HL Deb 18 December 1990 vol 524 cc729-31

2.58 p.m.

Lord Smith asked Her Majesty's Government:

With the shortage of in-patient beds in our hospitals, what arrangements they have made to admit and treat casualties evacuated to this country if there is a war in the Gulf.

The Parliamentary Under-Secretary of State, Department of Health (Baroness Hooper)

My Lords, in consultation with the relevant government departments, health authorities have reviewed their existing contingency plans for NHS treatment of military casualties in the event of hostilities breaking out in the Gulf. Detailed guidance on the reception and treatment of casualties contains sensitive information which it would not be appropriate to make public; but the guidance has gone out to the relevant individuals in the health regions, and contingency planning will be taken forward as necessary.

Lord Smith

My Lords, I thank the Minister for that Answer. Is she aware that many consultants are perturbed about the NHS being able to cope adequately with a rush of casualties, especially given the call up of medical reservists? Is she aware that some consultants, largely involved with the occupancy of beds in private hospitals, feel strongly that those beds should be available in an emergency? Have the Government any plans to urge private hospitals actively to support the National Health Service by accepting casualties?

Baroness Hooper

My Lords, the purpose of the National Health Service contingency plan is to treat United Kingdom armed forces casualties evacuated from the Gulf once the Ministry of Defence hospitals in England are full and up to that point to meet the demand for any specialist facilities and treatment which the defence medical services cannot provide. So far as I am aware, there has been no suggestion to date that the Ministry of Defence would use private hospitals.

Lord Molloy

My Lords, is the noble Baroness aware that while nearly every region has waiting lists, in some regions the situation is worse than in others? Does she agree that they ought to be identified and that a system of priority should be worked out by the Government to try to relieve areas with waiting lists and primarily those with chronic waiting lists?

Baroness Hooper

My Lords, the reception of casualties would obviously affect the National Health Service waiting lists. We are considering how best to recover the situation, should it become necessary, but we all most earnestly hope that it will not. What will need to be done depends on the number of casualties and how long they require to be treated. In a sense, this is an extension of the usual difficult area where decisions must be made on clinical priorities, sometimes at short notice, where emergency admissions are involved.

Lord Wyatt of Weeford

My Lords, does the noble Baroness agree that if the recommendations of the Audit Commission and the Royal College of Physicians for a much wider use of one-day surgery were carried out, waiting lists could instantly be cut by 300,000?

Baroness Hooper

My Lords, I feel that we are straying into different territory. I can tell the noble Lord that we make every use of one-day surgery. The results are seen in the faster and greater turnover of numbers in day surgery as well as in patient care.

Lord Ennals

My Lords, there is obvious uncertainty about what might happen. Some prophesy that it would all be over in 24 hours; others say that there might be a six-month battle. The committee under the presidency of Sir Raymond Hoffenberg has postulated as many as 200,000 UK casualties. May I have an assurance that the Government base their planning on the worst case scenario so that we are able to cope? Further, may I have an assurance that adequate ambulance planes will be provided to bring patients back from the Gulf if, tragically, that is necessary?

Baroness Hooper

My Lords, we have asked the National Health Service to base its Gulf contingency planning on the arrangements for dealing with major civil incidents such as rail or airliner crashes. Within that framework, obviously individual regions are responsible for their detailed arrangements which would include ambulance services. I can tell the noble Lord that dispersal is the name of the game; he will know exactly what I mean.

Lord Ennals

My Lords, will the noble Baroness answer my specific question? Are the Government making preparations on the worst scenario basis rather than simply hoping for the best?

Baroness Hooper

My Lords, I hesitate to say on a worst scenario basis; they are making the best possible plans.

Lord Mayhew

My Lords, is the noble Baroness aware that a parliamentary delegation visited the Gulf recently? It had the unusual experience of meeting British doctors, surgeons and other medical staff who were desperately looking for patients on whom to practise their skills. May we have an assurance that the Ministry of Defence will ensure that medical reservists go to the Gulf as soon as they are needed but that they will not be taken off work here until that need is imminent?

Baroness Hooper

My Lords, I was not aware of the noble Lord's recent visit to the Gulf. I am glad that he was in a position to meet some of our medical reservists and to know that they are ready for action. Of course, contingency planning is made on the basis that it will be used as and when necessary and that there should be no unnecessary rundown in anticipation.

Lord Williams of Elvel

My Lords, will the noble Baroness tell the House what provision is being made in the Gulf? How many beds are available for casualties there? Will she further tell the House what facilities are available under Ministry of Defence control in the United Kingdom so that we can be apprised of the size of the problem?

Baroness Hooper

My Lords, because of the sensitivity of the information, I am not in a position to inform the noble Lord of the detailed figures. I can reassure him and all of your Lordships that we are making as adequate provision as possible in all the circumstances.

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