Memorandum from Lynne Jones MP, Richard
Burden MP, Gisela Stuart MP and Steve McCabe MP
We are the local MPs concerned with University
Hospital Birmingham (UHB). We have regular meetings with the directors
of the Hospital Trust and have visited both Selly Oak and Queen
Elizabeth Hospitals on several occasions. Many of the staff are
constituents and the hospitals serve our constituents. Two of
us (LJ and GS) have also visited the ward caring for most military
personnel (recently 12 out of 20), which we shall refer to as
the military managed ward, where we have spoken to military and
non-military staff, as well as patients.
Prior to the establishment of the Royal
Centre for Defence Medicine (RCDM) at UHB we discussed the implications
with senior staff. We understood that the decision by the MoD
to base hospital care of military staff in the NHS was taken primarily
for clinical reasons. Health care has become more specialised
and the range of specialties and depth of experience required
to provide the full range of care (especially ensuring that seriously
injured troops receive treatment at the cutting edge of what is
available) can only be provided by a large acute teaching trust.
We were also anxious that the location of RCDM should not be to
the detriment of patient care for our own constituents. We were
convinced that the proposal would be of benefit to both military
and NHS patients.
Another benefit of this arrangement was
that the training and education of the clinical military staff
could be undertaken in an environment where the full range of
injuries and illnesses are seen and treated. This is to better
equip the military clinicians to deal with any eventuality when
deployed at times of conflict.
It was explained to us that the achievement
of both of these important functions (best possible care for injured
military personnel and training of military clinicians) would
require military clinicians to be deployed in whichever ward in
the hospital would provide the relevant experience and training
and that the injured and ill would be cared for in the specialist
clinical environment appropriate to their medical condition. This
would often mean a severely injured serviceperson being treated,
over time, in more than one location in the hospital and this
has proved the case. We have been pleased to meet up with military
staff in many different locations in the hospital eg physiotherapy
and such meetings confirmed our belief that this has been to the
mutual benefit of both the military clinicians and the NHS.
Unfortunately, over the past few months,
there has been a vast amount of negative press coverage about
RCDM, most of it, in our experience, inaccurate and ill-informed.
One of us (LJ) recently met one of the injured men whose case
has been given a high profile in the media. He was returning to
the ward after a weekend away. We understand that, by his choice,
he remains in the ward despite the hospital's view that he is
ready to be discharged to military-run rehabilitation.
As a result of this media coverage, which
has resulted in concerns being raised in parliament, it seems
that considerations other than clinical need are being brought
into play to determine where injured military personnel are cared
for and where military clinical staff are placed to gain experience.
There is a danger that the views of those with the knowledge and
skills to make those judgements, based on the clinical needs of
the patients ie the doctors and nurses looking after the patients,
will not be given due weight. As a consequence we fear that patient
safety could be compromised, both for the armed forces' patients
in Selly Oak and Queen Elizabeth hospitals (run by UHB) and for
those injured in the frontline before they are returned to the
UK. We are therefore pleased that the Defence Select Committee
is undertaking this inquiry.
Of course senior officers are going to
be concerned for the security and well-being of members of their
units who are injured but these concerns should not translate
into interference with clinical care. Military welfare issues,
whilst important, should be seen in the context of the overriding
need for severely wounded personnel to receive the best possible
treatment for their injuries.
We are concerned that efforts to make
the military patients feel as though they are in a more military
environment may be counterproductive. The two of us who have visited
the "military managed" ward have been struck by how
many staff, in particular military staff in uniform, were on the
ward. We are told by the hospital staff that this is usually in
double figures and on one recent occasion it was possible to count
19 non-clinical uniformed military staff on the ward.
There is no doubt that this ward is old
and cramped, as is all the accommodation in UHB. However, the
new build is scheduled to open in 2010 when all patients will
have first class facilities. All the additional staff (referred
to above) add to the feeling of the ward being cramped and busy.
In contrast, other wards we have visited, run as "normal"
NHS wards, with the same layout and design, appeared calm and
ordered.
Arising from the publicity referred to
above which, incidentally, has taken up a disproportionate amount
of senior staff time that may well impinge on the wellbeing of
our constituents, there have been calls for the reinstatement
of military hospitals and military wards. Having discussed these
issues with clinical staff, both NHS and military, we believe
the model established to be the right one and it should be allowed
to be run as was intended. It is vital for the wellbeing of our
armed forces that we still achieve the two aims of the best care
for injured servicemen and women and the training and education
of clinical military personnel to the highest possible standards.
We are dismayed that the views of military staff on the ground
seem to be being overridden by non-clinical issues and that money
is being wasted creating physical barriers between military and
NHS personnel when the numbers of military patients and their
location in the hospital can vary enormously.
14 June 2007
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