this sort. I haven't been near them. I don't know what they think. I have stayed clear of that. And it was not my original suggestion that something of that sort be done. It was a thought that came to me in response to some question I was asked. Senator ROBERTSON. Mr. Chairman, I want to make it perfectly clear, following Senator Tydings' questions, that nothing in my interrogating should cast any reflection on Admiral Sherman or any admiral or any officer, or the Navy, or those who appeared here. Because I believe that they were all absolutely honest and fair. Senator TYDINGS. Let me interject there, Senator, that I had no intention to put any such words in your mouth. But I thought, in view of the fact that the testimony had taken a rather unusual turn, that we ought to at least get the Navy Department in the position of coming here, representing a pretty fair point of view. Senator ROBERTSON. I agree with you. And I think that the Navy Department has represented the naval concept of this agreement which was signed by Forrestal and Patterson. But I do believe that General Royall's testimony here last Monday stated the Army concept of that letter; and the two do not jibe. Senator TYDINGS. I think you have got something there. The CHAIRMAN. Are there any questions? Senator Baldwin? Senator BALDWIN. I have no questions. The CHAIRMAN. Thank you very much, Admiral. Mr. HART. Thank you, sir. The CHAIRMAN. I believe we will continue with the hearing this morning by having the Surgeons General appear before the committee. Their testimony is comparatively short. If Major General Kirk, Major General Grow, and Rear Admiral Swanson will come forward, we will be glad to hear them. General Kirk, we will hear from you first, if we may. Your statement is very short.* The Chairman wants to comment that possibly later we may want to bring you back, because it is so short. But we have a short time left this morning, and inasmuch as the ball game proceeds this afternoon, I am sure we could not get a quorum. I do not know that the chairman would be here to call the committee to order. So we will let you give your statements, all of you, and at least hold our questions until you have completed them. General Kirk? STATEMENT OF MAJ. GEN. NORMAN T. KIRK, SURGEON GENERAL, UNITED STATES ARMY, WAR DEPARTMENT, WASHINGTON, D. C. General KIRK. Mr. Chairman and members of the committee: As General Eisenhower indicated in previous testimony, the provision of adequate medical support is one of the major problems confronting the Armed Forced today, and will continue to be for sometime in the future. Adequate medical support is an absolute essential if the Armed Forces are to fulfill the mission assigned to them in peace and war. Medical support means facilities, supplies, equipment and personnel, including some of the scarcest categories of professional and technical people in the country. Even under the most favorable conditions, the medical service will have to perform its mission in an atmosphere of scarcity rather than plenty, particularly with respect to medical specialists, who are the backbone of the service. The organizational structure of the medical service cannot disre-gard this situation. Under the provisions of S. 758, it is the War Department's plan to follow the Medical Department organization now in operation, and to have all personnel, installations, and activities presently assigned to the air forces continue initially. The Secretary of National Defense, during a period of 2 years, will develop plans and policies for the medical services which are to serve the Armed Forces. The CHAIRMAN. As I stated before you started your prepared testimony, General, that very short statement I know does not cover the questions that quite a few members of the committee have in mind. It does definitely state that the plan under this bill is to continue the Medical Department as it now functions in the Army. I hesitate to discuss these questions, because of the shortness of time, but I think we ought to explore this matter. There was difficulty during the war in getting enough personnel? General KIRK. Yes, sir. The CHAIRMAN. I think you will agree with me on this, and at least I will ask you the question: Do you agree that the Medical Department had difficulty in getting the necessary support sometimes, getting quick decisions, because of the fact that you were not able to go directly to the Chief of Staff? General KIRK. I had authority to go to the Chief of Staff. I had difficulties, as all corps do, under the present organization of the Medical Department, not only in Washington, but in the theaters and in the field. There have been difficulties. The CHAIRMAN. Senator Tydings, do you have any questions? Senator TYDINGS. I do not believe I have any. The CHAIRMAN. Senator Hill? Senator HILL. Of course, under this plan you will continue to serve the Air Forces just as you are serving them today? General KIRK. During the interim period; and the Secretary will determine what the future will be when this unification comes about, and the Air Force becomes a separate organization. That is the War Department's plan. Senator TYDINGS. From a medical standpoint, General, do you consider that this merger bill is a good or bad thing? General KIRK. It will all depend upon how the Secretary sets up the medical service, from a medical standpoint, from the standpoint of the future national defense. There is nothing in the bill that says anything about the medical service. Senator ROBERTSON. General, how do you feel that would have to be set up in order to be satisfactory for operation? General KIRK. Are you asking me a personal question, or as representing the War Department's plan? Do you ask me what I think, or what the War Department thinks? Senator ROBERTSON. I would like to hear what the War Department thinks and then I would like to hear what you think. General KIRK. I have stated the War Department's opinion. Senator ROBERTSON. I would like to hear what you think. You are a responsible officer in that Department. I would very much like to hear what you think. General KIRK. I have prepared a statement here on what I think, if you have time to listen to it. Senator ROBERTSON. I certainly will try to take it for 15 minutes. General KIRK. It won't take me that long, sir. The CHAIRMAN. We would very much like to have that statement, General Kirk, because I value your experience in operating the Medical Corps during the war. I know we are short on medical men, in civilian life as well as in the armed services, and I very definitely feel that we have got to do something in order to be sure we have enough medical men for the armed services, as well as civilians. We would be glad to have your own personal statement. General KIRK. Gentlemen, after having given careful consideration to the problems of providing medical service for the armed forces I have reached the conclusion that there is but one real solution, the establishment of a single, integrated, medical service, and offer for your consideration a plan for such a medical service. I am obligated to inform you that this plan is not in accord with the agreements reached by the Secretaries of War and Navy and approved by the President. It is a plan which I believe is workable. However, I do not wish to propose it as the only solution. I would be willing to go along with any reasonable plan which will accomplish the desired objective, namely, a single medical service. The plan for the organization of an armed forces medical service to provide a medical service to all components of the armed forces and to meet the specific requirements of each force. Initially, the armed forces medical service would be formed from the medical services of the Army and Navy, including their personnel and the medical department facilities now operated by these services. The Armed Forces Medical Service would be commanded by a Dire tor General appointed from the senior medical officers of the Regular Medical Corps of the Army or Navy, to serve on the staff of the Secretary of National Defense and to be responsible to him for advice on the health and medical care of all components of the armed forces. The Director General would prepare policies, plans and directives governing the Medical Service; operate, command, and administer all Medical Department troops and installations not attached to the major forces. Õperations of the Medical Service in the zone of the interior and overseas theaters would be decentralized to Deputy Directors, who would supervise and command the medical services and installations in these regional areas except those attached to a major force. The regional areas or districts would correspond to those set up by the armed forces, such as the six Army geographical areas into which the zone of the interior is now divided. The Armed Forces Medical Service, under the Director General, would be charged with (a) The operation of common hospitalization for the armed forces (all fixed hospitalization) including general, station, and convalescent hospitals in the zone of the interior and overseas departments and in the communication zone in war. (b) The operation of a preventive medicine service, vital statistics, and common sick and wounded records. (c) The operation of a common research and development program, clinical and research laboratories, the Army Medical Library, and the Army Institute of Pathology. (d) Common procurement, storage, and issue of medical supplies. (e) Personnel procurement, officers and civilian employees; technical training and assignment of all commissioned, enlisted, and civilian employees. (f) Organization and technical training of all Reserve components and affiliated medical units. (g) Preparation and defense of budgetary estimates for the requirements of its operations; the construction and repair of all required medical installations. (h) The coordination and direction of evacuation of sick and wounded by air and sea (medical regulator). Each major force would have a Surgeon General, appointed from the Medical Corps of the Armed Forces Medical Service, and such additional attached medical troops and installations as the Secretary of National Defense determined to be necessary for the force commander to perform the medical mission assigned to him. The Surgeon General of each of the three forces would have such a staff as he required to carry out his mission, the attached medical personnel to each to consist of such specialized and nonspecialized personnel and such units as would be required by that force. He would be responsible for the specialized technical and tactical training of the attached medical personnel and for the research and development pertaining to his special needs, e. g.— Surgeon General of the Army: Tactical training of battalion and regimental detachments, medical battalions, medical groups, dispensaries, field and evacuation hospitals. Surgeon General of the Navy: Specialized and tactical training of attached medical personnel for duty aboard ships, including hospital ships; naval air arm, and research and development in connection therewith; dispensary service; evacuation of sick and wounded by ship. Surgeon General of Air Force: Specialized and tactical training of attached medical personnel such as flight surgeons and flight nurses, research and development as it applies to the health of flying personnel, air evacuation of the sick and wounded, and dispensary service. The plan I have presented provides for complete unification of those phases of medical service which are common to all armed forces, and at the same time, provides for the Ground Forces, the Air Forces, and the Navy types of organic medical service completely adequate for their special needs. In showing why I believe that a single medical service for the armed forces is necessary, I should like to begin by stating that I am in complete agreement with the remarks of Senator Thomas of Utah, published in the Congressional Record of March 14, 1947, in which the Senator pointed out that the Medical Departments of the Army and Navy have identical primary missions; that there was in the past war an acute and serious scarcity of trained medical personnel; that parallel systems of hospitalization, evacuation, the procurement, storage, and issue of medical supplies were wasteful in terms of funds, personnel, and efficiency; and that medical service during the war, no matter how good, could have been better had there been a single integrated medical service. If integration of the two Medical Departments would have improved medical service in the war just past, it will be vital in any future war and likewise is vital during the peace that precedes that emergency. There are not now nor will there ever be enough competent trained medical, dental, and nursing personnel available to provide the sick, injured and wounded soldier, flier, sailor, or marine with the type of medical care demanded for them by the people of this Nation, without the strictest economy in the use of that personnel. Even now the Medical Corps of both the Regular Army and Navy are far below their authorized strength and efforts to recruit civilian doctors into these corps have not been successful.. Legislation authorizing increased pay and better promotion may help solve this peacetime problem. In the event of a war of equal or greater magnitude than World War II, there will not be sufficient skilled doctors in the United States to staff three separate medical services. This fact necessitates an organization capable of making the most effective and economical use of all of the medical resources of this Nation. Moreover, another war may well be, and probably will be, total war involving the civilian population of the United States. Only a single unified medical service can plan for and successfully meet such an emergency. When should unification of the medical services take place? It is my deep conviction that it should begin now. If unification is vital to meet a national emergency, it cannot be delayed until that emergency is at hand. Moreover, if no action is taken now to unify the Army and Navy medical services, the Air Forces will wish and may receive authorization for a complete medical service, thus spreading our weak medical resources still thinner, and this at a time, as has been pointed out, when both the Army and the Navy are unable to recruit to their authorized strength. If a plan for the unification of the medical services were put into operation now a certain period would be required before a complete integration could be effected smoothly. Many changes would be required in the present operating procedures of the two Medical Departments, as well as enabling legislation. However, I believe that a completion date 2 to 3 years hence should be specified. In conclusion, I reaffirm my deep conviction that a single medical service for the armed forces is essential to conserve and utilize efficiently the medical resources of this Nation in terms of personnel, supplies, equipment, facilities, and funds, in order that the sailor, soldier, airman, and marine may be assured of the best possible medical care in time of peace or war, and as a guaranty of medical service for the civilian population in event that total war ever comes in this country. |