By Ian R Whitehead
Pen & Sword, 2013
He opens by looking at how the role of the doctor within the British Army evolved from the Crimean War to the First World War, and how they gradually became more incorporated into the army and more respected. However the outbreak of the First World War immediately threw up a problem – how the medical profession could balance the army’s need for doctors (and their willingness to enlist), against the need to retain adequate numbers of doctors at home to continue to cover the civilian population. Some doctors, initially rejected by the War Office on the grounds of age, instead joined organisations such as the Red Cross, so eager were they to play their part. However the War Office later had to relax the age restrictions due to the shortage of Medical Officers. Interestingly an offer by the British Medical Association to administer a central register of trained medical personnel was rejected by the War Office.
By 1915 the tension between military and civil requirements was coming to a head, and a shortage of Medical Officers was also being felt due to the casualties sustained. By July 1915 25% of the profession had joined up, and doctors also became liable for compulsory service after conscription was introduced. There was also an impact on medical students – many enlisted in the early days of the war, and if killed, the country was denied a potential future trained professional. Many students who had enlisted were therefore released from service to continue their studies.
Increasingly women were used to fill vacancies at home, however the War Office refused to entertain the idea of female doctors treating the troops abroad. Many women doctors still served overseas, for example with the Scottish Women’s Hospitals.
Whitehead also describes the RAMC administration on the western front, and the administration function also had to expand to support the growing medical services. However some doctors became critical of the amount of form-filling and red tape that they experienced.
The training of Medical Officers is also covered. Civilian knowledge was adapted for the evolving military situation. There was little training in dealing with war wounds at the beginning of the war, but it quickly became apparent of the different dangers that the war presented, such as septic wounds due to the contaminated soil and the importance of sanitary discipline in the trenches. There were also technological developments that necessitated guidance, such as gas warfare. Another major area of development was psychiatric treatment due to the difficulty in the correct identification and treatment. Interestingly there was also a lack of guidance at the beginning of the war on how to deal with venereal disease.
Whitehead looks at the work of the doctors at different points in the chain of evacuation, and the danger that the Regimental Medical Orderly naturally faced as the closest MO to the action. He also touches on the fact that it was unclear how much risk they were expected to place themselves in.
Whitehead shows how the transition from peace to war was not an easy one for the medical profession, and that despite the advancements during the war it did not lead to many sustained developments in the delivery of healthcare in the UK after the war. Whilst focusing on the doctors naturally does not provide a completely rounded view of the other elements of the RAMC and associated medical services, overall this is an excellent overview of the role of doctors in the war.
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Doctors in the Great War