Royal Navy Medical Service

The Royal Navy Medical Service (RNMS), also termed the Royal Naval Medical Service is the branch of the Royal Navy responsible for providing 'comprehensive healthcare to ships, submarines and Royal Marine personnel at sea and on land'. It includes within its remit of responsibility Queen 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 and the present incumbent is Commodore Alison Hofman.

The history of the service can be traced back to 1692 when treatment for sick and wounded naval personnel was administered by the Commissioners of the Sick and Hurt Board (a subsidiary body of the Navy Board) until 1806, when medical officers of the Royal Navy had been under the direction of the Transport Board. In 1817 the Transport Board was merged with the Navy Board, and responsibility for medical officers passed to the Victualling Board.

In 1832 the Navy Board and the Victualling Board were both abolished (following recommendations by the First 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) was appointed Physician-General of the Navy; as such he had charge of the navy medical department and reported directly to the Board of Admiralty. The title of his post was changed to Inspector-General of Naval Hospitals and Fleets in 1841, and was again changed in 1844 to Director-General of the Medical Department of the Navy. In 1917 following further re-structuring within the Admiralty Department it became known as the Royal Navy Medical Service headed by Medical Director General of the Navy, also known as the Medical 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 in Somerset House. In the 1860s, along with the other Civil Departments of the Admiralty, it was removed from Somerset House to Spring Gardens (where the Admiralty Extension now stands); 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 the Junior Naval Lord.

In the early 1960s, with the establishment of the Ministry of Defence in place of the Admiralty, the Medical Director General and his staff moved into the Empress State Building. In December 1984 he moved, with a reduced staff, into a new combined Defence Medical Services central headquarters building in First Avenue House, High Holborn, which had been established with a view to bringing together the three medical services under a single administrative head (the Surgeon General); (albeit, in spite of expectations to the contrary, 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 in HMNB Portsmouth as part of the relocation of the Second Sea Lord and various directorates from London to Portsmouth.

From the early days of the Royal Navy, surgeons had been carried on board ships (albeit intermittently, depending on the length of voyage and likelihood of hostilities). In the Tudor period, surgeons were regulated by the Company of Barber-Surgeons. William Clowes, sometime Warden of the Company, and his colleague John 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 as physicians 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.

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. 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 their surgical instruments and medicine chest prior to their departure. As well as a surgeon, each fighting ship was provided with one or more surgeon's mates (depending on the size and rating of the vessel). Surgeon's mates were recruited from the age of sixteen. A junior rating assigned to assist the Surgeon and mate was known as a loblolly boy.