Mobile Army Surgical Hospital
Debate between Jim Shannon and Phillip Lee(10 years, 11 months ago)
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Dr Phillip Lee (Bracknell) (Con)
I never thought I would see the day when the words “Mobile Army Surgical Hospital” would be the title of a debate of mine. I grew up watching the television series “MASH”, which partly inspired me to become a doctor. I want to make a serious proposal about a capability that this country should be able to deploy abroad. I started thinking about the issue following the Syria vote in August. I voted against both motions before the House that day. After that, I thought that I should come forward with a constructive suggestion for our engagement with the crisis in Syria. This is my suggestion.
I will present a history of field hospitals in general—just a brief one; don’t worry—and discuss the humanitarian response capability that we need. I shall then mention the challenges of bringing that about and, perhaps more importantly, the details of the facility.
I became a doctor for a number of reasons, but a couple of things spring to mind. One is a book called “The Red and Green Life Machine” written by a commander in the Royal Navy, a chap called Rick Jolly. The title refers to a field hospital in the Falklands war, set up in a disused abattoir in San Carlos bay. I read the book when I was about 13. I watched every single episode of “MASH” and developed desire and ambition—initially, to become a trauma orthopaedic surgeon. I subsequently went to medical school and decided that I would be a GP. What inspired me was the desire to do something to help people in distress.
However, I stress that I am no pacifist. I did not vote in August against the intervention lightly; in fact, I am in favour of quite significant intervention if it is well thought through, coherent and backed up with a strategy for the region. However, I am against the wilful, somewhat reckless destruction of assets in a small way because that can breed more problems going forward.
We are experiencing the ongoing crisis in Syria through our TV screens. I first visited the country in 1998 and I went back as vice-chairman of the Conservative middle east council in February 2011, about three weeks before the civil war started. I have a sense of association with the country. I enjoyed both my visits—particularly the first one, when I was backpacking around as a medical student. I visited Homs, Hama and the beautiful parts of Aleppo that I fear are no longer intact. When I came back from my second visit, I was gripped with a sense of foreboding that trouble was about to start, although not as quickly as it did. I also felt the sense that Britain’s engagement with the country in its crisis should be constructive and trying desperately to bring about a peaceful end to the war.
The problem is that since then there have been more than 100,000 deaths and more than 2 million people have migrated away from the chaos. There has been one public use of chemical weapons, and it has been suggested that there have been others. We have all had to endure some pretty appalling footage of death and destruction, primarily affecting innocent civilians—women and children. It is pretty shocking to have to endure it.
Our response should be multi-pronged. We could foresee a situation in which hard power is wielded, but soft power should also be considered. This is where I come to the MASH or mobile surgical hospital facility that I envisage for Britain. The history of field hospitals goes back to the Napoleonic wars and the gentleman called the father of combat medicine, Baron Dominique Jean Larrey. From that concept of forward surgical hospitals bringing medical support to combatants at the front line, things developed slowly. I guess that the fastest development took place during the Korean war in the early 1950s; the “MASH” TV series is based on that war, although it was always associated with the Vietnam war because of when it was made. During the Korean war, major developments were made in pushing field hospitals closer to the front line. There was the famous image of a Bell helicopter with two casualties strapped into stretchers on either side, with the purpose of bringing people back to be treated very quickly. The dictum was, “Life takes precedence over limb, function over anatomical defects.”
Since then, there have been massive advances. I have not yet visited the hospital at Camp Bastion in Afghanistan, but I am told that it is a remarkable facility delivering the very best trauma care. Of particular note to Britain is our experience in Kosovo in 1999, where the British Army managed to create, in effect, a tented village for a load of refugees as well as medical facilities. It was a fantastic success, and proof of what our military are capable of.
Jim Shannon (Strangford) (DUP)
I congratulate the hon. Gentleman on bringing this innovative idea to the House for consideration. I have a Territorial Army ambulance unit in my constituency and they are renowned for the good work that they have done and can do. Does he see the MASH unit being staffed by regular soldiers or TA soldiers, because I believe that both could do the job equally well?
Dr Lee
Yes, I was going to come to that. There should be a DFID-funded capability.
The capability needs to be constructive. A friend of mine has talked about having blue overalls, not blue helmets. In other words, we have a United Nations force with blue helmets, so why do we not have a force of people in blue overalls? Our intervention should not necessarily be military in appearance—we can also intervene in other ways. The capability should be resourceful. We are good at this stuff. We can draw on our experiences in the Balkans and the Falklands—I mentioned Rick Jolly’s field hospital—and prior to that. We are very good at this; we have the clinical expertise, in particular. The capability should be able to be expeditionary—that is, to go abroad. In the case of Syria, I foresee a situation where it could be located in a friendly country such as Jordan. It should also have a domestic application. God forbid that there is ever a chemical attack in this country, but the facility could also be deployed here.
The core goal should be to try to develop a stable world that we all appreciate, and that can be brought about by making friends and influencing people. The Arab street is not necessarily with the British or the Americans. We need to persuade civilians on the ground that we do not always have a malign, vested interest—a sense that we are just doing it for ourselves—in our approach to the middle east, but that we are there to do constructive and good things and to genuinely help people.
Turning to details and capacity, as a result of the conversations I have had I envisage a facility with at least 50 beds, perhaps more. If it is as successful as I think it will be I suspect we will extend it, but 50 beds is a good starting point. I think it should include a CT scanner, which is often not available in more rural areas and far-flung destinations. It is possible to put CT scanners in containers and companies such as Marshall Land Systems in Cambridge make container hospitals. There is no reason why we cannot do this. We need to consider whether the facility should also have paediatric and obstetric services, because it is not just soldiers such as those in the “MASH” television series who will be coming in, but children who have been affected by a neurological agent—such as those we saw in that dreadful footage—and pregnant women who have sustained injuries.
Cost is always relevant when it comes to Government spending and there are some figures available. Apparently the Finns purchased a hospital for deployment for about £5 million. I envisage that my proposal will probably cost between £5 million and £10 million. I think it should be a military asset, because the military is best placed to run it, but it should be staffed primarily with reservists, not regulars. Military logistics are important: the army are the best people to get this facility quickly into the field, and Kosovo is an example of that. The army’s command and control systems are relevant.
My hon. Friend the Member for Beckenham (Bob Stewart) has rightly referred to the facility’s security, which is of paramount importance. I think it would be a target. The facility would focus on hearts and minds and on delivering care on the ground, and if I were an Islamist jihadist I would think, “We need to knock that out, because it’s going to start changing minds and attitudes.” The facility’s security would need some thought. For example, RAF Akrotiri is stationed close to Syria and the deployment of troops may need to be considered in exceptional circumstances.
Clarity of funding is clearly important, as my hon. Friend the Member for Woking (Jonathan Lord) has said. The politics of international aid are tough on the doorsteps of Bracknell—trust me: I experience it quite often. This proposal would be one way of using DFID funds for something that is demonstrably humanitarian and of leveraging in some funds to a defence asset that would be used primarily for humanitarian purposes, but—this would always be at the back of my mind—that could also be deployed if we ever go to war.
Jim Shannon
We are discussing examples of armed conflict in places such as Syria and Kosovo. Does the hon. Gentleman also see this MASH unit playing a role in responding to humanitarian crises or disasters?
Dr Lee
Yes, I do. In fact, the last American MASH unit was deployed in response to the 2006 earthquake in Pakistan and it was then given to the Pakistanis. I would hope that the facility would be used less for military purposes. There are likely to be future crises and I think it should be used in response to them.
Microgravity Research
Debate between Jim Shannon and Phillip Lee
Dr Phillip Lee (Bracknell) (Con)
This is a rather esoteric subject on the face of it, so I should like to explain why I have chosen it. I am vice-chairman of the parliamentary space committee, and as a consequence of that role I have come into contact with many people in the space industry who have spoken to me about microgravity, the research thereof and its potential value to the British economy. I do not have any direct constituency link, although I have a local company that provides equipment for satellites. In the past decade, the UK space industry has been growing, year on year, at a rate in excess of 10%. I genuinely think that it should be part of the Government’s growth strategy and that it would contribute to the diversification of this country’s economic base. I have had the particular pleasure of meeting Tim Peake, who is the only British astronaut on the European Space Agency manned programme, and who also happens to be a champion of microgravity. That is quite important, because it indicates how good we are in Britain at research in this area.
Why have microgravity research? First, as I said, the UK is very strong in that area. Microgravity crosses a large number of fields, and that may contribute to why it has not always received support from the research councils. Secondly, it has huge potential economic benefits, particularly in bio-medicine. Thirdly, I do not think I am alone in this House in thinking that we should have a manned space flight programme. We need to do that with partners—perhaps with Europe, Russia or the United States—but I genuinely believe that we are better off seeking out new knowledge, endeavour and aspiration. All those things are positives, and Britain was at its best when it was displaying those facets.
Let me explain the structure of my speech. First, I will explain microgravity. I am sure that all colleagues here understand it fully and do not need a definition, but I will provide it for the benefit of the many people who have tuned into BBC Parliament for this debate. I will then touch on the sectors that microgravity research can impact on; talk about the history of the involvement in microgravity research, or the lack thereof, of Governments, this one and previous; and put some questions to the Minister.
As life evolved on this earth, lots of physical and chemical change took place in the environment that caused adaptations to take place in life, be it plant or animal. The only thing that has been constant in 4.8 billion years is gravity. It is therefore thought that organisms now have little or no genetic memory of how they would respond to low gravity, and that the low-gravity environment could uncover some novel mechanisms and responses to adaptations that may benefit the economy through commercial applications. That is basically why researchers are so eager to get into space, so to speak, to test the impact of microgravity.
This definition is just one of many I have read:
“Microgravity research = the research into the impact of low or zero gravity on human health and on other materials, and the exploitation of the low gravity environment to conduct research into pure science and human applications.”
We can create such low gravity here on earth in drop towers—something like those found at Alton Towers—or through parabolic flights. However, the best place for it to happen is in space. It can be done by a sounding rocket; at the moment, it is done at the international space station. Why conduct the research? Put simply, gravity adds complexity to certain experiments by contributing to convection currents, shear stresses and buoyancy, and that can impact on processes that we would like to study. In order to try to remove those potentially confounding variables from the experiment, one needs to go into a microgravity environment, and the best place for that is in space.
Let me turn to the sectors that may be impacted on, both economically and in terms of human knowledge and pushing back these boundaries. First, I will mention bio-medicine; as a doctor, I would be expected to do so. The bio-medical applications are numerous. Essentially, it is thought that putting cells—any cells—into a microgravity environment affects the way in which they work. Understanding how cells work and how they communicate with one another will have broad applications in the study of cancer, coronary heart disease, AIDS and diabetes. We can all understand that that might lead to the development of new therapies and drugs that would benefit mankind. In economic terms, if British patents were attached to such developments, UK plc would benefit.
One can also grow pure protein crystals in microgravity, and by doing so aid the understanding of the immune system, which would again benefit health care. One of the most noted areas is musculoskeletal systems and the response of bone and muscle. I am sure that most hon. Members know that spacemen who have spent lots of time in space have been found to have reduced bone density and muscle wastage. Why that happens is not fully understood. By trying to understanding that and how tissue remodels, we may very well find new techniques to treat musculoskeletal disorders.
Another sector where microgravity can be used is fluid physics. The understanding of the forces that affect fluids has wide applications. If we can understand them better, it might contribute to the miniaturisation of electronic devices. The BlackBerrys and laptops that we use have all benefited from greater knowledge in this area. Using these developments will undeniably lead to a reduction in costs for the customer when they buy such electronic devices at John Lewis and elsewhere.
Jim Shannon (Strangford) (DUP)
I am not an expert in microgravity research—far from it—but I had a wee look at it before the debate. I understand that some microgravity research has looked at earthquakes and the pre-warning of earthquakes. Perhaps the hon. Gentleman would comment on that, because obviously if people can be warned of earthquakes and tremors, it might save life.
Dr Lee
I have absolutely no idea about the prediction of earthquakes and I am struggling to think why an understanding of microgravity would help to determine when there might be an earthquake. The hon. Gentleman has given me something to look up when I leave the Chamber.
The final area is material science. Understanding how materials or composite materials behave in a microgravity environment might help to develop new alloys and ceramics. That has broad applications. We are at the cutting edge in Formula 1 and in the use of composite materials and alloys. That knowledge originally came from the space sector. By doing this research we will enhance our standing in that area.
This list is not exhaustive. A variety of different sectors are involved. In the area of plant biology, I have seen the suggestion that plant stem cells could be grown on an industrial scale in space, thereby assisting us in our need to develop biomass for energy. I could go on.
Moving on to the history of Government involvement in microgravity, the Pippard report of 1989 was the first mention that I could find. It made some interesting observations that have since proven to be true. The Wakeham review of 2003 found a lack of interest among the research councils, which goes back to the point I made at the start of my remarks that microgravity does not have a single voice. That is why it has not received funding in the past. As a result of the Wakeham review, Britain did not contribute to the European Programme for Life and Physical Sciences—ELIPS—with the European Space Agency, which was started in 2001 and is ongoing. The ELIPS 4 funding round is due at the next ministerial ESA meeting in 2012. I would push for us to participate in that, not least because doing so would allow us to work with NASA, which will not work with us outside ESA as I understand it.
Finally, I have some questions for the Minister. First, will he confirm that the Government are not against manned space flight? For some time in this country, it was Government policy to be against manned space flight. I think that manned space flight is inspirational. Anybody who goes into a school on a science, technology, engineering and mathematics day will find children building rockets and looking at pictures of planets. The reality is that space inspires children and that we will need more scientists and engineers in the future. I spoke about the inspirational quality of space in my maiden speech—I do not know how many hon. Members who are present were here for that. I strongly believe that there has to be a man on top of the rocket for it to be inspiring.
Secondly, will the Minister outline the Government’s position on the ELIPS programme and the ESA manned space flight programme in anticipation of the 2012 ministerial meeting? I ask that because for about £200 million a year we could participate in that programme. Over a 20 to 25-year period, we could perhaps participate in the exploration of the moon and, further, of Mars. That may seem an extravagance to some, but it is not. For every $1 spent on the Apollo space programme, it was estimated that the US economy got $14 in return.
We can make money out of space—it is as simple as that. Britain is outstanding at space, and we do it on a shoestring in comparison with some of our competitors. I think that in future, we should be a greater player in space. I know that the Minister shares my feelings on that. I forget the figures, but we are projected to increase our space industry over the next 10 years, and I am wholly supportive of that.
What is the Minister’s opinion on a microgravity forum? I have had e-mails from around the world since I tweeted that I would introduce this debate, and I have met people, and it is interesting that there is not one, single voice for microgravity. Microgravity perhaps needs that one voice, but does the Minister have any views on that?
Finally, more generally, as a new boy in town, I get the distinct impression that Whitehall is risk averse. If there is one thing that we cannot be when it comes to space, it is that. We have to go for it. I am encouraged that the Government have in the last year announced changes to legislation with regard to aiding the space industry—it relates to space insurance—but ultimately, Whitehall remains risk averse. I would be interested to know the Minister’s view on that.
The best way to conclude is by quoting an e-mail that somebody sent. He ended one paragraphs as follows:
“In addition to providing benefits to society”
microgravity
“research will also help the UK to maintain some degree of scientific relevance - scientific capability in a nation is a recognised necessity for economic development.”
I could not have put it better myself, and that is why I called for this debate.