Medical Branch

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Medical Branch
Ensign of the Royal Navy animated.gif
Active1805-current
CountryUnited Kingdom
BranchRoyal Navy
TypeNaval Branch
Part ofRoyal Navy
Garrison/HQPortsmouth, Hampshire, England
Commanders
FirstPhysician of the Navy
CurrentMedical Director-General (Naval)

The Medical Branch was also known as the Naval Medical Service (NMS) (1805-1917) and changed to the Royal Naval Medical Service (RNMS) (1917-current) of the Royal Navy is responsible for medical care. It works closely with Queen Alexandra's Royal Naval Nursing Service.

It is currently controlled and directed by the Navy Board (Ministry of Defence) through the Medical Department (Naval). It currently forms the navy branch of the joint Defence Medical Services as part of the Ministry of Defence.

History

By Jane WickendenMA(Oxon) DipLib Historic Collections Librarian, Institute of Naval Medicine, Alverstoke, Gosport.

Rules relating to the provision of medicine at sea have existed for centuries: the earliest known in English derive from the 12th-century Rules of Oléron, codified in 1336 as the Black Book of the Admiralty. The surgeon’s kit from the Mary Rose (sunk off Portsmouth in 1545) can still be inspected, and there were surgeons aboard the ships that fought the Great Armada of 1588.

From 1626 the Company of Barber-Surgeons undertook the training and examination of ship’s surgeons for the Navy, and the supply of their medicines and instruments. In 1652, at the beginning of the Dutch Wars, the Admiralty founded the precursor to the Sick and Hurt Board, and developed arrangements for the care of sick and injured seamen in seaport hospitals. Surgical and medical techniques steadily improved, and although the lot of the Naval surgeon was variable – often they had to pay for their own instruments and supplies for example – they were not without status: surgeon James Pearse was a friend of Samuel Pepys.

For most people the history of Naval medicine begins with James Lind, the ‘Father of Naval Medicine’, who carried out one of the earliest recorded clinical trials aboard HM Ship Salisbury (50) in May 1747, seeking a cure for scurvy. For years diseases such as malaria, typhoid and yellow fever, and dietary deficiencies causing dysentery and scurvy, killed far more men than injury in battle, making the fight against disease as important as more conventional warfare. Lind’s Treatise on the Scurvy was published in 1753, the year of the opening of the Royal Hospital Haslar. The Naval hospitals at Jamaica and Port Mahon (Minorca) were older, but Haslar was the first to be built in Britain. It was followed within the decade by Stonehouse at Plymouth, and later by Great Yarmouth and Chatham. Elsewhere, in the 1780s Naval surgeon James Ramsay was a key mover of the campaign to abolish the slave trade.

1805 saw the victory at Trafalgar, in which the good health of the Royal Navy’s sailors played a major part. In 1807 the slave trade was abolished in Britain, and the Royal Navy was committed to stopping the trade, particularly in the Atlantic but also in the Indian Ocean. There were appalling losses amongst the seamen on the West and East African anti-slave trade stations to disease, and in the 1840s Alexander Bryson, a naval physician later to be Medical Director-General of the Navy, laid the foundation for the sciences of medical statistics and epidemiology while researching preventive measures against yellow fever and malaria. Mosquitoes were not identified as the vector for these diseases until the 1890s, knowledge which came too late for surgeons such as Sidney Bernard of the wood-hulled paddle-sloop HMS Eclair, who died in service in 1844.

The status of the Royal Naval Medical Service continued to rise, though erratically, at one period in the early Nineteenth century coming under the control of the Transport Board. It was 1866 before pay and conditions for Naval surgeons approached, and 1881 before they matched, those of Army surgeons. In the 1830s the Medical Officer’s Journal system was instituted, and with it the Gilbert Blane award. Medics and surgeons were allocated Naval ranks in 1857, with accompanying uniform, and from 1863 surgeons wore the characteristic red distinction cloth between their gold rings. The Royal Naval Dental Service was founded in 1880.

RNMS officers and men served worldwide in H.M. ships, Naval hospitals and convict ships; ashore in the Naval brigades of the Crimean War (1853-56) which also saw the founding of the Naval Nursing Service under the leadership of Mrs Eliza Mackenzie, and the First South African War (1880-81); investigating diseases, cures and surgical techniques, and publishing their findings; working as botanists and zoologists such as T.H. Huxley; exploring, like George Bass of the Bass Strait, and one – Will Maillard in 1898 – winning the Victoria Cross. Captain Scott’s Terra Nova expedition (1910-12) included two Naval medical men, Surgeon Commanders Edward Leicester Atkinson and George Murray Levick.

During the Great War (1914-18) RNMS personnel saw service ashore – Atkinson and Levick, back from the Antarctic, both served with the Royal Naval Division at Gallipoli and on the Western Front – or afloat in sea battles such as Jutland (1916). The development of the Submarine Service and the Royal Naval Air Service provided new medical challenges. In 1915 the Journal of the Royal Naval Medical Service published its first issue.

Many RNMS officers and men died in the war and in the influenza pandemic that followed, while for the first time women were officially involved with, and sharing the dangers of Naval medical care at sea. Queen Alexandra’s Royal Naval Nursing Service (QARNNS) received its charter in 1902, and nurses were among the casualties in 1918 when HM Hospital Ships Rewa and Glenart Castle were torpedoed and sunk.

It has always been the case that war stimulates medical and surgical advances, and the history of the Royal Naval Medical Service bears witness to this: it emerged from the trials of the Great War ready for the challenges of the later twentieth century and onwards, remaining the proud and effective service that it is today.

Royal Navy Medical Service Today

The Royal Navy Medical Service (RNMS) provides comprehensive healthcare to ships, submarines and Royal Marine personnel at sea and on land. It provides primary care, deployed surgical support and, through the Primary Casualty Receiving Facility on board RFA Argus, it provides deployable hospital care. It provides specialist advice in fields of radiation protection, diving medicine and environmental medicine through the Institute of Naval Medicine. It also includes the Queen Alexandra’s Royal Naval Nursing Service.

The RNMS is headed by the Medical Director General (Naval), a member of the Second Sea Lord’s Board of Management and the medical adviser to the Admiralty Board.

Branch Colour (1863-current)

In 1863 The Royal Navy introduced coloured cloth on to their uniforms in 1863, so that it was possible to distinguish between naval branches and admiralty departments. the medical branch colour for senior officers ranked surgeon and above designated red.For medical assistants colours were adopted from the Ward Master branch 1918 the colour for them was maroon until 1951 then after a salmon pink. 1956.[1] All distinguishing colours were abolished in 1955 except for medical, dental, wardmaster officers and the Special Branch of the Royal Naval Volunteer Reserve.[2]

Heads of the Medical Branch 1832 to current

Heads of the Medical Branch of the Royal Navy
No. Title and Style Highest Rank Held Term Notes and Ref
1. Physician of the Navy civilian head 1832 to 1835
2. Physician-General of the Navy civilian head 1835 to 1841
3. Inspector-General of Naval Hospitals and Fleets civilian head 1841 to 1843
4. Director-General of the Medical Department of the Navy Surgeon Vice-Admiral 1844 to 1917
5. Medical Director-General of the Navy Surgeon Vice-Admiral 1917 to 1966
6. Medical Director-General (Naval) Surgeon Vice-Admiral 1966 to present

Medical Officer Ranks

pre 1805

Medical Branch
Ranks
Physician
Surgeon
Surgeons Mate

1805 to 1832

Medical Branch
Ranks
Physician
Surgeon
Assistant Surgeon

1832 to 1835

Medical Branch
Ranks
Physician of the Navy
Physician
Surgeon
Assistant Surgeon


1835 to 1840

Medical Branch
Ranks
Physician General of the Navy
Inspector of Hospitals
Deputy Inspector of Hospitals
Surgeon
Assistant Surgeon

1840 to 1841

Medical Branch
Ranks
Physician General of the Navy
Inspector of Hospitals
Deputy Inspector of Hospitals
Surgeon
Assistant Surgeon

1841 to 1844

Medical Branch
Ranks
Inspector-General of Naval Hospitals and Fleets
Medical Inspector of Hospitals and Fleets
Deputy Medical Inspector of Hospitals and Fleets
Surgeon
Assistant Surgeon

1844 to 1855

Medical Branch
Ranks
Director-General of the Medical Department of the Navy
Medical Inspector of Hospitals and Fleets
Deputy Medical Inspector of Hospitals and Fleets
Surgeon
Assistant Surgeon

1855 to 1859

Medical Branch
Ranks
Director-General of the Medical Department of the Navy
Medical Inspector of Hospitals and Fleets
Deputy Medical Inspector of Hospitals and Fleets
Staff Surgeon
Surgeon
Assistant Surgeon

1859 to 1873

Medical Branch
Ranks
Director-General of the Medical Department of the Navy
Inspector-General of Hospitals and Fleets
Deputy Inspector-General of Hospitals and Fleets
Staff Surgeon
Surgeon
Assistant Surgeon

1873 to 1875

Medical Branch
Ranks
Director-General of the Medical Department of the Navy
Inspector-General of Hospitals and Fleets
Deputy Inspector-General of Hospitals and Fleets
Staff Surgeon 1st class
Staff Surgeon 2nd class
Surgeon

1875 to 1908

Medical Branch
Ranks
Director-General of the Medical Department of the Navy
Inspector-General of Hospitals and Fleets
Deputy Inspector-General of Hospitals and Fleets
Fleet Surgeon
Staff Surgeon
Surgeon

1908 to 1911

Medical Branch
Ranks
Director-General of the Medical Department of the Navy
Inspector-General of Hospitals and Fleets
Deputy Inspector-General of Hospitals and Fleets
Fleet Surgeon
Staff Surgeon
Surgeon

1911 to 1917

Medical Branch
Ranks
Director-General of the Medical Department of the Navy
Surgeon-General
Deputy Surgeon-General
Fleet Surgeon
Staff Surgeon
Surgeon

1917 to 1918

Medical Branch
Ranks
Medical Director-General
Surgeon-General
Deputy Surgeon-General
Fleet Surgeon
Staff Surgeon
Surgeon

1918 to 1920

Medical Branch
Ranks
Medical Director-General
Surgeon Rear-Admiral
Surgeon Captain
Surgeon Commander
Surgeon Lieutenant-Commander
Surgeon Lieutenant

1920 to current

Medical Branch
Ranks
Surgeon Vice-Admiral
Surgeon Rear-Admiral
Surgeon Captain
Surgeon Commander
Surgeon Lieutenant-Commander
Surgeon Lieutenant

Comparative ranks

The following table illustrates the slow progress made by the medical officers of the Royal Navy in reaching equality of rank with their colleagues in the executive branch.

Comparative ranks
# Medical Officer Dates Executive Officer
1 Surgeon's Mate –1805 Mate
Assistant Surgeon 1805–1859 Mate
Assistant Surgeon (-6 years) 1859–1861 Mate
Assistant Surgeon (-6 years) 1861–1873 Sub-Lieutenant
Assistant Surgeon (+6 years) 1859–1873 Lieutenant
Surgeon 1873–1918 Lieutenant
Surgeon Lieutenant 1918– Lieutenant
Wardmaster Lieutenant 1953– Lieutenant
2 Surgeon 1805–1859 Lieutenant
Surgeon 1859–1861 Commander
Surgeon 1861–1873 Lieutenant Commander
Staff Surgeon 2nd Class 1873–1875 Lieutenant Commander
Staff Surgeon 1875–1918 Lieutenant Commander
Surgeon Lieutenant-Commander 1861–1877 Lieutenant Commander
3 Staff Surgeon 1859–1861 Captain (+ 3 years)
Staff Surgeon 1861–1873 Commander
Staff Surgeon 1st class 1873–1875 Commander
Fleet Surgeon 1875–1918 Commander
Surgeon Commander 1918– Commander
4 Physician 1825–1840 Commander
Deputy Inspector of Hospitals 1840–1856 Lieutenant
Deputy Inspector of Hospitals 1856–1859 Commander
Deputy Inspector General 1859–1911 Captain (+ 3 years)
Deputy Surgeon-General 1911–1918 Captain (+ 3 years)
Surgeon Captain 1918– Captain (- 3 years)
5 Inspector of Hospitals 1840–1856 Commander
Inspector of Hospitals 1856–1861 Captain (- 3 years)
Inspector-General 1859–1861 Commodore 2nd class
Inspector-General (- 3 years) 1861–1879 Commodore 1st class
Inspector-General (+ 3 years) 1861–1879 Rear-Admiral
Inspector-General 1879–1911 Rear-Admiral
Surgeon-General 1911–1918 Rear-Admiral
Surgeon Rear-Admiral 1918– Rear-Admiral
6 Director-General 1856–1859 Commodore 1st class
Director-General 1859–1908 Rear-Admiral
Director-General 1908–1918 Vice-Admiral
Surgeon Vice-Admiral 1918– Vice-Admiral

Footnotes

  1. Schliehauf, Bill (2007–2019). "RN Branch Colours". www.gwpda.org. Mentzer, Plotke, Shackelford and Schliehauf,. Retrieved 12 August 2019.
  2. "badge, rank, British, Royal Navy, medical branch, Surgeon Commander". Imperial War Museums. London,l England: Imperial War Museum. Retrieved 12 August 2019.

Bibliography

  1. British, Royal Navy, Medical Branch. Imperial War Museums. London, England: Imperial War Museum. Retrieved 12 August 2019.
  2. Schliehauf, Bill (2007–2019). "RN Branch Colours". www.gwpda.org. Mentzer, Plotke, Shackelford and Schliehauf,. Retrieved 12 August 2019.