Supplementary memorandum from the Ministry
of Defence
Questions 10-11 (Chairman): asked about combat
stress, and whether members of the TA get as good a service as
the regular army.
Acute stress reactions and operational stress
injuries are treated in theatre or when people return from deployment,
whether regular or reservist. Whilst mobilised, TA (and all mobilised
Reserve) personnel get the same access to care as regular personnel.
Once demobilised, they are able to access the Reservists Mental
Health Programme based at Reserves Training and Mobilisation Centre,
Chilwell. This offers assessment and treatment if appropriate
at one of our military departments of community mental health.
This programme is open to reservists who have been mobilised and
are concerned about their mental health related to operational
service since 2003. Additionally, veteran reservists (and regulars)
who have seen operational service from 1982 onwards can attend
the Medical Assessment Programme (MAP) at St Thomas' Hospital,
London, for a specialist mental health assessment by a consultant
psychiatrist with extensive military experience. The MAP does
not provide treatment but a treatment recommendation is made after
the assessment. The cost of attendance and travel is met by the
MOD.
Questions 31-32 (Dr Pugh): about the timetable
for the publication of the King's study.
A "decompression" trial for Individual
Augmentees is planned during March 2010. The trial will consider
whether Individual Augmentees can benefit from decompression as
formed Units currently do. All Individual Augmentees in Afghanistan
who are due to depart during the trial period will participate
in the trial. Quantitative data will be collected and assessed
by our Academic Centre for Defence Mental Health with results
expected by the end of May 2010. We intend to publish the results
and place a copy in the Library of the House as soon as practicable
after that date.
Question 36 (Mr Williams): asked about how
widely the family is interpreted in the sense of support given
by the Department to families in getting to Selly Oak.
Accommodation and travel at public expense for
members of the Patient Group including nominated "significant
others" are governed by the Dangerously Ill Forwarding of
Relatives (DILFOR) scheme.
The Joint Casualty and Compassionate Centre
(JCCC) will authorise DILFOR for up to five members of the "Patient
Group" to visit the bedside irrespective of where the family
resides or where hospitalized. In exceptional circumstances, additional
members to the Patient Group can be authorised centrally.
The patient must be listed as Very Seriously
Ill or wounded(VSIL), Seriously Ill or wounded (SIL), have an
incapacitating illness or injury (III) or have a clear medical
recommendation that a visit from close family is in the best interest
of the patients' recovery. In applying the policy, the definitions
are: immediate family means a spouse/civil partner; close family
means a parent; step-parent; parent in-law; legal guardian; non-dependant
child; grandparent; sibling; including half and step-sibling;
or person nominated as Emergency Contact (EC).
Question 39 (Mr Mitchell): asked about the steep
increase in minor injuries and illness between Iraq and Afghanistan
and the ratio to troops deployed.
Figure 3 of the NAO Report shows raw numbers
of patients seeking medical treatment for a variety of medical
conditions on operations in Iraq and Afghanistan, but this must
be put in the context of the number of troops deployed.
The Surgeon General, in his response to Mr Mitchell
at Q40, explained that the graphs shown in Figure 13 on page
29 of the NAO Report do give the rate of minor injury and illness
per 1,000 troops. Noting that the axes on both graphs are different,
it can be seen that the rates are broadly similar; if anything,
the trendline values in Afghanistan are lower over the periods
under comparison.
Question 45 (Mr Mitchell): asked about making
a comparison between ourselves and the Americans of injury levels
and treatment levels.
The UK and US military medical services have
separately established quality assurance systems for their seriously
injured. Whilst there is overlap in some aspects, there are also
important differences in content and the analytical models used.
The UK uses internationally recognised mathematical models of
trauma system performance combined with expert peer review of
all survivors of major trauma in order to determine "unexpected
survivors". The US do not use these system performance measures,
and direct comparison is therefore not possible.
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