How Britain is failing to care for badly injured troops
Tuesday, 17 July 2007
British troops in Iraq and Afghanistan are suffering serious combat injuries at
a record rate, The Independent on Sunday can reveal, leaving the country facing
a crisis over their long-term care.
A new analysis of official figures from the Ministry of Defence has shown that
British troops in Iraq are being wounded at double the rate of last year, while
in Afghanistan the number of wounded this year already exceeds the total for the
whole of 2006. This has gone hand in hand with an increase in troops killed on
operational duty in Iraq, where 32 soldiers have already been lost in 2007,
compared with 29 during the whole of last year. In Afghanistan the toll is 20,
compared with 39 in 2006.
Advances in battlefield medicine and casualty evacuation mean that many more
soldiers survive, and with much worse injuries, for every one who loses his
life. But anger is growing among military commanders and charities at the
Government's failure to face up to the implications of Britain's wars for
veterans who will suffer pain, disability and mental problems for the rest of
their lives, and for the health system that will have to look after them.
Critics say their treatment violates the Military Covenant, under which soldiers
are entitled to expect proper care if they are injured in the service of their
country, and proper provision for their families if they are killed in the line
of duty.
General Sir Richard Dannatt, head of the British Army, said last week: "We must
acknowledge that in some cases we have been found wanting – our systems [both
medical and welfare], although generally robust, are not matched to the demands
placed upon them. Events have overtaken us at times."
With the end of the Cold War apparently reducing the need for military
deployments and spending, Britain decided to close its dedicated military
hospitals in 1995. In their place is a scattering of Ministry of Defence units
at NHS hospitals across the country, including Selly Oak in Birmingham, where
many of the most severely wounded are taken, and the flagship rehabilitation
centre at Headley Court in Surrey.
But the wars of the 21st century are straining the system to the limit: since
2001, Britain has lost 223 soldiers in combat and 573 have been wounded in
action, of whom 238 suffered life-threatening injuries. There have been more
than 40 amputations since the Iraq and Afghanistan wars began – half in the past
12 months. More than 5,000 have been airlifted out, requiring urgent medical
treatment.
The number treated at MoD NHS hospital units almost doubled from 24,000 in 2002
to 45,000 in 2004, while at Selly Oak the number of in-patients more than
doubled from 511 in 2002 to 1,024 in 2004. During the same period the number of
out-patients there rose eightfold – from 513 to 4,116.
Headley Court, which will announce a new 32-bed ward to add to its existing 200
places, is now a victim of its own success, with a backlog of soldiers seeking
to go there for treatment. It is the only unit in the country exclusively
reserved for military personnel – elsewhere in the NHS, military doctors spend
most of their time caring for civilians.
General Dannatt admitted that "the decision to close the military hospitals ...
may have looked right at the time, but the legacy challenges we face are
severe". The MoD says it has addressed problems at Selly Oak, where service
families complained that wounded soldiers had been abused by civilians opposed
to the Iraq war, but complaints now centre on what happens after disabled
veterans are discharged after initial rehabilitation into the civilian NHS
system.
NHS rules say soldiers should be given priority in the health system for
long-term care of injuries sustained in battle. But one charity said last night
that not only was this not happening, but some doctors were actually biased
against former servicemen. "Doctors are the gatekeepers, and they are often
stopping priority treatment going through," said Maria Rusling, head of the
National Gulf Veterans and Families Association.
Campaigners say the thousands of soldiers returning home with psychological
disorders represent a ticking timebomb and that it will take years for the true
number of traumatised personnel to become clear. "The intensity and type of
operations that British forces are committed to at the moment are actually
stockpiling some very significant problems further down the line, particularly
in areas like mental health," warned Athol Hendry, director of the Soldiers,
Sailors, Airmen and Families Association.
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