Select Committee on Defence Appendices to the Minutes of Evidence


Further Memorandum from the Ministry of Defence (31 October 2000)

  Following my letter of 23 June 2000 providing information on the medical standards for entry to the Armed Forces, you asked for further clarification of the policy adopted by each of the Services, in particular with regard to psoriasis.

  As I advised in my previous letter, the medical standards for entry to the Armed Forces are set out on a tri-Service basis in the Joint Service Publication (JSP) 346. The JSP is issued by the Surgeon General's Department as guidance to the three Services. Each Service may apply the guidance flexibility to meet its own requirements. The prime consideration when examining applicants for entry is whether or not they are medically fit to undertake the type of employment they seek.

  So far as dissemination of medical standards is concerned, a copy of JSP 346 and amendments is issued to all Service and civilian medical practitioners required to examine applicants for entry to the Armed Forces. The JSP states that examining medical officers must consider each applicant on his or her own merit and encourages them to apply their clinical judgement individually. They are also advised to seek specialist opinion where appropriate. Further single Service guidance is provided by the RN and RAF in additional publications on recruiting medical standards. The RN also runs biannual courses and the Army holds annual conferences for examining medical officers. Medical examination of applicants has been centralised by the Army at four units in the UK which means that, if necessary, cases of doubt can be discussed with medical colleagues before a final decision is made.

  I can confirm that the Army adopts a stricter policy on psoriasis than the other two Services and bars anyone who has, or has a history of, psoriasis. The reasons for this are that individuals need to be able to withstand the rigors of initial training and subsequent military operations, and to perform their tasks without risk to their own or others' health and safety. Soldiers may be required to serve in adverse conditions which may exacerbate psoriasis. Severe attacks can be debilitating and could prevent sufferers from carrying out their military duties, thereby potentially putting themselves and their colleagues at risk. Furthermore, some deployments to isolated areas may have limited medical facilities and it could be difficult to provide the necessary medical treatment.

  I can also confirm that being clear of psoriasis at the time of a recruiting medical examination would not mean that an applicant was fit for service; acceptance would depend, as in all cases, on an individual's medical history. As the Professor of Dermatology from Manchester has advised the Committee, it is recognised that stress can exacerbate psoriasis. Whilst this does not imply that psoriasis sufferers are more prone to stress than any other group in society, it does confirm that psoriasis sufferers have additional medical concerns to deal with when exposed to stress. Initial Army training and subsequent service can be highly stressful—both physically and mentally—and it is because of this, and the duty the Army has to care for both new recruits and serving personnel, that it excludes those applicants who have a history of psoriasis.

  As the Committee is aware, the RN and RAF may accept some applicants with psoriasis, depending on the severity of the condition and the type of employment sought. Those who have previously been rejected by the Army would be considered on their merits, as in all other cases. Applicants must declare if they have had an application rejected by one of the other Services and where an applicant to the RN or RAF has previously been rejected by the Army on medical grounds, the medical notes would be obtained and submitted to the RN or RAF medical directorate for advice.

  As I advised in my earlier letter, JSP 346 is kept under constant review and is regularly updated. However, the Committee will be interested to know that the Department is proposing to carry out a formal tri-Service review of the policy on recruiting medical standards. I will provide further information about plans for the review, including the timescale, when these are available.

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Prepared 23 February 2001