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Speech by the Rt Hon Alan Johnson MP, Secretary of State for Health, 4 April 2008: Supporting Britain's reservists and employers support dinner

It’s a pleasure to be with you tonight.

My purpose this evening is to pay tribute to our armed forces including the TA and to talk about how we can encourage more NHS staff to become reservists.

This month marks the centenary of the Territorial Army. With ongoing military commitments across the globe, the role of the reservist has never been more important. Now, more so that at any point in its history, the TA is not just peripheral to what the regular army does – it is an essential part of all its operations.

And I’m delighted to be able to make this speech at the Imperial War Museum – which, for nearly a hundred years, has been this country’s collective memory for all the major conflicts that we have been engaged in.

So there is perhaps no more appropriate time or place to talk about how the NHS and the armed forces can work together to improve healthcare for both serving troops and veterans. And in particular, what else we can do to encourage more NHS staff to become reservists.

Historical context

The idea of the military and medical services working together dates back to 1812 when the Royal Army Medical Corps was formally created, on the orders of Lord Wellington.

Before that, provision of medical services for troops was at best sporadic – in 1662 in Tangiers, conditions for the Royal Garrison were so bad that in the words of the incoming governor, soldiers: “…could only hope to be freed by the grave, the common friend that put a speedy end to their misfortunes,” and half of all fatalities to British soldiers were caused by disease, rather than combat.

And even  long after the establishment of the Royal Army Medical Corps, there were tensions between soldiers and the doctors working alongside them. Hans Zinsser, the American bacteriologist who went on to develop a vaccine for typhoid, wrote in the early 20th century: “To the average professional officer, the military doctor is an unwillingly tolerated non-combatant who takes sick calls, gives cathartic pills, makes transportation troubles, complicates tactical plans and causes water to smell bad.”

Fortunately, things seem to have improved a little since then. The House of Commons Defence Select Committee in their report published in February this year, said that the clinical care for UK servicemen and women is second to none and that Defence Medical Services, working with the NHS provide a truly world-class service. This is something we should endorse and celebrate this evening.

Current context

But that doesn’t mean that there aren’t problems to resolve. Currently, there are nearly 12,000 men and women serving in Iraq and Afghanistan. The majority of those who sign up to the armed forces are in better health when they leave the service than when they joined. But there are also more men and women returning from active service with serious injuries or life long health problems.

I am certain that my view reflects the view of the public at large. The men and women who serve in the British armed forces, who put their lives at risk on a daily basis, deserve the finest healthcare that it is possible to provide – whether or not they’re on active duty.

Since its creation in 1948 the NHS has always specified priority for retired veterans. In November last year, I announced that we would extend the right to priority treatment on the NHS to include all veterans with service-related conditions, regardless of whether they were pensioners or not.

I am proud that it was my own PCT in Hull that was the first to recognise  the need to give veterans such priority treatment - and I was pleased to extend what had been achieved locally into a national programme.

So it is important to give veterans faster access to care, but its equally important to provide continuity of care to veterans. Ex-service men and women have the right to receive exactly the same, high standards of care when they are civilians as they did when they were in the armed forces.

For example, those who have lost an arm or a leg serving their country and need their prosthetic limbs replaced, should be able to access the same state-of-the-art models supplied by Defence Medical services.

And whilst waiting times have reduced dramatically everywhere over the past ten years, armed forces personnel and their families should not fall to the bottom of any waiting lists for treatment when they move to a different location.  Recent guidance makes this crystal clear. So our armed forces will receive the very best service that the NHS can provide. 

Recruiting more NHS reservists

But the relationship between NHS and the armed forces is not just about the care it offers to veterans. Right now, most of the medical staff working in  our Field Hospital in Afghanistan are NHS reservists. 

The benefits of being in the TA for NHS staff and their employers in terms of training and development are clear. It’s been estimated that during a three month operational tour in Iraq or Afghanistan, a reservist will deal with more trauma than during fifteen years working for the NHS.

Just as important as building clinical skills are issues such as leadership, communication, adaptability and teamwork – often misleadingly thought of as “soft skills,” But of huge importance to today’s employers. I had the pleasure of meeting 9 reservists from 208 (Liverpool) Field Hospital at Aintree University Hospital this morning. All of them emphasised how much they’d learned about adapting solutions to find ways to get things done. Their commitment and enthusiasm was inspirational and their employers reaped the benefits.

Being a member of the TA shouldn’t be simply tolerated by employers as an eccentricity as if it’s some kind of hobby or social club. It demands serious commitment and increasingly, it attracts the very finest talent in the NHS.

I know that most trusts are supportive of employees who want to serve in the TA, but some worry about managing staff absences and other difficulties that may arise.  But even if every NHS reservist was called up for an operational tour, the absence rate would comprise less than one per cent of the average daily sickness absence rate in the NHS. All employers get six months to a year’s notice before an employee is called up for active duty and the TA works with employers and the reservist in question to ensure that any absence causes minimum disruption. The TA pays the salary of the individual in question during their tour of duty and tops up pension contributions.  

Sponsored reservists

There are particular shortages of health specialists, such as intensive care nurses and neurosurgeons in the Defence Medical Services and for some senior clinicians, signing up to the Territorial Army is simply not the right option for them. So tonight, I can announce that we are working with the Defence Medical Services and initially with the University College London Hospitals Trust, to set up a Sponsored Reserves Scheme across these “pinch-point" disciplines. This means that there will be opportunities for clinicians and nurses with much-needed specialist skills to undertake short assignments in conflict zones, in support of our armed forces.  I am confident that the introduction of the Sponsored Medical Reserve will bring great benefits to all the individuals and organisations involved.

Conclusion

Over the last hundred years, the Territorial Army has given thousands of men and women the experience of a lifetime. For many, being a reservist has provided a unique opportunity to develop new skills and responsibilities, testing themselves beyond the normal boundaries of their profession.

I believe that all Trusts can benefit from encouraging their employees to be reservists or sponsored reservists. The skills that NHS reservists learn on their operational tours are absolutely invaluable. I think that Lt Col Andy Bruce put it better than I ever could when he said that after working in Afghanistan: “I will never again be intimidated by anything that will come through the doors of an NHS hospital.”

I would like to pay tribute to all NHS reservists who give up so much of their time and energy to support our servicemen and women. Their dedication and commitment is being felt by troops and civilians all over the world. And the NHS continues to benefit from their experience.

It only remains for me to thank SaBRE not just for a wonderful evening but for all they do to promote reservists. You’ll be pleased to know that my speech marks the beginning of tonight’s entertainment, which reminds me of the time I was introduced with the words ‘Ladies and Gentlemen, we’re really going to enjoy ourselves tonight but first I’d like to ask Alan Johnson to speak’. I understand there’s music to come from the band and much else to look forward to. I wish you all the very best for the rest of the evening.

Thank you