Hospital Organisation
With extended experience the views of the writer on the subject of the organisation of military hospitals have crystallised. There is no doubt that the commander of a hospital must be a medical practitioner, and there is no doubt that in all matters relating to his hospital his authority must be final. In the last resort he must decide whether a patient is to leave the hospital or to stay; who should be admitted, and what the treatment should be. In a good organisation he will probably be very rarely required to express an opinion respecting these matters, but in the event of a conflict of opinion between say the consulting surgeon or physician and himself, there can be but one final arbitrament. The position is defined in the King's Regulations and is endorsed by common sense. So far as the Registrar is concerned I think that he should be a medical practitioner, but that in every instance there should be an assistant registrar with the rank of lieutenant, who should do the whole of the detailed work connected with the records, and who need not necessarily be a medical officer. In like manner, the Transport Officer and the Orderly Officer or Adjutant should be of the same character and rank. Difficulty, however, arises respecting the personnel of these non-medical offices. It is clear that, for purposes of discipline, they should belong to the Army Medical Corps and be under the control of the officer commanding. In time of war there is no doubt that invalided combatant officers would do very well, but no combatant officer would want such a position in time of peace, because there would be no subsequent career available. To effect a satisfactory solution of the problem it would be necessary to add to the establishment of a base hospital three non-medical commissioned officers of the same rank as the Quartermaster, preferably former Sergt.-Majors who have obtained commissions and who consequently know the details of hospital administration thoroughly. There would then be in each base hospital four non-medical commissioned officers, viz. the Quartermaster, the Asst. Registrar, the Orderly Officer, and the Transport Officer, and all would belong to the A.M.C. A hospital suitably staffed on this plan would run very smoothly.