Select Committee on Defence Second Report


Defence Medical Services

70. There is a parallel to be drawn between the relationship of the RAF to the civil aviation world and that of the Defence Medical Services with the NHS. We reported on the Defence Medical Services (DMS) in November 1999.[134] In that Report, we noted the damaging effects of the excessive rundown of the DMS under Defence Costs Study 15 in the early nineties. As a result, given the critical state of undermanning in the DMS, the government's vision of 'a fully manned, trained, equipped, resourced and capable' DMS was one that showed little sign of being realised rapidly. The Armed Forces' Pay Review Body, in its June 2000 report on Service Medical and Dental Officers,[135] noted our findings and agreed with our view that the critical question was whether the DMS could survive long enough for new measures designed to improve it to have effect.[136] The government is seriously addressing the problem—but coming up with a solution is proving to be an uphill struggle.

71. Progress towards achieving full manning in the DMS has not been inspiring. In June 1999, the total trained Regular requirement for the DMS stood at 8,528—actual manning levels were 6,061. By July 2000, there had been a net increase in manning of 74, to 6,135. In the meantime, the trained strength requirement has increased by 15, to 8,543. In other words, in 18 months the shortfall has been reduced by some 2.5 per cent. Towards the end of last year, the shortfall in trained anaesthetists was 76% (29 were in place out of a requirement of 120); for orthopaedic surgeons was 71% (8 out of a requirement of 28); and for Accident and Emergency specialists was 87% (3 out of a requirement of 23). Only for dentists was the DMS anywhere near its requirement.[137] The requirement on the DMS, for large scale war-fighting operations, is to provide 14 Field Hospitals, three manned by Regulars and 11 by Reservists. Currently, the Regulars could provide half their requirement (one and a half Field Hospitals) and the Reserves might be able to provide two and a half Field Hospitals—a total of four against a requirement of 14 (about 20%).[138] The Defence Medical Services are one area where undermanning remains both chronic and acute. The slow progress made in treating the DMS problem indicate the unlikelihood that general recruitment initiatives will be sufficient to remedy critical shortages in some key specialist areas. We remain to be convinced that these problems are being addressed with sufficient imagination. This is another area where the use of reservist staff will be essential to resolving the problem. Progress has been made, but it is not fast enough.


72. An obvious solution to the loss of trained personnel is to extend the service of personnel due to leave the Services after their 22-year term.[139] The Navy targets specific people in shortage areas and offers them a five- or ten-year 'open engagement'. About 700 people are currently serving on this basis.[140] In the Army, this process is known as 'continuance' and there are 1,100 currently employed in this way, again chosen on a case by case basis. The Adjutant General told us: 'It is doing us a great deal of good in making use of those who have had really successful careers'. In addition about forty per cent of senior warrant officers are offered 'late entry commissions' at the end of their term of service, providing the Army with very experienced junior officers.[141]

73. The Services are also doing more to persuade people that they are needed and to emphasise some of the realities of civilian life. The Second Sea Lord described a retention scheme targeted at operator mechanics who have been in the Navy for about six years, a key time to leave. Offering an additional sum of money to encourage them to stay at this point in their careers has proved 'extremely successful' and 'it is a fraction of the price of recruiting and training their replacements'.[142] The Minister told us of a successful initiative in the Army which involves distributing a pamphlet to those who may be thinking of leaving, setting out the relative benefits of the Services in the immediate and medium term.[143] The commanding officer of an infantry regiment we visited told us of the initiatives he was taking: a warrant officer had been appointed to work on retention and had since persuaded a number of people to stay on by giving them more realistic information, gleaned from frequent employers of ex-soldiers, on such matters as likely rates of civilian pay. The RAF write to those who have indicated their intention to leave, and spell out their career prospects if they were to remain in the Service. The RAF also contact pilots once they have left and invite them to rejoin, which sometimes pays off.[144] These are sensible measures which respond to local needs in an appropriate way. Moves towards extended service might also embrace, in the longer term, a more creative approach to the use of part-time service to meet particular shortages. This is likely to entail developing a career path for part-time personnel, something in which the TA, the RNR (including its air branch) and the RMR are all well ahead of the flying elements of the Royal Auxiliary Air Force.

Tackling the retention problem in the long term

74. The Armed Forces Overarching Personnel Strategy contains the twin aims, once personnel have been recruited, of retaining and sustaining them. This means the Services should provide personnel with 'a rewarding career which stimulates and develops them and provides the foundation of a second career on leaving the Services' and create 'an environment in which Service men and women and their families will be willing to maintain their commitment'.[145] The two are vitally linked, and meeting these aims in the context of an employment market where career and lifestyle expectations and possibilities are rapidly changing is a continuing challenge for the Armed Forces.

75. There are many aspects to a rewarding career. They include:

  • believing one's job to be worthwhile, satisfying and not excessively onerous;

  • the opportunity to undertake training which will lead to personal and career development and promotion;

  • trusting management to provide effective leadership;

  • confidence in the ability of one's colleagues to contribute to teamwork; and

  • feeling comfortable in the working environment.

Service personnel have the same right as other employees to these reasonable conditions of employment. We consider in the next section the aspects of Service life which impact particularly on families, and what the MoD is doing to ease the difficulties which might be driving personnel out of the Services. In this section we will consider the terms and conditions of Service life which should contribute to a satisfying career. A defining aspect of Service life which impacts on both personnel and their families is time spent away from home. This, and the linked problem of overstretch, is the key issue affecting quality of life for Service personnel at present and we will examine this first.


76. In assessing the demands placed upon Service personnel in the United Kingdom we have to recognise how much our Armed Forces' activities have changed in the ten years since the end of the Cold War. As the retiring CDS, General Sir Charles Guthrie, recently put it—

From comparatively static forces, with a fairly predictable rotation of accompanied postings and time spent away on planned exercises, our forces have become expeditionary, travelling to trouble spots around the world when they are needed, often at short notice, on active, unaccompanied deployments and operations.

77. The Army has experienced the greatest quantitative shift from the change to the expeditionary role because it is mostly Army personnel who are deployed to such places as Bosnia, Kosovo and Sierra Leone and who sustain the deployments over periods of years rather than months. But personnel in all three Services are affected (the 'culture shock' is perhaps greatest for the RAF), and if retention is to be improved these personnel need to believe that steps are being taken to remedy their sense of being overburdened, and to see results. The Armed Forces' Pay Review Body recognised in its report for 2000 the problems of overstretch arising from 'the imbalance between the personnel resources available to the Services and the current level of commitments' and the continuing deterioration of quality of life arising from 'more time spent away from families and longer working hours'.[147]

78. All three Services carry out Continuous Attitude Surveys (CAS) which assess satisfaction with Service life. Separation from family and its effects on relationships and the inability to plan one's life consistently score high on the negative aspects of Service life and predictably appear in the reasons for leaving the Services when surveys of leavers are carried out.[148] The problem is of course compounded by the Services being under-strength. If more tasks are spread amongst fewer people, and increasingly those tasks take people away from home, it is not surprising that Service personnel feel that too much is being asked of them, in terms of workload and the sacrifices they and their families are asked to make.

79. In our informal discussions personnel in all three Services, and at all levels, have told us that they feel they are being asked to do too much and to spend too much time away from home. Young naval officers and ratings told us that, despite the 60/40 sea-shore ratio which should operate, many were asked to do back-to-back sea jobs.[149] The point was made at RAF Cranwell that it is often spouses who put pressure on personnel to leave the Services because of the disruption to home life caused by repeated operational tours. There is also a consequential effect on personnel who remain on home bases while others are away on tours because the same tasks have to be shared amongst fewer people. Members of the Signals regiment we visited commented that increased operational tempo can have a greater effect on some individuals than others, if they are in trades where there are particular shortages, and that this is not necessarily reflected in the deployment statistics for the unit as a whole. Many personal examples of this were given to us. This is not just an issue for people with families: single people feel that they too are entitled to have a private life and that in fact the burden placed on them is often disproportionate as efforts are made to decrease the burden on married personnel first.

80. One way of reducing the burden on the Services would of course be to cut back on the number of operations in which UK forces participate. The government's intention that the UK should be 'a force for good' in the world was made clear in the Strategic Defence Review.[150] Given our NATO commitments and the fact that our forces are regarded as amongst the most capable in the world, it would always be a very difficult policy decision not to become involved when crises occur. Another option is, having become involved and dealt with an immediate crisis, to reduce the level of commitment at the earliest opportunity. The MoD has taken this approach and has drawn back UK personnel since the peak of the Kosovo crisis in July 1999 when 47 per cent of the Army, 45 per cent of the naval service and 40 per cent of the RAF were committed to operations. The levels are now down for the Army to 22 per cent committed to operations and 15 per cent actually deployed; and for the RAF the figure was down to 12.7 per cent by June 2000. The Navy, however, remained heavily committed at June 2000, with 32 per cent of personnel involved in operations.[151] It is unclear whether the levels represent any kind of target maximum for the MoD but if the MoD is serious about reducing operational tempo it needs to have a very clear idea what the maximum percentage of personnel committed to operations at any one time should be. At the moment the improvement in quality of life that the reduced levels of commitment so far achieved should bring is not yet being felt by personnel and the net result is that they are leaving the Services.

81. The Army Families Federation say that—

    The expeditionary nature of current deployment has significantly altered the way of life for Army families: separation has increased dramatically ... The Army must establish a reasonable expectation for time families spend together, and fulfil the expectation.[152]

It is this 'reasonable expectation' of time available to spend with families which the Services need to get to grips with. There are guidelines in place set down in the MoD's new Service Delivery Agreements. For the Navy, deployment away from the UK should not exceed nine months and ships may be away from their base port for up to 60 per cent of the time, averaged over two years. Army tour lengths should be no more than six months with an average interval between tours of 24 months. RAF personnel should spend not more than three months on deployed duties followed by nine months at their home base.[153] The actual intervals, and the deterioration in the situation last year, are shown below.

Table 10
Army intervals between operational tours

Royal Armoured Corps
Royal Artillery
Royal Engineers
Royal Signals

Source: AFPRB Report 2000, para 29

The Navy aims at what it describes as an 'at sea harmony' giving personnel in sea-going ships 40 per cent of their time in their base port but average operational time spent at sea has increased from 42.5 per cent in 1995 to 47 per cent in 1999.[154] In the RAF a squadron's programme for the next two to three years is published in advance and major deployments will be known. But, as in the Army and the Navy, RAF personnel are subject to short notice changes arising from operational requirements and there is an additional problem of particular individuals being affected more severely than overall figures for units would indicate.

82. The MoD and the individual Services are aware of the importance of addressing these problems. The Minister for the Armed Forces believed that personnel were more accepting of unpredictability caused by external events than by that arising purely from administrative decisions. Steps were being taken to eliminate as far as possible the adverse effects of the latter which at present can result in an individual returning to the UK from one deployment finding themselves immediately posted away from their home base again.[155] The Navy has taken a number of initiatives in this area. It is setting up a system, beginning in April, to monitor individual at sea harmony as which will give a much better indication of the pressures personnel are under than simply tracking the activity levels of ships.[156] The Second Sea Lord told us about a pilot scheme in HMS Scott (the hydrographic vessel) which involves providing it with one and a half crews so that even though the ship may be away for long periods, personnel can have more certainty about leave and time at home. The Navy has also taken a significant step in career management in the appointment of drafting and career management liaison officers whose role is to discuss with sailors at any rank the opportunities available to them over a 3-5 year period.[157]

83. We hope that the measures which the MoD is taking to address the feeling of over-commitment amongst personnel will be successful. However, it may be that a more radical approach is needed. If a sustained pattern of high operational tempo is to be maintained, it may be that the Services simply need more people to do the job than was envisaged in the SDR. The Minister told us that at present the Services believed that the SDR targets were adequate to meet the requirements placed on them but 'when we reach those targets then we will assess that'. The problem is, if the Services continue to lose the retention battle they will not hit their SDR targets and meanwhile the pressure on serving personnel will continue. If the Services cannot substantially reduce the burden on personnel in the short to medium term they may have to look at rewarding personnel more generously both financially and with other benefits to induce them to stay.

134  Seventh Report, Session 1998-99, The Strategic Defence Review: Defence Medical Services, HC 447 Back

135  Cm 4566 Back

136  ibid, para 2 Back

137  HC Deb., 27 November 2000, c 421w Back

138  Letter from the Parliamentary Under-Secretary of State for Defence to Rt Hon Menzies Campbell CBE MP, 5 January 2001 (deposited in the House of Commons Library) Back

139  In the RAF, some airmen have the opportunity to serve until the age of 47 or 55, subject to promotion to sergeant or flight sergeant respectively Back

140  QQ 285, 288 Back

141  Q 129 Back

142  Q 274 Back

143  Q 714 Back

144  Q 359 Back

145  AFOPS, p 16 Back

146  RUSI speech, op cit Back

147  Armed Forces' Pay Review Body Report 2000, op cit, paras 12-13 Back

148  Q 141; Ev p 39-40, paras 19.1-19.2 and 20.2 Back

149  See also paragraph 101 Back

150  Strategic Defence Review, Cm 3999 (1997-98), p 4 Back

151  Q 729; HC Deb, 31 October 2000, c 345w; AFPRB Report 2000, para 32. See also HC Deb, 26 July 2000, c 6777w. The number of troops deployed in Bosnia was 2,265 and in Kosovo 3,351 at 8 January 2001 (see HC Deb, 15 January 2001, c 10)  Back

152  Ev p 159 Back

153  Service Delivery Agreements, 6 November 2000, launched with the Spending Review 2000 and available on the MoD's website at Back

154  Q 141 and AFPRB Report 2000, para 30 Back

155  Q 729 Back

156  QQ 141, 284 Back

157  QQ 283, 289 Back

previous page contents next page

House of Commons home page Parliament home page House of Lords home page search page enquiries index

© Parliamentary copyright 2001
Prepared 23 February 2001