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House of Lords

Thursday, 15th December 1994.

The House met at three of the clock: The LORD CHANCELLOR on the Woolsack.

Prayers--Read by

the Lord Bishop of Worcester.

Message from the Queen

The Earl of Airlie: My Lords, I have the honour to present to your Lordships a message from Her Majesty the Queen, signed by her own hand. The message is as follows:

    "I have received with great satisfaction the loyal and dutiful expression of your thanks for the Speech with which I opened the present Session of Parliament".

Armed Forces: Medical Services

Baroness Cox asked Her Majesty's Government:

    What is their policy concerning the future of the medical and nursing services in the Armed Forces.

The Parliamentary Under-Secretary of State, Ministry of Defence (Lord Henley): My Lords, our policy continues to be that the standard of medical care for the Armed Forces when they are put in harm's way should, allowing for the special circumstances of the battlefield, be equal to the best provided under the National Health Service. The size of the uniformed medical service should be dictated by the number of personnel required to deploy with our front line forces.

Baroness Cox: My Lords, I thank my noble friend for that reply although I feel it will not adequately reassure those concerned about the defence medical services. Is my noble friend aware that the armed forces committee of the BMA fears that the reductions will lead to the disintegration of the defence medical services which will be so decimated that they are unable to provide sufficient career experience and prospects to attract and retain high calibre medical and nursing staff and also paramedical staff? Is he also aware that the closure of so many service hospitals is causing grave concern among the medical and nursing professions who fear that the residual services at the four military district hospital units will not be able to provide adequate specialist services for casualties in the event of war?

Lord Henley: My Lords, I am sorry my noble friend takes that attitude. We feel that the changes are necessary. At present there are three service hospitals which have far more beds than are currently required. Their occupancy by military personnel is at a level of between 25 per cent. and 55 per cent. Therefore, certain changes were necessary to make sure that all medical staff receive the appropriate training and experience. We value very much all defence medical service personnel who provide vital support for the front line. The Defence Costs Study Front Line First stresses the continued need for a high quality health care organisation in the Armed Forces. I can give an assurance to my noble friend that

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it is staffed, as it has always been and as it will be in the future, by high quality, well trained and well motivated staff.

Lord Monkswell: My Lords, the House will be interested to hear that medical services for the Armed Forces are to be at the same standard as those for the National Health Service. Does that mean that members of the Armed Forces who are injured or who fall sick will have the kinds of restrictions placed on their medical treatment which are currently placed on treatment under the National Health Service--for example, if the budget has run out at a facility or if a medical centre does not have an account with the relevant referring authority?

Lord Henley: My Lords, that really is the most ridiculous question I have heard for a long time; it is scarcely worthy of an answer. We shall continue to provide the excellent National Health Service we already provide. We shall continue to provide an equally good defence medical service to our service personnel.

Lord Carver: My Lords, can the Minister assure the House that, apart from the resources needed for the day-to-day medical care of the Armed Forces at their peacetime strength, the resources, human and other, will be maintained to ensure that in operations the evacuation of casualties is rapidly and effectively carried out and that all ranks of the Armed Forces are efficiently trained in first aid and hygiene?

Lord Henley: My Lords, the noble and gallant Lord is right to draw attention to the need for efficient services for the evacuation of wounded personnel. I can give him an assurance that as far as possible we shall maintain those services to the appropriate standard. As regards the number of personnel, there are about 8,900 regular medical staff within the Armed Forces and about 6,600 individual reservists. Even after the reorganisation of the Territorial Army, which I announced last week, there will still be 5,100 trained reserve forces in the TA, the Royal Auxiliary Air Force, and the RN Reserve.

Baroness Park of Monmouth: My Lords, I understand that further major savings in primary medical care have been forecast as still to come over and above those already announced in the Defence Costs Study. When will my noble friend the Minister be announcing the detailed figures? When shall we know? Does he agree that it is very difficult to understand how the Government can contemplate cuts in largely irreplaceable and indispensable expertise at this time--cuts which surely must affect our combat readiness?

Lord Henley: My Lords, I cannot answer my noble friend's question as to the exact timing of any further announcements. However, I can say, as I made clear in my original Answer, that we shall continue to provide the best possible service for our medical personnel.

Lord Stoddart of Swindon: My Lords, can the noble Lord say how the closure of the RAF Princess Alexandra Hospital at Wroughton is going to help the

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medical services? Has not that hospital provided good services over a very long period of time? How will it and its services be replaced?

Lord Henley: My Lords, the noble Lord will be aware that I wrote to him in some detail about that issue when we made the announcement last week. We felt that having the three service hospitals was unnecessary, particularly because, as I made clear to my noble friend, their bed occupancy varied between 25 and 55 per cent. in terms of service personnel. It was felt that provision for the three services should be merged at Haslar with three further Ministry of Defence hospital units being based in various National Health Service hospitals, two of which have yet to be announced. That in the south-west has been announced. We believe that that will provide a better service and will give the medical personnel a much broader range of work to do and therefore a greater opportunity to develop their skills.

Lord Richardson: My Lords, you have made it clear that you desire the best possible care for the Armed Forces. Other noble Lords have made that equally clear also. If this is to be so, you have to attract the best young men into the services. Do you agree that the quality of those who are senior will determine considerably (or perhaps ultimately) the willingness of young men to enter service life? Furthermore, will you--

Noble Lords: Order, order!

Lord Richardson: Do you agree--

Lord Hailsham of Saint Marylebone: My Lords, the question should be, "Does the noble Lord agree?"

Lord Richardson: My Lords, yes. Does the noble Lord agree that keeping personnel within the services at the levels of major and lieutenant-colonel is very much dependent on their future prospects and that the introduction and retention within the services of high quality, middle-ranking staff depends on the opportunities that are available to them?

Lord Henley: My Lords, the noble Lord is right to draw attention to the need to recruit the appropriate high quality staff. That is why we are concerned to ensure that we provide a full, varied and satisfying career for them. That was one of the factors that guided our changes, as was the need to provide an appropriate level and width of experience to all those we recruit.

Lord Peyton of Yeovil: My Lords, can my noble friend explain what he means by the phrase "the best possible"? Does he mean the maximum that the Treasury will allow or the standard that is required by the needs of the services?

Lord Henley: My Lords, there are always financial constraints. We want to provide the best possible service to the Army within the resources available to us.

Lord Williams of Elvel: My Lords, is it the case that the Government propose to close all military hospitals except for the Duchess of Kent's Military Hospital at Catterick and the Joint Forces Hospital at Gosport? If that is the case and if those hospitals are closed, how

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in practice will the Armed Forces obtain the necessary nursing and medical expertise which they would need in a crisis situation? What plans do the Government have to ensure that the Armed Forces have dedicated facilities available to them within the NHS--I believe that that is the way in which the Government are heading--and what extra resources will be made available in times of crisis?

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