I have never, in the eight years since I left the Army, received NHS priority treatment", Paul McClintock reveals.
This is a problem, because the 33-year-old – a former Rifleman with 1st Battalion The Royal Green Jackets – has been living with a serious back injury for nearly 10 years. While on an Army exercise in 1996, he fell and injured himself. For the next two years, Paul’s back continued to get worse. He was sent for an MRI scan in 1998 and diagnosed with disk disfiguration, a disk bulge and a spinal condition called lumbar spondylosis.
The condition was too advanced to be operated on, and Paul was eventually medically discharged in 2000. He now has to use walking sticks every day and a wheelchair if he wants to go further than a short distance.
Despite informing his doctors that he is a war pensioner, he has been given the same treatment as anyone else. "My doctor just turned around and said he didn’t know anything about the NHS priority treatment. I had to wait for everything I needed," says Paul.
This has meant waits of over a year for MRI scans, which he is supposed to have every six months, and a further six-to-eight months for the scan results. "It causes me more stress than I need and all the stress causes me more pain. If I received priority treatment, they would notice the things that are going on with my back more quickly and then try to do something about it."
Know your rights
Paul’s story highlights perfectly why the Legion felt the need to launch its Honour the Covenant campaign last year.
The Military Covenant sets out a mutual promise between the nation and the armed forces. Service personnel agree to sacrifice certain civil liberties and to place themselves in harm’s way in the defence of others. In return, the nation promises to help and support service personnel and their families when they need it most. This includes looking after personnel who are injured during service, even after they have left the armed forces.
It’s a promise rooted in history. World War I saw an unprecedented number of injured troops returning home in need of medical treatment, many thousands of whom continued to require medical care long after the war had ended. They were treated in hospitals run by the Ministry of Pensions, an arrangement that continued until the introduction of the NHS in 1948.
The new health service, together with falling number of veterans needing continuing medical care, led to the 1953 decision that ex-service personnel should no longer be treated by the Ministry of Pensions but should become the responsibility of the NHS. As a concession, and in recognition of their service and sacrifice, war pensioners were awarded priority treatment.
The system remained unchanged until November 2007, when the Government extended priority treatment to all veterans with service-related health problems, regardless of whether they are a war pensioner. This extension came into force on 1 January 2008 and means that all of the UK’s 4.8 million veterans are now entitled to receive priority treatment if they have a condition related to their service.
However, a Royal British Legion survey of war pensioners in September 2007 revealed some worrying figures. Of the 498 war pensioners questioned, 211 had sought NHS treatment for the condition for which they received their war pension. Over three-quarters (78%) said they were not treated ahead of other non-emergency patients. Only 3% remembered being asked by an NHS health professional if they were a war pensioner.
The results of another survey – this time of GPs – were even more concerning. It revealed that 71% of the GPs questioned knew nothing at all about priority treatment. Only 7% reported receiving information about priority treatment from their Primary Care Trust (PCT), even though PCTs are supposed to inform GPs about their responsibility to deliver priority treatment to ex-service personnel.
Mental anguish
In particular, it seems that NHS mental health services have struggled to offer priority treatment. The MoD and the NHS are hoping to change that by introducing a new set of pilot projects across the UK. The aim is to reveal the most effective ways to assist veterans, and then to roll out the plan nationwide.
The Legion is hopeful that this will put an end to long waits for treatment. There have been other encouraging developments too. Priority care guidelines have recently been re-issued and PCTs have been reminded of the changes in priority treatment. Also, following the welcome extension of the priority treatment scheme, the Legion has been in discussions with the Ministry of Defence and the NHS to make sure the scheme actually works.
There is a recognition that more needs to be done to inform healthcare professionals about their responsibility to provide priority treatment to veterans with a service-related injury.
The Legion will be working with the MoD and the NHS to find better ways to get information to GPs and other medical staff, and to ex-service personnel in particular, to make sure veterans injured in service get the priority treatment they deserve.
The Legion is also planning another survey of ex-service personnel and healthcare professionals in January 2009, to discover if priority treatment is being successfully delivered, one year on from the extension of the scheme.
Wait no longer
If you are a veteran with a service-related injury and you have not been offered priority treatment, you should inform your GP of your eligibility. Your GP should then make sure you are treated with priority in future, for that particular condition. If your GP does not accept your right to priority treatment or include it in your referral for further treatment, you can ask to see another GP or make a complaint to the practice manager.
If you don’t think you are being given priority treatment at hospital or other specialist NHS services, you should speak to the medical staff treating you. If they do not accept your eligibility for priority treatment, you can raise your concern using the NHS complaints system. You can also contact the Patient Advice and Liaison Service (PALS), located in each Trust, for support and advice on making your complaint.
By taking this action, it will hopefully ensure that veterans like Paul McClintock will not have to suffer as they wait. Paul says he hasn’t noticed any difference since priority treatment was extended and does not believe the system is working properly, yet, because too few GPs and health professionals know about it.
Like the Legion, he thinks something should be done to make sure more medical staff know about priority treatment and more injured veterans get the service they have been promised.
He says: "Service veterans have served Queen and country and some of us have been injured in the process. I am not saying veterans should jump in front of people who need treatment more urgently, but we should be looked after in the right way as we have done our hardest to look after the country we live in."
