Previous Section Back to Table of Contents Lords Hansard Home Page

Lord Bramall: Before concluding the debate on this important and vital clause, perhaps I may ask the noble Earl the Minister whether he is aware of the deep concern in the service medical services in the fields of surgery and anaesthetics there will not be enough medical expertise to be able to deal with the sort of situation that exists in Bosnia if it goes on for any length of time. I should like him to go back to the Ministry of Defence to make inquiries. My understanding is that in those two fields they are utterly reliant on the reserve forces. It may be very helpful to go back to the Ministry of Defence when there is a clash between the requirements of the forces and the requirements of the National Health Service.

30 Jan 1996 : Column CWH104

Lord Judd: Before the Minister winds up, perhaps I may reinforce this point. We will all have been reassured by the terms in which the noble Earl has replied, but the whole debate underlines the fact that we have gone extraordinarily far in cutting down these essential services within the regular forces. I should like to have some indication from the noble Earl that he accepts and recognises this point.

This is coupled with another point which I think it is in order to raise in the Committee, although it is the other side of the coin. With market disciplines having been introduced into the National Health Service to the extent they have been introduced, flexibility has been eroded and the ability to meet unforeseen circumstances has been very much diminished. Everything has been reduced to the absolute bare minimum so that the whole problem becomes more acute.

In trying to further an excellent intention, the noble Earl is brought face to face with problems which both probably originate in the Treasury rather than in his own department. It would be good to hear him acknowledge the strategic issues that lie behind all this and to have him indicate that he may be able to address them.

I wish to make just one other point. I am pleased the noble Earl has said that he will consult, and that the ministry will consult, with the hospital trusts and so on. But I should like to hear him say at the same time that, as this very valuable new role for the service is developed, the Ministry will make a point of consulting with the humanitarian and voluntary agencies as a whole, not just in specific situations, but in the whole approach as to how the armed services can be best equipped and prepared to fulfil this role. There is a wealth of experience in those humanitarian agencies. We all know how these things happen and it will be a great shame if what could be a very fruitful and positive collaboration became a slightly uneasy one because of a lack of consultation and of a feeling of mutual involvement. Anything the noble Earl is able to do to foster that kind of spirit would be well worth while.

Earl Howe: The noble Lord, Lord Judd, makes a very valid point. I am sure the services themselves would say that they do not have a monopoly of wisdom in such matters and that consultation with the voluntary organisations would only produce a better and more effective service wherever it is deployed. I gladly take that suggestion away with me.

If I may address the other concern that he covered and the concern that the noble and gallant Lord also poised. It is clearly true that there is no pool of unemployed doctors in the UK. One cannot pretend that there is. Indeed, in some specialities there is a shortage. The noble and gallant Lord mentioned anaesthetists in particular. I am certainly aware that there is a shortage of anaesthetists. We are trying to address that. Of course the problem cannot be solved overnight, but I understand that that particular problem is a very long-standing one indeed. There are always shortages of some specialism or other. What we have to do is to ensure that our planning takes account of that.

30 Jan 1996 : Column CWH105

In the circumstances that we are in, holding a higher proportion of trained doctors in the regular services would merely serve to exacerbate the shortage of doctors in civilian life. If a crisis arises, we must, as I am sure the Committee will agree, ensure that our services have full and proper medical support. In some circumstances, that will require the call-out of reservists. Such call out will inevitably have an impact on the NHS, but we believe that within the context of the NHS as a whole it should not have an unmanageable impact. There may, of course, be localised difficulties and we will discuss them with the Trusts concerned. Bear in mind that the exemption provisions in Part VIII of the Bill do provide a formal channel for such concerns to be aired if ever there is a real need to do so.

I readily acknowledge that there are shortages, but not in every discipline by any means. I hope the Committee will be somewhat reassured by the fact that our planning has been very detailed and thorough in this regard.

Lord Callaghan of Cardiff: I do not wish to abuse the indulgence of the Committee, but I must say that my noble Lord's second answer did not reassure me as much as his first answer did. I wish he had left it at the first. What he has to avoid is a feeling which I am not able to comment on, but I quote:

    "that Reservists were being called out for peace keeping, humanitarian and disaster relief operations which should perhaps more properly be performed by Regular Forces, i.e. the Reservists were being used as a cheap substitute for Regulars who have now been made redundant."

If that impression is widespread--and I am not able to say whether it is or not--then he really has a problem to overcome it. Does not this debate really amount to this: that the regular forces in this particular area, the medical services, have been run down too fast, and that there ought to be a small increase perhaps in the number of people serving in the regular forces on the medical side so that the dilemma which will undoubtedly arise will be avoided.

Earl Howe: Let me simply say two things. First, a point I made at the Second Reading was that calling up reservists is not a cheap option. It certainly is not a back door route to filling a gap that may have been left by the run down in the regular forces. It is in many circumstances an expensive option. Even if that were in the Government's mind, which it is not, it would be a very expensive thing to do.

Lord Callaghan of Cardiff: But forgive me--if it is an expensive option, why adopt it?

Earl Howe: Because it is a cheap option if you regard the reservists, as I am sure your Lordships all do, as an insurance policy against severe contingencies. So long as we have reservists, there ready and waiting if we need them, it is an extremely cost-effective option for the nation; but clearly, once they are deployed, they become more expensive.

The second point I simply repeat for the benefit of the Committee is this. Bosnia, and the deployment of our forces there, represents the largest single

30 Jan 1996 : Column CWH106

deployment of NATO forces since the Second World War. Despite that, we have not felt it necessary to call out any medical reservists at all, either doctors or nurses. We have sufficient in the regular forces for our needs.

Lord Bramall: It is really not fair to say that, because this operation has been going only for about six weeks. The problem arises when the operation has been going for about one year, not when it has been going for about four to six weeks. That is the real problem which the Ministry of Defence must address.

Lord Williams of Elvel: If I may say so, there is also a secondary problem which my noble friend Lord Callaghan raised. It is not necessarily a question of military operations; it is humanitarian operations which are important. If the feeling were to get around that NHS doctors, surgeons and anaesthetists were being used for humanitarian operations abroad when they were fully occupied with humanitarian operations in the United Kingdom, that would be bad indeed for morale in the NHS.

Earl Howe: I take the noble Lord's point, but clearly we would always look first for volunteers rather than for those who perhaps were being wrested unwillingly from their place of employment. These are very pertinent matters to the consultation that we shall undertake on the regulations. I believe that the points that have been made in the debate this afternoon will be most informative as we conduct that consultation. I hope that, once the regulations are formulated, noble Lords will be considerably reassured about the precise way in which we intend to implement them.

Clause 56 agreed to.

4 p.m.

Clause 57 [Maximum duration of service on call out under section 56]:

Lord Williams of Elvel moved Amendment No. 36:

Page 32, line 6, leave out ("9") and insert ("6").

The noble Lord said: I beg to move Amendment No. 36 standing in my name and that of my noble friends Lady Turner and Lord Judd. We come here to a central point in the whole Bill: the length of service required under a general call-out order. During the Second Reading debate this point was raised by a number of noble Lords, including myself and the noble and gallant Lord, Lord Bramall. If a call-out order is issued in a particular situation, the question is how long should the reservist have to serve before he is released.

It is clearly in everybody's interests that there should be sufficient time, because once you demobilise the reserve force that has been called out, it is very difficult to remobilise it again. We understand that. On the other hand, if a reservist is in service beyond a proper time--whatever the proper time might be remains to be defined--that will give rise to great discontent, loss of morale and, in certain instances in history, even mutiny. I would be grateful if the noble Earl could tell the Committee exactly how the figure of nine months was

30 Jan 1996 : Column CWH107

arrived at, because in my submission it would be better if it were six months and a possible extension allowed for. I beg to move.

Next Section Back to Table of Contents Lords Hansard Home Page