Thread: Evidence of the need for a military hospital?

Over the past couple of years a number of people have posted comments on ARRSE in support of bringing back military hospital(s) in the UK. In the link below, the cost of treating seriously wounded military personnel is quoted as 71 million in 2008-9, it is also said in the article that hospitals in both Afghanistan and Britain are now under growing pressure due to the increasing number of casualties being treated.


What does the team think, do we need a new military hospital or not? Are the facilities at Selly Oak going to be adequate in view of the expected increase in casualties that seem likely? And will the other hospitals in the Selly Oak area be able to offer adequate care in the event that Selly Oak is working at full capacity and cant deal with the numbers expected?

Increase in the number of military casualties expected

And you think that Gordon and his cronies give a damn? Let's be serious here, for all his crap of 'no one admires and respects the armed forces more than I', he still sees the armed forces as a waste of money. None of the government are personally involved, and for all the vote catching crap about 'our wonderful and professional armed forces' many of the government do not come from a background where support for the forces was high on the list. If you think that Cyclops is going to stump up for a dedicated Military Hospital having just closed the last one, then you need your bumps felt.

Of course there is no evidence of need for proper military hospitals, FFS Lyneham is closing in a few months time, I am quite sure the neddies with scrambled egg on their hats are barely recognising there is a war on in Afghanistan. They are too busy fighting internecine warfare to ensure funding for their own particular pet projects in a difficult funding round.

Maybe when we have wounded sodiers camping out in corridors and air conditioned tents in the suburbs of Birmingham they might wake up and smell the coffee.

Military hospitals under pressure in advance of new offensive
Military hospitals in Afghanistan and the UK are operating close to capacity as British forces prepare to launch a major offensive against the Taliban.

By Aislinn Laing
Published: 6:30AM GMT 10 Feb 2010


The numbers of wounded troops treated at the main British military hospital in Afghanistan, Camp Bastion, rose from 131 in 2008 to 300 from just January to October last year as operations intensified. Commanders are warning a renewed push will lead to a surge in casualties.
In the UK, those returning to Selly Oak Hospital in Birmingham and later being referred for rehabilitation to Headley Court in Surrey virtually doubled in the same period.


Now, on the eve of an joint operation involving an estimated 4,000 British troops, the National Audit Office has warned that medical teams at home and in theatre could struggle to cope with many more patients.
The report coincided with a separate warning from the Commons Defence Committee that seven years of fighting on two fronts in Iraq and Afghanistan have left the armed forces ill-prepared to take on any new tasks.
The Committee said that RAF pilots were unable to train because aircraft were tied up on operations, the Navy had too many commitments, while senior generals believed the Army needed another 10,000 troops.
Operation Moshtarak is expected to dwarf last summer’s Operation Panther’s Claw in which 10 British soldiers were killed and more than 100 injured.
British commanders have said that the operation - the biggest since the first Gulf war - could also generate the highest casualty levels seen so far in the eight year battle as forces try to wrestle control of some of the most dangerous areas of central Helmand from the Taliban.
According to the NAO public spending watchdog, medical teams at Camp Bastion are on standby and can cope with a short term increase by calling in off-duty staff.
But despite a surge in troop levels, it revealed that staffing levels there have decreased from 10 medics per 1,000 of the military population in 2006 to four per 1,000 in 2009, and a drawn-out battle could see them working around the clock.
In the UK, Selly Oak and Headley Court are already under pressure from a steady rise in numbers as the Afghan conflict intensifies.
In 2008, there were 573 patients - 254 with battle injuries - treated at either one or both of the two centres, and in 2009, there were 912 patients and 490 with battle injuries.
The NAO has urged the Government to step up its planning for possible scenarios involving a big increase in casualties.
As in July last year, it said, Selly Oak’s 90 trauma and orthopaedic ward beds for both military and civilians were operating at 80 per cent of capacity, with a third of beds filled by injured servicemen and women.
If the numbers of wounded predicted in the forthcoming battle materialise, the hospital could close its Accident and Emergency Department to civilian patients altogether, rereouting them to other hospitals.
Headley Court is also under pressure. Throughout 2009, the number of seriously injured patients there exceeded the 28 beds originally set aside for them, although not bed numbers overall.
The surge in casualties returning to the UK is in part to the credit of the "highly effective" medical care now provided by military medical teams, the NAO said.
It estimated that between April 2006 and July 2008, at least 75 UK, coalition and local casualties survived from Iraq and Afghanistan who might previously have died of their injuries.
But it also raised concerns about thousands of working days are being lost to potentially preventable less serious complaints like stomach bugs and sprained ankles, it found.
Rates of minor injury and illness among troops deployed to Afghanistan nearly doubled between 2006 and 2009, increasing from four per cent to seven per cent of the total, it found. In Iraq the rate went up from five per cent to nine per cent over roughly the same period.
The watchdog estimated that 6,700 days were lost in Afghanistan between October 2006 and September 2009 because of the increase.
Patrick Cordingley, commander of the Desert Rats in the first Gulf War, said the Government must provide all three medical centres with all the support they need over the coming months.
“This is concerning to hear,� he said. “The NHS has got to gear itself up and make sure that not only does it have the bed capacity, but that it has available sufficiently well-qualified and experienced surgeons otherwise it will clearly run into difficulties if large numbers of casualties begin to come back and quality of care could suffer.
“The quality of care provided by staff is Bastion is commendable but it is worrying if they too are working for extended periods of time because that is unsustainable.�

I love where the NAO have stated that stomach bugs and sprained ankles are preventable injuries. In a nice comfy office block in London, maybe!

What planet do these people live on?

P-T

Originally Posted by postman_twit

I love where the NAO have stated that stomach bugs and sprained ankles are preventable injuries. In a nice comfy office block in London, maybe!

What planet do these people live on?

P-T

Agreed. You can only reduce the risk of these things not prevent them. The NAO need to send some researchers out, to live at a PB or FOB for 6 months. I wonder how many of them would get stomach bugs?

In fact, maybe they should tell developing countries to 'man up', because according to the WHO, diarrhoeal diseases are the biggest killer (even worse than Malaria!) especially of children!

As for bringing back Military Hospitals, it's a great idea, but no Government would be willing to cough up the dosh to fund it.

WHO linky

EXACTLY what I thought upon first seeing this. The answer seems inevitable, as the problem of sick and injured soldiers isn't likely to go away any time soon!

I did wonder though, was the increase in minor injuries a result of better IPE?

Just out of interest, when the Tories were cutting ward after ward in civvy hospitals and reducing NHS bed numbers, Labour were ranting regularly that it was disgraceful. Does anyone know if "New" Labour have actually increased the net number of hospital beds in the UK?

Don't forget that by the end of the year most of Selly Oak will cease to exist and all services move to a new build hospital at the Queen Elizabeth site.

http://www.uhb.nhs.uk/NewHospital/index.html

Of course Labour hasn't increased the number of beds. They set artificial targets for occupency and increased turn-around time to free bedspaces up quicker. The number of administrators has increased to ensure that the targets are met, fudged and reported in the most positive manner. The policies helped contribute to the massive increase in hospital acquired infections.

But back on thread - it is so reassuring to see that there is a voluntary agreement with the NHS to move patients out of Selly Oak wards in the event of there being more casualties than are currently planned. No need for a contract eh? I am sure we can rely on a bit of joined up government to make an "independant" NHS Trust honour any voluntary agreement.

Originally Posted by craign

Just out of interest, when the Tories were cutting ward after ward in civvy hospitals and reducing NHS bed numbers, Labour were ranting regularly that it was disgraceful. Does anyone know if "New" Labour have actually increased the net number of hospital beds in the UK?

It does make me wonder that with mass immigration and the extra millions the country has had to absorb in the past decade wether hospitals and other important civil infrastructure were expanded to cope with this. I don't think the answer is going to be very positive.

Whilst I will be jumping for joy when this set of corrupt marxist are voted out, I will not hold my breath that a dedicated Military Hospital will come to fruition.

It's not just cost, it's the expertise, and whilst we've got plenty in trauma, nuclear therapy, A&E ect we still don't have enough in uniform and our NHS colleagues fill that gap and bloody-well do it fantastically. So for the moment we'll simply have to adjust the through-put to cope with the expected surge in Casualties.

If that means some civvie trauma on the M6 has to be re-directed, so be it. Bed management goes on all the time, particularly in very large NHS Hospitals but the press seem to think that we haven't thought of a surge in Casualties. It's first tenet of Mil medicine....be capable of expansion...you WILL need it at some time.

I also remember that in their haste to pocket the 'Peace Dividend' a decade and a half ago, it was the Tories thet pulled the pin on BMHs overseas and Mil Hosps in UK. Defence and NHS Medicine is effin' expensive and sadly we fall into both categories in terms of need and funding.

So, a brand New BMH UK is but a pipe dream at the moement. That said, I am imensley proud of the Defence Medical Services, they're performing magnificently and I include the NHS cohort at Selly Oak and Headly Court in that statement. I also include the Army Medical Services TA because without them we would be truly stuffed.

I do rather get fed up of MoD being the stick for which to beat up this despicable government - and it's a stick mostly wielded by the media. One week it's the turn of Defence Estates and Quatering, the next it's Procurement and then there's the usual PC bullshit that hampers the efforts of us all. It's not a perfect world, but all this focus on the short-comings of Defence, and I would be the first to admin that there are many, makes us look like a whinging set of cnuts.

We are very good at what we do. We're even better because we do it with dwindling resources and are hampered by an inept, politicised MOD structure - and all this whilst fighting a war.

The media, I've said it before, should be treated like a weapon. Safety catch will be "ON" unless required. They have whipped up public opinion in our favour but they can turn on us just as easily. Consistently showing the shortfalls lowers morale of the public as well.



Edited for typos done whilst irritated.
Rant Off.

The case for the dedicated military hospital is overwhelming, but you aren't going to get a British government to pay for it. If you want one you're going to have to divert charitable donations in that direction. It would have to be Help for Heroes on steroids.

B

Originally Posted by bakerlite

The case for the dedicated military hospital is overwhelming, but you aren't going to get a British government to pay for it. If you want one you're going to have to divert charitable donations in that direction. It would have to be Help for Heroes on steroids.

B

Simply, no it isn't. It would be nice and fluffy to have a military hospital but the fact remains that services can't support a dedicated hospital due to the number of specialities required.

The armed forces combined does not have the numbers of personnel required to support even a small general hospital in NHS terms, never mind one with full physical rehab, neuro rehab, burns, facio max, orthapedic, prosthetics, plastics etc with the required throughput of patients to retain clinical expertise and currency.

These are facilities you'd find in a regional population of some million, not one of a large town, 150, 000, give or take.

The current idea of MDHUs (with some development) is the most clinically safe and appropriate way forward in my opinion.

Charitable hospitals? Not a chance as it would far too costly to conform to the governance standards required for any healthcare organisation under the Care Quality Commission.

So what is your argument Psychobabble - that you must have a population of "some million" to justify a hospital with a range of capabilities. What is "some" millions"? 2-3million. So on that basis we only need 20-30 hospitals for the whole of the UK then?

A military hospital can dispense with a number of departments which traditionally cost the NHS a fortune. The dependancy can be increased by offering priority treatment to veterans and dependant families whilst still offering spare capacity to the NHS to the mutual benefit of both the MoD and the NHS.

Other countries of similar size, economy and status as the UK manage to have military hospital - why don't we?

It is not a case of being able to afford it - it is more a case of can we afford not to do it as the list of casualties and long-term injured grows. You might like to consider the fact that more Falklands Veterans have committed suicide than were killed in the conflict. Sooner or later the PTSD problems of Afghanistan will kick-in and it might be useful to have a dedicated psychie wing of a military hospital to assist in dealing with the aftermath. Many of the badly injured will also have enduring problems that the NHS will not be able to cope with. BLESMA, the ABF and St Dunstan's can only do so much.

'BLESMA, the ABF and St Dunstan's can only do so much.' - St Dunstans is in deep financial trouble due to the demands placed upon it by Iraq and Afghanistan. They are having to make a sixth of their staff redundant - they are, after all, a charity, not taxpayer funded.