Thousands of British soldiers classified as unfit for active service are to be treated at private hospitals in the starkest admission yet that the NHS is in crisis. The Ministry of Defence has signed contracts with 40 private hospitals to try to get around the long waiting lists in the state system.
The move comes as new figures reveal that fewer people now work in the health service than at the beginning of Margaret Thatcher's first government. In 1982, 874,000 people were employed in the NHS, including consultants, nurses and GPs. The figure for 1999, the latest available, is 873,000.
The Government pointed out that most of the fall in NHS staff was in the last years of John Major's government and that figures have been steadily increasing since 1997. 'We were left with a legacy of decline,' a Department of Health adviser said. 'We have turned that around.'
The MoD contracts with Bupa and Nuffield Hospitals are part of a 'waiting list initiative' to deal with sickness in the ranks. MoD sources said problems with getting people treated in the NHS were so acute that they had to sign the multi-million-pound contracts or face armed forces running 'on half empty'.
'It's not exactly a vote of confidence in our hospitals,' said one official. 'But it was this or leave people who are unfit waiting for months or even years for treatment.'
The MoD took action after it was revealed that nearly 16,000 personnel had been medically downgraded as fit for 'light duties' only. The Army figure was nearly 10,000 or 10 per cent of strength.
Government advisers admit that the use of private hospitals by a Labour government, which said it wanted to build a 'first-class NHS', has caused huge tensions. Last October The Observer revealed that Nigel Crisp, the new chief executive of the NHS, had signed the first 'concordat of understanding' with the private sector to treat 100,000 patients who could not get an NHS bed.
The move was heavily criticised by prominent backbenchers. David Hinchliffe, Labour chairman of the Commons health select committee, said the Government should not do deals with the private sector. Tony Benn said the move was tantamount to privatisation of the NHS.
The Government said it was up to local health authorities to sign the contracts and the Government did not have 'an ideological problem' with the private sector.
The fact that the Government is now signing contracts directly with the private sector brought a fresh wave of criticism.
'I feel very uneasy and very unhappy about such a move,' Hinchliffe said. 'The more work that is given to the private sector, the more consultants and nurses are pulled away from the work they are doing with the NHS.'
Some soldiers and civilians in the armed forces will be allowed to 'queue jump' NHS waiting lists if their condition is urgent and their role cannot be filled by other staff.
Peter Viggers, Conservative vice-chairman of the Commons defence select committee, said the Government's record on armed forces sickness was 'lamentable'. He said the Defence Medical Services operation, responsible for health in the armed forces, was in chaos and that the last military hospital in Britain, the Royal Hospital at Hasler in Gosport, Hampshire, was about to be closed.
'Fifteen or 20 years ago there were eight service hospitals and now we are in this position,' he said. 'It is quite staggering that we have failed to tackle what is such a serious problem.'
Lieutenant-General Tim Granville-Chapman, the Army's adjutant general, said this month that illness in the armed forces was causing serious problems. The Army is 5,000 soldiers under-strength, leading to a high degree of 'overstretch'.
Asked during a hearing before the defence select committee about the high number of soldiers medically downgraded, he said: 'It is a big figure, I would much rather it was not that size. We are looking at fast tracking, putting as many people through the system as we possibly can. It seriously affects getting people from recruiting into the trained Army.'
