'Mesopotamia Commission. Report of the Commission Appointed by Act of Parliament to Enquire into the Operations of War in Mesopotamia, together with a Special Report by Commander J Wedgwood, DSO, MP, and Appendices. London: HMSO, 1917.' [‎47v] (94/248)

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PART X.—MEDICAL BREAKDOWN.
F. Supplementary.
113 Similarly the device of eking out insufficient hospital accommodation by using
the field ambulances as hospitals might have been less reprehensible, if it had been possible
promptly to send all field-ambulance patients down river when necessary. But the
inadequacy of transport upset all certainty of the proper evacuation of the field
ambulances, with the result that they became congested with patients. In fact, the
known lack of river transport accentuates, but does not excuse, the unwisdom of
resorting to this practice.
114. Even in the case of the ambulances of the reinforcing divisions from France left
behind at Basra, the difficulties of insufficient transport might have been largely overcome
if the authorities in Mesopotamia had at an early date explained the situation to the
authorities despatching the reinforcements, and had asked for the field ambulances to be
sent on in advance so as to provide sufficient time for their conveyance to the front. But
this was not done ; and the omission is significant of the prevailing lack of foresight and
organisation. Even in such an obvious matter as detailing an embarkation officer to see
to the proper despatch of medical equipment, stores, etc., nothing was done till quite
late in the campaign, and there are numerous instances of such equipment having failed
to reach its destination, owing to the packages being insufficiently labelled or improperly
packed in the steamers.
]15. That the lack of ordinary river transport was not the principal cause of the suffer
ings of the wounded is also proved, as Sir Beauchamp Duff points out, by the great improve
ment which is noted by the Vincent-Bingley Commission and other witnesses m March,
1916. At that time the amount of river transport was proportionately no greater than it
had been during the breakdown after Ctesiphon and Sheikh Saad ; but the organisation
had been improved and the personnel had been increased, with the consequences that the
sufferings of the wounded were very materially decreased. We are convinced that very
much of the avoidable sufferings of the sick and wounded in Mesopotamia was due, not so
much to lack of ordinary river transport as to the lack of organisation and foresight.
The difficulties of river transport were present from the first and should have stimulated
the prevision and resourcefulness of the medical authorities ; but instead, as we have seen,
they remained supine, until galvanised into unavailing action by the disasters which at
once disclosed their incompetence and aroused their fears.
Frequent Changes in Occupancy of Office of D.M.S. India.
116 Between the summers of 1914 and 1916 no less than four individuals have held the
post or administered the duties of D.M.S. in India—wz., Sir W. Babtie, Surgeon-General
MacNeece, Sir Pardey Lukis and Surgeon-General O’Donnell. Few systems of administra-
tioiC even’if good in themselves, could in time of war sustain the strain of such rapid dis
location of supreme authority.
Responsihility for Provision of Medical Necessities.
117 It has been made clear to us that, according to the existing system and regulations,
the higher military medical authorities themselves only directly provide doctors, nurses,
instruments drugs and dressings. All other things required for the medical treatment
of the sick and wounded, or for their transport (many of these special to the medical service)
have to be provided by and obtained from other departments often busy with the needs
of combatant branches.
118. It is well known that the scientific treatment of sick and wounded has advanced
by leaps and bounds of recent years, and we need not argue that any appliances or arrange
ments tending to assist or accelerate the healthy restoration of those in hospital to the
Army or to civil life, are of national importance. The question, therefore, suggests itself
whether the higher medical authorities should not in future be given greater responsibility
as regards the purchase and provision of these matters. It is true that the Mesopotamia
Campaign has not redounded greatly to their credit, but at the same time, it is clear that
their difficulties were increased by the failures of other departments. We refrain from
' making a definite recommendation on this matter, recognising that very considerable
experience elsewhere than in Mesopotamia is now available for guidance, but we think the
time is ripe for the re-examination of the practice that has obtained hitherto, and that the
1 distribution of responsibility amongst four departments, each of whom has to provide
something, without which the contributions of the other three may be rendered futile,
is an unwise application of collective effort.