No need for separate military hospitals

By Lt Gen Louis Lillywhite, Surgeon General, Ministry of Defence

The idea that the medical care for our Armed Forces would somehow be better if we created a dedicated military hospital in the UK is just plain wrong. I am absolutely clear that it is no longer clinically viable to maintain such a facility. Simply put, the NHS is the best place to treat our injured Service personnel and to train our military consultants, doctors and nurses.

Our commitment to providing the best medical support for our Servicemen and women begins with the skills of the Defence Medical Services personnel who deploy on operations, who provide world-class medical treatment and care to injured personnel on the front line. And to do so, they need to have the best possible clinical training.

I am proud to lead the Defence Medical Services in which I have served my full career, and I started out at a time when the Armed Forces did maintain their own hospitals in the UK. But it became clear by the mid-1990s that they were no longer able to provide the volume and range of cases essential to train our medical personnel in the advancing medical skills needed for their essential operational roles. The advances we have seen in medicine and clinical practice in recent years makes this even more relevant today.

Training for military medics is now done in Ministry of Defence Hospital Units (MDHUs) established within NHS hospitals at Derriford, Frimley Park, Peterborough, Portsmouth, Northallerton and at the Royal Centre for Defence Medicine at Selly Oak in Birmingham.

Serious casualties from Iraq and Afghanistan need and receive advanced levels of care across a wide range of medical disciplines that can only be found in a major trauma hospital. This is what Selly Oak provides, supported by the other medical expertise that the NHS provides in the Birmingham area. In two years we will move into the new NHS hospital being built at Edgbaston – where we will have a dedicated military ward in Europe's largest and most modern critical care teaching hospital.

All our military patients deserve the very best. But I am pleased to say there are not many of them. On a typical day we barely have enough military inpatients – whatever their illness or injury - across all the UK to fill two wards in a major hospital. Last Thursday night, Selly Oak hospital had just 15 military inpatients – only 11 of which were battle casualties. It simply does not make sense to sustain for so few patients a completely separate military hospital to deliver the quality clinical care that Birmingham provides.

This is not just my view. The independent and cross-party Defence Select Committee visited Selly Oak and grilled me last year, but concluded by agreeing our approach, saying the arguments to close military hospitals were "irresistible". They said "the principle behind the decision to move from stand-alone military hospitals to facilities which co-operate with the NHS was the right one... and we see no evidence that the care offered to military personnel has suffered as a result. Indeed, we believe that Armed Forces clinicians now have experience of a much broader range of cases, which benefits their training".

General Sir Richard Dannatt, the Chief of the General Staff, is also on record as saying "there is nowhere better in the country, nowhere more expert at polytrauma medicine than that hospital in Selly Oak, that's why our people are there".

Medical staff at Selly Oak – military and civilian – do a fantastic job looking after our injured troops and deserve the support of all of us. So let's praise their success, not chase an out-dated model that would put at risk the excellent care our patients deserve.