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MC 17 Memorandum from Soldiers, Sailors, Airmen and Families Association (SSAFA) 1. In general SSAFA Forces Help believes that medical care for serving personnel of the Armed forces is very satisfactory, and in some cases outstanding as it relates to physical illness and injury.
2. Despite recent public and press interest in the treatment of wounded on repatriation from Iraq and Afghanistan , SSAFA has no evidence that the care provided by the Centre for defence Medicine (CDM) at Birmingham University NHS Trust , and other hospitals , is anything other than excellent in clinical terms. Rehabilitation services at the MOD facility at Headley Court are second to none in the UK.
3. SSAFA has less confidence in the far more complex, and less tangible arrangements in terms of support to service personnel once discharged from hospital, ie personal support welfare in the broadest sense, including psychological and mental health , including clinical aspects. This not just the immediate post operations support, but the ongoing care of service , and indeed ex-service personnel which may extend for very many years. To be fair, this is not a task which the MOD could, or indeed should be expected to do alone. This is not intended to be a criticism of MOD, which is just not equipped nor configured for such a highly complex task. We believe that personal support welfare and community mental health provision would be far more economically, and consistently performed by specialist civilian organisations, including charities such as SSAFA. This is a matter of practicality, expertise, concentration, continuity, and commitment.
4. It should be emphasised that mental health issues are not by any means restricted to those wounded or overtly exposed to trauma on active service. Life in the Armed Forces is in itself a high stress activity, and the effects are by no means restricted to the serving individual , but are invariably also suffered by families. The whole modus operandi of service life, even without active service operations, involves constant change, movement and uncertainty. Relationships and family health are often the casualties themselves.
5. The MOD only has responsibility for the healthcare of families who accompany the serving person on an overseas posting (eg Germany, Cyprus, Gibraltar). In general again this healthcare is generally very satisfactory) and indeed in most cases excellent, although it should be observed that the very substantial increase in funding enjoyed by the NHS in UK over the past 5 years has not been matched by the MOD in funding overseas health services for which it has responsibility, and these are steadily slipping behind in terms of parity with the NHS. In particular, the NHS budget as increased by some 5%/year since 2002. By comparison, spending on health by the MOD has risen in line with the RPI of some 2% in common with other Defence expenditure. Nonetheless, salaries of MOD medical staff and standards of care must be comparable with the NHS, albeit within tighter constraints.
6. The healthcare of service families (as opposed to the serving person) in the UK is not the responsibility of MOD. These families are dependent upon local NHS provision. The only difference with other civilian counterparts is however that service families move home often to 'follow the flag', and lack of continuity of residence can inhibit ability to access all parts of the NHS, particularly relating to prolonged or complex treatments. Of particular concern is the extreme difficulty in accessing NHS dental practice, which although is also common with civilian families, is much exacerbated for service families with young children.
7 June 2007 |