Focus: Hospital on the Home Front; Is a Return to Military Hospitals or Exclusive Military Wards Really the Best Option for Injured Soldiers?
Byline: By Dr Sue Sinclair Consultant anaesthetist and intensivist
Much has been said recently by politicians and war veterans amongst others about the treatment of injured military personnel in general wards at Selly Oak Hospital in Birmingham, where the Royal Centre for Defence Medicine is based.
The Prime Minister has even vowed to reintroduce the use of military managed wards for the war wounded amid claims that a soldier injured in Iraq was abused in his hospital bed by a Muslim visiting another patient. Here two medics from the hospital, one military, one civilian, add their views to the debate.
Evolution not revolution. That's the best way to describe the partnership between the Royal Centre for Defence Medicine and University Hospital Birmingham NHS Foundation Trust (UHB).
Because, despite what you read in the newspapers and see on television, UHB has been treating military patients very successfully for the last five years. In fact during that period we have cared for 6,422 military inpa-tients and 29,616 outpatients.
The Royal Centre for Defence Medicine originally set up the partnership with UHB because of the quality and range of clinical specialities a top-performing NHS trust like ours could provide. Unlike a military hospital, or military ward, UHB has experts in burns, plastics, trauma, critical care, neuro-surgery, cardiothoracic, vascular and liver surgery, general surgery, hand surgery, all under 'one roof', ready to respond 24 hours a day, seven days a week, 365 days a year.
Two weeks ago, with just 12 hours notice, we received six seriously injured servicemen from Afghanistan into our intensive care unit. The clinical needs of those patients demanded immediate response from consultants in many different specialities.
We were able to meet the clinical needs of these patients, while having no impact on our ability to care for civilian patients, or the day-to-day running of our hospitals.
Five weeks ago a team of UHB and military staff spent 17 hours in theatre rebuilding a soldier's hand from three of his own ribs. Both the soldier and his family believe had he been treated anywhere else, his arm would have been amputated from below the elbow.
On Friday night we received another soldier from Iraq who had been victim of a suicide bomber.
On Saturday he spent many hours in theatre having his pelvis rebuilt alongside the treatment of a multitude of other injuries. There are only a handful of pelvic experts in the country. UHB employs one of them.
Haslar, the last remaining military hospital sited in Portsmouth and due to be handed over to the NHS in the spring, has six-eight critical care beds. UHB has 56 critical care beds.
Haslar does not have the range of experts in diverse medical disciplines on-call and ready to respond to the clinical needs of the injured usually at short notice and outside of normal working hours.
I think it is also important to point out the procedure for dealing with critically injured servicemen during the first Gulf War in the early 90s when all military hospitals were operational. Mercifully back then there was not the number of severely injured needing critical care.
However the military hospitals recognised that they would not be able to begin to cope and the contingency was that all military patients in need of critical care beds were to be referred to a London teaching hospital who would co-ordinate dispersal around a number of South east hospitals - none of which had any military infrastructure and welfare staff, unlike University Hospital Birmingham, home of the RCDM. …