and after six weeks he has those very heavy hospital stoppages, which are very hard on his wife and himself. The officers have no hospital stoppages, and I think in common fairness they should be removed from the men.


The Noble Lord is now speaking on questions which arise on Vote I. (Wages, etc.).


I have now said all I desire to submit on this Vote, and I shall await a further opportunity in regard to other questions.


I support what my Noble Friend says with regard to the sisters. If Members will kindly turn to the Votes they will see that a sister, besides her beard and washing allowance, has a salary of £37 10s. per annum, rising by £2 10s. yearly increase up to the maximum of £50 per annum. She has therefore no more to look forward to than this salary of £50 a year, after a great number of years' service. I would put to the Committee whether this is sufficiently high pay for a woman who has devoted her best years to looking after the sick? If she continues to hold the position she must possess a great deal of skill, must be full of sympathy, and ready to sit up at night, which is a most trying and tedious duty, and I do think the right hon. Gentleman should see his way, not to raise the minimum pay, but to make such provision that an ordinary sister should be able in the later years of her service to look for more than £50 a year remuneration. The Noble Lord also made the very excellent suggestion that civil surgeons should be retained for medical service in the Navy in time of war, because it is obvious that we are very short of surgeons, and the surgeons who are in the Merchant Service are just the men who will be thrown out of employment when war breaks out. It is obvious that a considerable number of surgeons in the Merchant Service would not be required, because the passenger steamers, many of them, will not be able to run in time of war. These are the very men who are skilled in the use of medicine, who are familiar with the sea, and who would be ready in time of war. There is one question I should like to ask the right hon. Gentleman. On page 50 I see a note that medical stores to the amount of £800 are to be drawn upon during the current financial year. What I want to know is whether these medical stores are to be replaced or whether we are living upon our capital in using the stores which we have?


The hon. Gentleman's remark, I think, was answered by the Noble Lord. If it be the fact, as I know it to be the fact, that the sisters employed under certain conditions do the work entrusted to them in a most skilful and admirable manner, then I think there is no case for increasing their wages, since you can get very good people for the wages now given. I am afraid the hon. Member for Blackpool has views which would increase the Estimate. My view of the business of the House of Commons is that we should rather diminish them. Passing from that to the much more important point urged by the Noble Lord as to the sufficiency of the number of naval surgeons, I do not know whether it has received the attention of the Admiralty, as undoubtedly it ought. It is quite clear that in time of war you will want considerably more surgeons in the Navy than you now have. I do not think the sugges- tion that we should derive the additional number of surgeons from the Merchant Service would at all suffice. I think it would provide scarcely any, as the Merchant Service does not carry surgeons except in the great liners, which would require their surgeons in time of war, as in time of peace. I do not agree with the hon. Member for Blackpool that in time of war passenger vessels would be stopped from running. I should be very much disappointed with the Navy if the greater part of the passenger service did not continue to run as at present. However that may be, there are very few surgeons in the Merchant Service. The larger number of merchant vessels do not carry them; it is only the large liners who employ them. Therefore, I do not think you can look for any great increase in that direction.


I am afraid I failed to make my remarks clear. What I meant was that those who had already served as surgeons in the Mercantile Marine—and there is a very great number—are the men I desire to see in the Reserve. But of course they would only form a part of the large number required.


I follow the Noble Lord in what he says. As a matter of fact those who have served—after passing a short time in the merchant service —generally take a country practice which they would not readily be induced to leave. The suggestion has something in it, but my criticism is that you can get very few surgeons from that source. I think that will be found to be the fact. I must presume that the Board of Admiralty have considered the steps to take in order to make the necessary increase required in the number of surgeons in time of war, and I rose with a view to asking what proposal they have before them, and, if possible, to ascertain what arrangements they have already made to increase the number of surgeons in time of war.


The provision of hospital ships is a point on which I feel rather strongly, having had a somewhat painful experience. When I was seriously ill I was first of all sent from Cuba to Porto Rica, in 1898, during the Spanish-American War, in a merchant vessel which had been converted to the purposes of a hospital ship. Afterwards I was transferred to a vessel which had been built as a hospital ship, where the change in practice and treatment was so great as to really make the whole difference. Men were suffering from a peculiarly pernicious form of fever, and were dying like flies in this converted merchant ship, with its small staff, stuffy cabins, and strange odours connected with its former career. This was not a vessel under the British Government, and there is no reflection on the Admiralty. The illustration, however, may be in order. I think it may be of some value to the Committee that one should speak from experience on a ship of the kind I have referred to, and of what one afterwards experienced on being transferred to a vessel built as a hospital ship, with large airy wards, and a free circulation of air. I hope that the right hon. Gentleman will not forget that a ship built as a hospital should be constructed with some regard to extra stability a quality which is of considerable importance, especially in certain seas. I trust this point brought forward by my Noble Friend will be borne in mind by the Government. Good hospital ships are really the most economical thing in the long run. Information can be obtained by a study of what has been done by the United States Government in regard to hospital ships. They have built specially for this service the "Solace" and "Relief," and other vessels of that kind. Whilst many of us do not like to see money spent except on those things which increase fighting efficiency, nothing is so likely to increase and improve that efficiency than a due regard to the health of the men.


I have listened to the speeches made on this subject, and I cannot help feeling a certain amount of satisfaction in recognising that every point of criticism that has been raised has in fact been dealt with by the Committee which inquired into the Medical Service. I regret that it has not been possible for me to publish even a part of the Report of the Committee before bringing on this Vote. Certainly it would have made my duty of replying very much easier than it now is. I hope the Committee will accept it from me that not a single point which has been raised here has been overlooked in the inquiry that has taken place. The recommendations of the Committee are at this moment being considered by the Board of Admiralty and I am not going too far when I say that not only the bulk of them have been accepted, but provisions will be made in order that they may be carried into effect. Of course, some points which have been referred to are matters upon which the Admiralty are not the only authority who have to be consulted. I am not speaking now of the hospital ships; but when you come to questions of the nurses and doctors, and of raising the standard of existing salaries, there is another authority that has to be consulted as well as the Admiralty. Consequently I am not in a position to make any promise upon any such point. But certainly the recommendation of the Committee of Inquiry shall receive from the Board of Admiralty the recognition they undoubtedly deserve.


Is the increase of salaries a recommendation?


I hope the Noble Lord will not press me as to particular points in the Committee's Report. It is far better that we should not deal with a part of it, but I hope to be able to give some information shortly. I would remind the Noble Lord, who referred to the experience gained in the South African War, that Sir Alfred Keogh was a member of the Committee of Inquiry, and we have had the advantage of the knowledge he acquired in regard to the Army. The point was raised by the hon. Member for Blackpool as to the consumption of stores without replacement. He referred to Page 50 of the Votes. I would call his attention to the fact that the amount of stores so consumed amounted to only £800. I hope he will recognise that in the adjustment of any store account it may very easily be that some small item of that sort may be consumed without replacement without a charge being properly made against us that we are living on capital. In this particular case I can assure him that it was a mere question of adjustment. The Admiralty quite rightly call the attention of the Committee to every case, no matter how small, in which we use some stores without replacing them.

The question of a hospital ship was raised, and I entirely agree with the observations that fell from hon Members opposite upon the superiority of the hospital ship over the converted merchant ship. Here, again, I am not willing to pledge myself. I cannot pledge myself to what the Estimates of the ensuing year shall be, but I can assure the Committee of this point, that it is the present intention of the Board to include a sum in next year's Estimates for the building of a hospital ship. I cannot undertake, as the Noble Lord suggests, that we should build two at once, but we, at any rate, hope next year to make a start and to build one. No doubt when we build one, we shall be so satisfied with the result that a second will shortly follow. I believe those are all the points that have been raised.

Question put, and agreed to.

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