The Defence Medical Services (DMS) provide a range
of healthcare, from treating Service personnel injured in combat
to providing rehabilitation for sports injuries in the UK.
The clinical care for Servicemen and women seriously
injured on operations is second to none. DMS personnel, working
with the NHS, provide world-class care and we pay tribute to them.
Recent improvements at the Royal Centre for Defence Medicine in
Birmingham in areas such as ward management and welfare support
are welcome. We acknowledge this progress, and encourage the Ministry
of Defence to continue it, and to incorporate these considerations
into its plans for developing the facilities in and around Birmingham.
There has been considerable inaccurate reporting about the care
at Selly Oak. We strongly deprecate this behaviour, and believe
editors have a responsibility to ensure that their newspapers
report on the basis of facts rather than hearsay.
The DMS's rehabilitation services, especially at
Headley Court, are exceptional, and are contributing enormously
to the welfare of injured Service personnel. We welcome the review
of Headley Court in the light of the continued high operational
tempo, and look forward to its results.
Services are delivered to Armed Forces personnel
by the MoD, the NHS, and charities and welfare organisations.
We believe this is right, and builds on a proud tradition in the
UK of linking the community with the Service personnel who have
been injured fighting on their behalf. However, the Government
and voluntary organisations should engage with a wider public
debate about which services are most appropriately provided by
The MoD's decision to base its secondary care around
units embedded in NHS Trusts was, and remains, a sound one. It
allows DMS personnel to work side by side with civilian clinicians
to develop and maintain their skills, while offering the opportunity
for Servicemen and women to be treated in a semi-military environment.
However, more needs to be done to address the sharing of best
practice between the DMS and the NHS.
Devolution means that the MoD must cooperate with
a number of different health departments to provide the full range
of appropriate services for Armed Forces personnel, their families
and veterans. This cooperation is usually good, but we found that
in Scotland it was often inadequate. The MoD must review the structures
through which it engages with other departments and administrations.
The Scottish Executive must also examine its procedures for engagement
and cooperation and look at how improvements could be made.
We welcome the Government's extension of the priority
access to healthcare available to veterans but we are not sure
that adequate procedures are in place to identify veterans and
to ensure that priority access. The MoD's reliance on self-identification
is simply not good enough. We are also concerned that medical
records are not transferred efficiently enough from military to
civilian clinicians. An automatic system of transferring medical
records and tracking veterans in the NHS, with an option to opt
out, would provide a more robust system which took account of
The MoD provides high-quality healthcare for Service
families abroad, but spending has lagged behind that in the NHS.
There are also doubts about the long-term viability of the stand-alone
hospitals in Cyprus and Gibraltar. The MoD must say what plans
it has made for the facilities, and how it will continue to provide
healthcare for Service communities overseas. It should also set
out a timetable for tackling this issue.
Mental health is a vital responsibility for the DMS.
We acknowledge the progress they have made and their adoption
of a preventative approach where possible. Their community-based
system of mental healthcare is in line with NHS best practice.
We pay tribute to the work of Combat Stress in assisting veterans
with mental health needs, but we are concerned that the identification
and treatment of these veterans is not sufficiently thorough or
systematic. The NHS needs both a robust method of tracking veterans,
and a detailed understanding of their problems.
Reserve personnel play a critical role in the delivery
of military healthcare. The Territorial Army has so far met around
half of the Armed Forces' medical commitment in Iraq and Afghanistan.
The public should recognise the contribution which the Reserve
forces make to the military and to society as a whole. The MoD
needs to make sure that the Reserve forces are not overstretched
and that recruitment and retention remains buoyant.