Examination of Witnesses (Questions 20-39)
MS SAMMIE
CRANE, COMMODORE
TOBY ELLIOTT
RN, AIR COMMODORE
EDWARD JARRON,
MS SUE
FREETH AND
MRS ELIZABETH
SHELDON
12 JUNE 2007
Q20 John Smith: I think we should
stick to accurate and factual information.
Ms Crane: I am sideswiped by it
because I rely so heavily on unit welfare officers. The SAM system
is now in place and it is the CO who is responsible. Whether or
not that works and is effective is a really important factor in
looking after sick and wounded troops. It is critical that the
resources and manpower are put in to support it so there is focus.
It is true that we must have more focus on where individuals are.
Interestingly enough, the reserves are doing it very well. They
have a track and trace from Selly Oak on all their troops who
are not fit for discharge. That has been very successful. I hope
that the SAM system will produce a better method for families.
We have discussed Selly Oak, but to my mind the area that we really
ought to be looking at is discharge from that establishment before
rehabilitation at Headley Court. That is the area of concern for
most of us here.
Commodore Elliott: I sit on the
defence medical discharge policy committee as the ex-service representative.
I have watched the Army roll in the new sickness and absent management
system. By comparison with the Y list that went before it, this
is a fantastic step forward. I think it is too early to judge
whether it is just a success or a great success, but it is a major
change in the way things are going.
Q21 Mr Jenkins: I want to go back
about 15 minutes to the discussion on the central unit. We decided
to use a central unit for bringing back personnel. We know that
teaching hospitals in London are fully occupied. Birmingham is
approximately the centre of the country and Selly Oak is conveniently
there. On reflection, do you think that the Selly Oak unit is
the best location for the siting of that facility?
Ms Crane: It is the closest to
the main recruiting areas and I think that is a major point for
families. It also has good communication to and from it. Possibly
the only weakness is the lack of military units nearby and therefore
support to begin with has been confused, but I believe that has
been taken on board by them.
Q22 Mr Jenkins: We do not want to
base our garrisons in the south of England where we do not recruit
anyone. We have had that argument. I fully agree with you. We
need a garrison in the Midlands and more personnel there.
Ms Crane: Which you now have with
Stafford which is very close to Birmingham.
Ms Freeth: In terms of relevant
medical expertise Selly Oak has a great deal to offer. I think
that the foundation trust is in the process of building new facilities
and some of the shortcomings and future improvements could be
taken into account in that redevelopment. An area that we are
particularly concerned about is accommodation and recognition
that some families and visitors will have to stay there for considerable
amounts of time needs to be built in. At the moment I think that
investment for that facility relies almost exclusively on charitable
support. If this is to become a future centre of excellence and
one point of contact for people returning it ought to receive
government funding.
Q23 Mr Jenkins: The Government has
put a tremendous amount of money into the NHS. If anyone says
that we do not have the money for this service believe me he is
using a different hymn sheet. I want to come to the MoD's contribution
later. Let us look at the facts rather than run off at a tangent.
You say that Selly Oak is the right place to be?
Ms Crane: I do not think that
could be argued on the clinical side, but we need to look at what
facilities are available for patients and families beyond the
clinical aspects. We have been very closely involved in setting
up temporary accommodation at Selly Oak and working with the MoD
on leased flats on the hospital grounds that were originally very
grotty hostels for doctors and nurses. We have paid for temporary
refurbishment of those flats. It would be fantastic if public
funding could set up accommodation within the new PFI build, but
in the meantime—over the next five or six years—what
will happen? This is where you can say that, yes, public funding
should step in and try to find a better interim solution, but
equally more use should be made of the agility of the charities
to step in and help.
Q24 Mr Jenkins: When injured personnel
come back what has been the process? Has the management at Selly
Oak been able to deal with those casualties? How has it intermeshed
them with its everyday work? Have you had any complaints about
the reception and processing of injured personnel in Selly Oak?
Ms Crane: To begin with it was
confused and shameful for a period of time. The way people were
managed was poor. I am reassured by what has been put in place
in the past six months, specifically the introduction of a senior
officer in the hospital to liaise directly with the hospital and
put chain-of-command control into what is happening there and
how we work with the hospital. It is critical that we work very
well with Selly Oak.
Q25 Mr Jenkins: So, has the military-managed
wing been an improvement?
Ms Crane: Yes.
Q26 Mr Jenkins: Has that been a big
step forward?
Ms Freeth: Yes. To sustain that
will need continuous commitment. After all, that unit is a very
small proportion of the overall Selly Oak budget.
Q27 Mr Jenkins: What concerns me
and I believe one or two other Members of the Committee is the
constant media coverage. Disgraceful stories have been run. When
probed it has been found that the situation described has not
happened and does not exist. It has a demoralising effect on the
staff at Selly Oak. The NHS does not want the press to be critical
of it. We have to fight our own media to get the truth out. Are
these stories in accordance with what you have heard? How do some
of these stories affect you as individual organisations?
Ms Freeth: I should like to encourage
more openness and transparency about when these reported incidents
come to light. We know that they are investigated. I think there
needs to be more openness about what comes out of those investigations,
namely that when there are mistakes we are told what has been
done about them and, when they have been looked at and found to
be erroneous, we make sure that it is better understood. As organisations
we are trying very hard to educate our own membership and the
people with whom we have contact to make sure that the true story
is told, but individuals and the press are particularly keen to
highlight failures in this area. In the past 12 months a number
of us who have talked to the press have tried to focus their attention
on other areas where we believe there are difficulties. They have
been much less interested in drawing attention to that, which
is disappointing.
Q28 Mr Jenkins: Therefore, when "The
Daily Blurb" runs a story about a soldier being insulted
and it is found to be fabricated and has no essence of truth do
you believe that its front page story the following day will be
"Sorry, we got it wrong. We lied to you again"? Do you
think that will ever happen?
Ms Crane: No. In April we conducted
a short-term survey asking families their views of the provision
for wounded soldiers. The vast majority were concerned but 71
per cent said that their concern came from media reporting. That
gives us a very graphic explanation.
Q29 Mr Jenkins: That is the struggle.
We have to get it over on our website that people who complain
about Selly Oak have never been there; they have read about it
in the media. Imagine the effect that has on the families of injured
personnel. There is a slanted story in the media. With the best
will in the world, how do we overturn it? We conduct an inquiry
and say that the story is untrue. That is not printed.
Mrs Sheldon: One wonders whether
some of this could be ameliorated if there was clarity about support
for patients and families, not just immediately but beyond. People's
perceptions can change. I am sure that initially people are so
damned grateful to be in a safe bed and being looked after but
as they start to recover and look around and rebuild their lives
they begin to ask what else they can do. What can be done for
them and how are their families coping? It is a matter of starting
to think about getting the systems of support in place and it
is clearly communicated. If they are not in place it will cloud
people's perceptions, rightly or wrongly. I believe that that
is an extremely important matter that needs to be dealt with.
Ms Freeth: Individual expectations
are very high. If they do not receive what they have been led
to expect the disappointment factor hits very quickly, particularly
if they have lost a career that they have wanted for many years
and in which they have been successful. This is why we have to
aim for 100 per cent because it is expected.
Q30 Willie Rennie: The military-managed
wards are not just for military personnel. Although they are managed
by the military they are mixed wards, are they not? Is that an
issue for some servicemen? As I have heard from various health
professionals and the military, do they prefer to be treated in
wards with only their colleagues because only they understand
what they have been through? Do you hear that as an issue among
service personnel?
Ms Crane: There are two issues
here: one is perception. The guys out in Iraq and Afghanistan
want to believe that when they come back they will be treated
in an ethos with which they are familiar. That has a very powerful
influence here and on morale in operations, and it is one that
should not be overlooked. Strangely, I have had feedback both
for and against having other types of patients in the ward with
the patient concerned. Some patients quite like not being just
military, but I think the majority would rather be military. I
think the advantage of having a closed-off area, which is S4 ward
that is purely military, far outweighs any other consideration.
Q31 Willie Rennie: How would one
get into that closed-off area? Would it be through personal choice
or would it be a medical matter?
Ms Crane: As long as the wound
is skeletal or orthopaedic in nature the patient would go there.
Selly Oak comprises five hospitals, so one must have the right
kind of wound to be in that ward. There is no point in putting
someone with burns, blindness or brain injuries into S4 ward because
it would not be the best clinical care for that patient.
Ms Freeth: It is part of a larger
orthopaedic ward. Individuals will go to a range of other beds
in the whole complex depending on what treatment they need at
any one time. The only part that is military-managed is that section.
In terms of casualty numbers, so long as they continue as they
have been for efficiency it would probably be quite difficult
to have anything very different from what is currently in place.
Q32 Willie Rennie: I am not quite
sure I understand the last bit. Does one go into the military-only
section by personal choice or is it determined medically?
Mrs Sheldon: It is based on clinical
need
Ms Crane: The priority must be
the saving of life; that is what we all want. Any other consideration
comes after that and therefore one must go for the best clinical
care. But the majority of injuries will be in the orthopaedic
ward. That is where the majority of casualties go and if they
go into that ward they go into S4.
Commodore Elliott: As a serviceman,
I have been to a military hospital where there have been civilian
NHS patients. The experience of being on a ward with demented
old ladies in adjoining beds is horrific. It was undignifying
for them. I was terribly embarrassed about it. I experienced that
in one of the Birmingham hospitals when I became a civilian. There
comes a stage for every casualty when he or she is well enough
and needs to be recovered into the military environment where
he or she sits or lies alongside other veterans of the particular
campaign and feels comfortable about that. They should not be
with civilians at that stage unless they want to be. There is
also the scandal of mixed-sex wards. I do not know whether it
happens at Selly Oak, but that practice is still prevalent in
the NHS. I hope that our servicemen are not experiencing that
if they go to other wards.
Q33 Mr Jenkins: Can we kill this
myth again? The Government has put a lot of money into stopping
the practice of mixed-sex wards. We have not dealt with it fully,
but it is not true that it is prevalent.
Commodore Elliott: I am not saying
that, Mr Jenkins. I am saying that I have experienced being on
a mixed-sex ward as a patient. It was undignifying for the civilian
old ladies there, let alone what I felt about it.
Q34 Mr Jenkins: Was it last year?
Commodore Elliott: It was about
four years ago.
Ms Crane: Do not forget that we
have female wounded personnel.
Q35 Chairman: Ms Crane, earlier you
said that 71 per cent of the complaints you were talking about
were induced by the media. The Ministry of Defence says that it
has received only one formal complaint, but if 71 per cent of
the complaints you have talked about come from the media it implies
that 29 per cent are based on something other than that. Can you
rectify these different figures?
Ms Crane: I said that we ran what
we call a short-term survey before the welfare conference held
in April. We went out and asked families four simple questions.
The first one was: "Are you concerned about the medical care
provided for wounded and injured soldiers? Yes or no." The
majority, 84 per cent, said that they were worried, but when we
asked why they were worried 71 per cent said that their concern
came from media reporting. I am not talking about complaints but
families' perception of care.
Q36 Chairman: Where did the other
29 per cent come from?
Ms Crane: Fourteen per cent said
that it came from information from friends and 15 per cent from
experience.
Q37 Chairman: But there has been
only one formal complaint?
Ms Crane: We have not had formal
complaints.
Q38 Chairman: The Ministry of Defence
says that it has had only one formal complaint. Can you explain
that?
Ms Crane: I believe that there
have been failings and early on particularly shameful ones, but
a lot of the delivery has been successful. Selly Oak has saved
a lot of lives. It is the post-operative period and the time after
discharge that has caused the most upset for families.
Q39 Mr Holloway: How many of the
witnesses think the media has been helpful? My impression is that
people like Mark Nichol in the Mail on Sunday have been
almost valiant in standing up for these guys.
Ms Crane: I think we needed more
focus on it. Media attention does help, but it has been very difficult
for the morale of families and troops.
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