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Armed Forces

My Lords, the intention is to do both. We are working in an imaginative way to ensure that we have the diversity of skills that we need in our Armed Forces, taking into account the increasing importance of specialist experience. That imaginative approach, some of it relating to advertising, needs to be continued. The noble Earl, Lord Attlee, highlighted in the case of reservists—though it is true for all our troops—the importance of training, which came most clearly home to me last week in meeting some of our youngest recruits, who were in Iraq within weeks of completing their basic training. We all know that safeguarding training resources has been a challenge for us within the operational pressures, as several noble and gallant Lords have mentioned. We need to do further work on that. We talk about our young people, too, in the context of learning from the mistakes of the past, some of which—at Deepcut—had tragic consequences, as the noble Lord, Lord Garden, highlighted. We have been working closely with the Independent Adult Learning Inspectorate in recent years to change and reform. Every level of the initial training organisation has been scrutinised and we are building and promoting an improved culture. A key part of this will be our new staff and leadership school at Pirbright. It is important that we continue to focus on this area. I know that the House will continue to scrutinise progress, but the recent report from the chief inspector of the ALI was a positive sign that the Armed Forces are making real progress. We are seriously committed to making these improvements. Accommodation is an important part of the overall package and how we maintain the covenant with our Armed Forces, and it is an area in which we are making considerable investment. However, there is much room for improvement. My noble friend Lord Young highlighted concerns over the housing prime contract. He is right: this is something that has been recognised and that is now being got to grips with. The noble Lord, Lord Luke, highlighted concerns over maintenance and how the organisation of our accommodation is working. These areas are recognised by the Ministry of Defence as being unacceptable, and active measures are being taken. New accommodation is coming on-stream. In 2005-06, we spent more than £500 million on accommodation and, in the next decade, we expect to spend more than £5 billion. However, as one of the country’s largest property owners, this is a big project and we have some way to go, as has been said this afternoon. It is an area that has been neglected for some considerable time and we must be realistic about the time that it is going to take to fix it. Noble Lords should not underestimate the commitment of this Government to fixing it. For example, some 20,000 new single bed spaces will be provided this year. We are also imaginative in using other approaches to address these problems. For example, we have opened up opportunities for home ownership as part of our strategy, and we have lobbied successfully for the forces to be included in the Government’s key worker living programme, which makes it easier for our men and women to become home owners. There has been tremendous coverage in the press of medical care—and, rightly, noble Lords have highlighted today that other important aspect of how we look after our Armed Forces. We absolutely owe it to the men and women in our Armed Forces who put themselves in harm’s way to provide for them the best possible medical care when they are hurt. The noble Lord, Lord King, asked whether we are overwhelmed by the numbers of wounded personnel, and the noble Lord, Lord Bilimoria, gave an overly negative impression of the situation. I have done this before in the House, but it is important to focus on the data and on numbers. We are not overwhelmed. Last Friday we had17 military in-patients in the Birmingham hospital for any injuries or illnesses suffered worldwide. On a typical day, we would have 75 military in-patients in all UK hospitals. I can assure the noble Lord, Lord Bilimoria, that there is no waiting list for operational casualties going into Selly Oak. I am sure most of us agree that frontline medical care and treatment is quite simply outstanding. Many of us have seen it; I have seen it myself on operations. I have spoken to some of the highly skilled medical personnel who staff these operations, but we should not forget that it is their work in the NHS—in hospitals across the UK—which enables medics within our Armed Forces constantly to update their skills and then use them to save lives when on operations. The noble and learned Lord, Lord Mayhew, gave the hand as an example. The most important thing is that in the NHS we provide absolute state-of-the-art clinical care. I do not understand—it is old-fashioned I believe—the rationale behind the calls for a dedicated military hospital. That decision was taken by the previous Government and it was the right decision. Military hospitals cannot, I am glad to say, because of the small number of patients, provide enough experience to support the wide range of complex medical equipment and training that is required in the 21st century and could never hope to do so. Our primary reception hospital at Selly Oak can and does do that for our people. They are treated in a dedicated clinical unit that specialises in their particular condition if that is required. Their clinical needs come first. Military patients are supported by welfare teams and we have created a military-managed ward where they can be together, if their clinical condition allows. Each individual gets full military support. A number of noble Lords have stressed the importance of military ethos. Although it is vitally important, our first duty is to make sure that our people get the best possible treatment. Once they are on the mend we can then place more emphasis on caring for them in an exclusively military environment. The Defence Medical Services Rehabilitation Centre at Headley Court is such a military facility and will remain so. I have been both to Selly Oak and to Headley Court and talked to the staff and patients there. I was inspired by the tenacity of the patients and I am convinced that they are in the best possible hands. I also recognise that there have been reports of some individual problems at Selly Oak. These are being robustly investigated. But let us not kid ourselves that occasional problems do not occur under any system. We need to ensure that we investigate any problems thoroughly. I absolutely take the point made by the noble Lord, Lord Burnett. In a complex society we need to be good at tracking patients within the system. We are working on that. It is about caring for our people within the NHS system and making that system work, not trying to undermine it. That is not just my view; it is the view of the NHS and military medics that I speak to. With his experience, the noble and gallant Lord, Lord Guthrie, talked about being let down by the medical plan in the future. This is not going to happen from here on. The RCDM, which is now at Selly Oak, will be moving to the new hospital in Birmingham. It is a £690 million investment. It will be the largest hospital in Europe providing acute training and care. The RCDM will be part of that project. I know that some of the changes that have been made in medical care make some people feel uncomfortable. It is significantly different from the way things were done when we had military hospitals and change is never easy. This is what the noble Lord, Lord Garden, was referring to: the importance of managing the form in an effective way, recognising that the world does not stand still. We need to be excellent at having the agility to respond to the short-term pressures we face on operations while improving our ability to plan ahead and deliver the complex equipment that we need for our Armed Forces. We also need to look at the role of the state and its relationship with the private sector to deliver this improvement. Many of these projects into the long term require investment over many years, retaining capabilities which once lost cannot be regained. That is what underpins the new defence industrial strategy which we launched at the end of 2005: to deliver that reform. We are now seeing the benefits of the implementation of that reform, which in itself means recognising and acting on the mistakes of the past. Defence procurement has for too long been an area of challenge within government. In this Government, we are fixing it. Let us be clear: it is about reform, not about cuts. The defence budget has risen by £1 billion a year. I take the point about the proportion of GDP, but we should focus on the amount of money invested in defence, and last year the defence budget reached £30 billion for the first time. We need to do more.