HC Deb 21 November 1952 vol 507 cc2323-34

Motion made, and Question proposed, "That this House do now adjourn."—[Mr. Oakshott.]

4.1 p.m.

Mr. Austen Albu (Edmonton)

I put down today for the Adjournment the subject of the Army Medical Services—and I apologise to the Under-Secretary if he has had to wait rather a long time in order to make his reply—because of some very considerable anxiety that has come into my mind and, I believe, into the minds of other hon. Members through incidents brought to our attention by our constituents. I do not intend to deal with a very large number of these. In fact, I am only going to refer to two.

The first one concerns the case of a fusilier about whom I have written to the Secretary of State for War and to the Under-Secretary. This fusilier, who is a National Service man, from an early age has had a history of some type of fits. It is not quite clear what the cause is, possibly epilepsy, and when still a child he went into the Royal Hospital for Nervous Diseases for examination. There was no firm diagnosis and certainly there was no actual diagnosis of epilepsy.

His parents naturally had no desire to believe that he was suffering from epilepsy, and at the time in 1951 when he was called up for medical examination I believe that neither they nor he made any reference to the subject before the medical tribunal. But during the time he was training in the Army he suffered from further attacks, and in March, 1952, the medical officer in charge of the Chaucer military barracks at Canterbury wrote to the boy's own National Health Service doctor as follows: I am extremely grateful for your immediate co-operation in the case of Private James—In my opinion this man should be out of the Army, and I am taking steps to see this. In spite of this letter, the boy was posted to Hong Kong for training and he was also engaged on patrol work. He understood that later he would be sent to Korea.

One can well understand the anxiety of the parents of this young National Service man, not only because of what they knew of the past history of the boy, but also because they held this letter from the medical officer at Canterbury showing that, in fact, the boy ought not to be in the Army at all. Whether the medical officer's diagnosis was right or not, I do not know. I am only putting myself in the position of my constituents whose son was at Hong Kong while they had this report from the medical officer.

Unfortunately, it was only after the boy had gone abroad that my constituents came to see me and thus brought the matter to my attention. I immediately rung up the Under-Secretary of State and I wrote to him on 25th August. Although this was a matter of considerable urgency—that is, if one thinks that the anxiety of parents is a matter of urgency—I regret to say that I received no reply until 12th September. The reply which I then received informed me that the War Office had signalled for a further medical report. I then wrote to the Under-Secretary complaining about this delay, and I received a reply on 30th September in which he said that the preliminary signal from the Far East indicated that my constituent was suffering from migraine. I am not a doctor, and I do not really know what migraine is. I know it is a sort of severe headache which affects people and that people frequently pass out under its effects. Those who suffer from it are in very great pain indeed, frequently with loss of consciousness.

On 11th October, I received a further letter, which told me that the history of the boy, as known to the War Office, was that he had had five attacks a year since the age of 10 and six attacks since he had joined the Army. No mention was made of the report of the medical officer at Canterbury, and there was no reply to my complaint that the boy had been sent abroad while his parents were in possession of that medical officer's letter.

As a result of this, I put down a Question on 21st October to the Secretary of State for War, to ask him whether the boy was still engaged on active patrol duties in Hong Kong. The reply was as follows: I cannot at present say whether or not this soldier is still engaged on active patrol duty, although I know of no reason, medical or otherwise, why he should not be so employed. I have, however, called for a report on his present employment and will write to the hon. Member."—[OFFICIAL. REPORT, 21st October, 1952; Vol. 505, c. 96.] Quite apart from the fact that no reference was made to the complaint being one which might cause loss of consciousness and so be a reason for keeping a soldier from going on active patrol duty, no mention was made at that time of the fact that the boy had been posted to Korea, and was already there.

I do not blame the Secretary of State for not making a statement publicly in this House, but I suggest that it was the business of his office, of him himself, or of his Under-Secretary, at least to inform me privately that the boy was in Korea. If the War Office had taken this case seriously and had taken seriously the anxiety which I was trying to express on the parents' behalf, they would at least have let me know what was going on. It was only when I started to kick up a row and to demand an interview with the Under-Secretary on a matter which still seemed to me to be the subject of very considerable delay, and after I had drawn attention on the telephone to the report of the medical officer at Canterbury, that the War Office decided to bring the boy home for a medical examination, as I was informed on 5th November.

My complaint in this case is not only that the boy was employed on duties which seemed to me to be quite unsuitable—a matter on which I admit I am not fully competent to judge—but about the delay that there has been in dealing with the matter, especially in view of the opinion of the medical officer at Canterbury and of the anxiety which this must have caused to the parents. It seems not only that there was prevarication but that this very important matter was completely overlooked by the War Office.

The other case to which I wish to draw attention has a very old history and is now closed, but I have been reminded of it by one of my constituents. It concerns the case of Lance-Corporal Harris, who died in Catterick Camp military hospital on 2nd July, 1950, of pulmonary embolism and acute rheumatic carditis, after having been confined to his barrack room for five days before admission to hospital.

No doubt the House will remember that a military court of inquiry was held which acquitted the medical authorities of negligence but, after the parents had conducted a very considerable campaign, personal negligence was admitted. Finally, the Under-Secretary of State admitted that Lance-Corporal Harris was neglected and had received inadequate medical attention before being admitted to hospital. He admitted that there was very considerable delay in admitting him to the hospital at all.

My constituents happened to have a son in the same barrack room as Lance-Corporal Harris. He expressed the opinion that if his comrades had felt free to give their evidence to the original tribunal, the findings might have been very different. I took this matter up with the Under-Secretary, who told me that there was nothing to prevent that lad from giving evidence but, in fact, some of these boys who were in that barrack room were posted away from the camp, quite naturally, before the court of inquiry was set up. As far as I can make out, no attempt was made to get them to come and give evidence on this matter.

This was, and it has been admitted freely, a serious case, and I believe it was typical of the conditions existing in that hospital at that camp for a considerable time. We all realise the difficulties of the Army in these matters. Many Army doctors are themselves young National Service men possibly straight out of hospital, although I am told that the number of men they have to look after is much less than the number of patients which a National Health Service doctor has to look after in civilian life.

I want to put a number of questions to the Under-Secretary. First, is there adequate medical supervision of the young doctors in charge of this work? Secondly, are there adequate and hygienic arrangements for bedding down sick men before their admission to hospital? Are there proper nursing facilities with proper medical orderlies and special diet if necessary? Are there proper arrangements for ambulances and stretcher parties when men have to be removed from barrack rooms to hospital?

We know that the medical profession is one of the closest trade unions in the country and that there is difficulty in bringing, let alone proving, a case of negligence against a doctor. Yet I suggest to the House that, whatever may be the case, it is certainly not the duty of the War Office to protect the medical profession or the doctors in the Army if they are guilty of negligence. In these matters the duty of the War Office is first of all to the soldiers and their families.

The British people have accepted what is unique in peace time, a fairly long period of National Service. The War Office is now responsible for a large number of young men who have frequently left their homes for the first time. If National Service is to be maintained for any length of time it is essential that the parents of these young men can have absolute confidence that their sons will not be subject to unnecessary hazards due to carelessness in medical treatment. This is a grave matter of public confidence and, when the Under-Secretary replies, I hope he will be able to give us assurances that the abuses to which I have referred, which have greatly worried not only myself but some of my hon. Friends also, are being dealt with.

I cannot exaggerate the importance of this matter. The Under-Secretary knows what is in my mind: the feelings throughout the country which all parents feel who have young sons abroad in the Services. We cannot except them to be protected from the hazards relating to the purpose for which they are called up, but we can expect that they are not subject to unnecessary hazards and that, when cases are brought to the attention of the War Office, they are dealt with promptly, efficiently, and without the protection of anybody who is responsible.

4.15 p.m.

The Under-Secretary of State for War (Mr. J. R. H. Hutchison)

I apologise to hon. Gentlemen opposite for the fact that I shall not have the time to deal with the question adequately if I allow an intervention to take place. I can sincerely say that I am indebted to the hon. Member for Edmonton (Mr. Albu) for having brought forward this debate, because it gives me an opportunity of correcting a number of false impressions which may be abroad in the country on the question of the Army Medical Services.

As the hon. Member has said, this is a subject of great importance. There are few of us who have not got a relative in the Army in these days, and nothing causes greater anxiety than to be in doubt and to wonder whether the health services and the treatment available to our relatives is, in fact, good. I think I shall be able to give some reassurances and supply some comfort to those who are anxious.

I propose to deal, first, with the general question of the Army Medical Services and, thereafter, to say something about the two cases to which the hon. Gentleman has referred. I would underline that the Army Medical Services are at present responsible for a total of about 750,000 persons, because not only are soldiers treated by them but often their families elect to come under their care. I can also say that the health of the Army has never been better. The statistics of admissions to hospitals have shown a continuous decline all through this century and are still declining, with the exception of periods when war is actually taking place.

Further, the health of troops in overseas stations is also very impressive. The Army Medical Services which are responsible for these good statistics consist, broadly, of specialists, then what I may call general practitioner officers—medical orderlies, and Queen Alexandra's Royal Army Nursing Corps. In addition, there are certain other components, such as non-medical commissioned officers, Army research establishments, and so forth.

The posts for Army medical officers are filled in two ways; first, by regular recruitment and, secondly, by National Service men—the young officers mentioned by the hon. Member—who have qualified for a medical degree. I want to deal with the latter category first and I start by underlining the fact that all these National Service medical officers are fully qualified and that the great majority have had some six months' hospital experience. Next year that period is going to be extended so that they will have 12 months' hospital experience.

In my view—and, I think, in the view of my right hon. Friend the Secretary of State for War—these National Service doctors are doing an extremely good job under the circumstances. I will say frankly, however, that a gap has revealed itself in the more experienced type of officer owing to the war. There is a shortage among medical officers with five to ten years' practical experience, and many of these are specialists. This shortage has been causing much thought and measures to improve the situation are under review at the moment.

Another thing that we have done is to expand the number of administrative commissioned officers in the R.A.M.C.—quartermasters, hospital secretaries, and so forth—so as to free the purely medical officers for purely medical duties.

I want to say a word about the nursing side and the Q.A.R.A.N.C., who are shouldering their responsibilities manfully, if I can use so male an adverb for so feminine a duty.

Dr. Barnett Stross (Stoke-on-Trent, Central)

Before he leaves the point of the qualified medical men, could the Minister tell us how many National Service men who are qualified doctors are available at any particular moment?

Mr. Hutchison

I have not those figures, but they will be obtained and may be available before I have finished. I have not them at my finger tips. These nurses are quietly and efficiently performing a most important task, and we are anxious to recruit more of these devoted nurses.

In addition to our own officers, the broad picture of which I have sketched, honorary consultants to the Army are appointed by my right hon. Friend the Secretary of State after consultation with the Royal College of Physicians and the Royal College of Surgeons, and these eminent doctors are available for consultation all over the country and in some cases, indeed, abroad, and the Army owes much to their generous help. Further close links and ties exist with the local civilian services both at home and abroad, and these facilities work both ways. Specialists are made available in cases of need and civilian patients quite frequently find their way into Army hospitals and vice versa. For instance, the specialists at Radcliffe Infirmary are available and often go to Wheatley Hospital at Oxford, when needed.

In considering the Army medical services and Army health, we must not lose sight of two most important points. First, there are fewer patients per doctor in the Army than in civil life and, secondly, the doctor is generally within easy reach. A soldier can scarcely be ill without it becoming noticed. In his home, an individual may be ailing for some time without taking any steps about it, but in the Army the presence of the doctor, so to speak, alongside the soldier, brings about the early diagnosis, which is so very important in curing illness. There are no waiting lists for admission to Army hospitals, and military hospitals overseas exist in all our major theatres. For example, in B.A.O.R. there are 1,750 beds—enough for 2.1 per cent. of the troops—which compares favourably with the beds available per head of the population in civil life.

I can give one personal example of this from when I was in Austria. The wife of a general had to have an operation. She came to London to consult an eminent specialist who told her that there was no need for her to go to London because she could get all the attention, and attention as good as she could wish, in the station where she was living. She went back and the operation was carried out there, and she thoroughly endorses that specialist's opinion.

Taken all in all, parents and relatives can have confidence that their boys and husbands are getting the best medical attention, and we are determined that the Army health statistics shall go on improving. Man is fallible, including even the hon. Member for Edmonton, and, of course, there will be mistakes—but how many of the hon. Gentleman's friends in private life, as they have advanced in life have not at some time been wrongly diagnosed or wrongly treated? But we do not hear so much of those cases. Yet as soon as a suspected mistake takes place in the Army—and I am not complaining about it—some one hurries to bring it into the limelight.

May I deal with the case of the late Lance-Corporal Harris, the sad and regrettable case to which the hon. Member has referred. I believe that, looking at it dispassionately, the House will think that the War Office has behaved honestly in admitting that there has been an error in diagnosis. I have no intention of sheltering Army medical officers who are incompetent or negligent—

Mr. Albu

It took two years for the error to be admitted.

Mr. Hutchison

At any rate, that is the position now. We have no intention of sheltering those who are incompetent or negligent. As a result of this case, a number of administrative rules have been altered and tightened—rules of the kind which the hon. Member mentioned. I think I can say that three out of the four about which he asked have already been improved as a result of this very case.

In the other case, that of the young fusilier, we have a conflict of medical opinion, and I am most hesitant to intervene when medical experts are at loggerheads. This man was called up in August, 1951, and in November his medical condition was fully investigated and a diagnosis of migraine was made. I am informed that he has never in any of these attacks which are, let us face it, splitting headaches, lost consciousness. In March, 1952, his unit medical officer, Lieut. Morris, corresponded with his civilian doctor whose letter stated that he was suffering from epilepsy. Lieut. Morris accepted that as a proper diagnosis and wrote the letter about which the hon. Member has spoken.

Thereafter, this man was referred to Shorncliffe Military Hospital, as a result of this conflict of opinion, where migraine was again diagnosed, confirming the previous investigation. It may be stated that his parents themselves resisted the statement that their son was epileptic. Let me say that before the hon. Gentleman entered the scene in this case the man was already in Hong Kong, and there was no question of sending him to Hong Kong after the hon. Member had taken up the matter. We asked Far Eastern Land Forces to investigate and report and the result was again a diagnosis of migraine. I apologise for the delay. But when we are dealing with Hong Kong things may take a little time.

When the case was once again brought before me I instructed that this man should be brought home for further investigation. This is being done. I do not think, looking at it objectively, that the War Office can be criticised as not having taken care and interest in this case. Diagnosis is not so easy, and no doubt hon. Members have had experiences in their own lives of many contrary diagnoses.

I would before I close like to give the hon. Member for Stoke-on-Trent, Central (Dr. Stross) the figures for which he asked. There are just over 900 National Service medical officers out of a total of medical officers of approximately 1,550; that is, rather more than half.

Dr. Stross

That is approximately one National Service medical officer for about 800 or 850 in the Service?

Mr. Hutchison

About that.

May I conclude by saying that we thoroughly agree that this is a most important question, for the whole nation is completely interested in it. We in the War Office and in the Army are determined to do all we can to reduce illness to a minimum, and to see that the medical services and their equipment are worthy of the gallantry of our men.

4.28 p.m.

Mr. George Wigg (Dudley)

The Under-Secretary has finished a few minutes earlier than he anticipated and the reason for that is that he has run out of whitewash. The story he told this afternoon may have convinced him, but it will not convince anybody who knows the facts of the Service.

The truth is that there are a considerable number of young National Service officers, recently qualified, who are very able and very keen on their job. Then there is the large gap which the hon. Gentleman says was created by the war, and then there are the senior officers of the Royal Army Medical Corps, the majority of whom have never opened a medical book since the time they qualified—[HON. MEMBERS: "Oh."] Yes, they are engaged in administration and are completely out of touch with modern methods. The breakdown that occurred is due very largely to that factor.

I have often thought that when I die I will leave my body to the Royal College of Surgeons, because I remember being operated on for appendicitis by an officer of that Corps and I am quite sure that an equally successful operation could have been carried out if it had been done by a veterinary officer. I agree with the hon. Gentleman that virtue has no publicity value. One hears all about the bad cases, but one does not hear about the good ones.

The remedy for that is not for the hon. Gentleman to come here with a bucket of whitewash, but to do what he can to integrate the medical services in all the Services with the civilian services; leaving the problem of the overseas stations as a special problem to be solved by volunteers. If that happens it would improve the medical departments of the Services immeasurably, and at the same time add to the strength of the civilian medical services.

Mr. Hutchison

I thought I had made it clear that this integration was what was happening.

Mr. Wigg

If the hon. Gentleman will carry out a survey he will find that many young National Service officers complain of the lack of opportunity to work in civilian hospitals, even when they are standing about doing nothing. That is a simple step which could be taken, and I very earnestly urge him to pursue his inquiries along those lines.

Mr. Hutchison

We will certainly look into that and if something more can be done along those lines it will be done. But I resent the hon. Gentleman's implication that senior medical officers in the Army are bad. Some 40 or 50 per cent. of them are specialists and a suggestion that, under those circumstances, they could remain specialists, and carry out the excellent work which I personally know is going on, does not bear investigation.

Question put, and agreed to.

Adjourned accordingly at Twenty-nine Minutes to Five o'Clock.