TheRoyal Navy Medical Service (RNMS), also termed theRoyal Naval Medical Service[1] is the branch of theRoyal Navy responsible for providing 'comprehensive healthcare to ships, submarines and Royal Marine personnel at sea and on land'. It includes within its remit of responsibilityQueen Alexandra's Royal Naval Nursing Service.
The Head of the Royal Navy Medical Service, also holds the position of 'Head of Navy Healthcare' in Navy Command Headquarters[1] and the present incumbent is Commodore Alison Hofman.[2]
The history of the service can be traced back to 1692 when treatment for sick and wounded naval personnel was administered by theCommissioners of the Sick and Hurt Board (a subsidiary body of theNavy Board) until 1806, when medical officers of theRoyal Navy had been under the direction of the Transport Board. In 1817 theTransport Board was merged with the Navy Board, and responsibility for medical officers passed to theVictualling Board.
In 1832 the Navy Board and the Victualling Board were both abolished (following recommendations by theFirst Lord of the Admiralty,Sir James Graham). At the same time,Sir William Burnett (who had served as one of the medical commissioners on the Victualling Board since 1822)[3] was appointedPhysician-General of the Navy;[4] as such he had charge of the navy medical department and reported directly to theBoard of Admiralty.[5] The title of his post was changed toInspector-General of Naval Hospitals and Fleets in 1841,[4] and was again changed in 1844 toDirector-General of the Medical Department of the Navy. In 1917 following further re-structuring within theAdmiralty Department it became known as the Royal Navy Medical Service headed byMedical Director General of the Navy, also known as theMedical Director General (Naval) (which was the official title by the start of the 21st century).
The Medical Department of the Navy was initially, like its predecessor the Sick and Hurt Board, based inSomerset House.[6] In the 1860s, along with the other Civil Departments of the Admiralty, it was removed from Somerset House to Spring Gardens (where theAdmiralty Extension now stands);[7] in 1879 the offices of the director-general were located at 9 New Street, Spring Gardens, London. The director-general was at this time under the direction of theJunior Naval Lord.[8]
In the early 1960s, with the establishment of theMinistry of Defence in place of the Admiralty, the Medical Director General and his staff moved into theEmpress State Building. In December 1984 he moved, with a reduced staff, into a new combinedDefence Medical Services central headquarters building in First Avenue House,High Holborn,[9] which had been established with a view to bringing together the three medical services under a single administrative head (theSurgeon General); (albeit, in spite of expectations to the contrary,[10] the RN Medical Service and its Army/RAF counterparts maintained their autonomy). In 1993 the office of the Medical Director General moved to Victory Building inHMNB Portsmouth as part of the relocation of theSecond Sea Lord and various directorates from London to Portsmouth.[11]
From theearly days of the Royal Navy,surgeons had been carried on board ships (albeit intermittently, depending on the length of voyage and likelihood of hostilities).[12] In theTudor period, surgeons were regulated by theCompany of Barber-Surgeons.William Clowes, sometime Warden of the Company, and his colleagueJohn Banister (both of whom had served at sea early in their careers) did much to ensure that naval surgeons were properly qualified and prepared. Clowes emphasized the fact that, although surgeons were prohibited from acting asphysicians on land, at sea they would routinely be required to prescribe medicines, administer treatment and offer medical advice; appropriate instruction was provided and Clowes advised ships' captains only to engage as surgeons those whom the Company had approved.[12]
Later,British colonization of the Americas led to longer sea voyages, battles and skirmishes far from home and encounters with new diseases, all of which contributed to a greater regularisation of the naval medical service.[13] In 1629 the Company of Barber-Surgeons was empowered to examine every individual intending to act as a surgeon (on 'any ship whether in the service of the Crown or of a merchant') and likewise to conduct an examination of theirsurgical instruments andmedicine chest prior to their departure.[12] As well as a surgeon, each fighting ship was provided with one or moresurgeon's mates (depending on the size andrating of the vessel). Surgeon's mates were recruited from the age of sixteen. Ajunior rating assigned to assist the Surgeon and mate was known as aloblolly boy.
Physicians, who (unlike most surgeons) were university graduates, were regarded as belonging to a higher social class.[12] Physicians served on the Sick and Hurt Board. In addition, the principalRoyal Naval Hospitals atHaslar andStonehouse (both established in the mid-eighteenth century) were overseen by physicians, with surgeons working under them. Towards the end of the century, superintending physicians were appointed to naval fleets;[13] but (other than when seconded to fleets) physicians did not usually serve at sea. The title of Physician was abolished in the Royal Navy in 1840.[14]
Nursing services in the naval hospitals were initially provided by locally-recruited women, overseen bymatrons; but in 1854 the women were (except for a few specialists) dismissed and replaced by men (mostly aged pensioners). Thirty years later, a review of naval nursing provision led to the employment of a number of trainednursing sisters, who would later be constituted asQueen Alexandra's Royal Naval Nursing Service (QARNNS), and the establishment of aSick Berth staff, to provide nursing assistance afloat as well as ashore.[14]
Dental services are provided by the Royal Naval Dental Service, which since 1996 has formed part of a tri-service organisation (Defence Dental Services).
Medical Assistants are deployed on all major warships and submarines of the Royal Navy, and provideprimary care to the crew. They also have the role of training the crew in first aid.[16] Capital ships often carry non-commissioned medical technicians as part of the larger medical department, who perform laboratory work to aid the medical assistants and officers.[17]
Medical Assistants both male and female provide medical close support and shore side medical care to all Units of 3 Commando BrigadeRoyal Marines.
All medical assistants are ranked in the same manner as other ratings.
Medical Officers may be embarked temporarily on smaller vessels when on a long operational tour,[18] but theQueen Elizabeth-class aircraft carriers have medical departments permanently staffed by one or two medical officers.[1] Medical officers are ranked in the same manner as other officers, but wear red stripes between the gold on their epaulettes, and have the title 'Surgeon' added to their rank (Surgeon Lieutenant for example). All Medical Officers are required to be registered with theGeneral Medical Council and to hold a currentlicence to practise.[19] Although Royal Navy medical officers are qualified doctors, they do not use theDr prefix, like those in other British military medical organisations.[20]
Medical Services Officers provide support in areas such as medical administration, training, logistics and planning, as well as in more specialised areas such asenvironmental health andradiological protection. They do not have to be registered medical practitioners.[19]
The Head of Navy Healthcare/Head of Royal Navy Medical Services continues to hold the appointment of Medical Director General (Naval).[21]
In 2009 the title Chief Naval Medical Officer was introduced, to be held together with the title Medical Director General (Naval) (which was retained 'for liaison with outside authorities').[22] In 2015 the rank of the Medical Director General (Naval) was 'de-enriched' from Surgeon Rear Admiral to Surgeon Commodore;[23] Surgeon Commodore Peter Buxton, who was at that time in the discrete post of Head of Royal Naval Medical Service and Assistant Chief of Staff Medical, was the following year promoted to Medical Director General (Naval), retaining in addition the designation Assistant Chief of Staff Medical.[24] Subsequently the separate appointment of Head of Royal Naval Medical Service was merged with that of Assistant Chief of Staff Medical/Medical Director General (Naval). In 2022 the post of Assistant Chief of Staff Medical/Head of the Royal Naval Medical Service was eliminated in favour of the title Head of Navy Healthcare/Head of Royal Navy Medical Services.[25][2]
On 8 August 2006 Queen Elizabeth II appointed members of the Royal Family to serve as Royal Patrons, styled Commodores-in-chief, of various Royal Navy Commands, 'in recognition of the strong links between the Royal Navy and the Royal Family'.[50]Camilla, Duchess of Cornwall was appointed Commodore-in-Chief, Naval Medical Services at that time and has continued in the role as Queen.
^Reports from Commissioners (7): Naval and Military Promotion. London: House of Commons. 1840. pp. 185–191.
^abDod, Charles R. (1848).The Peerage, Baronetage, and Knightage, of Britain and Ireland. London: Whittaker and Co. p. 116.
^McLean, David (2006).Public Health and Politics in the Age of Reform: Cholera, the State and the Royal Navy in Victorian Britain. London: I. B. Tauris. p. 59.
^Hamilton, Admiral Sir R. Vesey (1896).Naval Administration. London: George Bell and Sons. pp. 22–25.
^Grant, E. J. (2013). "9".The Toothwrights' Tale: A History of Dentistry in the Royal Navy 1964–1995. Andrews UK Limited.ISBN9781909183315.
^abcdWakeley, Sir Cecil (November 1957)."Surgeons and the navy"(PDF).Annals of the Royal College of Surgeons of England.21 (5):267–289. Retrieved15 June 2024.
^abTurnbull, William (1806).The Naval Surgeon. London: Richard Phillips. pp. v–xxvii,394–395.
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