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Military medical services to be restored

BMJ 1998; 317 doi: (Published 18 July 1998) Cite this as: BMJ 1998;317:166
  1. John Warden, parliamentary correspondent
  1. BMJ

    Reinforcement of the defence medical services is a key theme of Britain's strategic defence review announced by the government last week. It is to include the recruitment of 250 hospital specialists, nurses, and technicians as well as a series of operational changes to restore the medical capability of the armed forces.

    In a statement to the Commons, the defence secretary, George Robertson, spoke of “serious weaknesses in our hollowed out and demoralised defence medical services.” Last year the Commons defence committee said that Britain's military medical services were at crisis point and not capable of supporting the nation's global military commitment (BMJ 1997;314:695).

    The defence review reshapes Britain's armed forces to meet new needs–the cold war has now ended, and military forces need to be deployed rapidly to world crisis points. This calls for medical support of combat operations overseas, rather than permanent facilities at home.

    The government therefore intends to procure a 200 bed ship for receiving casualties, provide an additional 800 field hospital beds with appropriate surgical support, establish a new regular ambulance regiment, and increase the regular element of the defence medical services. There will also be an additional Royal Air Force aeromedical evacuation flight, 18 air escort flights, and a new medical supply organisation.

    Further improvements are targeted at the defence secondary care agency, the peacetime base of operational military hospital staff. Staff shortages have meant that they are spending too little time at home between operational deployments. Many who work closely with the NHS have difficulty in maintaining their military training.

    Apart from the recruitment of some 250 medical and other staff members, contracts with NHS trusts will be renegotiated to allow more time for military activities.

    An important change will be the compulsory (rather than voluntary) call out of medical reserves to augment regular field hospitals when a surge capability is needed, in situations such as the Gulf war. The review states that it would not be practical to maintain permanently the extra medical support, which would only be required for a substantial fighting operation. Plans are to be developed with the NHS to enable compulsory call out of medical reservists without disruption to the health service.

    The Ministry of Defence stated: “We are committed to restoring operational medical capability to the required level as soon as possible, and a major investment will be made to achieve it.”

    The remedial programme, however, will be a long term undertaking and will include decisions about the future of the remaining military hospital at Haslar.

    The Strategic Defence Review is published by the Stationery Office, price $8.65.

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