In the Spring of 1916, Sir Alfred Keogh called for forty women doctors to replace men in the hospitals of Malta. It was already a well-known fact that the soldier and the woman doctor were compatibles, and the outcry which had greeted the establishment of the Military Hospital, Endell Street, was not repeated. Out of her experience as an army surgeon, Dr. Garrett Anderson wrote to those who were engaged in recruiting these doctors, urging that an effort should be made to secure temporary rank as officers for them, and that they should ask to be formed into a uniformed corps attached to the R.A.M.C. She pointed out that as they were proceeding abroad and were to be distributed among the various hospitals, they would be working with R.A.M.C. officers, and that they would be at a disadvantage professionally if they had not the same status and position as their men colleagues.

Her advice was not taken, and the medical women left England in mufti. They were not graded, nor paid at officers’ rates, but were given a flat rate which made no allowance for seniority. These terms, once accepted, were imposed, in spite of protest, upon all the medical women—except those at Endell Street—who subsequently served in hospitals and camps at home or abroad under the War Office. They did fine work in Malta, Egypt, Salonika, India, and in France with the Q.M.A.A.C. At least four hundred of them gave of their best in the service of the sick and wounded, carrying on courageously and generously, although the conditions under which they had taken service often proved difficult and humiliating.

The Army’s need of women’s service grew greater every day, and the War Office was forced to consider the necessity of introducing them widely into hospitals and camps, as dispensers, storekeepers, cooks, and motor-drivers. In November 1916, a deputation of Red Cross ladies, headed by Dame Katherine Furse, visited the Doctor-in-Charge, to inquire into the work done by women who had replaced men at Endell Street, and to discuss the formation of a new section of V.A.D.’s for general service. The uniform of the Women’s Hospital Corps was highly approved by the deputation as a practical service dress, and when a letter was received asking for the name of the maker, the Doctor-in-Charge thought it advisable to request in writing that it might not be too closely copied. In her reply Dame Katherine Furse wrote:

The writer went on to ask questions as to the physical fitness of women for the work it was proposed that they should do.

The Doctor-in-Charge was also asked to give evidence before a Committee of Enquiry which met in December under the auspices of the Board of Education, with a view to determining the capacity of women as substitutes for men. She was actively questioned by the members of the Committee on the subject of stretcher-bearing by women, and offered to arrange a demonstration, so that they might see how well-trained women could acquit themselves in this work.

A few weeks later, Dr. Chalmers Watson, C.B.E., engaged in the organisation of the Q.M.A.A.C., and many long talks over formations and detail were held in the doctor’s sitting-room upstairs, when Dr. Chalmers Watson’s ideas on uniforms and her views on discipline and regulations came in for some friendly criticism. It was at Endell Street, too, that she and Dame Helen Gwynne Vaughan were first made known to each other, and it was from the same quarter that she drew some of the early members of her corps. In the desire to help the new service, the Doctor-in-Charge set free Miss Ethel Thomas, the Steward, and Miss Doreen Allen, the Assistant Steward, that they might take administrative posts in the Q.M.A.A.C. Afterwards she always maintained that their success in that corps was due, not so much to their own ability and exceptional qualities, as to the training which they had received at Endell Street.

Dr. Chalmers Watson steered the Q.M.A.A.C. through the shoal of vexatious delays and difficulties which beset its early days with great skill, and she and Dr. Laura Sandeman made a gallant struggle to procure for the women doctors serving with it a position and terms equal to those granted to men.

The first detachments of Q.M.A.A.C. were hurried overseas in the early summer of 1917, and as was only natural, a demand for hospital accommodation arose almost at once. In August, the Deputy Director of Medical Services, finding himself at a loss how to meet this demand, approached the Doctor-in-Charge and asked whether Endell Street could make temporary accommodation for women returning from France. The arrangement of the building did not lend itself easily to this purpose, but his request was met most willingly, and the top floor of one of the blocks was made ready for their reception. The situation was complicated by an order from the War Office to set aside two beds for officials of the corps.

At first a little room on the Women’s floor was adapted for these ladies; but an order was shortly received to make room for women requiring to be segregated, and the little room was no longer available for general use. Small rooms on other floors were very seldom empty, and in these circumstances the only beds which could be offered to officials were those in curtained cubicles in the general ward, which were used in sickness by the Sisters of the hospital. The ladies objected to this accommodation even temporarily, and they were certainly entitled to better quarters; but they were apt to lay the blame for a situation over which it had no control on the hospital, instead of on the Army Medical Department. After frequent representations from the Doctor-in-Charge, extending over nine months, instructions were given for the reception of officials elsewhere; but in the meantime irate administrators, arriving in the middle of the night and refusing to make use of the only empty bed in the hospital, were sometimes a real difficulty.

The Q.M.A.A.C. Hospital at Isleworth was not opened till the end of January 1919, and the ‘temporary accommodation’ at Endell Street was required for more than two years. The other women’s services found it convenient to use it, and members of the G.S.V.A.D., the W.R.N.S., N.A.C.B., W.R.A.F., and W.L., found a resting place there. Ladies were admitted from overseas and the East, with babies, nurses, governesses, and occasionally husbands; while, under the heading of ‘civilians,’ women who were working in France with the Y.M.C.A., the Soldiers’ Christian Union, the Expeditionary Force Canteens, the Lena Ashwell Concert Parties, and officers’ wives and servants, were also given hospitality.

While this development in the women’s services was proceeding, the Government was making increasing demands upon medical women, and was introducing them in greater numbers into the hospitals at home and abroad. In August 1917, a cable from Lady Chelmsford reached Dr. Garrett Anderson, asking to be informed as to the terms of appointment of doctors at Endell Street, and this was followed by a letter from the Secretary of the Central Committee of the Countess of Dufferin’s Fund at Simla. She stated that it had been decided ‘that one of the large military hospitals in Bombay should be handed over to women doctors,’ and she asked for information and suggestions which might be helpful in organising it. The reply sent gave details of the Endell Street establishment, and urged that the women should undertake the ‘entire control and management’ of the hospital. It advised, on grounds of economy, that women should be employed as quartermasters and storekeepers, spoke of the ease with which discipline could be maintained by women, and of the help which a good warrant officer could give.

The Indian hospital was established on one of the finest sites in Bombay; but the charge of the hospital was vested in men, a Colonel and a Registrar being appointed, although women doctors could have filled these posts. The professional work, however, was in the hands of women, and they made an undoubted success of it. In 1919 when men were brought home from India in large numbers, some who had been in the Women’s Hospital at Bombay came to Endell Street. They said it was ‘the only good hospital they had been to in India,’ and spoke of it and of its doctors with great appreciation and pleasure.

A request for information and help came from medical women in America during 1918, enclosing a copy of a resolution which the Women Physicians of California were sending to their Government. The resolution urged

As a result of this petition, the American War Department communicated with the British War Office, asking a number of questions concerning the employment of women doctors. The right hand of the War Office never seemed to know what the left hand was doing, and three separate staff officers, each armed with notebook and pencil, called on three separate occasions to obtain the information which the American Government required from the Doctor-in-Charge.

Doctors working for the Army in isolated posts wrote to Endell Street to tell of difficulties or grievances arising out of their anomalous position. They were doing the work of officers and were supposed to exercise the authority of officers, yet they were not officers. In some cases, they were refused first-class travelling warrants and were furnished with third-class ‘as for soldiers’ families,’ while their R.A.M.C. colleagues and the nurses were issued with the former. Or, on the ground that they were ‘civilian women,’ the right to drive in an army motor-car would be withheld from them; or they would be excluded from the officers’ mess.

One wrote from East Africa, stating that her position had been excellent under a C.O. who allowed her to wear a captain’s badge of rank, but that his successor had ordered her to remove it, and she was therefore a discredited person in the hospital to which she was posted. Women working under R.A.M.C. colonels in R.A.M.C. hospitals were at the mercy of the wisdom or the prejudices of the officers-in-charge, and the pin-pricks and little indignities to which they were often subjected were very unfair. They were volunteers, in the best sense of the word, and if their services were accepted at all, no difference should have been made between them and the men they worked among.

In a women’s unit, internal difficulties like these did not arise; but the officer-in-charge of a military hospital is required to deal with small offences; and when the Doctor-in-Charge ‘admonished’ defaulters, she was conscious that her authority would have been greatly strengthened if she had been wearing the badges of a lieut.-colonel. In the casualty room, where men might not recognise a woman as an officer, the doctors were sometimes placed at a disadvantage; but the good feeling of the N.C.O.’s and the support which they gave to their medical staff avoided any real trouble.

Urged thereto by the President of the Medical Women’s Federation, Dr. Garrett Anderson and Dr. Flora Murray took up the question with the War Office, and asked for honorary rank or commissioned rank for women doctors serving with H.M. Forces. The Department refused, but it was interesting to find that many individual officers could see no objection to rank being held by women.

During the weeks of tension and anxiety which preceded the armistice, no further action seemed possible; but shortly after that event, the medical staff was unanimously in favour of reopening the matter. The campaign started with a letter from Dr. Garrett Anderson to The Times. But the Editor suppressed the correspondence which followed, and the doctors therefore circularised the House of Commons. A leaflet entitled ‘Bricks without Straw’ was sent out to all Members of Parliament in November 1918. It stated the disabilities complained of by medical women serving under the War Office, and called attention to the action of the Income Tax Commissioners, who had refused their claim to be assessed at the service rate.

Women had been recently enfranchised and the General Election was approaching. The circular received a large and sympathetic response. One member wrote:

Other members wrote:

And:

And:

Altogether sixty-two Members of Parliament gave definite promises of support and many others expressed a desire to help. Questions were asked in the House; and the amount of sympathy and interest evinced by Members were astonishing to those who made the usual official replies. It was, however, too late in the session to do more. Parliament was on the point of dissolving, and every one’s thoughts were concerned with the coming election.

When the new House of Commons met in February 1919, the Prime Minister and Mr. Bonar Law were pledged ‘to remove all existing inequalities of the law as between men and women.’ The doctors circularised the new House without delay, desiring to obtain consideration for their requests before the new Army Act and Finance Act were drafted. The documents forwarded to Members were entitled: ‘Memorandum on the position of Women Doctors serving under the War Office,’ and ‘Application for Relief under Service Rate of Income Tax by Women Doctors serving the War Office.’ The first requested that legislation might ‘be introduced under the New Army Act to enable women doctors serving under or attached to the War Office to hold Commissions.’ The second asked for an alteration in the wording of the Income Tax Act.

In 1915–16, the doctors had claimed to be assessed under the Service Rate of Income Tax, quoting Schedule E, page 2:

The Surveyor of Taxes, however, disallowed the claim, though he could give no reason for doing so. The matter was referred to the Secretary of the Board of Inland Revenue in 1916–17, and without giving any reason, he also informed them that they were not eligible for the special rate of tax. In 1917–18, an appeal was heard by the Income Tax Commissioners, who decided that ‘on the wording of the Section relief could not be granted,’ and advised them to spend a large sum of money in making an application to the High Court. All these persons were profuse in expressions of sympathy, which were naturally irritating to women who were only asking for justice. The application to Parliament made a point of asking that relief might be made retrospective over the years 1914–1919. This appeal to the House of Commons met with far less response than the first one had done. Members who had written almost gushingly before the general election, forgot to reply at all; others thought that everything had been done which could be done, or pointed out that the War was over; and when unsatisfactory replies to questions were received and friends moved the adjournment of the House, sufficient support was not forthcoming.

The women were supported by the British Medical Association. The matter had been brought before the Naval and Military Sub-Committee, and its members had been unanimously in favour of commissioning medical women.

Although the first point was not conceded, the second was, and the new Income Tax gave women doctors relief under the Service Rate, and allowed them to claim to be refunded, as from the year 1915–16. The staff at Endell Street had learnt to look upon Surveyors and Commissioners as ‘oppressors of the poor,’ and it was with genuine satisfaction that they forwarded to these sympathetic gentlemen claims for abatement and refund.

In the autumn of 1919, an official circular letter invited the commanding officers of all units and formations to suggest ‘amendments’ to the Army Act. This gave the Doctor-in-Charge a last opportunity of pleading for equality for women and men, whether as medical officers, nursing orderlies, general service orderlies, clerks, or storekeepers. And it enabled her to propose the formation of a reserve of women organised on territorial lines and available in future emergencies.

Whether her draft ever reached the War Office, or whether it was buried in some waste-paper basket on the way, is not known.