Monday, October 22, 2007

How Many British Casualties Require High-dependency Clinical Care?

Radio 4 Today addressed the issue of why the Ministry of Defence refuses to say how many injured soldiers are being cared for in high-dependency wards? The MOD has tried in the past to claim that patient confidentiality prevented them releasing the data. This is clearly little more than obfuscation. An application for ethical approval from a research ethics committee would not even be required for the release of anonymised data, and such data is, or at least should be, kept by the MOD for monitoring and resource planning purposes. As someone who sits on a research ethics committe myself this is transparent; on the Today programme this morning a national expert on clinical ethics, Dr Tucker, confirmed that the MOD position was untenable.

John Humphries interviewed the Defence Minister Derek Twigg to try and obtain some clarity on why the MOD refuse to release the data and what the numbers actually are. The interview can be heard here (.ram).

The minister stated that there are currently 24 high dependency patients in the MOD medical facilities at Selly Oak, and 45 in Hedley Court. Strangely however, he refused to say how many patients there were outside of these facilities, but asserted that the number was less than 5. Why would he claim to be certain of the situation but yet be unwillinging to state what the number of patients is? There appears to be two possible explanations. One is that they just don't know, they have lost track of the destination of the cases after dischage or just don't have the data. The other plausible explanation is that the MOD wishes to somehow prevent the tracking or follow up of these cases.

While it may be true that there are currently about 73 high-dependency cases under inpatient treatment, the numbers who have survived the initial stages of clinical care and are now under out-patient treatment or rehabilitation will be much higher. From the official figures published on the MOD www site we can see that, up to 15th September 2007, they are reporting 205 very seriously or seriously injured casualties in Iraq and 81 in Afghanistan. Another striking statistic is that since April 2006 there have been 1189 medical evacuations of personnel from Iraq. Current treatment figures will only represent a proportion of people who have suffered catatrophic injuries.

Knowing just how many young men an women have lost mutiple limbs, suffered brain damage, or other horrific injuries is something the British Government would much prefer remains obscure and uncertain.