7 The role of Reserve medical personnel
111. The DMS is particularly heavily reliant on Reserve
personnel, who serve alongside their Regular colleagues on operations.
This reliance has increased due to the higher tempo of operations,
combined with smaller numbers of deployable Regular DMSD personnel.
This is part of a balance: while Reservists volunteer in order
to use their skills, there is a danger of deploying them so often
that the pressure upon them becomes excessive.
112. The Surgeon-General explained that a degree
of the reliance on Reservists had been necessitated by manning
shortfalls. However, he argued that the situation was "significantly
improving", and that this would ease some of the pressure.
For example, in 2002, there had been serious shortfalls in the
number of anaesthetists, with only 20 posts out of 95 filled.
There were now 45 filled and by 2012 that figure would rise to
71. "That, of course, will automatically reduce the reliance
on the Reserves."[89]
113. Workforce planning within the NHS plays an important
part in the management of Reserve forces. Andrew Cash told us
that the MDHUs, in which large numbers of Reservists were employed,
had to ensure that they were not placed under unmanageable pressure,
for example by the deployment of Reserve forces at that same time
as the Regulars were sent on an operational tour. This was an
objective of the DH/MoD Partnership Board.[90]
114. When we visited the Headquarters of 2 Medical
Brigade at Strensall in Yorkshire in October 2007, we were told
that the TA had so far met around 50% of the Armed Forces' medical
commitment for Operations TELIC and HERRICK, and that there were
currently substantial numbers of TA medical personnel in Afghanistan
(the numbers in Iraq were much smaller as medical provision for
Operation TELIC is currently a Regular commitment). We also saw
a TA unit, 201 (Northern) Field Hospital (Volunteer), preparing
and training for operational deployment as part of Operation HERRICK.
We were told that TA recruitment remained steady, but there was
a need to recruit younger people, as the TA medical service represented
an ageing population, with medical specialists taking a long time
to train.
115. Another issue affecting Reserve medical personnel
is the attitudes of employers. With increasing commercial orientation
and focus on targets in the NHS, the BMA argued that "given
the choice of two equal candidates for a consultant post [an employer
is likely] to appoint the candidate with no reserve liability".
Furthermore, similar problems were likely to exist in general
practice: "reserve liability […] will often be considered
a handicap and a disincentive to recruit". It concluded that
"these situations are driven […] by the medical workforce
shortage coupled with the severe lack of contingency capacity
in most NHS organisations and general practices".[91]
116. Witnesses from the Department of Health did
not accept the scale of this problem. Mr Cash told us that he
had "not specifically" encountered this kind of discrimination
against Reservists, and stressed that NHS employers fully supported
staff who had to undertake their annual 15-day commitment to the
Reserve forces.[92] The
Health Minister went further, saying that he would urge Reservists
who felt that they had suffered discrimination to use the complaints
procedure to seek redress.[93]
117. Officials admitted that more could be done in
terms of providing support for Reservists returning from operations.
There were procedures in place for occupational health departments
to debrief personnel, for line managers to discuss relevant issues
with staff, and generally to create an environment in which participation
in the Reserve forces was encouraged. However, Mr Cash admitted
that "there is room for more and I think that is why we have
picked this up as an issue in our next phase of work, to really
restate that we support this".[94]
118. We understand
and appreciate the vital role which Reservists play in delivering
the Armed Forces' healthcare capabilities, and believe that they
are an integral component of the DMS. We have seen ample evidence
of excellent cooperation between Regular and Reserve forces, and
believe that Reservists bring important skills to the Armed Forces.
We also think that operational deployment gives members of the
Reserve forces the opportunity to make use of their training when
back in the UK.
119. The MoD
must not take the integral involvement of Reservists for granted.
It must make sure that recruitment remains buoyant and that retention
is sufficient to guard against any degradation of capability.
It must also ensure that members of the Reserve forces receive
proper support, both from their civilian employers, and from the
Armed Forces when they return from operational deployments. The
public should recognise the contribution which the Reserve forces
make to the military and to society as a whole.
89 Q 472 (Lieutenant-General Lillywhite) Back
90
Q 475 (Mr Cash) Back
91
Ev 102-04 Back
92
Q 476 (Mr Cash) Back
93
Q 476 (Mr Bradshaw) Back
94
Qq 479-81 Back
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