Care after Combat

January 25, 2020

Doctor’s Log - Star Date 25012020

Help us please to help them

I listened with great interest to an interview with Sue Frieth’s, CEO Combat Stress earlier today. Partly because of a cut in its NHS funding support ((£16million to £10million in 2018) Combat Stress has decided to no longer accept new referrals in view of a funding crisis. The decision she said, had been taken with great sadness.

Combat Stress continues to receive more than £1m from NHS Scotland and will continue to take on new cases there and in Northern Ireland.

It had been receiving around 2,000 referrals for treatment a year. It will now send all new referrals from England and Wales to the NHS, which Combat Stress said needed to demonstrate it could deal with the increased demands.

She told the BBC: “I don’t believe the NHS can pick this up. That is why we exist.” She said 80% of veterans who came to the charity had either used the NHS and not had their needs met or had felt unable to use NHS services.

Contrary to the views expressed by Ms Frieth, the NHS and Care after Combat together with Project Nova are at present working in tandem with Veterans’ Regroup. The project is delivering significant numbers and will never turn any veteran away, too so would be unforgivable, contrary to our core values and Jim, moreover, would never sanction such a course of action.

Meanwhile, several organisations and charities have spoken of a rise in the number of veterans taking their lives.

Whilst I fervently support the veteran population, especially those who each day of their lives are faced with mounting challenges, I felt aspects of the interview only served to confuse and possible muddy the waters. Having access to significant funding (in excess of £10m) whilst pleading poverty is, I believe, somewhat incongruous.

When servicemen and women leave the armed forces, their healthcare is the responsibility of the NHS. The Armed Forces Covenant is a part of the NHS Constitution. NHS England commissions secondary care for serving personnel and Armed Forces families registered with MoD GP practices. It is also responsible for commissioning a range of services for veterans, such as those for limb loss and mental health.

Combat Stress with its vast financial resources are no longer accepting new referrals, Care after Combat in comparison is the poor cousin in the family, despite producing evidence-based outcomes and our work with veterans in prison being published on the MoJ Research Lab website funding remains a constant source of concern. We have, over the previous four years significantly reduced reoffending rates in the veteran population to 8%, this compared to 48% in the general prison population in year 1 following release which increases to just less than two thirds in year 2. Apart from the financial savings the overall cost to veterans and their families is of course immeasurable. To date we have never said “no more” and despite virtually running on empty are unlikely to do so.

I understand and acknowledge suicide is a simple act but one of infinite complexity. I equally believe there must be a zero tolerance whereby one life lost is one too many. Serving in the Armed Forces is a risk laden occupation hence our efforts should continue to be invested in mitigating risk and recognising that whilst 90% of us transition safely there are those, who for whatever reason, will struggle and ultimately succumb to their demons.


As Father to a son who was awarded his prestigious green beret in 2005 I was especially saddened when hearing of the death of the Royal Marine recruit who was injured in a training incident earlier this week when part of a group practising an assault from a landing craft at Tregantle beach. It is extraordinarily sad news. His family must be absolutely and understandably devastated and may I, on behalf of all my colleagues at Care after Combat express our deepest condolences.

Dr Nicholas Murdoch