New Zealand Medical Services in Middle East and Italy
DURING 1939 the Territorial Force in New Zealand was in the process of reorganisation from a cadre to a peace establishment within reasonable reach of its war establishment, and the National Military Reserve was being formed and plans for home defence were being revised. Shortly after the outbreak of war on 3 September 1939, the Government decided to raise a special force of one division and ancillary troops for service overseas or for home defence. Medical examinations were necessary before the men responding to the call for volunteers for the Army were admitted to mobilisation camps.
By 31 July 1939 the machinery for medical boarding was ready to operate at short notice. The country had been divided into eleven areas, and a Regional Deputy, a senior medical practitioner, was in charge of the medical examinations in each region. A total of 253 medical boards, each comprising two doctors and a dentist, had been chosen to meet the requirements and places of mobilisation of the Army. For their guidance these medical boards had the comprehensive Code of Instructions which had been printed in 1938.
With the number of boards arranged, and sessions of four hours a day each, it was expected to complete in four days the examination of the 39,900 men the Army proposed to mobilise. (In actual experience it was found that the army mobilisation did not achieve any such intensity as mooted in pre-war proposals. Up to 9 December 1939 nine of the eleven regions had been called upon to examine only 15,796 recruits. Figures were not available for the other two regions but they probably did not exceed 1000 each.)
At the meeting of the Medical Committee on 24 September 1939 it was stated that reports received and inspections made indicated that the organisation for medical boarding was carried into effect immediately and efficiently following the outbreak of war. The Regional Deputies, who functioned in a part-time capacity, were asked at that stage to report in regard to the Code of Instructions, the forms in use, and whether there was need to improve the literature or the organisation. The reports were generally satisfactory as regards accommodation and staff but a number of suggestions page 23 were made for the improvement of the Code of Instructions, the Army Instructions for conduct of medical examinations, and Army Form 355 (Record of Medical Board). Some of the suggested improvements led to amendments to the instructions.
The introduction of compulsory military service under the National Service Emergency Regulations 1940 (dated 18 June 1940) brought about certain alterations in official policy and imposed additional responsibilities on regional deputies and medical boards. It was therefore necessary to supplement the original instructions, prepared as they were primarily for initial examination under a system of voluntary recruitment.
When conscription was introduced in 1940 the Army demanded that boarding of the men on each ballot list should be completed within six weeks. This entailed the use of every available doctor at a time when practitioners were reduced in number and busier than ever with the introduction of more classes of benefit under the Social Security legislation.
Under the National Service Emergency Regulations 1940, Regulation 35 et seq, the responsibility for medical boarding was transferred from the National Medical Committee to the Minister of Health. The Regional Deputies became therefore, in fact, deputies for the Minister of Health, to whom the National Medical Committee was, strictly speaking, only an advisory body. The effect was to weaken the administrative control that had previously been exercised by the National Medical Committee, which had a body of military experience from the First World War, and concentrate authority in the Minister of Health.
As deficiencies in the medical examination system became apparent, modifications and additions were made to the Code of Instructions. On 2 December 1940 the definition of Grade I men, which had been ‘men who attain the full normal standard of health and strength and are capable of enduring physical exertion suitable to their age’ (the age limits being twenty-one to forty years), was qualified by ‘Fit for Active Service in any part of the world’. A new medical examination form (NZ 355) was drawn up to give a more complete procedure for examination of recruits and a record of pre-enlistment medical history, besides incorporating the amendments to grading classification. (Later, with the experience gained from the examination of men returned from overseas for health reasons, and from reports of medical officers overseas, the National Medical Committee drafted a greatly improved Code of Instructions giving more complete instructions to medical boards regarding grading and detailing the procedure to be followed in the case of various disabilities. The new edition, printed in February 1942, was page 24 made available to medical boards in the middle of 1942. Certain aspects of medical boarding were still unsatisfactory, and consideration was given in December 1942 to constituting selected medical boards staffed preferably by doctors with military experience, acting in a full-time capacity, but these were not set up.)
There was a case in the earlier years of the war for a closer liaison between the army medical services and the Health Department, which was in executive control of the civil medical boards examining recruits, so that doctors could have been kept constantly aware of the disabilities likely to cause rejection from the Army. On this question of rejection the same problems were encountered in Australia and Canada.1
1 This subject will be further elaborated in Vol III.