Surgeon General’s Triple Serpent Conference 2012

Speech delivered by Mark Francois, Minister for Defence Personnel, Welfare and Veterans at the Medical Services Training Group, Ash Vale, Aldershot on Tuesday 2 October 2012.

This was published under the 2010 to 2015 Conservative and Liberal Democrat coalition government
The Rt Hon Mark Francois MP


Thank you Philip [Surgeon Vice Admiral Philip Raffaelli, the Surgeon General] for that introduction.

It’s a pleasure to join you at the end of the first day of the Surgeon General conference, and so soon after taking up my post.

I know this has been a long day and the bar beckons.

I hope to join you later for a drink, medicinal purpose only of course.

One of the first things I discussed with my team was getting me some early opportunities to see you on your own turf, and the work you do for our armed forces personnel.

I hope to visit our troops in Helmand in the coming months, and I will make sure that includes the hospital in Camp Bastion, and, of course, its new maternity ward!

I am planning to see some of you at the Royal Centre for Defence Medicine at the Queen Elizabeth Hospital next week.

And one of my first public duties was to be present when HRH The Prince of Wales opened the Jubilee Complex at Headley Court last month.

That, for me, was both a humbling and an inspirational experience.

It is clear that the bravery the men and women of our armed forces possess is not just expressed on the battlefield.

I was incredibly impressed by the spirit of our wounded personnel.

But I was equally impressed by the care and commitment shown by the people who look after them.

And I am advised that even our US and Israeli colleagues would admit that we are now world leaders in this field.

So I want to start today by saying thank you.

You work at the cutting edge of medical science and the first beneficiaries are those to whom the people of this country owe a great debt; those who risk life and limb to protect our national security.

Many of them are alive now because of you, and, compared with previous conflict, many of the seriously injured can expect to lead much more fulfilling lives because of the efforts you make.

So again thank you.

Given that this is our first meeting I thought I would use this occasion to let you know where I’m coming from, and to talk just a little bit about the challenges we face together.

Working together

So just a little about myself.

My father served in the Royal Navy in World War 2. He fought at D-Day.

My own service was as a TA officer with the Royal Anglian Regiment during the 1980s.

It was a different army then, trained for a very different war, a war that thankfully never came to pass.

So, I never saw active service and I have no medals.

But I have worn the uniform, and, as a reservist, I also remember what it was like to juggle service with life outside.

I hope that counts for something with you, because it certainly counts for something with me.

I asked to come to the MOD, and I am doing a job I want to do, working to improve the lives of the best and most dedicated people our country has to offer.

But I know that this is something you have been doing probably your whole professional lives.

Many of you are recognised internationally as experts in your chosen field.

So I’m not coming here to second guess you as professionals.

I am here primarily to listen and learn.

But, as a minister, I also intend to be pro-active in getting things done, not sitting back and waiting for problems to cross my desk.

As a young platoon commander I was taught to seize the initiative and that is what I plan to do.

I hope that my fresh eyes and ears will be of help in trying to get to the heart of some of the issues so that together we can make progress.

So what are those issues?


The first priority, of course, is operations.

Afghanistan remains the number one priority for the Ministry of Defence and the armed forces and the work of the doctors, nurses and medics on the front line is quite simply awe-inspiring.

I was at the National Arboretum last week and read the memorial for Army Medical Officer Captain Noel Chavasse, the only man to win the Victoria Cross twice during World War 1.

Captain Chavasse died from his wounds at Passchendaele but not before saving the lives of countless others, which is what earned him the Bar on the Victoria Cross he originally won at the Somme.

The example of Captain Chavasse lives on in today’s medics.

Just last week we honoured Corporal Julie May, who twice put her own life at risk to save colleagues in Afghanistan.

She received a Mention in Dispatches for attending to an IED casualty despite the significant danger posed by secondary devices in the area, and for stabilising an Afghan soldier whilst her position was under fire.

When I hear stories like this I am truly impressed by the courage and skill displayed by members of your profession.

As UK forces draw down from a combat role between now and 2014, one of the greatest challenges will be to make sure that we maintain the right medical support in theatre.

It will be difficult to strike the right balance between reductions in scale and maintaining the capability and the capacity to deal with the unexpected.

But strike the right balance, we must.

Following the withdrawal from Afghanistan, we will to identify what lessons learned and new skills might be embedded in the Defence Medical Services for the future and, indeed, transferable into current NHS practices.

Where we are now

Back here at home defence transformation will be the vehicle that will shape the future of defence.

You are now part of Joint Forces Command, which is one of the first tangible signs of transformation.

And I know Air Chief Marshal Sir Stuart Peach will be addressing you this evening.

Of course, the history of Defence Medical Services has been one of transformation, not always positive and certainly not straightforward.

But over the last few decades, just as the armed forces themselves have changed from the massed forces that trained to face the Warsaw Pact across the North German Plain, Defence Medical Services has changed too.

From the virtually autonomous single services that ran their own hospitals when I served in the 1980s, to consolidated joint Defence Medical Service today, where the patient is the focus, which is part of the wider medical community, and which collaborates far and wide to ensure that evidence based, cutting edge medicine and treatment are embraced.

This is especially evident in the work being done in partnership with others.

The establishment last year of the National Institute of Health Research Centre for Surgical Reconstruction and Microbiology in Birmingham enables military personnel to share advances and surgical innovation with the NHS.

Other examples of the partnership approach are the work being done with the Royal British Legion and Imperial College London on blast injury, and the King’s Centre for Military Health Research on mental health.

And I will be meeting Professor Simon Wessely to talk about his pioneering work at King’s, which is doing so much to further develop our understanding of the psychological effects of warfare.

Incidentally, I did my Masters in War Studies at King’s College, under Sir Laurence Friedman, so I am looking forward to visiting my alma mater in the not too distant future.

Now, I know this transformation hasn’t been easy, or without controversy.

But we have come a long way since the outcome of defence cost studies 15.

Nevertheless, I think we should be proud of the quality of the care that is now being provided to our Service people.

At the Clinical and Academic Units at Queen Elizabeth Hospital, our service personnel have access to some of the best medical care available in dealing with the most serious injuries with all the key specialities, such as plastics and neurosurgery, under one roof.

I hope to see for myself next week how having a military ward in a cutting edge NHS hospital provides a reassuring environment for our service personnel while at the same time providing a level of care that would be difficult to recreate in a purely service environment.

And, as I have seen for myself, at Headley Court, the Defence Medical Rehabilitation Centre provides world class care and we are constantly investing in staff, facilities, patient welfare and treatments.

I am particularly, and personally, pleased that this government is helping you to focus attention on mental health - which had, perhaps, for many years not been given the priority it really deserved.

I intend to continue to champion a through life approach to mental health, drawing on the work of my new ministerial colleague Doctor Andrew Murrison, as well as the considerable amount of research undertaken at King’s College.

So this is where we are now.

The recent care quality commission report praised the facilities available to casualties in theatre, as well as those for patients at Headley Court.

This doesn’t happen by accident.

It happens because of people like you.

But no successful organisation can be complacent.

So let me turn briefly to the future

The future

We must continually strive for greater excellence.

But in today’s economic climate we must also strive for greater efficiency.

I don’t need to go into detail on the pressures on the government purse or on the defence budget, and I don’t want to get partisan about the reasons for that.

Suffice to say we are where we are, and we face a delicate balancing act: reducing the fiscal deficit while making sure front line services are protected as much as possible; making sure that our service personnel get the best care available, because the best is what they deserve.

But there is no pot of gold to fix things with.

Going forward we are going to have to be innovative and agile.

That is why the work underway on Defence Medical Services 2020 cannot happen in isolation from the wider changes taking place.

This is particularly true when it comes to reserves, who will play an increasingly important role in the future.

In the autumn, we will be looking closely at the deal for reservists and employers to make sure the offer to both supports our plans for a larger, more integrated reserve.

And it is also true when it comes to the changes taking place in the NHS.

I have already had a very productive meeting with Dr Dan Poulter.

Dan is a GP and the new minister within the Department of Health with responsibility for the provision of secondary healthcare to service personnel.

We have agreed to work together on a number of service personnel and Veterans’ issues.

For instance, the planning application to build the Defence and National Rehabilitation Centre at Stanford Hall in Nottinghamshire is soon to be submitted to the local authority, and I am hoping to go and see the site for myself next week.

I have committed to work with the Department of Health, the NHS and the project team to ensure that the national element of the project is given a high priority.

Ultimately, this close working together is framed by the armed forces covenant, in which healthcare is a key and enduring obligation.

Progress has already been made in delivering against our commitments, such as a greater focus on mental health.

But, as we go forward, the challenge will be to continue working successfully with the NHS as both organisations, them and us, go through transformation and reform.

There will soon be a major change in the management of primary healthcare in defence itself.

This is designed to provide opportunities for better use of resources, improved quality through sharing best practice and expanded career options for medical staff.

And the Surgeon General has set out his clinical priorities that range from combat casualty care, to mental health and research.

So, throughout this transformation we need to advance these clinical priorities, see through the cutting edge research, become even more efficient and even more patient focussed, while improving the standard of care provided to our armed forces personnel.

This is going to be what my officials refer to as: “challenging”.

And we are only going to succeed if we work together to achieve all this.


I am in no doubt that when the government sends the young men and women of our armed forces into harms way we have a moral obligation to make sure they are properly equipped for the task they have been set.

That they are given the best medical care available on the job.

And that they and their families are properly looked after when they are away and when they get home.

I am determined to strive as hard as I can as a minister to ensure that this is the case.

I hope that together, with your help, that is what we will achieve.

Thank you for your attention.

Working together, let us do our best.

Published 2 October 2012