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Lord Harlech
Main Page: Lord Harlech (Conservative - Life peer)Department Debates - View all Lord Harlech's debates with the Ministry of Defence
(2 days, 2 hours ago)
Lords ChamberMy Lords, I declare my interest as a serving officer in the Army Reserve. In moving Amendment 6, I shall also speak to Amendment 7, which stands in my name in the same group. Before I focus on the amendments in detail, I would like to briefly preface the intent behind all the amendments to the Bill in my name. The Government Whips can rest assured that I am not about to launch into a Second Reading speech—but, as Max Hastings wrote in the Times this week:
“When the Cold War ended in 1990 the TA still mustered a strength of almost 73,000”.
We can all agree that we are a long way from that now. All my amendments are with the aim of improving the lived experience of reservists in order to strengthen recruiting and retention and therefore the operational effectiveness of the Armed Forces.
The two amendments in this group have a single purpose between them. Clause 2 puts the covenant properly into law, and I welcome it, but a duty of due regard is only as good as the ability of the body under it to see the people it is supposed to be regarding; Amendment 6 makes them visible, and Amendment 7 gives the duty a specific task. Amendment 6 would require bodies subject to the Clause 2 duty to ask, and to record, whether an individual belongs to the Armed Forces community and, in particular, to distinguish current reserve service from veteran status. I anticipate that the Minister will tell me this already happens. The registration form for a general practice does carry a question about Armed Forces service, but the question is optional, is framed in the past tense—about having served—and is asked once at the point of registration. Consider what that means for a reservist. Reserve service is a status acquired in mid-life. I registered with my general practitioner long before I attested, and nobody has asked me since. The whole design is veteran-shaped, and serving reservists fall through it.
Although a clinical code for Armed Forces reservists already exists within the National Health Service, it remains entirely underutilised. The framework is in place, yet throughout my years in the reserves I have never been queried about my military status when scheduling a medical or dental appointment—an experience that I am confident is widely shared. The consequence is that the entire burden of the covenant falls on the individual to self-advocate. They must explain what the covenant is to a receptionist who has potentially never heard of it in order to claim something to which they cannot prove they are entitled. Most people do not bother, and I do not blame them.
I will address the inevitable criticism head-on. Proposed new subsection 4 would ensure that the decision to respond remains entirely voluntary, stipulating that declining would not prejudice an individual’s access to or quality of care. While the serviceperson retains their autonomy, the provider is stripped of the plea of ignorance.
If we lack this data, the ministry remains unable to evaluate the covenant’s impact and this House is denied the means of oversight. We would in effect be creating a statutory obligation while simultaneously refusing to provide the tools necessary for its fulfilment.
Amendment 7 turns to what the duty should deliver. It would require health bodies to have due regard to a reservist’s need
“to attain and maintain the standards of medical and dental fitness required”
for call-out and recall.
The Bill expands the liability to serve, extends recall to the age of 65 and introduces a lower threshold for mobilisation and an opt-out model. Every one of these provisions assumes that the individual is medically and dentally fit to deploy. Applying recall powers to people who cannot pass a medical grading is simply relabelling, not enhanced capability.
Dental fitness is the sharpest illustration of this. A reservist who cannot obtain a dental appointment fails dental fitness standards and becomes non-deployable. That is not a health inconvenience; it is a capability loss that the state has created by asking the serviceperson to be ready in the first place.
Reservists routinely pay privately to stay deployable. That is a hidden tax on service. Proposed new subsection 3 would provide that nothing in the clause
“requires a health body to provide any assessment … or treatment otherwise than in accordance with clinical need”.
The amendment bites only between patients of equivalent clinical priority. It is a tie-break, not a preference, and it cannot displace a single patient with a greater clinical need. It is the same bounded logic as the existing veterans priority, which survives precisely because it is bounded. Proposed new subsection 4 would require the Defence Council to publish those standards, because nobody can have due regard to a standard they cannot see.
I have two questions for the Minister. What is the department’s assessment of the proportion of trained reservists who are currently medically or dentally non-deployable? Will the Government publish those standards, irrespective of what happens to this amendment? Neither of these amendments costs any money. Together, they are the difference between a covenant that is declared and a covenant that is delivered. I beg to move.
I support my noble friend and declare an interest in that my daughter is a serving member of the reserves. Amendment 7 would have helped her enormously in the autumn when she received her call-up papers to join the Welsh Guards in Kenya. She had a wisdom tooth issue and had been on the waiting list for some time. Because her reservist service was not known to her dentist or, frankly, anyone else, she was very nearly medically undeployable and people had to bend rules. That had an effect not only for her and the Welsh Guards but for her employer, who had to sign up to give her the time off to go and do three months with the Welsh Guards. That was a real-time example of why these amendments really matter.
As the noble Baroness will know, the “due regard” point has come up ever since the covenant was introduced. The question of what it means has been a debate all the way through the existence of the covenant, but “due regard” has stood the test of time. It means what it says. We do not believe in compelling a dental practice, doctor’s surgery or hospital always to prioritise that particular person in that circumstance over and above everyone else. Although I understand the intent of the noble Lord’s amendment, it would require preference to be given irrespective of the needs of everyone else.
That is not right. The amendment expressly says that clinical need takes priority and it is only with two patients of equivalent clinical need that service need would affect the waiting time.
The point I am making is that “due regard” is the way that we try to ensure that the point the noble Lord makes is actually delivered. Rather than compel a particular organisation or body to do X, Y or Z, we require it through the guidance—the previous Government did it successfully and we have extended and developed it—to have due regard. When somebody comes forward in that situation, with the extension of the national bodies required to have due regard and the issues which they have to have due regard to, such as health and social care, that due regard will not exist until this Bill is passed into law. That means that there is a significant step forward in ensuring that the intent of the noble Lord’s amendment is realised, through ensuring and requiring that those bodies have due regard in the way that the term been accepted over many years since the existence of the covenant. That is why we think that is the appropriate way forward. We believe this meets the right balance between health bodies having due regard for the sacrifices of service life and removing disadvantage arising from service where appropriate.
As I said to the noble Lord, although I support the intention behind his amendment, I do not believe that a statutory obligation on health bodies is the right mechanism for delivering the outcome. What is outlined in the Bill about the extension of the covenant to the new specified persons, which include a health body, and the specific matters, which include health and social care, and requiring all of them to have due regard, is the appropriate way forward. With that, I hope the noble Lord will consider withdrawing his amendment.
My Lords, I am very grateful to the Minister for his remarks. I understand the case he is making and standing behind. I am incredibly grateful for the contributions from my noble friends and the noble Baroness, Lady Smith of Newnham. I think our argument has been more persuasive. If we are meant to be moving to a war footing and war readiness, I think this, “It would be nice if this happens”, with due regard is wrong. That is a cop-out from the Ministry of Defence. It sounds like it is just trying to take up a bit of slack because it does not want to overburden the NHS even more. If we are meant to be moving to a war footing and war readiness, this is not going to cut it and will come unstuck really quickly. This has been a useful debate to open up some more questions and move the discussion on, but I feel like we might return to this on Report. With that, I beg leave to withdraw.