Defence Medical Services Organisation (Hansard, 25 February 1997)

§ Mr. Soames

The Defence Medical Services Organisation is established primarily to provide care for service personnel deployed on operations. This is a vital task. To provide this capability, the DMSO must comprise peacetime structures and a recognised training base which can produce uniformed medical personnel with the right skills and in sufficient numbers to meet forecast operational demands. That peacetime structure can also make a significant contribution to the provision of secondary medical care for all service personnel and, in certain circumstances, for their dependants, to facilitate effective training, it works closely with the NHS.

Since 1984, there has been a series of separate studies into the Defence Medical Services Organisation, aimed at rationalising an area which was consuming over 2 per cent. of the defence budget and adapting them to the changing strategic environment. This work culminated in the defence costs study in 1994, which recommended major restructuring of the DMSO to enable it to provide sufficient rapidly deployable units, primarily manned by regular personnel, to support forces deployed on operations, and a more efficient and cost-effective support structure, including establishing a number of agencies to provide secondary medical care and recognised training for medical personnel.

These necessary changes have meant major upheavals for the DMSO which, naturally, not all those involved have welcomed. The DMSO was suffering from some shortages of personnel—particularly anaesthetists, orthopaedic surgeons and intensive care nurses, mirroring shortages in the NHS—and we are striving to improve this situation. We have established all the key elements of the new organisations and we are now focusing on achieving the right balance in their relationships with the NHS and their function as military units in the light of experience with the operation of the new structure.

Three regular field hospitals of 200 beds have now been established with permanent command and administrative staff. The clinical staff to support the field hospitals will be drawn from the Defence Secondary Care Agency. There are currently gaps in some specialities which we look to fill, as we did in the Gulf and in Bosnia in other specialisations, by volunteer reservists under the provisions of the Reserve Forces Act 1996. We have provided the proper level of medical support to British troops on operational deployment in the Gulf, Bosnia and elsewhere.

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Defence planning to reflect the changing strategic circumstances has already evolved further since 1994. We have therefore set up a study team to examine whether these new circumstances, together with recent changes in medical practice, require further changes to our detailed assumptions for the provision of medical support to the front line. This should report by the middle of the year.

We continue to improve our holdings of medical equipment and supplies. Two sets of containerised modular operating theatres are now in use in Bosnia. We intend to purchase more of those in the future; the next will be delivered later this year. We also plan to improve medical facilities in RFA Argus for its role as a hospital ship.

At the time of the restructuring of the DMSO—which involved the closure of three service hospitals and the concentration of medical facilities at the Royal hospital, Haslar and in three Ministry of Defence hospital units at Derriford, Frimley Park and Peterborough—waiting lists increased. They have now been substantially reduced through robust management action by the new Defence Secondary Care Agency. There is also a programme of improvements at the Royal hospital, Haslar. Most of the enhancements to the clinical facilities should be completed by June 1997, with the remaining programme of capital works—for health and safety—completed over the next two years.

Work to align terms of service for medical personnel in each of the three services and so produce a more cohesive DMSO is well in hand. The first measures will be implemented in April. Naval and Army medical and dental officers will be allowed to extend their

Costs of decommissioning and lay-up of nuclear submarines
£ million
	Financial year
Project	1990–91	1991–92	1992–93	1993–94	1994–95	1995–96	1996–97	Total
Warspite	1.6	9.6	—	0.1	—	—	—	11.3
Conqueror	—	4.7	5.7	—	0.2	—	—	10.6
Courageous	—	—	9.9	0.9	—	—	—	10.8
Churchill	9.0	2.2	—	—	—	—	—	11.2
Swiftsure	—	1.6	9.9	—	—	—	—	11.5
Revenge	—	—	8.2	6.5	4.0	—	—	18.7
Resolution¹	—	—	—	—	0.3	2.1	13.8	16.2
Total at outturn prices	10.6	18.1	33.7	7.5	4.5	2.1	13.8	90.3

1. Valiant, Renown and Repulse have not yet completed their de-fuelling, de-equipping and layup preparations (DDLP) so are not included in this table.

2. It is not possible to provide costs of HMS Dreadnought's DD and LP; the information insofar as it is available could be provided only at disproportionate cost.

3. Average annual maintenance costs of decommissioned nuclear submarines are £50,000 and ten yearly dockings are approximately £3 million.

4. Financial year 1993–94 costs for HMS Warspite spread into years financial year 1992–93.¹ HMS Resolution's DD and LP completed January 1997. Final costs are not yet available.