As I write this, Britain and the wider world stands at the cusp of a medical emergency, with most countries experiencing partial or total lockdowns. Medical services strive to provide care for the increasing tsunami of Covid-19 patients, often with inadequate resources and equipment.
80 years ago Britain faced a crisis of similar gravity. This blog post will be the first in a series examining the ways in which the British Army expanded its medical provision in order to support the successful prosecution of the war.
At the outbreak of the Second World War, the strength of the Army Medical Services stood at just over 9,000. By May 1945 it had doubled to nearly 18,000.
In order to address the immediate demand for medical officers at the start of the war, British Medical Association was appointed by the War Office as the instrument for recruiting from the medical profession.
All medical practitioners in the United Kingdom were contacted, and asked for details of their employment and commitments, and their willingness to undertake service with the fighting or civil defence forces. It was agreed that in the event of compulsory service, the committee would notify the War Office of their particulars.
During September 1939, the Central War Committee of the British Medical Association nominated 110 medical men for commissions as specialists, but only 98 were forthcoming during the subsequent six months. Therefore, qualification requirements were lowered so younger and less experienced men could take up appointments where they could work under the guidance and supervision of those more experienced specialist officers.
These were known as `graded’ staff, e.g. `graded surgeon’, `graded physician’ and granted a temporary rank of lieutenant. These new officers immediately replaced those who had been mobilised for field service, to reinforce military hospitals, but due to shortages of existing medical staff, some were used to address deficiencies in field medical units due to be despatched overseas. By mid-1941, 869 specialists and 187 graded specialists were serving with the Army Medical Services as a whole.
In addition to the efforts made by the BMA to recruit doctors into the military, in September 1939, around 800 medical practitioners volunteered for service in the army. Each one was medically examined, and then interviewed by a D.D.M.S. at the headquarters of a command. By the end of June 1940, due to the post-Dunkirk realisation that the war would be a long-drawn-out affair, this number had risen to nearly 3,000 professionals signing up for the duration of the war.
Despite this increase, it had become apparent that voluntarism would not be sufficient to meet the need for medical officers, so conscription was introduced. The practice of medicine was removed from the list of reserved occupations and medical practitioners became liable for compulsory military service under the National Service (Armed Forces) Act. The CMWC was informed of War Office requirements and established local medical war committees to determine the most suitable recruits from each district. The War Office then notified the individual, offering him a commission in the RAMC. He was informed that if he declined this, he would be liable to be called up for service under the normal arrangements of the National Service Act.
In the midst of this recruitment drive, the Ministry of Health had to be conscious of balancing the medical needs of the armed forces with those of a civilian population under immense strain. The ratio of medical practitioners per 1,000 of population was found, in early 1941, to be:
Civil – 0.82
RN – 4.1
Army – 2.8
The Royal Army Medical College at Millbank, London, had been reopened soon after the conclusion of the First World War as a teaching establishment for the postgraduate training of RAMC officers in areas such as military surgery, tropical medicine and hygiene. Other ranks were also trained for technical roles such as radiographers or laboratory assistants
An Army School of Hygiene was established at Aldershot in 1922, with the aim of promoting efficient hygienic practice across the army, as `nothing less would suffice than that every individual solider should be taught to observe the principles underlying a healthy existence and to live his life according to a regimen based on their application.’
The school featured laboratories and lecture rooms, and outdoor demonstrations including scale models of water supplies, sanitary appliances, disinfectors, mosquito breeding grounds etc. Officers from outside the medical services also received training here. Subjects included soldier welfare, dietetics, general hygiene, field sanitation and anti-malarial measures.
The school was relocated to Mytchett Barracks near Aldershot on November 13th 1939. Training for those officers wishing to work in specialist branches of surgery such as ophthalmic, thoracic, cranial and maxilla-facial took place in special hospitals and surgical units, and was augmented by attendance at lectures and demonstrations, and clinical instruction in wartime medicine and surgery was arranged by post-graduate teaching bodies.
A system for the training of medical orderlies; the men who would work as nurses, stretcher-bearers, theatre assistants, radiographers, laboratory technicians and a host of other technical and support roles within the corps, had to be established. The RAMC had two main training depots in England; one in the north and one in the south of England, in addition to No. 2 Depot at Newbattle Abbey near Edinburgh.
Beckett Park in Leeds had served as a military hospital during the First World War and had been a teacher training college up to 1939. On 1st December 1939 it was established as No II Training Depot RAMC, where recruits would undertake a special intensive course of training in technical subjects extending over two months.
The remit of the staff was to turn civilians into trained troops within that period. Men came from all walks of life and all parts of the country. One of these was John Broom, a twenty-three-year-old furniture salesman from Colchester.
Men were formed into platoons of thirty and were housed in the accommodation blocks, where they were issued with mattress covers, which they filled with hay and straw. Daily, they would be woken and breakfasted then be marched off to the main building where they would learn drill and medical training.
Each Sunday there would be a compulsory Church Parade, sometimes in the main hall, and at other times in St Chad’s Church, Headingley. One block at Beckett Park had a swimming pool where the men would be taught how to take casualties over the water. At the end of the training period there was a route march, over a twenty-mile route and taking a day to complete. At the end of the training period, men would be given a few days leave then receive their posting orders, being sent to different RAMC units as nursing orderlies. John Broom was sent up to Whitby to join No 7 Light Field Ambulance in December 1940.
You can read more about the RAMC across all theatres of the Second World War in my critically acclaimed book Faithful in Adversity: The Royal Army Medical Corps in the Second World War