Back in 1994, Malcolm Rifkind, the then Defence Secretary, was faced with a familiar problem: too many defence commitments and not enough money. He found a politically very attractive answer to his problems by combining the government's policy of outsourcing public sector activity with a rebalance of military effort towards combat forces. Abandoning the usual defence programme mechanisms, he established over 30 separate study teams with Jonathan Aitken as the minister in charge. These teams of young Turks were charged with cutting through the bureaucracy and coming up with fast and radical methods of reducing support area costs. The whole exercise went under the slogan of "Front Line First". Many of the difficulties that are being experienced by the Services now stem from elements of this ill judged defence review.
Just before the parliamentary recess, the catastrophic state of military medical services burst into the public domain. Menzies Campbell, the Liberal Democrat spokesman, put a series of questions on defence medical statistics to Dr Lewis Moonie, the junior defence minister. The written answers reveal that military medicine has virtually disappeared over a period of 5 years. Front Line First had announced that there would be much greater integration between the Services and the NHS and that savings of £55M a year were possible out of a 1994 budget of £400M. 1000 medical posts would disappear as would two out of the three then remaining military hospitals. What was not to taken into account was the effect of such drastic pruning on the viability of the remaining military medical services. The 27 July 2000 Hansard replies gives the detail. For example there are just two specialist burns consultants out of an establishment of 10; 3 Accident & Emergency consultants to fill the 23 places; 9 orthopaedic surgeons for the 28 posts; 30 anaesthetists out of 120; and under half of the GP slots are filled. Fewer than half of all service personnel with hospital appointments are seen within four weeks.
To address this critical situation, the government is having to offer medical pay incentives for retention, and is establishing a new Centre for Defence Medicine in Birmingham. The NHS cannot provide the specialist expertise for the treatment of combat injuries. All of this is likely to exceed the predicted savings of the Front Line First medical study. The MOD (or Treasury) should hold an investigation into how its medical services forward planning went so badly adrift. There are many lessons to be learned about the dangers of undermining critical capabilities for the sake of hypothetical savings.
There are other specialist manpower problems looming on the horizon. The RAF is seriously undermanned in its fast jet pilot requirement. Earlier in the year, the Air Member for Personnel admitted to the Defence Select Committee that the position would worsen over the next three years to be 135 pilots short out of 500. It looks as though a solution will be sought by turning the flying training organisation into an outsourced activity, as well as further reducing the number of operational squadrons. This will mean that, unless commitments reduce, individual pilots will be deployed more often and will have no option to spend a tour at home as a flying instructor. The long term effect on retention is unlikely to positive.
The army manpower problem continues to be all pervasive. The shortfall of over 5000 is currently predicted to be overcome in 5 year's time. However, this is a timescale well beyond the horizon of any manpower planner. Retention remains the key problem, as expensive experience bleeds away from the army.
The current government is well aware of the problem that it is having to manage, but it may be less aware of why the problem has arisen. Past decisions to achieve apparently good savings in the defence budget have given rise to increased manpower costs. There are some elements of a defence capability which are essential: battlefield medical support and pilots are two of the more obvious. Trimming force sizes to make savings can take one to a cliff edge of viability surprisingly quickly. If savings are unavoidable, it may be wiser to remove complete capabilities than to spread the misery equally. In that way the critical components can be protected. Politicians always tend to focus on equipment and industrial concerns. It may be time for them to be more attentive to the long term needs of their service personnel if they want to retain any defence capability.