Medical organisation within the British Army can trace its formal origins back to 1660 and the formation of the Standing Regular Army, when each regiment of infantry and cavalry had a Regimental Surgeon and his assistant. In the reign of Queen Anne (1702-1714), the Duke of Marlborough introduced ‘Marching’ or ‘Flying Hospitals’ which accompanied his armies, but it was not until the Peninsular Wars of 1808-1814 that the medical services of the army were organised on a more formal basis.
Following the Battle of Waterloo in 1815, the Army Medical Department underwent a major reorganisation under Sir James McGrigor, who himself had introduced significant changes to the army medical services during the Napoleonic Wars. He established a well-planned system of casualty evacuation, arranged for pre-fabricated huts to be sent from England, instituted large convalescent depots, which kept thousands of trained men in the field, introduced a system of registering casualties, which forms the basis of medical statistical returns in use today, and also set up a Benevolent Fund and Widows and Orphans Fund. Sir James McGrigor was Director General for 36 years but it would be forty years before the British Army was called on again to fight a war of such a large scale and by then the lessons learnt from Waterloo had been forgotten.
Following the Battle of Waterloo, officers in the British Army enjoyed a relatively long period of stability and had the opportunity to enjoy the social benefits of life as an Army officer. When the Crimean War began in 1854, the medical and logistical support was organised by civilian departments, which often held meetings without any consultation with the army. The consequences were disastrous.
Medical organisation was largely based on a peacetime arrangement of regimental hospitals. Although the medical officer was commissioned and wore the uniform of his regiment, he held no military rank and was entirely under the command of the Colonel of his Regiment. He had no trained staff, just a few men detailed to him from the Regiment, who had no medical knowledge or training but received instructions as he could give them. The recent invention of the telegraph meant that the scandal of inadequate medical provision reached the shores of Britain relatively quickly. There was national outrage as the public read about the suffering of soldiers, dying of disease in the Crimea. The Director General, Sir Andrew Smith, urged the necessity of a medical corps and the War Office responded by collecting together 300 old army pensioners to form an ambulance corps. Shortly before their departure to the Crimea, Smith declared they could hardly carry themselves let alone care for the sick and wounded. Sadly, he was proved correct when many of them died of cholera and others turned to the consolation of alcohol. Finally, in 1855 the Medical Staff Corps was formed, composed of ‘Men able to read and write, of regular steady habits and good temper and of a kindly disposition’.
In 1857 the Medical Staff Corps was reorganised into the Army Hospital Corps, although it reverted back to its former name in 1884 and by 1898 there were two distinct organisations within the Army Medical Services, the Medical Staff Corps and the Medical Staff (i.e. the officers). These two separate organisations were reorganised into one Corps, the Royal Army Medical Corps, by Royal Warrant on 23rd June 1898. With the formation of the RAMC medical officers were granted the same rank structure as the rest of the British Army and assumed full executive and administrative responsibility. Three months later RAMC personnel were serving in the Sudan and only one year after its formation the RAMC was fully committed in the Anglo-Boer War.
The Boer War highlighted the importance of medical care for the army; the medical services treated 22,000 wounded and a staggering 74,000 for dysentery and typhoid fever alone. The advice of the new hygiene officers was ignored and as a result consequences were fatal; water purification was defective, sanitation deplorable and rations inadequate.
However, the Professor of Pathology, Sir Almroth Wright, along with Captain Leishman (later Lt-General Sir William Leishman Director General Army Medical Services 1923-26) was working on an anti-typhoid vaccine. As a result of their work typhoid fever, which killed 8,000 soldiers during the Boer War, was reduced to negligible proportions during the two world wars.
Lessons learnt during the Boer War were not forgotten and the efficiency of the army medical services in the build-up to World War One was largely due to Lt-General Sir Alfred Keogh (Director General 1904-1910 and 1914-1918). His foresight and planning ensured that the medical services were recognised as an essential part of the British Army.
At the outbreak of war in 1914 the majority of transport was horse-drawn and organisation for casualty evacuation was based on a ‘chain of evacuation’ in which the sick and wounded were moved backwards by a series of posts; the regimental aid post, the collecting post, the advanced and main dressing station, the casualty clearing station and finally the general hospital either in France or England via hospital ship. At an early stage in the war, Casualty Clearing Stations were expanded into forward areas and in some cases could take up to 1,000 patients.
The RAMC expanded rapidly during World War One; on mobilization the Corps consisted of approximately 9,000 other ranks, by 1918 there were 13,000 RAMC Officers and 154,000 other ranks. The RAMC served across the globe in France, Belgium, Macedonia, Italy, Palestine, South Russia and Mesopotamia.
During World War Two technology enabled the RAMC greater access to mechanised land and air transport, allowing specialists and operating teams to get right to the front-line in an increasingly mobile war.
There were major medical developments pioneered by the army, such as the use of penicillin for the first time in the North African campaign and also the development of blood transfusion, which was so crucial in wartime.
Many medical personnel were taken prisoner during the war, as they often remained with the wounded. In the Far East many British and Australian medical personnel were amongst those taken prisoner at the Fall of Singapore in 1941.
The end of World War Two saw the start of the Cold War. British troops were needed worldwide and National Service lasted from 1948 to 1962. Many National Servicemen served in Korea and Malaya, East Africa, Borneo and Cyprus, as well as the Suez operation of 1956.
The British Army have been committed to Northern Ireland since 1969, the Falklands War of 1982, the Gulf War 1990-1991, Bosnia and Yugoslavia and more recently Afghanistan and Iraq, as well as numerous other peacekeeping and humanitarian operations across the globe. In each instance, the Army has been supported by medical personnel from the RAMC.
Since the Victoria Cross was instituted in 1856 there have been 29 Victoria Crosses and two bars awarded to medical personnel. A bar, indicating a subsequent award, has only been awarded on three separate occasions. Twenty-three of these Victoria Crosses are on display in the museum and details of the awards can be found in the Museum publication The Medical Victoria Crosses, available from the Museum Shop.