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17 July 2008 : Column 135WH—continued
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Mr. Kevan Jones (North Durham) (Lab): I, too, pay tribute to those members of our armed forces who provide medical care for people injured in the line of duty. I think not only of those who work here but of those deployed on operations, whom the Committee saw during the last two weeks on our visits to Iraq and Afghanistan. It gives me great pleasure to see them—many are reservists or volunteers—taking such a great pride in their work, which they do with commitment and dedication.
I shall cover four points. The first is the question of Selly Oak hospital. The second is how veterans are treaded in society. The third is mental health. The fourth is about operational issues to do with medical cover in Afghanistan and Iraq.
The Committee’s report did not get a great deal of coverage in the press, but we were not surprised because it was quite positive. That is sad because the issue has been kicked around a lot and even used by certain people as a political football. It is too important an issue to be treated in that way. Having visited Selly Oak with the Committee, I am sad at some of the misreporting and criticisms that have been made about the dedicated men and women who work there. Although such criticisms might get headlines, the press must remember that the staff, who work long hours with dedication—sometimes working more hours than they are paid for in order to look after the individuals in their care—find that criticism harsh.
When the Committee took evidence in Birmingham, I was keen to find out how many of the urban myths that have been generated were true. The way in which the press have dealt with some of those issues is disturbing. I shall read out some of the headlines that Selly Oak hospital has had to face. One was “Muslim accosts
injured Para in hospital”. Another was “Hero squaddie told by British hospital to strip uniform as offensive to Muslims”. A third was “Muslim women abuse soldiers at troops’ hospital”.
The Committee took evidence from Ms Julie Moore, chief executive of the University Hospital Birmingham NHS Foundation Trust, and Dr. David Rosser, the hospital’s medical director. I asked what had been done about those allegations. I also asked whether the trust had received complaints directly from the patients or their families about the treatment of the injured soldiers, given some of the more outlandish accusations made in the press. Surprisingly, the hospital had received no direct complaints. I wonder where the press gets its headlines. Some newspapers produced headlines without asking the hospital trust to comment.
The other thing that disturbed the Committee was the fact that when the hospital trusts were asked to comment and had said that the stories were not true, the press still went ahead and printed them. That was irresponsible. I am concerned that The Daily Telegraph is saying even at this late stage that the headlines stand up for themselves. I would like to see evidence for that.
Another thing that disturbs me is that someone wrote in The Daily Telegraph a couple of weeks ago what should have been the good news story that investment in Selly Oak was going ahead under the headline “Troubled hospital gets extra investment”. The writer did not make any of the more spurious accusations, but he repeated some of what he had written earlier. The press is right to report when things go wrong. They should do so. Such matters should be considered. The Committee would not have ignored such reports if we thought they were correct. However, I believe that the press should instead tell some of the good news stories.
What is remarkable about Selly Oak is not only that the staff are dedicated but that many of the young men and women there who have been terribly injured would not have survived those injuries a few years ago. Some of the pioneering surgery is not only state-of-the-art here, but is of high quality and internationally groundbreaking.
Linda Gilroy: I wonder whether my hon. Friend has noted the suggestion in the recently published recognition study that the armed forces parliamentary scheme should be a model for the media? Although there are specialist journalists, it seems that some of them have a great deal to learn.
Mr. Jones: I am not sure that I would want to inflict that on the military. The press have a responsibility to report accurately. We should remember that their criticisms are causing damage. It is disturbing also that Members sometimes repeat such reports without checking the facts.
Some say that this terrible Labour Government are cutting back defence medical services and closing military hospitals on financial grounds. I have said in the House before that the last Conservative Government got some things right. Commencing the closure of military stand-alone hospitals was one. The MDHU is clearly the best model. It is not that it will save money, but it will ensure that the staff have up-to-date clinical experience, which is not always available given the size of today’s armed forces.
When I visited Northallerton MDHU, I was impressed by the range of experience among the staff there, including expertise in paediatrics and other relevant areas. For instance, when we were in Camp Bastian last week the commanding officer said that the staff were dealing with a number of children and that it would be a disadvantage if the hospital did not have that experience but could deal only with the small throughput of members of the armed forces. I am convinced that that is the right way forward.
We agreed in our report that the Government’s decision to close Haslar was right. I accept that the hon. Member for Gosport (Sir Peter Viggers) has a constituency interest in the matter, but if he reads the report I hope that he will be convinced that it is being done for clinical reasons.
The other factor about Selly Oak that impresses me is that MOD surveys of people that have been through Selly Oak during the past 12 months show that the overall majority rate it as excellent, very good or good. I am sure that the Minister realises that members of the armed forces are not shy of making criticisms when things go wrong, so that is a good testament to the hard-working staff at Selly Oak.
Related to that is the question of Headley Court. I agree with the right hon. Member for North-East Hampshire (Mr. Arbuthnot), the Committee Chairman, that it is a world-class centre. We also visited the rehabilitation centre in Edinburgh, another first-rate facility for getting people back into the military—not only those severely injured in operations but people with sports injuries and others. The staff’s dedication to ensuring that people can return to an active life in the military is important. It is certainly highly regarded by those whom we met there.
I want now to discuss veterans. The Government should be proud that they are one of the first Governments to have recognised the role of veterans in society. They set up the Veterans Agency, and today’s Command Paper, which is a very good one, recognises the needs of veterans, so that we do not just forget about individuals who have given dedicated service to this country at times of need. The Command Paper tries to fill in some of the gaps, but we need to do more work on the issue.
There was a recommendation in the report—I think it was something on which I put in an amendment—about how we track veterans once they leave the military. Increasingly many doctors do not have experience of military life, and we need a system of trying to track individuals, because some illnesses or mental health issues will present themselves later in a person’s life. The option that was put forward was a system of automatic tracking when individuals leave the forces, with the possibility for people to opt out somehow if they wanted to. I appreciate that not everyone might want the information included on their medical records. A system from which people could opt out would at least mean that in future years if someone attended their GP’s surgery it would be possible to tell from their records that they had been a member of the armed forces. If we are to take seriously the prioritising of medical services for veterans we need a method of tracking people through the system.
I agree with the Select Committee Chairman about what I must describe as the lack of concern on prioritisation in Scotland when we took evidence. Frankly those
concerned did not think that veterans deserved a great deal of extra service compared with anyone else. All that we kept getting from the NHS there was the fact that they would be treated just as well as anyone else, which I do not think is acceptable.
A good feature of the Command Paper, which I hope will be extended to health, is the idea of ensuring that its contents will be followed through. I was reassured when I put my question to the Secretary of State today that there will be a Committee to consider those issues, to ensure that there will be joined-up working between, for example, the Department of Health and the Ministry of Defence as well as, I hope, the devolved Administrations. It would be terrible if, despite today’s very good Command Paper setting out what we expect for members of our armed forces and veterans, those things were to fall through the system at the point of delivery locally. We should consider that carefully. The Government have rightly put veterans on the political agenda, and we should keep them there. I pay tribute to organisations such as the Royal British Legion, and others who have worked closely with the Government on the Command Paper, but it is important to remind people that veterans have needs, and to make sure that those are met.
Mental health, even in civvy street, is a taboo subject. Even in the NHS it seems to be the poor relation within medical provision. I work with my local Mind group and its director says that it is possible to see that someone has lost a limb or broken an arm, but the problem with mental illness is that it cannot be seen. As has been said, many mental health issues will not appear while the people concerned are in the armed forces, but will emerge many years later.
I noticed last week, when we were going round the field hospital at Camp Bastion, that mental health services are now in theatre. That is important. I talked to the commanding officer there, and he said that if mental health issues can be dealt with while they are developing in theatre, that is the best way to do it, rather than trying to unpick them later. The subject needs a lot of research and the Government and the Department are right to try to organise such work. The King’s Centre for Military Health Research is now doing that on behalf of the Government. We do not understand how the experience of combat affects people later in life and it is important to pull together that body of evidence.
I offer congratulations on the work of the regional pilot schemes, because it is open to veterans to come forward and ensure that their experiences and any issues that they have are fed into the process. Once such data and research are secured, priorities can be allocated for serious issues that need funding. As with the treatment of other veterans, we need a way to ensure that people are tracked through the system.
The final issue that I want to deal with is the deployment of medical facilities in the field. To hear some people talk, one would think that those were of a very poor standard. In Camp Bastion last week the commanding officer was very proud of the facilities that he was showing us. He said on occasion that they might be better than some of what was in the NHS in the UK. It is staggering to think that in the middle of the arid desert, where Camp Bastion is, there are CT scanners and some of the most high-tech equipment. We also need to recognise not only the good quality of the care being given, but the very efficient system for evacuating
seriously ill servicemen and women back to the UK. Within 12 hours seriously injured servicemen are getting the best of treatment at Selly Oak, because there are aircraft on 24-hour call.
I want to pay tribute to some men and women who do not get a great deal of notice, but whose job I think—having talked to them last week—is very difficult and, on occasion, dangerous. They are the medical emergency response teams who fly into the combat zone, often under fire. When we flew into Camp Bastion last week we saw tracer fire, but it was not aimed at us, but at a helicopter crew going in to evacuate injured UK personnel. Those people are tremendously dedicated and are often volunteers, who put their lives at risk to ensure that our men and women serving on the front line get good treatment and are taken back. The dedication and bravery of those medics and helicopter pilots should be recognised in this debate.
Overall I am very impressed with the state of the Defence Medical Services. We should keep them under constant review and it is the role of the Select Committee to return to the issue in a few years to see what is happening. However, the story is good overall and I am very sad that it has not received more coverage. I also think that the role in which some volunteer medics work in Afghanistan and Iraq should attract more credit and more media coverage. We can be proud of the job that they do. I am satisfied that the servicemen and women who put their lives on the line for us should get the best medical treatment. From what I have seen in theatre and in this country we can be reassured that they get exactly that.
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Mr. Mike Hancock (Portsmouth, South) (LD): I am delighted to take part in the debate. I congratulate the right hon. Member for North-East Hampshire (Mr. Arbuthnot), the Chairman of the Select Committee on Defence, who with his customary unbelievable fairness put the case for the Committee’s report and the evidence that we were given. He should be congratulated on the way he presented that case this afternoon, and on having the patience to continue to chair the Defence Committee in the way he does. There are three of its members present this afternoon who would, I am sure, share that view.
I, like the hon. Member for North Durham (Mr. Jones), want to congratulate all the staff involved in the Defence Medical Services, which have been an easy target for the press and others to criticise. What the experience of preparing the report did for the Committee, and, I hope, for many other hon. Members who will have taken the time to read it, was to show that the story is not just doom and gloom. There is a lot of hope, and a lot of good work continuing to be done.
I remind hon. Members of a comment made by the Minister at the end of the Select Committee sitting on 27 November, about Headley Court:
“We are absolutely committed to providing the best possible treatment and service and care for our people. As I said, the report is going on at the moment”
to review expenditure on the site. I think that that is true. I spoke recently to two young men who benefited from Headley Court’s expertise. The experience gave them an opportunity in life that they would not have
had five years ago, let alone 10 years ago. They will be able to have a career outside the military, mainly owing to the efforts of the staff at Headley Court, who need to be congratulated. I am delighted that the Government lived up not only to their promise to provide the facilities and the money to carry out the review of services at Headley Court, but to deliver on their commitment.
The tracking of veterans is vital. Many general practitioners have told me of their experiences of helping ex-servicemen when they arrive at surgeries and say that there is a lack of coherent records of what servicemen have been through, what treatments they have had, and what injections they have received, for example. That was especially true in the early 1990s and throughout the decade following the first Gulf war, but, sadly, the problem still needs to be addressed. Although systems within the MOD have changed, the link between it, the local GP and the primary care trust needs to be maintained via an understandable and clear system. The tracking of veterans, especially for medical purposes, is vital. We should make every effort to ensure that PCTs, especially those in areas where large groups of ex-servicemen live—in Hampshire, for example, there is a large concentration of ex-Navy, Army and Royal Marines, and, to a lesser extent, around Odiham, Air Force personnel—are made aware of servicemen who are leaving but who will continue to live in the area. That way, GPs would have accurate records. Ministers have said on a number of occasions that they are trying to improve the system, but there is still no clear indication of how it works. At some stage, as the hon. Member for North Durham said, the Defence Committee should concentrate, and produce a report, on the tracking of veterans and how services are delivered to them.
The Chairman of the Committee and the hon. Member for North Durham spoke about the decision, which was initially made many years ago, to close Haslar hospital. Anyone who knows Haslar could not fail to be impressed by the services that it has provided for generations in the Gosport and greater Portsmouth area. Nobody who comes from Portsmouth would willingly wish to see the facility go. When we consider the amount of money that has been spent in Haslar in the past 10 years—I am sure that the hon. Member for Gosport (Sir Peter Viggers) will make clear the commitment that was put into it—we realise that the loss of the facilities will be a great loss to the community. I am optimistic that solutions will be found for the future use of the site, but the best use was as a military hospital that had a huge involvement with the community. I am expressing my personal disappointment, but I accept the Committee’s decision and what the Government have said on the closure. I visited the MDHU at the Queen Alexandra hospital and was mightily impressed by it. It was unlike the situation that the Chairman of the Committee found when he went to Frimley Park, because there was more than one serviceman there, and a number of service families. The exciting prospect about the former unit relates to the service personnel. One would find it remarkable if one went into QA hospital and did not see a member of the services walking around, be it a nurse or a doctor. They are proud to wear their uniform, and the people who use the hospital are proud to be served by them.
I spent a couple of days there fairly recently, and received medical care from two young doctors who were about to go to Afghanistan, one of whom had been to
Iraq. Talking to them was encouraging. They spoke with a great deal of sympathy for the people who did not want Haslar to close, but talked about the experience that they had gained in a large general hospital and their ability to transfer that expertise to the places to which they were going. The young lad—I say “young lad”, but he was a lieutenant in the Royal Navy and probably in his early 30s—spoke with a great deal of feeling for the way in which he had been able to use the experience he gained in the hospital in Iraq. It is a testament to the co-operation between the health services and the military that they can make such units work as successfully as they do. The way in which they try to maintain the military ethos to a level that would perhaps not have been possible in the past at Haslar was interesting. The ethos was maintained at a level that encouraged people to think that they were not simply wearing the uniform, but were part and parcel of the military.
The criticisms that were levelled at the Selly Oak facilities were, in the main, very unfair to the hospital, the staff and everyone concerned. They put a lot of fear in the minds of the families of people who were at the hospital. Some people from the Portsmouth area were at Selly Oak, and I received letters from parents who were worried about the care they were receiving. It was unfair that those people, on top of the trauma of a loved one being brought back from a battle front, were confronted with the idea that their loved ones had been taken to the wrong place and that they would not survive. The hon. Member for North Durham was right that many of those young men and women who have been to Selly Oak would not have survived had it not been for the care and ability of the staff there. I hope that the Committee’s report puts the record straight on Selly Oak.
If we look at the report, we will see how many reports the Defence Committee has undertaken in the past few years. Not one has been so well received both by the Committee—many of us had serious reservations at the beginning, but when the report was prepared, the whole Committee was impressed by what we had discovered. I was impressed that the Minister came with the Minister of State, Department of Health, the hon. Member for Exeter (Mr. Bradshaw) to give evidence to us. There was a willingness to work together. The latter was vague on who was paying for what, but there was undoubtedly co-operation and a willingness to co-operate. That things have moved on considerably in the past five years or so is transparent in the report, which is welcome.
I do not wish to delay hon. Members and I must apologise because I will be absent for 45 minutes to chair a different meeting, but I will be back, if the sitting does not adjourn early, to hear the winding-up speeches—I apologise to colleagues who will speak after me.
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