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- Jul 11, 2004
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How military medical care was ruined by cost-cutting strategy
Sir - Let us be clear. Successive governments, both Tory and Labour, have equally been responsible for the reduction of the Defence Military Medical Services over the past 20 years, notably in the blatantly motivated cost-cutting Options for Change exercise in 1990 (ordered concurrently and obscenely with the first Gulf war).
This led to 33 simultaneous defence costs studies. The Medical Services were but one of these. It is scarcely surprising that even the military defence staff had their eyes taken off the "medical" ball - one senior military chief was even heard to say that we had "over-egged" the medical support in the first Gulf war.
The excuse for the proposed reductions was that Britain was unlikely to be committed on such a scale again. The result was the loss of all the military hospitals in Britain, save one, which was temporarily reprieved. Military medical hospital staff were to be absorbed into NHS hospitals, an arrangement that, from the start, was bound to lead to "second-class citizenship" and that exists today.
The old military hospitals were not only the natural end-point for our wounded and sick Servicemen, but were also obliged to take more than 50 per cent of their patient-numbers from all age-groups of the local population - thereby helping the NHS and simultaneously providing training for the military medical, nursing and paramedical staff.
This arrangement benefited all parties, particularly the local citizens, who appreciated that the standards of care were without peer. These were based on a hierarchical system of a medical commanding officer, an admin officer (chief executive), a matron and senior ward sisters. From personal observation, I have no doubt such an organisation would benefit NHS hospitals.
When casualties under the old arrangement were sent back from war zones, where, incidentally, life-saving treatment had been administered by military medical staff (who even now have to be found, fully expert in traumatic and emergency medicine), the majority were housed in military hospitals.
They included those suffering from stress-related illnesses, who found their chances of recovery enhanced in the military environment by contact with their friends and peers, who could relate to their experiences. The medical staff had the option of referring severely injured patients to local hospitals of excellence if they were beyond the capabilities of the military staff. They were returned once stabilised.
Whatever the alarming stories now arising from the treatment of military patients in civilian hospitals, I strongly deny that these arrangements were recommended by the military medical staffs themselves, except by necessity having to make the most of the badly damaged defence medical services.
Lt Gen Sir Peter Beale, Surgeon General 1991-1994, Avebury, Wiltshire
Thursday 15 March 2007
Sir - Let us be clear. Successive governments, both Tory and Labour, have equally been responsible for the reduction of the Defence Military Medical Services over the past 20 years, notably in the blatantly motivated cost-cutting Options for Change exercise in 1990 (ordered concurrently and obscenely with the first Gulf war).
This led to 33 simultaneous defence costs studies. The Medical Services were but one of these. It is scarcely surprising that even the military defence staff had their eyes taken off the "medical" ball - one senior military chief was even heard to say that we had "over-egged" the medical support in the first Gulf war.
The excuse for the proposed reductions was that Britain was unlikely to be committed on such a scale again. The result was the loss of all the military hospitals in Britain, save one, which was temporarily reprieved. Military medical hospital staff were to be absorbed into NHS hospitals, an arrangement that, from the start, was bound to lead to "second-class citizenship" and that exists today.
The old military hospitals were not only the natural end-point for our wounded and sick Servicemen, but were also obliged to take more than 50 per cent of their patient-numbers from all age-groups of the local population - thereby helping the NHS and simultaneously providing training for the military medical, nursing and paramedical staff.
This arrangement benefited all parties, particularly the local citizens, who appreciated that the standards of care were without peer. These were based on a hierarchical system of a medical commanding officer, an admin officer (chief executive), a matron and senior ward sisters. From personal observation, I have no doubt such an organisation would benefit NHS hospitals.
When casualties under the old arrangement were sent back from war zones, where, incidentally, life-saving treatment had been administered by military medical staff (who even now have to be found, fully expert in traumatic and emergency medicine), the majority were housed in military hospitals.
They included those suffering from stress-related illnesses, who found their chances of recovery enhanced in the military environment by contact with their friends and peers, who could relate to their experiences. The medical staff had the option of referring severely injured patients to local hospitals of excellence if they were beyond the capabilities of the military staff. They were returned once stabilised.
Whatever the alarming stories now arising from the treatment of military patients in civilian hospitals, I strongly deny that these arrangements were recommended by the military medical staffs themselves, except by necessity having to make the most of the badly damaged defence medical services.
Lt Gen Sir Peter Beale, Surgeon General 1991-1994, Avebury, Wiltshire
Thursday 15 March 2007
