Should Veterans have right to treatment on NHS?

#1
I am informed, by the Department of Health, that Mrs. O'Carroll is the person responsible for answering queries on this subject and that emails should be sent to the address shown below and headed FOA (for the attention of) Mrs O'Carroll.
I have copied my email to Alan Johnson Secretary of State for Health, Veterans' Minister Derek Twigg and to the chairman of local NHS Trust.

Subject: Rights of War Pensioners to receive Priority Treatment


To: dhmail@dh.gsi.gov.uk
CC: johnsona@parliament.uk,twiggd@parliament.uk,chris.mann@powyslhb.wales.nhs.uk
Subject: Rights of War Pensioners to receive Priority Treatment

FAO MRS O'CARROLL
I am in receipt of a letter from the Veterans Agency that states that under National Health Service Guidelines WHC(2003)65 shows that war pensioners have a right to priority treatment for their war pensioned injuries as an inpatient or outpatient subject to clinical priority.
The letter goes on to say that it might help to show the letter to my GP or consultant.
On showing the letter at reception when attempting to book an appointment with my GP, I was informed that the medical practice did not accept any such priority for war pensioners.
I then contacted the Veterans Agency who informed me that the priority was for hospital appointments only (not GP appointments) and stated that it was not their remit to interfere on behalf of war pensioners, as their duty finished with the issuing of the 'priority' letter.
This is clearly a nonsense, as without a referral from a GP, there is little (no) chance of getting an appointment (as either in- or out-patient) with a consultant.
Also, and I quote from a reply received from 10 Downing Street:
"The rights of war pensioners are protected by legislation .
... War pensioners are entitled to priority NHS treatment and to free prescriptions for illness or injuries accepted as due to service."
On the other hand, it would appear that the NHS has only Guidelines, which omit any onus on General Practitioners to treat war pensioners with any priority, let alone refer said persons to a hospital consultant.
Please confirm that war pensioners are entitled to priority treatment from GPs as well as consultants, under law, for their war pensioned injuries, and ensure that all NHS Trust hospitals and GP surgeries are aware of this clarification.
I remain,
Yours faithfully,
 
#2
Is the problem that you can't get a GP appointment or that your GP won't refer you to a consultant?
 
#3
Ancient_Mariner said:
Is the problem that you can't get a GP appointment or that your GP won't refer you to a consultant?
Letter seems to suggest that GP will not give a priority appointment. Need that GP appointment to get a consultant referral.
 
#4
chris951 said:
Ancient_Mariner said:
Is the problem that you can't get a GP appointment or that your GP won't refer you to a consultant?
Letter seems to suggest that GP will not give a priority appointment. Need that GP appointment to get a consultant referral.
quite, chris - Vets Agency confirmed to me that there is no onus on GPs to either give priority treatment to War Pensioner/AFCS recipients or to refer them to a consultant.

Now comes the funny - No 10 says "The rights of war pensioners are protected by legislation including access to an independent appeals process."
and that
"War pensioners are entitled to priority NHS treatment and to free prescriptions for illness or injuries accepted as due to service".

YET

The NHS only lays down guidelines - NHS GuidelinesWHC(2003)65.
I have spoken to the Department of Health at length today. They agreed that GPs were not specifically mentioned in the guidelines thereby making a nonsense of the right to receive priority treatment, and suggested
that I contact Mrs O'Carroll.

I have also spoken to (Secretary of State for Health) Alan Johnson's secretary who suggested that I should copy the email to him.

I added Derek Twigg as he is Veterans' Minister and the other bod who is chair of Powys NHS Trust for good measure.

Mrs O'Carroll is on annual leave at the moment, but returns to work on Monday.
 
#5
chris951 said:
Ancient_Mariner said:
Is the problem that you can't get a GP appointment or that your GP won't refer you to a consultant?
Letter seems to suggest that GP will not give a priority appointment. Need that GP appointment to get a consultant referral.
Perhaps a change of GP might help. I know that the standard of service at surgeries varies enormously but many of them will give you an appointment on the same day if you say that your problem is urgent.

If yours is a surgery where everybody needs to wait 2 weeks or more for an appointment it might be worth shopping around for a practice with more GPs or a more flexible appointment system.

If you are in pain, would it be worth going to A&E at the hospital?
 
#6
Rockape, I wonder if it's worth writing to the head of your local NHS, recorded mail, pointing out the guidelines and the fact that they are being ignored?. Maybe you have already, but in that case how do they justify ignoring them, if they are already aware of them?. Are the Legion interested?. I wonder if it is worth trying to get an active campaign going, nationally?. A bit of embarrassing publicity seems to go a long way (Mr P, VC).
 
#7
A_M
In the hills there ain't many GPs (or dentists) - get off one list and its difficult to find another - although my GP is only a mile away, getting to my dentist isa 34 mile round trip, and the nearest A&E is 36 miles away (72 mile round trip).
As to pain - they'll give me as many (opioid) painkillers as I ask for on repeat prescription.

Nosher, Chris Mann in the above email I sent is the Local (Powys) Chair for the NHS Trust.

The guidelines are being ingnored
- worse still they are only guidelines, whereas No 10 (Downing Street) states:
"War Pensioners rights are protected by legislation"
and that
"War pensioners are entitled to priority NHS treatment and to free prescriptions for illness or injuries accepted as due to service."
and from Derek Twigg (Vets Minister)
“priority treatment applies to all disablements that have been found to be due to service, irrespective of whether they result in a pension”, in an adjournment debate on 12 June 2007 (Hansard column 262WH).

This is contrary to Department of Health guidance issued in 1997, which states that the NHS “should give priority to war pensioners […] for examination or treatment which relates to the condition or conditions for which they receive a pension or received a gratuity” (HSG(97)31)."

Much of the problem is that VA will not intervene - they say it is outside their remit, and Government denies that there is a problem.

As soon as I receive a reply I'll post it here.


I am not selfishly pursuing this subject, although I have a vested interest,
I fell that it is in the interest of all serving and ex serving forces personnel to get this contentious subject sorted out.
 
#8
This has been a problem for many years; with the NHS ignoring its obligations towards War Pensioners, and the Veteran's Agency (and its predecessor) wringing its hands but doing nothing.

The usual excuse is that they can't give priority other than on the basis of clinical need. Trusts rarely seem to understand that they are not being asked to make or interpret the rules - merely to abide by them. The old 'we can't give priority to any one group' is balls - as demonstrated by the amount hey spend on interpreting and translation services for a minority of patients.
 
#9
Rockape34 said:
The NHS only lays down guidelines - NHS GuidelinesWHC(2003)65.
I have spoken to the Department of Health at length today. They agreed that GPs were not specifically mentioned in the guidelines thereby making a nonsense of the right to receive priority treatment...
Rock

You might like to draw the DOH's attention to their own Chief Executive's Bulletin (Issue 37), which specifically mentions GPs as among the NHS staff who are involved in referrals and therefore need to be aware of the guidelines:

4. Priority Treatment for War Pensioners

Despite the reminder in the Chief Executives' Bulletin for the period 10-16 March 2000, there have been cases where the guidance in HSC(97)31 has not been followed. Chief Executives should ensure that all staff involved in the referral process are aware of the requirements of HSG(97)31. This will include:

* general practitioners

* hospital consultant medical staff

* medical secretaries.

HSG(97)31 sets out the arrangements under which NHS hospitals should ensure that they give priority treatment to war pensioners, both as inpatients and as outpatients, for examination or treatment relating to the condition for which they receive a war pension.
Note also that the DOH acknowledged that there had been cases in which the guidelines had not been followed, whereas the MOD Veterans Agency tends to deny this.

Rock, you seem to be doing a very effective job of fighting your own corner on this issue. Just for general information, BAFF would be prepared to take up this issue on behalf of subscribing members, whether on a named or anonymous basis.
 
#10
If you have an urgent problem and you can't get in to see your GP, complain to your PCT. I have been a practice manager in a GP surgery since leaving the Sigs 11 years ago. GP surgeries must offer you a routine appointment within 48 hours "if possible" and an urgent appointment within 24 hours.
Ours is a very busy surgery with a high immigrant (mainly Asian) population who are very demanding. They insist on seeing a GP for every little cough or sneeze which puts a huge demand on us. However, we offer routine appointments within 1 week (with 11,000 thousand patients we can't meet the 48 hour target), urgent appointments within 24 hours and emergency appointments the same day you contact us. That is my policy and is rigidly stuck to. I also know the VA guidelines for the treatment of War pensioners and they are given priority at our surgery. It doesn't matter how many patients the doctor has, a patient claiming emergency treatment is required is seen that same day, in fact, they are seen in the session they contact us. Phoning at 0830 gets you an appointment before 1200. Phoning at 1430 gets you an appointment by 1800. Of course, this system is abused by a lot of patients and they claim things like "sick notes" or "forgot to order my Viagra" are emergencies.
However, back to subject, if your GP is not seeing you urgently, get on to your PCT and he/she will lose money if they do not achieve these targets. The money is substantial (up to £32,000 a year depending on how many in the practice).
Our older doctors are well aware of my policy on this. I have to "train" younger doctors coming of the factory line but they soon get the point when I threaten to cut their pay if they don't meet the targets.
If appropriate, our GPs will also refer a patient to a specialist consultant and have an appointment made within 48 hours. In 85% of cases, you will see the GP urgently within 24 hours and walk out of the surgery clutching an appointment in your sweaty little mitt to see a consultant. Of course, the GPs have no control over the consultants and cannot guarantee how long you will have to wait for that appointment. The secondary care providers, however, also have targets to reach set by the NHS.
So, advice to you, complain to your PCT that your GP is not meeting his access target. The PCT also pays the hospital consultant so they should inform them of the government rulings on the treatment of War Pensioners. They have enough managers in these organisations to ensure this is carried out.
Best of luck in your campaign, the more people made aware of this the better.
 
#11
Exbleep thanks for the info :)

However, my problem was at hospital level - they claimed to know not of this legislatin 8O
 
#12
Then their hospital administrator should be taken to task PDQ. It's his (or more likely her) job to know these things. For my first 5 years in the job I took home the NHS Statement of Fees and Allowances (SFA) and it was my preferred bedtime reading. I still read through it, albeit now in electronic form) on a regular basis. It's part of my job to know the rules and it is the hospital administrators' job to be conversant with theirs. These rules are much the same as Unit Standing Orders and are called protocols in this context. Again, ensure your PCT (or in your case I think it's called the Powys Health Board) makes the hospital aware of these rules.
Now you've brought this up, I will send an e-mail on Monday to all NHS trusts with the guidelines you have mentioned via the NHS Intranet system.
 
#13
This is going off at a tangent slightly but shortly before I got out I joined the BUPA HM Forces scheme, due to having no faith whatsoever in Liabours handling of the NHS.

For those of you who have never heard of this before (I hadn't until shortly before I was leaving) I would recommend it to anyone. You get a 47% discount for life, i.e. you retain the discount even after you have left the Forces, providing the policy does not lapse and you can add your wife and kids at the same discounted rate.

In my case it has paid for itself and then some. I had a minor operation about a year after I took out the policy and instead of the 6 months (minimum) wait on the NHS (and it was quite painful) I was operated on 2 weeks after seeing the consultant and recuperated in a nice MRSA free private room with Sky TV etc, the physiotherapy began immediately afterwards and was also paid for in full...

You can't put a price on yours and your family's health....And before anyone asks, I am not an employee of BUPA..

LINK - BUPA, HM FORCES
 
#14
Although all of this is way too late for me:

Sadly your link died last year:

"BUPACare is one of BUPA's more extensive private medical schemes for individual members. As a member of the Armed Forces you and your family can benefit from a 47 percent discount † on this scheme.

† This discount applies to current standard BUPACare subscription rates and is available to those joining between 1/7/2005 and 30/06/2006. It may not be combined with any other discounts for which you may be eligible. BUPA reserves the right to alter or withdraw the discount on or after your first renewal date and the right to vary subscriptions during a contract year if the rate of insurance premium tax changes. Terms and conditions of BUPA group schemes may differ from those of BUPA personal schemes."


I hope BUPA have updated this - if not watch the negative advertising.
 
#15
Hmm...didn't notice that (I didnt read the page at all actually I just googled it to get the link).

I joined the scheme in 2003 and I've always had the discount...and still do..
 
#16
Thanks Hackle - you understand the situation - I am trying to wake up others as to the problems they may (nay will) face.

The points made in my email to the addressees have to be personal in order that I might get an answer.
I have spoken on the 'phone, at length to DOH, VA, Secretary of State for Health's office, NHS Trust on an area level (Powys that is) and so have addressed the missive to each, and copied to the Veterans Minister for good measure.

Anyone could have done this.

I have received a reply from (Secretary of State for Health) Alan Johnson's Office stating "I have forwarded your letter, as promised, to the Department of Health" for action.

exbleep said:
- I have been a practice manager in a GP surgery since leaving the Sigs 11 years ago. GP surgeries must offer you a routine appointment within 48 hours "if possible" and an urgent appointment within 24 hours.
... sounds fine, however then semantics kick in "if possible" could mean you receive an appointment in days/weeks/years/never here it tends to be three weeks.
"Urgent" in this, and other areas I know of, means life threatening (or if you like "I might just be able to make it to your surgery with the help of paramedics").

I would draw your attention to Hackle's post:
Just for general information, BAFF would be prepared to take up this issue on behalf of subscribing members, whether on a named or anonymous basis.
p.s.
Hackle, as you probably know, I am not a member of BAFF, but if you lot won't join me, may I join you? :crazy:
 
#17
Eventually dug up the relevant bit of Hansard with his answer to the rights of veterans - interesting reading as far as it goes.

Hansard12 Jun 2007 : Column 262WH said:
HERE
Rt Hon. Derek Twigg MP, Veterans Minister:

My hon. Friend points to an alternative route: ensuring that ex-servicepeople who have hearing loss caused by service receive priority access to up-to-date hearing aids. Hon. Members may know that priority treatment refers to the long-standing arrangement whereby war pensioners are entitled to priority from the health services for treatment of injury or illness caused by service, subject only to overriding clinical priority, as decided by the clinician in charge.

I am happy to confirm that priority treatment applies to all disablements that have been found to be due to service, irrespective of whether they result in a pension. For clarity, three groups are eligible for priority treatment from the health services for a service-related condition: those who receive a continuing war pension; those who receive a one-off gratuity; and those whose condition has been found to be caused by service, but has not attracted an award

My hon. Friend raised the issue of funding such arrangements, so it may help if I were to explain that payments were once made under the war pension scheme for privately supplied hearing aids for people with hearing loss due to service. Following changes to health service policy and practice in the 1990s, payment from war pensions was no longer appropriate and such payments ceased. At the same time, funds relating to hearing aids were transferred from war pensions to the health service.

I reassure my hon. Friend that officials are in continuing discussions with the UK health departments regarding the awareness of priority treatment among health professionals. I have also met the Secretary of State for Health and the Minister of State, Department of Health, my right hon. Friend the Member for Doncaster, Central (Ms Winterton), to discuss priority treatment. A lot of work is clearly being done on this issue. Later this year, the health departments will distribute reminders to the chief executives of trusts requiring them to ensure that general practitioners and hospital clinicians are aware of all those veterans who are eligible for priority treatment, including the group that we have been discussing.

I thank my hon. Friend the Member for Knowsley, South for raising this important issue. I hope that I have been able to provide answers to some of the points that he made.

Question put and agreed to.
Adjourned accordingly at five minutes to Two o'clock.
...as can be seen there is much, still, to push for as he says "Later this year Health departments will distribute reminders ..."
Why later this year... why no date - is this another "Jam Tomorrow" promise from weasel politicos?
 
#18
Rock, I will PM you later about BAFF. The membership comprises serving and ex-serving members of the three Services, including the RAF Regiment!

This is the corresponding Scottish Executive Circular HDL(2002)18 dated 21 March 2002, "Priority Treatment for War Pensioners", WEB LINK. It confirms once again:

(a) the origins of the undertaking given by the Government when the Ministry of Pensions hospitals were transferred to the NHS in 1953 and

(b) the fact that GPs are expected to be aware of the arrangements for priority treatment.

Health Department
Directorate of Service Policy and Planning
Health Planning and Quality Division
St Andrew's House
Regent Road
EDINBURGH
EH1 3DG

Dear Colleague

PRIORITY TREATMENT FOR WAR PENSIONERS

Summary

1. This letter has been issued as a reminder about the arrangements for priority treatment of war pensioners.

Action

2. Chief Executives of NHS Boards and Trusts should ensure that:

· general practitioners and relevant hospital staff are reminded of the arrangements for priority treatment; and

· Directors of Finance, General Practitioners, Dentists, Opticians, Chiropodists and staff responsible for payment of invoices and travel expenses are reminded of the arrangements shown in Annexes A and B.

Background

3. A war pensioner was previously classed as someone who has a pension or receives a gratuity for disablement caused by armed service during the 1914-18 and 1939-45 wars and services since 1945. With effect from 29 July 1996 the term 'War Pensioner' includes those people who were injured or disabled as a result of service in the Armed Forces of the Crown either before 4 August 1914 or between 1 October 1921 and 2 September 1939. NHS MEL(1996)73 refers.

4. In 1953, hospitals run by the Ministry of Pensions for the treatment of war pensioners were transferred to the NHS. The Government gave an undertaking that there would be priority examination and treatment for war pensioners in NHS hospitals for the condition or conditions for which the war pensioners received a pension or gratuity.

5. In accordance with this undertaking, NHS hospitals, including NHS Trust hospitals, should give priority to war pensioners both as out-patients and in-patients for examinations or treatment which relates to the condition or conditions for which they receive a pension or received a gratuity (unless there is an emergency case or another case demands clinical priority). Priority should not be given for unrelated conditions.

6. Referrals for treatment should make it clear that the patient is a war pensioner and requires treatment for the condition or conditions for which the war pensioner was given a pension or gratuity.

Yours sincerely
 
#19
Our med centre holds current (dtd2007) leaflets from BUPA advertising this 47% discount
 

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