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Baroness Scotland of Asthal: My Lords, Her Majesty's Government have always taken the issue of nuclear disarmament very seriously in a number of fora. Discussions with our friends and allies continue. We entirely understand that we cannot afford to ignore the threat from the proliferation of ballistic missiles. That is a matter of real importance to all of us.

Lord Burnham: My Lords, does the Minister agree that NATO remains the bedrock of western defence? Is there not a huge danger in all this talk about setting up a European Union army that the United States will feel increasingly isolated in NATO, which will encourage her to think again about a ballistic missile shield?

Baroness Scotland of Asthal: My Lords, NATO remains extremely important. Currently, there is no sign that the United States feels isolated. We are discussing with our friends matters pertaining to that issue, and that situation will continue. There is no need at this moment for any degree of alarm.

Baroness Williams of Crosby: My Lords, will the Minister take a rather more urgent attitude in view of the fact that, first, according to American sources

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there is a possibility that the anti-ballistic missile treaty of 1972 would have to be breached, and, secondly, there is a real danger that Russia will not, as she has made clear, consider further the ratification of SALT II or proceed to SALT III if there is any question of the establishment of an anti-ballistic missile system? Virtually the whole of the slow progress towards mutual world disarmament could be put at risk. Will the Minister ponder that in her further responses?

Baroness Scotland of Asthal: My Lords, the American Administration and the Russians are looking at this issue together. The US Administration has not yet decided to deploy a national missile defence system, and it has made clear that it will not do so until June. We have welcomed the US recognition that if an NMD system is pursued it will be important to preserve strategic stability.

We have also welcomed the agreement of Presidents Clinton and Yeltsin at Cologne in June that the US and Russia should begin talks on the anti-ballistic missile treaty and on further cuts in the US and Russian nuclear arsenal.

Lord Chalfont: My Lords, does the Minister agree that we are not talking only about national missile protection systems but theatre missile defences and the defence of expeditionary forces, should we need to use them in the future? Does the noble Baroness agree that deterrence is no longer sufficient protection against rogue states in possession of ballistic missiles? Will she assure the House that we shall keep our minds open on this and continue our discussions to that end with the United States?

Baroness Scotland of Asthal: My Lords, the UK, US and allies are actively engaged in efforts to counter the proliferation of missiles and of weapons of mass destruction. We are in discussion with the Americans about the consideration that they are giving to a defence system. We shall of course continue to consider openly the issue as to what would best meet British interests.

Defence Medical Services

3.21 p.m.

Baroness Cox asked Her Majesty's Government:

    Whether the Defence Medical Services have the capability to meet the current and potential needs for medical care of the Armed Forces.

Lord Burlison: My Lords, I am pleased to say that the Defence Medical Services have met all their operational commitments to date. The call-up of medical reservists may be necessary in future according to the scale of possible additional operational commitments. Regrettably, shortages of medical personnel mean that service personnel in the

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United Kingdom wait longer for hospital treatment than we would wish. However, we are working hard to address that issue.

Baroness Cox: My Lords, I thank the noble Lord for that reply. Does he agree that there is a disturbingly high rate of premature voluntary retirement of senior experienced medical personnel which has serious implications for those still serving, for example, in over-stretch and stress and increased weekends on duty with yet more separation from their families? What are the Government doing to improve morale and conditions of service for those still serving?

Lord Burlison: My Lords, the figure for recent premature voluntary retirement of senior medical officers from 1st December to 30th November 1998 was 36 consultants and GPs. I agree with the noble Baroness that morale is a strong issue. It must be quite depressing for others in the services involved to see people moving out, especially at a time when we have difficulty recruiting personnel in that area. Quite a lot is being done to restore morale. We seek to identify which factors militate against recruitment and retention of trained personnel. However, there are national shortages of some medical disciplines which make it extremely difficult for the MoD to compete in the job market.

Lord Swinfen: My Lords, the noble Lord says that 36 medical consultants have left or have given notice of leaving. What is the establishment of medical consultants? The House would then know the proportion of those leaving. Is the Minister satisfied that we have sufficient medical consultants in battlefield surgery to make certain, should the need arise, that our servicemen are properly catered for if wounded in action?

Lord Burlison: My Lords, at 1st September the total strength of the Defence Medical Services was 6,101, against an expected figure of 8,500. There is a shortfall of about 28 per cent. I shall write to the noble Lord. I am unable to give him the exact breakdown of the individuals and the level of membership in each of the senior medical areas. The Defence Medical Services have until now met requirements in terms of operational capability. The Strategic Defence Review allotted £140 million over the next four years to help with personnel and equipment. We are satisfied that we would be able to meet our requirements as regards operational capability. We might have to do a little juggling of our relationship with the National Health Service depending on operational circumstances. But in general we are satisfied that we can meet commitments.

Lord Walton of Detchant: My Lords, in asking a supplementary question, I must declare an interest. Many years ago I commanded the No. 1 Northern General Hospital in the TA. Having said that, and

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accepting that the Reserve Forces are making an outstanding contribution to the medical care of service personnel, I ask the Government whether they are yet in a position to clarify the call-out responsibilities of such individuals in the reserve medical services. I understand that without that being clarified there is anxiety on the part of potential recruits, doctors and nurses, about the effect that call-out for peacekeeping operations, as distinct from a major national emergency, might have upon their civilian employment in the National Health Service.

Lord Burlison: My Lords, the noble Lord asks about the Reserve Forces. I acknowledge his greater knowledge in this area. The shortfall of voluntary reserves is some 40 per cent. So in that area, too, we have some difficulties. We seek to encourage recruitment. I am most heartened that the Department of Health is very helpful in respect of the reservists who are employed in that sector. With that co-operation--it is on the way to becoming very substantial--I am sure we can meet commitments.

Baroness Masham of Ilton: My Lords, is the Minister aware that Catterick Military Hospital has been run down? Therefore the largest military camp in the country has to use a National Health Service hospital. There are many airfields in the area. Civilians are worried about the pressure being put on the local National Health Service hospital. Some who previously used the military hospital now have to travel over 40 miles to the nearest accident and emergency hospital.

Lord Burlison: My Lords, I am aware that the Catterick Military Hospital has reduced its commitment. However, we are in an arrangement with hospitals locally. There will be a relationship with, and a commitment to, the general hospital in Northallerton which will assist with the problems created by the changes at Catterick.

Lord Winston: My Lords, what percentage of defence medical work is currently contracted to the National Health Service? How much does that cost the defence services?

Lord Burlison: My Lords, I am unable to give the noble Lord those figures. I shall write to him. The relationship that the MoD has with the National Health Service is very important. Where a commitment is entered into between the local trust or the health service nationally, there would be an expectation that the MoD would pay for those services, and we would be establishing the best services to meet the needs of that area.

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EU Withholding Tax

3.30 p.m.

Baroness Blatch asked Her Majesty's Government:

    Whether they will reject any proposal for a European Union-wide withholding tax.

Lord McIntosh of Haringey: My Lords, there can be no agreement to the draft directive on the taxation of savings as long as it risks damaging the competitiveness of European Union financial markets.

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