RAAF Crest

RAAF Medicine
Official History

The following quotations are taken from
Australia in the War of 1939-1945 - Medical (Series 5)
part of the 22-volume official history of Australia's involvement in World War Two
As well as direct mention of Group Captain Lawrence
they provide context to his work with the RAAF.

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The Move for Amalgamation - Between the Wars

The Move for Amalgamation

From: Australia in the War of 1939-1945
Medical (Series 5 Volume II) Middle East and the Far East
Chapter 1 The Inter-War Period, 1919-1939 written by Allan S. Walker from pp. 6, 9 and 18.

Page 6

During 1922 a wider field of service medical organisation was opened. The general subject of coordination had been in the air for a long time, even before the 1914-1918 war. In 1909 Mr Asquith, speaking in the House of Commons on the functions of the Defence Committee, stated that in all countries of the world, and in particular in Britain, the necessity was felt for coordination of the work of the army and navy. This general statement no doubt expressed in a general way the ideals of those interested in defence, but in addition there were many advocates of a high-level unification of control.


In 1922 the interest was crystallised by the holding of a coordination conference to examine the desirability or otherwise of amalgamating the f medical services of the Australian Navy, Army and Air Force. Representatives of the Naval, Military and Air Boards considered those activities of the three arms which possibly could be coordinated or even brought under unified control. This conference recommended that there should be a single Australian Medical Corps, with a single administrative medical section the head of which would be responsible through heads of the individual services to the boards concerned. Mechanism was suggested to ensure that technical advice would carry full weight. In March 1922 the conference expressed the opinion that such amalgamation was both feasible and desirable. The service heads concerned, Major-General Sir Neville Howse, Surgeon-Captain E. T. P. Eames and Squadron Leader A. P. Lawrence stated that past experience had shown that efficiency and economy had not always been served, owing to the disadvantage of the medical branches of the navy, army and air force "competing in open market and working in water-tight compartments with all the attendant friction and difficulties".


In July 1922 the minister approved of the plan for amalgamation, and preliminary directions were given to prepare the three services for the change. But, though there was a suggested unanimity among the service representatives, the heads of the naval and air force medical services were opposed to the idea of amalgamation, and held that though funds might be saved, efficiency would suffer. The influence of Howse and the minister exerted enough pressure to confer approval on the scheme, but there the matter rested, more or less in suspense.


Page 9

Before the end of 1927, a joint committee had met at the instance of the Department of Defence, representing all medical services, with the task of examining the suggestions made in the War Book. The chairman was Major-General G. W. Barber, D.G.M.S., members were Dr J. H. L. Cumpston, Director-General of Health, Surgeon-Captain L. Darby, R.A.N., Director of Naval Medical Services, Lieut-Colonel Wynter, Director of Mobilisation, and Squadron Leader A. P. Lawrence, Director of the R.A.A.F. Medical Services. This committee which first met on 9th December 1927, favoured the joint acquisition of medical stores by the three medical services to meet their requirements, though the R.A.A.F. representative disagreed, considering that his service should be empowered to make independent arrangements for medical supplies. The importance of maintaining reserve stocks in time of peace was stressed, and to this end the minister was advised that quantities of supplies not obtainable from Australian sources should be imported, and that local production of medical material not yet produced in Australia should be stimulated. The committee recommended that a system of control and rationing of medical supplies should be prepared which could be put into effect if necessity arose. Such control would not be exerted without sanction of the Government, and would be imposed equally on the requirements of the services and the civil population. The War Book suggested that control of medical supplies in emergency should be vested in a committee presided over by the Director-General of Health and including representatives of each of the defence medical services and of the medical profession, with a combatant officer. The committee however, recommended that these and other powers be placed in the hands of the Department of Health, giving it unfettered authority. The effect of this would be far-reaching, as this department would then be responsible for


(1) preparation in peace of schemes for controlling the medical profession and medical supplies,
(2) the putting of these plans into effect in case of war,
(3) recommendation to the Government of estimated requirements for reserve stocks of medical supplies in peace and special importations of them on the outbreak of war,
(4) arranging for acceleration and increase of local production of medical supplies in Australia.


This method of control proved to be a most contentious matter, particularly with regard to the control and disposal of doctors both for the services and the civil community. However, this report was approved by the Minister for Health, and a second committee was appointed to discuss mobilisation of the medical resources of the Commonwealth in time of war. Dr Cumpston presided, General Barber and Lieut-Colonel Wynter represented Defence and Dr Downes the medical profession. Dr F. W. A. Ponsford and Major V. P. H. Stantke also attended. The numbers of medical officers likely to be required in the event of a full scale war were estimated, and it was apparent that mobilisation would cause so great a dislocation of the medical services of the community that.......


Page 18

In October 1935 a move was made to coordinate the supply of medical, surgical, dental and veterinary supplies for the whole community in the event of war. An army committee was in existence known as No. 7 Supply Committee (Food and Drugs), part of the organisation of the principal supply officer, and this was asked to examine the position. Coopting the D.G.M.S., the Director of Veterinary Services (Lieut- Colonel L. C. Whitfield) and the D.D.M.S., R.A.A.F. (Group Captain Lawrence) this body concluded that six months' supply of surgical instruments was held by the army, all but nine items of necessary equipment were held either by the trade or could be locally made, and dental supplies were sufficient. Ordnance held 2,900 stretchers. The position about X-ray equipment was not very good: much apparatus was required, some of which would have to be imported. The committee recommended that the Supply Board place dormant orders in the United Kingdom for filling on the outbreak of war.


So far then, preliminary arrangements were made to secure adequate medical supplies in the event of war, but it was evident that a. much more specialised body than the No. 7 Supply Committee would be needed. Should war break out it was evident that requirements would increase and stringency of supplies become more pressing, and the problem of coordination of control had not been touched.


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Between the Wars

From: Australia in the War of 1939-1945
Medical (Series 5 Volume IV) Medical Services of the RAN and RAAF
Chapter 19 Between the Wars written by Allan S. Walker pp. 173-177.


THE Royal Australian Air Force, developed from the Australian Flying Corps, which until 1921 was part of the Australian Army.1 At the end of the 1914-18 War the A.F.C. comprised three squadrons in France and one in Palestine. All units were disbanded when they returned to Australia, but in 1920 it was decided to raise some of them again to form an Australian air force. This was done in the following year. The new Service, which was based on Point Cook, Victoria, was named the Royal Australian Air Force, and on 1st September 1923 the Royal Assent was received to the Air Defence Act which gave the R.A.A.F. status equal to that of the Royal Australian Navy and the Australian Military Forces.


The medical service of the R.A.A.F. had a modest beginning. It was housed in a small hut which served as sick-quarters at Point Cook, and its sole medical officer was Squadron Leader A. P. Lawrence. Lawrence, who had served in the Australian Army Medical Corps in the war just ended, was appointed to the new air force hi July 1921.


In addition to performing his normal duties as a medical officer, Lawrence began to take an interest in aviation medicine. He was particularly interested in the selection of recruits for flying training, and in die problems of high-altitude flying. In this latter connection he observed very closely the post-flight reactions of Flight Lieutenants A. T. Cole and H. F. De La Rue, who, without supplementary oxygen, flew a DH-96A to a recorded altitude of 28,000 feet. (The height reached was probably rather less than this, as the altimeter was not checked or corrected for high altitude recordings.) Lawrence noticed, when the aircraft reached the ground, that De La Rue was very cyanosed, and that both pilots showed other signs of recent oxygen lack. Both were somewhat unwell for a few days afterwards. Lawrence also wished to observe his own reactions at high altitudes, and he persuaded Squadron Leader W. H. Anderson to take him up for the purpose. This flight was again made without supplementary oxygen. At a recorded altitude of 22,000 feet Lawrence noted in himself signs and symptoms of considerable oxygen lack, and realised that he was incapable of making accurate observations. These rather haphazard experiments can be said to mark the beginning of work in aviation medicine in Australia.


By 1922 the air force had expanded somewhat, and the need was felt for a medical officer on the headquarters staff at Victoria Barracks, Melbourne. Squadron Leader Lawrence was given this appointment with the title of Director of Air Force Medical Services. The post of medical officer at Point Cook was filled by Dr G. F. Cherry who had the rank of flight lieutenant. Squadron Leader Lawrence had only a small staff, and the Director-General of Army Medical Services advised him that until the air force expanded further it was proposed, for the sake of economy, to use existing army machinery as far as possible.


In 1922 a conference was held, with the Chief of the General Staff as chairman, which considered among other matters the question of the amalgamation of the naval, military and air medical services. After this, a sub-committee was appointed consisting of Surgeon Captain E. T. P. Eames, the Director of Naval Medical Services; Major-General Sir Neville Howse, Director-General of Army Medical Services; and Squadron Leader Lawrence. This sub-committee, under the strong personal influence of Howse, recommended to the Minister for Defence on llth July 1922 that one medical corps should provide the medical service required by the three defence forces. The chiefs of the naval and air force medical services were not, however, enthusiastic about the plan, and it remained in abeyance until September 1925, when the Minister for Defence ordered the conference to reassemble to advise further on the proposal to amalgamate the three medical services. The First Naval Member, Rear-Admiral P. H. Hall-Thompson, circularised members of the conference, objecting to amalgamation on the grounds that it was impracticable, and offering as an alternative close cooperation between the three medical directors. Squadron Leader Lawrence also prepared a statement for the Air Board, withdrawing his agreement to the recommendations of the original subcommittee and advocating cooperation instead of amalgamation.


The conference met on 9th November 1925. It decided that amalgamation was not feasible, and a sub-committee was appointed to suggest means of improving the administration of the three medical services. It consisted of Colonel T. J. Thomas, chairman, and the three directors of medical services—Surgeon Captain C. A. Gayer Phipps (navy), Major- General G. W. Barber (army), and Squadron Leader Lawrence (air force). The sub-committee submitted a report on llth November 1925 advocating cooperation, while a minority report by the Director-General of Army Medical Services pressed for amalgamation.


The Directors of the Naval and Air Force Medical Services considered that amalgamation would lead to inefficiency without resulting in any substantial economy. They contended that each of the Services had medical problems peculiar to itself, and that each should therefore continue to have its own directorate. They suggested that the Service boards should organise the existing directors into a Defence Medical Advisory Committee, to meet at least quarterly but more often if necessary, for the purpose of considering medical matters of common interest. The proposed committee, as its title implied, would be purely advisory, and its proposals would be subject to ratification by the Service boards concerned. Phipps and Lawrence pointed out that the Director-General of Army Medical Services, while adhering to his preference for unification and considering it quite feasible, nevertheless conceded that the proposed scheme would be an improvement on existing conditions. It would, moreover, be in general accordance with the principle laid down in the Manual of Combined Naval, Military and Air Force Operations (1925), subscribed to by the British Admiralty, Army Council and Air Council. The proposed committee would examine the entire field of naval, military and air force medical activities, from time to time,formulating proposals for improvement and suggesting the administrative arrangements necessary to give them effect.


The two medical directors instanced three items to which the committee, if appointed, might be asked to give immediate attention. These were: (i) hospitals on land; (ii) shore personnel; and (iii) medical stores. In the case of the first, there did not appear to be any objection in principle to the hospital accommodation and facilities of any one of the Services being available to the other two. There was, of course, the difficulty of location. The naval hospital at Flinders, the army hospital at Queenscliff and the air force hospital at Point Cook were each so located as to be of little potential use to the other two Services. But should an army casualty occur near Flinders or an aircraft crash in that vicinity, then the Flinders Naval Hospital could be used by the army or air force, and in the same way the army and air force hospitals would be available to the other Services. The army was not organised for operations north of the Tropic of Capricorn, and the war preparations of the navy might therefore contemplate the provision of a hospital ship in the waters to the north of Australia which would be available to the other two Services, but south of the Tropic of Capricorn the navy would look to the army and air force to provide it with hospital accommodation on land. It might also be possible for some coordination to be effected between the navy and air force in the northern part of Australia. The establishment of a Defence Medical Advisory Committee charged with the duty of bringing about coordination would ensure, it was stated, that all medical matters of common interest were carefully investigated, and would thus avoid any hiatus or, conversely, any overlapping either in the peacetime activities or the war plans of the three Services.


The sub-committee's report was considered by a Royal Commission on Health (1925), along with a separate submission by Major-General Barber, who detailed an administrative plan for coordination rather than amalgamation. The Royal Commission recommended that:


(1) the medical services of the Repatriation Commission should remain as at present;
(2) the medical services of the army, navy and air force should be coordinated under one director-general, with a sub-director in each Service;
(3) a consultative board should be established, consisting of the Director-General of the Defence Medical Service, the Director-General of Health and the Principal Medical Officer of the Repatriation Commission, to devise methods and means of cooperation between the medical services.


The Minister for Defence considered this report, and in September 1927 ruled that the Director-General of Army Medical Services should be responsible to the Air Board for the administration and control of medical and dental services in the R.A.A.F. from 1st October 1927. The Air Board submitted a minute to the Minister in November, protesting against the decision, but the Minister gave instructions that his ruling was to be put into effect immediately. As a result, Standing Orders for the R.A.A.F. Medical Service were produced by the Director-General of Army Medical Services. Wing Commander Lawrence's commission in the Permanent Air Force was terminated on 24th September 1928, and next day he was appointed to the Citizen Air Force, still with the rank of wing commander, to be part-time Deputy Director of Medical Services (Air).


When the Director-General of Medical Services assumed control of the R.A.A.F. Medical Service it consisted of two full-time medical officers, flight lieutenants with short-service commissions, stationed at Laverton and Point Cook; and several Citizen Air Force medical officers, flight lieutenants who did part-time duty at Richmond and in camps with the Citizen Air Force squadrons at week-ends. There was also one full-tune dental officer on a short-service commission who worked at Laverton, Point Cook and at Headquarters in Melbourne. In December 1928 the following officers held appointments:


Wing Commander A. P. Lawrence (C.A.F.): D.D.M.S. (Air)
Squadron Leader R. B. Davis (C.A.F.): D.A.D.M.S. (Air)
Flying Officer J. J. Swift: Medical Quartermaster
Flight Lieutenant W. D. Counsell: Medical officer, Point Cook
Flight Lieutenant E. A. Daley: Medical officer, Laverton
Flight Lieutenants S. C. Steele and G. P. Arnold (C.A.F.): Part-time medical officers, Richmond


During the next two years the gradual growth of the air force and the special nature of the problems of aviation medicine, in particular those met with in assessing the fitness of recruits for flying duties, necessitated the appointment of further full-time officers on short-service commissions, and also, in Sydney and Melbourne, of part-time specialists, both physicians and surgeons.


The air'force was reduced in size during the economic depression of the early nineteen-thirties, but in 1933 the reverse process began and in the estimates of 1935-36 there was provision for considerable expansion. Further appointments of full-time medical officers on short-service commissions were made, including one at Richmond; the senior permanent medical officer, Squadron Leader Daley, now divided his time between the Medical Directorate, where activity was increasing, and his duties at Point Cook.


Sick-quarters had been established at Point Cook, Laverton and Richmond, where ordinary sick parades were held, and medical attention given to members of the air force and to their wives and families living on the stations. Preliminary surgical treatment was also given in the case of accidents. Nursing was carried out by male orderlies. If major hospitalisation or special investigation was required, the hospitals of the Repatriation Commission were used.


There had been no direct liaison between the R.A.A.F. and the R.A.F. on questions of air force medical organisation since 1924. With rapid developments taking place in this field, it seemed desirable that a definite link should be established, but the fact that the R.A.A.F. Medical Service was administered by a part-time D.D.M.S., who also had his private practice to consider, presented a serious obstacle. The situation was brought to a head when Group Captain Lawrence submitted to the Air Board that he and Squadron Leader Daley should go to England on exchange to the R.A.F. This proposal was rejected by the board, and Group Captain Lawrence tendered his resignation, at the same time recommending that Squadron Leader Daley should be sent. The resignation was accepted, and also the recommendation that Daley should go to England, the intention being that he should gain additional experience before taking up full-time duties as D.D.M.S. (Air).


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