Select Committee on Defence Seventh Report

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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Prepared 18 February 2008