It should be remembered that the bulk of the medical officers were civilians, that they were unaware of the broad questions of policy involved, and that they were inclined on principle to give a holiday to a man who had been fighting, and even to believe the stories told them by the malingerer. The reader will therefore not be surprised to learn that a number of men who were certainly not in a very bad way were recommended for two, three, or six months' change, or even for discharge. The proceedings of the Board were reviewed by a responsible officer; for a long time by Lieut.-Col. Barrett when acting as A.D.M.S. on General Ford's staff. It was, however, difficult to persuade any Board which had once expressed their opinion to modify it, and almost impossible to get them to reverse it. If their recommendations had been rejected altogether, the conduct of the Service would have become difficult. Under direction, an attempt was made to modify the practice by appointing a permanent Board in each hospital, presided over by a senior medical officer charged with the duty primarily of attending to Board work, and of acting as a clinician only when he had time.
The Following Draft was made the Basis of the Arrangement
1. Two medical officers are to be detached from other duties at Nos. 1 and 2 Australian General Hospitals respectively, in order to form a majority of a permanent invaliding board at each hospital. They will be known as the senior and junior invaliding officer respectively.
2. The duties of the Board at Nos. 1 and 2 Australian General Hospitals will be to form an Invaliding Board by meeting in each case the medical officer in charge of the case.
3. The Board proceedings when completed will be sent to the A.D.M.S. Australian Force, Headquarters, Cairo, and on being approved will at once be forwarded with nominal roll to the Australian Intermediate Base Depot, Cairo.
4. The Australian Intermediate Base will forward to the O.C. Hospital or Convalescent Home nominal roll of patients who are to be discharged or transferred to Australia or England. These patients will be transferred to the Convalescent Home, Helouan (if they are able to leave hospital), and will remain at the Home till transport is ready for them.
5. The only circumstances in which completed Board cases are to be retained in any hospital, except the Convalescent Home, Helouan, are when patients require a considerable amount of treatment, and are unfit to leave the hospital.
6. The senior invaliding officer will be responsible for the accuracy of the nominal rolls.
7. At Alexandria an invaliding officer will be attached to the Australian Convalescent Home at Ras el Tin. It will be his duty, under direction of the A.D.M.S. Alexandria, to proceed to the various hospitals and camps in Alexandria, arrange for the formation of Boards, of which he will be a member, to deal with all cases in Alexandria. These cases, in like manner, must be forwarded to Convalescent Home, Helouan, except in the cases of those who are unfit to leave hospital.
8. The cases to be dealt with fall into two classes: (a) men unfit for military service, who may be sent by (i) transport to Australia or (ii) by hospital ship to Australia; and (b) men likely to profit by change to England during hot weather, to proceed by (i) transport or (ii) hospital ship.
9. The Board proceedings are to indicate, in the opinion of the Board, the best manner of dealing with patients under the several headings.
June 30, 1915.
Again difficulties arose, since none of the medical officers wanted the job. In fact, medical officers in general never want to do anything except attend to patients. They are unsuited temperamentally for administrative work, and dislike it. Even with this modification, though the system worked somewhat better, evils obtruded themselves. The statements of men who swore they were suffering from rheumatism and severe pains in the back were sometimes taken at face value, and further modification consequently became necessary. Any medical officer could recommend any patient to be boarded. The Board then sat and sent in its report to the A.D.M.S. Under the modified arrangement no patient could be boarded until he had been examined by the senior medical officer of the Australian Force in Egypt, or by the D.D.M.S. Egypt, Col. Manifold. By this means most of the trouble was eliminated and a satisfactory principle was established. It is the old story—the reversion to direction by a limited number of experienced and responsible people.
It was decided not to send Australian patients to Great Britain other than in exceptional cases, that is if they had friends or relatives there, and if they only required a short change, say two months. As the voyage to Australia occupied a month each way, it was absurd to send them back there for two months. For three months or more they were sent to Australia, and in some cases were discharged on arrival. Some men who were no longer fit for service at the front were kept in Egypt for Base Duty.
Only those who have experience of base work become aware of the enormous demands made on a garrison for guard work, for clerical work, orderly work, and the like. At Al Hayat, Helouan, for example, the commandant really required ninety men for sentry work, though he had only forty. The demands for competent clerks were incessant.
As soon as patients were destined for dispatch to Australia they were forwarded to Helouan and kept there until the ship was ready to leave. As a result Helouan was filled with waiting cases. In order then to ease the pressure at Helouan, a waiting camp was established at Suez close to the Government Hospital, to which any patients could be admitted. This establishment of course necessitated further demands for medical officers, orderlies, etc.