Examination of Witnesses (Questions 80
WEDNESDAY 8 NOVEMBER 2000
80. I am relieved to hear it.
(Brigadier Holmes) The whole question of fact sheets
for employers flows from the earlier question. The National Employers
Liaison Committee, which was set up to make it easier for reservists
to be reservists in peace time, is re-focusing its activities
to communicate better with employers and to tell them what might
happen if their employee got mobilised. Clearly if we are going
to reach a situation where reservists have to tell their employers
that they are reservists, then the employer needs more information.
What we have done is that we have produced draft fact sheets.
We have circulated these using the good offices of NELC to employers
who have come back and you will not be wholly surprised to hear
that the employers are saying that they want things which are
more straightforward, couched in less jargon and are more readily
comprehensible to somebody who does not work for the MoD. We hope
to have the finished versions out by the 1 April next year. NELC
does have a very important role here in its regional committees.
If we take the example of your reservist who works for an employer
who is anti-military, in working through cases on a case by case
basis many of these things are going to be arguably too difficult
for a reservist to take through on his own. We need to give him
more support and more help at the local level. The redirection
of NELC so that NELC is developing much stronger tentacles locally
is I think good news.
81. We have one last block of questions to ask
although we shall be writing to you on questions we do not have
time to proceed with. We have touched upon medical services, so
perhaps we could go over a little bit of the ground from a different
angle. What progress has been made in creating an effective relationship
between the MoD and the NHS to supply NHS employees to support
the Defence Medical Services?
(Brigadier Holmes) Very considerable progress. There
has been a recognition that the Defence Medical Services are part
of the NHS more generally, and this has got to be an interdepartmental
issue. What we have now is NHS representatives on the top Defence
Medical Services Boards, that is, VCDS's (Vice Chief of the Defence
Staff) Medical Board, and the Surgeon General's Medical Management
Board. We have got Barbara Stocking who is Director of the South
East Region NHS on the VCDS Board, and Mark Brittan, Chief Executive
of the Royal Berkshire and Battle Hospitals NHS Trust on the Surgeon
General's Board. We have also got an NELC Medical Committee chaired
by Dame Margaret Turner-Warwick which is also looking at improving
medical relationships through NELC. In the NELC capacity we have
sent medical visits to reservists in Bosnia, so NHS managers have
the opportunity first to go to Chilwell and to see how reservists
get mobilised, and then go off to Bosnia. At the strategic level
we are addressing the issue and we are recognising that this is
not just a matter for reserves, not just a matter for defence,
but also for the NHS. By and large NHS Trusts are positive towards
the reserve service. I say "by and large". A pilot exercise
has suggested that a mobilisation would have a fairly modest impact
on the NHS. The practical difficulty with that is that although
the Reserve Medical Services require a relatively small percentage
of the overall NHS, clearly the way that the TA in particular
was structured in Cold War days meant that the TA produced general
hospitals, field hospitals, which battened on particular hospitals.
One of the results of this is that there has got to be some better
way of spreading the reserve medical requirement across the NHS
as a whole rather than imposing a particular burden on a particular
trust which that trust might not be able to bear. Again, I am
really confident that this is now getting the strategic emphasis
which it deserves and we are including the NHS in defence discussions
at the very highest level.
82. You have got the structure in place. How
long then do you think before we start seeing some benefits from
(Brigadier Holmes) I think we are already getting
the benefits. The SDR imposed on the TA a medical burden which
it was in no position to bear. What it has now done, as we heard
from an earlier answer, is that there is a net gain and the net
gain is in what I might call inelegantly serious medics. These
are not cooks and drivers. These are serious medical personnel
and there has been a net gain over the last year. I am confident
that this net gain, which is the profit if you will once the outflow
is removed, and if this net gain is sustained year on year we
will move inexorably to our goal.
83. We thought the MoD was a little bit ambitious
in its 2,000 additional medical reservists. How long will that
take? Were you too ambitious?
(Brigadier Holmes) I think it was certainly ambitious.
I think now that the thing is being addressed in the way that
it is we will get there and I would hope that we will be getting
a bonus of about 200 or 300 year on year but it will take time.
This will not be quick and easy.
84. Last year when we interviewed the Defence
Medical Services, and we were all very impressed with Barbara
Stocking who happens to be my Regional Director and is very good,
the one real fly in the ointment was that the then Director General
of Medical Services did not know the name of any of the three
most senior single service volunteer medics. I think the TA has
a medical brigadier, although I do not know what his name is.
Are you satisfied that the senior volunteer reservists, people
who have come up through the RA, the RNR and the Royal Artillery
Air Force, have proper access to the people at the top of the
Forces Medical Services?
(Brigadier Holmes) Yes, but I say that guardedly as
this is an area where my own radar does not reach terribly well.
I do not know if there is a single service view on this.
(Air Vice-Marshal Sudborough) Can I add some statistics
to Brigadier Holmes's side? We are relatively small in this total
picture. I think it is interesting, in addressing the whole issue,
that our air medical evacuation squadron (4626 Sqn) has got 192
against a required strength of 201. That has been very positive
85. It is a full unit. That is one of the reasons;
one that has been deployed as a full unit too, and we are very
proud of it.
(Air Vice-Marshal Sudborough) That is as may be. We
are proud of it and I think rightly so. And 612 Squadron, which
is perhaps a more difficult area, which is the Air transport surgical
Squadron, has got a strength of 52 against an establishment of
65. We are still getting problems with recruiting surgeons and
radiographers but I think that is a national problem. The other
interesting thing is that you asked, Chairman, what is happening
as regards us trying to promote this recruiting. I read here of
a recent NHS conference of theatre nurses. We needed three vacancies
of theatre nurses. We got 82 firm enquiries. There is quite a
lot of interest on this side. I cannot talk in the wider sense
of medical support but refer solely to aero-med.
86. You can pass them on to the Army then.
(Air Vice-Marshal Sudborough) Oh no!
87. Or does single service rivalry not extend
(Air Vice-Marshal Sudborough) I have no comment to
make on that!
(Ms Seammen) In a previous reply to the Committee's
observations I think we said that the Government plans to form
composite regular reserve units. I just thought I would say that
that has happened in two instances and a third I think is in the
process of formation. That is a plus point.
88. What incentives do we offer NHS personnel
to join the reserves?
(Brigadier Holmes) We offer them no more financial
incentive than anyone else gets, but as part of the current recruiting
effort, which is considerable, we do emphasise the personal and
professional advantages that come from military training: challenging
training, the opportunity to go off on an operation and to practise
accident and emergency medicine in a place like Pristina. That
actually does have an extraordinary appeal, the more flexible
we are now able to be about the times which people serve so that
they are able to go for relatively short periods of time, which
does not represent knocking a large hole in the day job. There
is that sort of incentive. There is no extra financial incentive.
89. Lastly, and I suspect this is something
you will have to write to us about because it might be confidential,
how many medical reservists would have been called up to support
the ground invasion of Kosovo and where would they have come from?
(Ms Seammen) We will write to you.
90. Thanks very much for coming. Brigadier,
you must now be reduced to only five separate careers. How are
you going to fill the vacuum?
(Brigadier Holmes) I shall try to stay married and
I have a large book which needs to be finished by Christmas which
I have not yet started.
Chairman: Good luck and thank you
all very much for coming.