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The Hawley Board and the establishment of the Air Force Medical Service

  • Published
  • By Dr. Joseph Frechette, Ph.D.
  • Air Force Medical Service History Office
The Air Force Medical Service celebrates its 72nd birthday on July 1 thanks in part to the “Hawley Board” and the “Hoover Commission,” the earliest joint panels that advocated for greater centralization within the Military Health System while also providing venues for ideas in favor of a separate medical service.

The National Security Act of 1947 provided for a separate Air Force within the National Military Establishment, but at the time, the Army, led by General Dwight D. Eisenhower, was clear that it would be adamantly opposed to the creation of separate technical services, including a medical service, within the nascent Air Force.

Despite misgivings that this would keep the Air Force dependent on the Army, General Carl Spaatz and the Air Force leadership conceded that, “the Air Force will not set up additional technical services as an immediate result of unification,” as a necessary compromise.

In early 1948, however, Secretary of Defense James Forrestal appointed a joint committee that included the Surgeons General of both the Army and Navy and the Air Surgeon, Maj. Gen. Malcolm C. Grow, and was chaired by the eponymous Dr. Paul R. Hawley to study and make recommendations concerning the military medical services. It was no surprise that Grow seized his chance to advocate before the board in March 1948 for a full-fledged Air Force Medical Service. Perhaps more surprising at first glance was the fact that Hawley, who was a retired major general and had served as the European Theater of Operations Surgeon in World War II, addressed the current arrangements between the Air Force and Army even before Grow’s presentation by noting, “I would say, being neutral in this completely, that they need not necessarily be bound by that if they can evolve something better.”

Concurrent with these developments, President Truman convened the Commission on Organization of the Executive Branch of the Federal Government chaired by former President Herbert Hoover, the “Hoover Commission,” in order to recommend improvements throughout the executive branch. The Hawley Board actually functioned as the Subcommittee on Armed Forces Hospitalization of the Commission’s Committee on Federal Medical Services. While Grow lobbied the relevant committees, it is also worth noting some points in the Committee on Federal Medical Services’ formal report to the commission. It specifically rejected a unified medical service for both the Army and Air Force and argued that the Air Force should be given the right to operate its own medical service, noting that, while unification might be efficient, it was impractical, and that “the structure of military medicine must conform to the organization of the National Defense Establishment.” It approvingly quoted a passage in Hawley’s subcommittee report that “the medical service of an armed force is a necessary and integral part of that force. To separate it from the force is largely to destroy its usefulness.” While a good deal of additional wrangling and staff work remained before the establishment of the Air Force Medical Service on 1 July 1949, Hawley and his board provided crucial input that aided the process.

At first glance, it might seem incongruous that Hawley, who had retired from the Army as a major general, might be an ally in the establishment of the AFMS. It may be worth noting that, as the theater surgeon for the European Theater of Operations in World War II, he had been favorably impressed by aeromedical evacuation as the preferable method for movement of casualties out of the war zone, an effort that Grow had been very much involved in as the U.S. Strategic Air Forces in Europe Surgeon. Personal connection or experience with large-scale successful aeromedical operations may have made Hawley sympathetic to an organic AFMS. It may also be worth noting that readiness was paramount. As Hawley’s subcommittee report to the Hoover Commission put it, “The most important responsibility of a medical service in peace is constant readiness to support its parent force in war.”