Reorganization of the C.A.M.C.
From events in The Times
In 1916, Herbert Alexander Bruce, inspector-general of the Canadian Army Medical Corps (C.A.M.C.) investigated medical practices in the CEF and issued a Report on the Canadian Army Medical Service which urged a complete reogranization of the medical corps. This report was disowned by Borden's Government, and was one of the issues used to force the retirement of Sir Sam Hughes, Minister of Militia. Bruce was dismissed from his duties, and a subsequent panel was drawn up that had significantly different conclusions. Some of Bruce's recommendations were eventually implemented, and in 1919 he published Politics and the Canadian Army Medical Corps, criticizing the government for its actions.
The accounts on this page are from The Times of London, during the period of October 6, 1916 and January 3, 1917. The transcriptions have been done by Marj Kohli, Waterloo, Ontario.
|Letter from Lady Julie Drummond||Oct. 6, 1916|
|Response by Mary R. Gooderham||Oct. 7, 1916|
|Rebuttal by Beckles Wilson, plus two other letters supporting Lady Drummond||Oct. 9, 1916|
|The Canadian Wounded: No Demand For Separation||Oct. 10, 1916|
|The Canadian Wounded: Letter from Lady Julie Drummond||Oct. 19, 1916|
|The Canadian Wounded: Letter from Herbert Branston Gray||Oct. 24, 1916|
|Report on the Canadian Army Medical Corps||Jan. 3, 1917|
|Canadian Wounded: Verdict Of Special Inquiry Board||Jan. 3, 1917|
Lady Drummond’s Protest
To The Editor Of The Times
Sir,–Some time ago a Red Cross visitor, recently arrived from Canada, fell into conversation with an English Tommy who was in London on light duty, and had “time-off” which he said hung heavy on his hands. It occurred to our visitor to suggest that he might do up parcels at the Canadian Red Cross quarters, 14, Cockspur-street. “But,” she added, “I do not know the rules yet, and possibly only Canadians are admitted there.” The answer given will serve as my text and introduction.
Canadians only! Are we not all brothers? Don’t we fight for one cause and under one flag? Haven’t we all British hearts? If the head of the Canadian Red Cross has a different opinion from this, let him keep it to himself and not spread the disease.
The astonished protest of the English Tommy was, as he soon learnt, uncalled for; the Red Cross by its charter and its spirit is least exclusive of all organizations; a day or two later he was tying up parcels for Canadian prisoners in Germany. But the amazement which he felt is ours to-day, when we hear that it is seriously proposed to make a radical change in the distribution of the Canadian wounded and to place them in a “concentration area” where they will be separated from the other wounded of his Majesty’s Forces.
Against such a disposition a very large number of Canadians both in Canada and in England feel called upon to protest.
Against it the words of Sir Robert Borden, Prime Minister of Canada, stand out with that singular clarity of expression of which he is a master:–
In hospitals beyond the seas I have many times met men from the British Islands, from Australia, New Zealand, and Canada, brought together in close association and comradeship, each learning the better to realize their Empire and all united in their common determination to do their duty in this war to the end. One can hardly exaggerate the immense advantage of such association and blending of the Empire’s manhood.
Against it stand the words of a great Imperial statesman, Mr. Arthur Balfour, in which he expressed his regret that there should be any hospital to which the men of only one Dominion could go, and said that “our loss would indeed be incalculable if, at the end of the war, we had wasted this great and unique opportunity for a more complete personal knowledge of one another.”
Against “separation” are the conclusions drawn from nearly two years’ intimate contact with the men in the hospitals, through the Information and Visiting Bureau of the Canadian Red Cross Society. There, to take only two typical instances, from my personal observation in the last few days, we find a British Tommy working a belt in an ingenious pattern and many coloured wools for the returned Canadian prisoner in the next bed, and another British Tommy wheeling a poor fellow from Ontario, both legs gone and an injured back, “to see the sights of London, Trafalgar-square, and St. Paul’s.” Under the conditions of this war it is in the hospitals, and there only, that the men of the different parts of the Empire can really get to know each other, as well as the greatness of their common heritage and citizenship. There prejudice is dispelled and differences bred of a wide diversity of climate, of environment, of other circumstance, cease to be barriers and become rather an incentive to friendship.
Against it is the warmly sympathetic interest of a large number of English visitors, who, with Canadian women residing temporarily in this country, make the work of the Canadian Red Cross Bureau possible. When, for a short period last year, there was a narrowing down in the distribution of the Canadian wounded there was widespread disappointment and the constant appeal, “Can you tell us if this is accidental, or is it true that we are not to have Canadians any more? We should be so sorry. One got so fond of them seeing them so often.” And how deep and true that feeling is may be told in an extract from a letter of September 26, 1916, about a boy from Alberta who had died:–
Poor Pte. K. They gave him a very good military funeral. Four horses to the hearse (they have no guns at Derby). A band, a firing party, a carrying party, and a good turnout of men. In the marketplace there were about 100 policemen lined up for the procession to pass through. It was done to show appreciation of Canada’s work. The flowers were beautiful. People felt so sorry for a soldier dying far from his home.
Is it a light thing to withdraw or narrow down an opportunity so eagerly welcomed, to show kindness to our living and homage to our dead?
Why, then, we ask, is this to be done? Certainly not for “economy”; and as for “convenience,” those who have worked through nearly two years on the former plan have testified that any difficulties which may at the first have attached to it were largely the result of hurried and incomplete organization.
Is, then, a plan so obviously “Provincial” adopted to meet the views of the men of the Canadian Contingents? We have our answer in the words of a General Officer, writing from the front:–“The Canadian soldiers wish to be treated like soldiers of the Empire and not like anything else.”
What shall we say, then, in conclusion? The reasons for separation we have not found. Those for blending, it may be said, are largely sentimental. We frankly admit it. For, in truth, our Empire is held together by two things–sentiment and a point of view. These are not only important, they are all-important, and it is as our policies affect them that they should primarily be judged. The outward and visible bonds, the Imperial organization which we may and must create, will have value only as they express and conserve these things. This Empire will hold together, across all sundering seas, so long as the tide of sentiment, as a warm and vitalizing stream, flows through the colder waterways of our commercial and political relationships.
For some of us there comes at times an anxious thought for to-morrow. It is the danger of a conflict in Canada between those to whom the Empire stands for a great and noble interdependence, a community rather than an alliance of free nations, and those whose mistaken and selfish nationalism sees greatness in “separateness” and safety in the narrowing of responsibility. Nothing is small or unimportant which inclines men’s minds to one or other of these points of view. It is no small choice that confronts us now. I write as a Canadian to Canadians. Shall we blend or shall we divide?
The Canadian Wounded
To The Editor Of The Times
Sir,–I have read Lady Drummond’s protest against the segregating, or, if I might use the word, “colonizing” of the Canadian wounded in a “concentrated area” in England, and I wish to associate myself with it, not only as an individual, but as the representative head of the Imperial Order, Daughters of Empire, an organization comprising over 30,000 women. Every Canadian who is heart and soul for Imperial unity will endorse what she has said. Indeed, I would go further, and say that Canadians are too apt to keep themselves apart socially in this country. If this proposal goes through, Canad will stand to lose the very things which her manhood came to fight and die for. The women of Canada protest against this attempt to keep away from their sons the privilege and opportunity of mixing with the other soldiers of the King. There is no time for me to consult my executive, but I feel confident that I am expressing the views of the Order when I say in reply to the question at the end of Lady Drummond’s letter–“Our will is to blend and not to divide.”
Mary R. Gooderham.
The Canadian Wounded
An Explanation Of The Proposed Change
To The Editor Of The Times
Sir,–While in thorough agreement with the sentiments expressed in Lady Drummond’s letter, I cannot help thinking that some slight misapprehension on the subject exists. There is, I am convinced, no intention on the part of the Canadian Government to interfere at all with the present very happy arrangement with the Imperial hospital authorities by which our sick and wounded soldiers are received into British hospitals and vice versa.
The proposed change only concerns the finality of treatment in the case of the Canadian disabled
soldier, i.e., when he enters a Canadian Command depôt, casualty assembly centre, or casualty discharge depôt. These three units, charged with the disposition of light duty cases and those about to be evacuated from the Expeditionary Force, are at present scattered throughout the country. It is now contemplated, for greater administrative convenience and for economy in transportation, to assemble them under one command.
I trust this brief explanation will tend to allay Lady Drummond’s anxiety and that of those who, like myself, are convinced of the value of the free intercourse of our British and Canadian troops. None, I am persuaded, holds this idea more strongly than our Minister of Militia, who, besides being aware of his Majesty’s views on the subject, is himself too tried and stanch an Imperialist not to approve any and every medium whereby a common sympathy and understanding between our Overseas fighting men and your own may be promoted.
I beg to be, Sir,
Your obedient servant
1, Hyde Park-place, W., Oct. 7.
To The Editor Of The Times
Sir,–Allow me, as a French-Canadian and a civilian, to join my humble protest to that of Lady Drummond and of Mrs. Gooderham, President of the Imperial Order, Daughters of the Empire, against the proposed segregation of wounded Canadians from their fellow-soldiers from other parts of the Empire. The contemplated system, as I understand it, would be along the lines of that adopted in Canada for our native Indians, who are placed in reserves established at various points of the Dominion, where the whites are not allowed to reside, and are especially looked after by the Dominion Government. I hold no brief for the heroes of Courcelette or any portion of my compatriots, but may safely say that this assimilation to the redskins was not asked, nor is it desired by them.
E. Fabre Surveyer
Savoy Hotel, London, Oct. 7.
To The Editor Of The Times
Sir,–I trust that the outcome of Lady Drummond’s excellent letter in The Times will be that we shall see and hear more of the gallant Canadians. I notice that the Australian Force has an “Eye-witness” in Captain Bean, and that the doings of the New Zealand troops are chronicled by Mr. Malcolm Ross, but I do not remember having seen any accounts recently which show that the Canadians have also their “Eye-witness.” We people of London know much too little of what our brothers from the Dominions are doing–although we know that they are always to the fore when duty calls. A fine opportunity was given on Saturday of judging the mettle and physique of the Canadians when the Ontario Regiment went to the Abbey to deposit their colours. Could we not see more of them? A Hyde Park review and a march past the Mansion House on a Saturday afternoon might be arranged. I hope we shall see Canada represented in the Lord Mayor’s Show, for there must be many who want to pay their tribute, besides.
A Man In The Street
The Canadian Wounded
No Demand For Separation
An extraordinary amount of interest has been aroused in Canadian circles by the letter from Lady Drummond, which appeared in The Times of Friday last, combating the intention of segregating the Canadian wounded. A flood of correspondence from wounded officers and men, from Englishmen who have lived in Canada, and from Canadians in London has poured in on Lady Drummond at the offices of the Canadian Red Cross Society, 14, Cockspur-street, all of it supporting her action in objecting on Imperial grounds to the suggestion of such differentiation between men who are fighting in the same cause and under the same flag.
Lady Drummond expressed yesterday her surprise and pleasure at the feeling that had been evoked. “Many of the letters I have received have been from people in high position whose names I am not at liberty to use,” she said. “From officers and men in hospitals in England and Scotland I have received some very interesting letters. A Canadian officer writes:–
May I take this opportunity of thanking you for your letter to The Times. I Am only authorized to speak for the men of my own company, but I know that to a man their mingling with the English “Tommies” has not only been of benefit to them from a disciplinary, even a military point of view, but, moreover, it has decidedly “broadened” them. The isolation of the Canadians would be a greater pity for our French-Canadians than for any others.
A Canadian private says:–
I think it does us good when they mix us up together, as we are all comrades, fighting for the one end, the freedom of the world which the English people have always given.
All day we have had officers and men calling and saying the same thing, and I can only hope that this consensus of opinion will have some weight. How the men feel may be judged from the post-cards we receive from Canadians who are in English hospitals. A great number of them are English by birth, and they enjoy the opportunities they get of exchanging opinions and views on the land they have left and the land they have gone to. There is no demand for segregation from any of them.
The Canadian Red Cross communicates each week with the relatives of the wounded men and keeps in very close touch with the men in hospitals, who are supplied with a “welcome” card on arrival, which invites them to ask for anything they want. Here are a few extracts from letters of men in British hospitals. They are quite spontaneous, and were chosen at random by a representative of The Times:–
We are treated just like gentlemen here, and I have much pleasure in returning you my kindest wishes for sending this card. This war hospital is just lovely; there is a fine sea beach here, and it is only about 18 miles from Glasgow, and that is my birthplace. I had one of my friends seeing me on Saturday. So it is nice to be near a city. (Greenock)
I am very well looked after here and have pretty near everything I need. (Keighley.)
I beg respectfully to thank you for your kind offer and thought, but am pleased to say I am receiving everything I require in this hospital. (Yorks.)
I’m in a good hospital here and everything for our comfort and well-being is well looked after. (Northampton.)
Am getting well looked after. It’s a lovely place; the sisters are very kind and attentive. (Daimeny.)
We receive the best of attention here, and the North Country people are very good to us. We all appreciate the good work which you are doing.
To The Editor Of The Times
Sir,–A letter from Mr. Beckles Willson in The Times of to-day, headed “Canadian Wounded–An Explanation of the Proposed Change,” seems itself to need some explanation. I have it on his own authority that it is not in any sense an official statement, but simply an individual opinion, strengthened into belief by his own fervent Imperial feeling. Therefore I wish to point out that his letter in no way modifies my protest in The Times of the 6th inst.
Canadian Red Cross Society, 14-16, Cockspur-street, S.W., Oct. 9
To The Editor Of The Times
Sir,–Might I add to the remarks of Lady Drummond that the universal feeling of wounded officers and men of the Canadian Forces is entirely against segregation? Not from any conscious desire to develop Imperial sentiment in ourselves or others, but purely and simply because we find it more interesting to go to the English hospitals and meet new people. Without any reflection on the efficiency or kind endeavours of our own people, it is a pleasant experience to get away from a purely Canadian atmosphere. Moreover, in a general way we object to being herded together like a lot of detention prisoners. We feel confident, however, that when those who propose this change find out the wishes of our wounded, who are, after all, those chiefly interested, they will abandon their present intention, even if this course does involve some extra expense or inconvenience.
Wounded Canadian Officer
A London General Hospital, Oct. 7.
The Canadian Wounded
Imperial Interests And Segregation
To The Editor Of The Times
Sir,–We are informed that an order has gone forth from the Canadian Militia Department which, when arrangements are complete, will confine the Canadian wounded to one or probably two areas in England. This, at least, is what we are given to understand by those in authority. Whether the department has plenary power in a matter of this significance does not yet appear.
It is to be hoped that no one for a moment will think that those who are responsible for this scheme ignore or deny Imperial values. They know that this is not an Imperial policy, but they have their reasons for it, which, as they have been stated to many may be now set forth as follows:–First, that it suits the wishes of the Canadian wounded and of Canadian doctors and nurses. Secondly, that two serious risks attach to Canadians being in other hospitals than their own. They may get lost, or they may be kept too long. Now, it is evidently a very worrying thing to lose the men: and then, if they are kept too long, think of the wastage! It can only be computed in terms of three men–the man occupying the bed, the man who should be in camp ready to take someone else’s place at the front, and the man who should be in the trenches and isn’t. The argument has been strongly put, and if the case be proven one need hardly go further. From the point of view of winning the war it is conclusive. In fact, little more has been said. Generalities as to the desirability of Canadian wounded being under Canadian control are rather the statements or assumptions for which we are seeking proof than arguments in themselves. To keep nothing back, however, one must say that still another reason has been advanced, which, though brief, may to some appear convincing. It is, “Canada first. The Empire afterwards.”
Now, it may seem temerity for one who is not even a feminine lieutenant to question the entire wisdom of a policy which, being set forth in script, has received the signatures of six Canadian Generals. Yet if one stops to think, even the highest military command need not carry with it an intimate knowledge of hospitals, not as much, for instance, as comes to those who, since the day the first Canadian Contingent went out to France, February 10, 1915, have gradually built up an organization, and made it their entire work and endeavour to get into touch with every wounded Canadian soldier in hospital. Because of this personal knowledge, as well as of a strong body of Canadian opinion, I ask the privilege of making some comments on the reasons for concentration which have been given.
First. There is overwhelming proof that the great majority of the Canadian wounded have no desire whatever to be with Canadians only, but value and enjoy the variety and interest of meeting the wounded from other parts of the Empire. Anyone who wants to know if they are happy in hospitals where they are “mixed in” should call at the Canadian Red Cross Information Bureau, 14, Cockspur-street, and glance at their letters. One of the departments of this bureau was in direct communication with over 4,000 of them last week; this apart from many thousands of reports from visitors telling of their condition and their needs. From such testimony it can be said of our intelligent and adaptable Canadians that, while they prefer not to be the only Canadian in hospital (which seldom happens), they have a profound dislike and even resentment to being classed apart and with Canadians only. One of them from Shorncliffe said the other day:–“We hear we are all to be in a colony. Is it malice?” And when assured to the contrary, “Ah, well, perhaps they don’t know why themselves.”
As to losing our men in British hospitals, attention may be directed to the fact that, in addition to the Canadian Government Records, there has been kept for nearly two years at the Information Bureau, 14, Cockspur-street, a register of all wounded men in hospital, their whereabouts, transfers, progress, and condition, which information is at the service of all legitimate inquirers.
To pass on the most serious reason of all, the danger of wastage through too long detention in hospitals not under Canadian control. While a tribute to the “kindness” of British hospitals, this is certainly the last thing one would expect of them in a time of unexampled stress. It is true that those who have followed the history of each man in hospital may have remarked sometimes on the prolongation of what may be called the secondary period there, but this has been quite as often in Canadian as in British hospitals, and we would suggest that it finds its excuse and explanation in the fact that it has taken much time to complete the machinery for the final period of restorative treatment in Canadian Command Depôts and Casualty Assembly Centres. These arrangements are now well advanced, the results so far achieved reflecting much praise on Surgeon-General Jones and the C.A.M.S.; and henceforth a man may be evacuated from the hospital, without risk, before he is fit for the camp. As for the permanently unfit, we have it on authority that it has only of late been decided that they should receive their final treatment in Canada. Failing any clear policy in this matter or adequate preparedness, it is clearly unfair to say that instances of “delay” which have been cited reflect on either British or Canadian hospitals, even should they be largely multiplied.
It remains only to refer to the last reason, if such it can be called, that has been given. “Canada first. The Empire afterwards.” Now, this is a saying or motto which is difficult to treat, because it has no meaning whatever. Canada is not an attachment to the Empire any more than England is. She is not fighting for an abstraction or for something outside herself. She is within and of it, and the whole Empire is her trust and her inheritance. From her broad prairies goes forth the call to the men of Britain, “Come! We are yours. Shall those of alien race usurp your birthright? Come!” This call may echo faintly across an ocean, but the message goes warmly and with power from bed to bed. A Canadian sergeant (British born) in hospital writes:–“I talk Canada here on every occasion; in fact, I am taking the part of Government agent. I want to see Canada settled with Britishers. One Old Country-man on a homestead looks better to me than, say, a whole colony of Germans. There is room for millions such as I see in bed around me. This cannot be advertised enough and now is the time to do it, and the best place of all is a hospital, where men have lots of time to talk things over.”
No longer when the new plan is carried out will this best of propaganda be possible. For the concentration which has always, and rightly, been considered necessary in the final stages of convalescent treatment is to be carried backwards and to include the whole course. The opportunity that comes in the primary hospitals through long days of intercourse is to be taken away. If, as is said by the framers of this policy, the opportunity will not be altogether withdrawn, for there will always be some Canadians over, who will have to go to British hospitals, this will be no thanks to them, but in spite of all their endeavours.
In the interests of Canada, social, moral, and economic–on behalf of Canada and the Empire–this protest stands.
The Canadian Wounded
To The Editor Of The Times
Sir,–Many of us who have been connected by residence or sympathy with Canada and the Canadians are still hoping that Lady Drummond’s protest in your issue of October 19 will not be allowed to die. The reasons which have apparently actuated the sudden policy of the Canadian Militia Department were, indeed, effectually disposed of in her letter–and that, not only from what was said in it, but possibly also from what was left unsaid. Any further endorsement might therefore seem superfluous. But meanwhile there is no sign that the policy (or is it the politics?) Which she deprecates has been or will be modified, unless, indeed, the Department has no plenary power and may be overruled by higher authorities in the Dominion.
In the circumstances I may, perhaps, be permitted to add my testimony, gained through personal contact with Canadian soldiers and civilians in this country, that (to quote the words of Lady Drummond’s letter) “there is overwhelming proof that the vast majority of Canadian wounded have no desire whatever to be with Canadians only.” But this is not all. The last reason stated by Lady Drummond as having been advanced as a reason for segregation is by far the most serious. It is summed up with the words, “Canada first, the Empire afterwards.”
If this really reflects the policy of the Department, anything more reactionary in this crisis of our national history, more foreign to the spirit of Canada herself, or more ruinous to Imperial interests can hardly be imagined. It strikes, indeed, at the root of all that Canadians are fighting for–the unification and consolidation of the Empire. The curse of war has brought with it this compensating blessing–a unique opportunity of bringing all the sons of Empire face to face, and of their learning, each from the other, new modes of thought and new ways of looking at life–to say nothing of the practical effect of such mutual touch in solving the problems of emigration after the war. The Canadian Militia Department, by its policy of enclosing wounded Canadians in water-tight compartments, apparently proposes to shut all this off with a snap. To one who has lived and seen some public service in Canada, it would appear little less than an attempt at imperial suicide. And if the Department is disposed to cry, “Hands off Canada!” it may fairly be rejoined–“Hands off the Empire!”
I am, Sir, yours faithfully,
Herbert Branston Gray.
Authors’ Club, Oct. 23.
The Canadian Army Medical Service
The report on the Canadian Army Medical Service, a summary of which we publish to-day, is a very interesting and reassuring document. About three months ago a number of disquieting rumours about the Canadian Medical Service in this country were current here. They crystallized into a statement, made evidently with official backing, that wounded Canadians were no longer to be sent to British as well as to Canadian hospitals, but that a “concentration area” was to be established for them, in which they would be separated from other wounded British troops and would be treated in Canadian hospitals. This intention elicited immediate and vigorous protest, led by Lady Drummond in a letter which she contributed to our columns. Soon afterwards Sir Sam Hughes resigned under pressure from the Prime Minister of Canada, his post as Minister of Militia for the Dominion; and nothing more was heard of the “concentration” scheme.
The report now published reveals its unhappy genesis and its deserved fate. The scheme originated in a report on the medical work of the Canadian Expeditionary Force, by Dr. Herbert A. Bruce, who was appointed by Sir Sam Hughes to be Special Inspector-General charged with the investigation of its conditions in Great Britain. His report condemned the work, root and branch; laid the blame on the Director of Medical Service, Surgeon-General Carleton Jones; recommended the “concentration” scheme; and castigated the Voluntary Aid Hospitals in the United Kingdom as “inefficient, expensive, and unsatisfactory.” The immediate result of Colonel Bruce’s report was that Surgeon-General Jones was recalled to Canada, while Colonel Bruce remained in London as Inspector-General. But the fierce controversy which the report aroused, and which led to the resignation of Sir Sam Hughes, had other important results. Surgeon-General Jones was asked to remain in London, and a new special board of eminent and independent doctors was appointed to inquire into Colonel Bruce’s findings. Their report, published today, reverses all these findings except in some miner particulars. They condemn “concentration” as involving great and unnecessary, expense. They declare that they have found “no general sentiment among Canadian troops in favour of their exclusive treatment in Canadian rather than British hospitals.” They adduce, in favour of the existing system, “grounds of hig policy” identical with those which we urged at the time when the change was proposed. “To separate,” they say, “on their return to England men who have fought side by side must tend to undo the bond of brotherhood sealed in the face of the enemy.” Their report challenges and contradicts, too, the adverse comments made by Colonel Bruce on British V.A.D. hospitals. They give the V.A.D. hospitals high praise, and show that the strictures made by Colonel Bruce “are unjustified and regrettable.” Finally, the Board have cleared Surgeon-General Jones of the charges made against him, praising his “zeal and efficiency” and “tact,” and commending the “good work” done by him and his staff “under circumstances “of novelty and great difficulty.” The result of their report is thus to dissipate the sinister rumours that have been current, to dispose of the “concentration” system, to vindicate the V.A.D. hospitals in Great Britain, and, through the administrative act of Sir George Perley, to terminate Colonel Bruce’s appointment as Special Inspector-General in London.
Verdict Of Special Inquiry Board
Col. Bruce And His Report
The Canadian Medical Service in Europe, which was recently the subject of serious official criticism, has been handsomely cleared of the charges against it, and its work warmly praised by a Special Board of Inquiry, presided over by Surgeon-General Sir William Babtie, of the Imperial Army Medical Department.
Last summer Sir Sam Hughes, then Canadian Minister of Militia, appointed Dr. Herbert A. Bruce, the distinguished Toronto surgeon, Special Inspector-General, to report on the medical work of the Canadian Expeditionary Force. Colonel Bruce, with the aid of a committee consisting of Colonel F.A. Reid, Colonel Wallace Scott, Lieutenant-Colonel Walter McKeown, Lieutenant-Colonel F.W.E. Wilson, and Captain Charles Hunter, drew up a report which was rightly described at the time as one of the frankest indictments of a Government service ever received by a responsible Minister.
Colonel Bruce reported that a reorganization of the Canadian Medical Service “from top to bottom” was necessary. His report was divided into 28 sections, and each section was a severe criticism of one branch or another of the work. The blame was clearly put at the door of the Director of Medical Service, Surgeon-General Carleton Jones.
Two sections of the report aroused special interest in England: (1) The concentration of Canadian sick and wounded in Canadian hospitals was strongly urged, in place of the existing system of scattering the patients among Canadian and British hospitals alike; (2) the Voluntary Aid Hospitals in the United Kingdom were condemned as inefficient, expensive, and unsatisfactory.
As a result of this report Surgeon-General Jones was recalled to Canada, and Colonel Bruce remained in London as Inspector-General. Immediately before General Jones’s departure he received further orders to wait in England for a time. A fierce controversy arose, and strong protests were made the Canadian Government by eminent, authorities. Heat was added to the difference by a statement by Sir Sam Hughes at a public meeting in Canada that Canadian wounded were badly treated in British hospitals.
Good Work Ignored
Sir Sam Hughes resigned office at the request of Sir Robert Borden, the Canadian Premier. One of the first acts of Sir George Perley, who took over his work in England, was to appoint a special board of eminent independent medical men to inquire into Colonel Bruce’s findings.
The new Board was presided over by Surgeon-General Sir William Babtie, and consisted of Colonel E.E. Ashton, General Officer Commanding Canadian Training Division, Shorncliffe, Colonel J.T. Fotheringham, A.D.M.S., 2nd Canadian Division, Colonel A.E. Ross, A.D.M.S., 1st Canadian Division, and Colonel J.M. Elder. Its report, dated December 21, has been presented to Sir George Devley, and is a startling reversal of Colonel Bruce’s findings. Some of the Inspector-General’s minor recommendations are accepted, but on the main points the Board pronounces emphatic disagreement from him. The work of Surgeon-General Jones and his staff is praised. General Jones is specially commended for his zeal and industry and for the tactful performance of many delicate duties that fell to his lot. The Inspector-General is charged with “ignoring the good work done by Surgeon-General Jones and his staff under circumstances of novelty and great difficulty,” and with lack of intimate knowledge of Army organization.
The Board wholly condemns Colonel Bruce’s recommendation that Canadian sick and wounded should be concentrated in Canadian hospitals. It points out that there are 20,000 Canadian patients in hospitals in the United Kingdom. After making special allowance for some cases, it would require 4,000 additional beds to accommodate all Canadian patients in Canadian institutions, apart from allowing for special battle casualties. This would involve an additional capital expenditure of a million dollars, if buildings had to be erected, which is believed to be inevitable.
It would be quite impracticable to earmark and collect Canadian casualties at the base in France, and difficult and inconvenient to direct them solely to Canadian hospitals in England. The difficulties are not insuperable, but they are sufficient to add to the complexity of an already complex problem. Clearing hospitals would have to be provided at or near the ports of England.
Such a policy would be expensive and unnecessary, “After conversation with many Canadian soldiers in different hospitals and with officers and others familiar with the present system the Board has failed to discover any general sentiment among Canadian troops in favour of their exclusive treatment in Canadian rather than British hospitals.”
The Board goes further. It objects to concentration on grounds of high policy. The following passage is remarkable in a formal official document:—
It appears to the Board that to separate, on their return to England, men who have fought side by side, must tend to undo the bond of brotherhood sealed in the face of the enemy. The Board is aware that these considerations of high policy do not strictly come within its purview, but cannot refrain from adverting to this aspect of the matter, because it would almost appear as if the report under consideration was based upon the conception that the Canadian Forces had a similar relation to the British Armies as that held by the Allied nations.
The same line of reasoning is used in dealing with a whole series of arguments against the blending of Canadian and British medical activities, in research work, and elsewhere:–
All though the report of the Inspector-General the dominating idea is a conception that the Canadian Expeditionary Force is something separate and apart from the Imperial Army, a conception that may be summarized as the “water-tight compartment” policy in matters medical. The Board is of opinion that as long as the Canadian Expeditionary Force forms an integral part of the Imperial Army, such a view is no more possible in the United Kingdom than it is in France, and so long as Canadian troops continue to operate under the command of the Commander-in-Chief. British Expeditionary Force, it must continue to be impossible to discriminate in the medical arrangements of Canadian and British troops.
This view, it will be seen, is that expressed by The Times in a leading article on October 7, 1916, the day following the publication of a letter from Lady Drummond protesting against the policy of separating Canadian wounded from their fellow-soldiers of the United Kingdom and the other Dominions. The Times said:–
“Whatever the official justification of the new system of concentration may be–and of course the authorities have judged it to be unimpeachable–there are very strong arguments on the other side, as Lady Drummond plainly showed in her letter. It is no small thing that men from Canada who bear in their bodies the marks of their devotion to our cause should share the wards of the hospitals with the wounded of Great Britain and of the other Dominions....On our side there is an advantage equally weighty.”
The British V.A.D. Hospitals so severely condemned by Colonel Bruce are now commended. It is pointed out that the V.A.D. system has done much to link up the military medical service with the civil population. The three points of criticism, inefficiency, expense and unsatisfactoriness, are taken in detail. It is not agreed that as a class they are inefficient, and evidence which to Colonel Bruce indicated inefficiency was really due to defective classification. In no case did the Board find that faulty treatment could be fairly attributed to the V.A.D. system.
Efficiency Of The V.A.D.’s
The charge for a patient in a V.A.D. hospital never exceeds 3s. a day; the cost per patient in a military hospital is at least 6s. per day. The report continues:–
The investigations of this Board do not support these allegations of inefficiency. The standard of professional efficiency naturally varies, but there is no ground, even in the special reports made by Colonel Bruce’s direction, for the grave indictment contained in his report. “A good deal of the surgery is bad”; and if patients have been retained in these hospitals too long it has been caused by the insufficiency of accommodation in Canadian convalescent hospitals and to delays in connecting with the C.C.A.C. in England.
Nursing Staff: In all hospitals there is a nucleus of trained nurses (10 per cent.) whose work is supplemented by the devoted efforts of the Voluntary Aid Detachments, the numbers of which have undergone courses of instruction in first aid and home nursing and who, after two years of hospital work are many of them so efficient that the Imperial Government has not hesitated to send them to the great hospitals in France and in the Mediterranean. In no case has the Board had reason to be other than satisfied with the nursing in these institutions.
The comments made in Colonel Bruce’s report on the V.A.D. Hospitals have been widely resented, and this board is of opinion that these strictures are unjustified and regrettable.
Later the Board pays another handsome tribute to the V.A.D. Hospitals. “In these hospitals the Board found the patient well fed, comfortable, and happy, and receiving an amount of care that is only possible in institutions organized on the lines, of ‘the home.’ This has been an enormous asset in the case of soldiers widely separated from their kith and kin.”
There is a sequel to the report. Sir George Perley has cancelled Colonel Bruce’s appointment as Special Inspector-General.
Among the points with which the Board is in agreement with Colonel Bruce are that large numbers of soldiers have come and continue to come from Canada who are unfit for service at the front, and that large numbers have been passed who ought not to have been passed by medical officers; that additional inspection of Canadian hospitals and of Canadian patients in British hospitals is desirable; that additional consultants should be appointed; and that there should be a greater return of invalid soldiers to Canada.
Colonel Bruce declines to discuss the report, saying that he is debarred from doing so as a commissioned officer.