Members of Parliament have criticised the Scottish government for failing to ensure that its military veterans receive the same fast-track National Health Service treatment as is provided to retired service personnel in England.

The report, by the House of Commons Defence Committee, also concludes that levels of clinical care provided for UK servicemen and women injured on operations are “world-class,” but that the government needs to do more to look after the health of their families and of service veterans, especially in terms of mental health provision. Support “has to go beyond the period of service in the armed forces, and should form part of the compact between the services and society,” says the Committee, in its new report on medical care for the armed forces.

Ex-service personnel in Scotland are not getting the help to which they are entitled because of poor levels of cooperation and communication between the Ministry of Defence and the Scottish Executive, say the MPs. “Depending on guidance and taking a laissez faire approach to making sure that such guidance is implemented is totally inadequate, and reinforces our view that the issues confronting service personnel and their families are not sufficiently high up the list of priorities for the Scottish Executive," they add.

The Scotland on Sunday newspaper reported Committee member David Hamilton, Labour MP for Midlothian, as saying the panel was “shocked by the lack of knowledge that the Scottish officials had for the fast-track system. It seemed that the officials didn't really know that these things were available for veterans in Scotland."

Replying to the MPs’ concerns, Scottish Health Secretary Nicola Sturgeon has pointed out that the “long-standing arrangement to provide priority treatment for war pensioners for the condition, or conditions, which gives rise to their war pension or gratuity” is being extended to include those who have served in the armed forces and have a service-related medical condition “but are not currently in receipt of such payments.”

Need to track for mental health care
Meantime, the Committee report also describes the armed forces’ treatment of mental health problems overall as “mixed.” The provision for serving personnel is “adequate,” albeit with room for improvement, but with many problems only coming to light some years after people have left the armed forces, there is currently no proper system for tracking them and making support available to them when necessary, it says.

Giving evidence to the panel, the Department for Health had described mental health as “an issue of concern for service personnel, veterans and reservists,” while Combat Stress (the Ex-Services Mental Welfare Society) observed that veterans with mental health problems can be “extremely difficult to deal with in an NHS setting, often quickly exhausting the patience of practitioners and the limited and frequently overstretched community mental health care resources available.”

The Royal College of Physicians (RCP) pointed out that many aspects of secondary and tertiary care for service personnel are good, and in particular that trauma care is regarded as outstanding, “considering the facilities available,” but welfare support has not yet reached an acceptable standard.

The College also warned: “there is a sense of entitlement that more should be provided for personnel in terms of medical, welfare and social support than the NHS can provide,” and called for efforts to be made “to ease tensions between civilian and military expectations regarding service provision and treatment.”

Commenting on the report’s findings, Committee chairman James Arbuthnot, (Conservative MP for Hampshire North East) praised the armed forces medical personnel for doing “a brilliant job in treating and rehabilitating wounded servicemen and women. Patients are recovering from injuries which, even ten years ago, would have been incapacitating or fatal,” he said. He also welcomed the government’s announcement last November that it was expanding priority access to healthcare for veterans, but called for more effective ways of tracking, monitoring and treating them properly. “Too much is being left to good intentions and good luck. Unless the NHS can identify those who are entitled, priority access can be an empty promise,” said Mr Arbuthnot.