“Ministry of Defence 1”

The coroner’s concerns

Ministry of Defence 1. I have a concern as to the number and availability of psychiatrists and psychologists within the Ministry of Defence and accessible to serving personnel. This concern extends to ensuring a soldier receives access to appropriate treatment including diagnosis. Diagnosis is also important as under the Armed Forces 4 Compensation Scheme, mental disorders must be diagnosed by a relevant accredited medical specialist, namely, a medical practitioner whose name is included in the specialist register kept and published by the General Medical Council as required by section 34D of the Medical Act 1983. At the time Jonny Cole was accessing the DCMH Lisburn, gave evidence that there was just one psychiatrist for the whole of Northern Ireland who also had duties in the DCMH Kinloss, Scotland and no psychologist. 2 Rifles was based in Northern Ireland and at this time issues relative to Operation Herrick 10 and traumatic combat experience were being identified. told me relative to the impact of Operation Herrick 10, “Well all I can say is that we knew that we had a problem with post traumatic stress disorder and there were several suicides in Northern Ireland before I arrived. I can’t comment on that too far because there was a board of inquiry and the regiment was moved from the isolated position of Ballykinler to Lisburn because of that. In order to make them less vulnerable,” Following the evidence given by , I queried the Service expectations for the number of psychiatrists covering Northern Ireland and Scotland in 2010-2013 and now, and was provided with the following response from Defence Medical Services. “NI is now covered by DCMH . The staffing of mental health posts is however now lower that that at the time the Coroner is concerned with. This is partly due to reducing military population in NI which would not justify a full-time consultant and partly due to significant difficulties in staffing mental health posts. Recruiting more mental health clinical staff is something that the DMS is working hard to do; however, the pool of mental health workers for both the DMS and NHS to draw from is finite. Additionally, the DPHC Standard Operating Procedure on management of referrals makes some reference to this. Though it does not specify a manning ratio, it does give guidance on waiting list management (para 13). In essence it states an Officer Rank 7 or Civil Service Band 6 has day to day responsibility for monitoring waiting lists and has direct access to the clinical lead, they are also responsible for all review arrangements and Multi-Disciplinary Team actions which are in place. It would follow from this if waiting lists are becoming unmanageable the named individual would be able to escalate the problem”. Chief of Staff at Defence Medical Services Headquarters, 5 gave evidence when asked about the current position as to whether there was shortage of consultant psychiatrists and psychologists within the DCMHs, that, “we certainly have a shortage of mental health clinical staff at the moment. There are a lot of initiatives in place to try and continue to recruit those both military and civilian and we are working very hard at producing a more resilient and enduring so that we can actually build a career structure for our mental health practices going forward, something we have lacked in defence up until now.” This concern also extends to the knock-on effect that this apparent shortage of psychiatrists and psychologists has upon later claims for compensation by veterans as mental disorders must be diagnosed by a relevant accredited medical specialist, namely, a medical practitioner whose name is included in the specialist register kept and published by the General Medical Council as required by section 34D of the Medical Act 1983. 2. I have a concern that the Vulnerability Risk Management Process [Suicide Vulnerability Risk Management as was] is Unit led and that DCMH clinicians do not have a greater role in influencing the Army’s vulnerability risk management (VRM) process for suicidal soldiers. 3. I have a concern about: a. the training and experience of the Medical Advisors at Veterans UK providing advice under the Armed Forces Compensation Scheme. b. rejection of claims for PTSD under the Armed Forces Compensation Scheme if there is not a formal diagnosis by a consultant psychiatrist or psychologist but evidence of PTSD within medical records from other medical professionals. was a retired GP who went on to work as a part-time medical advisor at Veterans UK in October 2013 and rejected Jonny’s claim for compensation for PTSD and psychological injury under the armed forces compensation scheme. had no specialist knowledge of psychiatric or mental health issues and had had no specialist training in that area. In evidence accepted that there was an issue with the advice he gave that resulted in Jonny’s claim for compensation being rejected. In evidence told me: “Q. Can I ask you: The approach that you adopted on Jonny Cole’s case, in respect of his claim to PTSD, would you have applied a similar approach to other files or claims of veterans in respect of PTSD? 6 A. It’s possible, I suppose, but I suppose as you gain experience and understanding of how the scheme is to be applied, then it changes. When I looked at this a week ago, which is when I first saw the documents, I could see straightaway the issue, but obviously I didn’t see that in December 2013. Q. So, then, can I ask you: Obviously, when you reviewed the file as part of your preparation to give evidence, and to be fair to you, you had not had that opportunity when you provided your statement, you say you saw straightaway what the issue was. Can you tell us what it was that you saw when you reviewed the file, and what that issue is? That there was a consultant diagnosis1. A. Q. A. Q. A. Q. A. Q. Would there ever have been a scenario where you had rejected a claim, as part of the advice

An extract. Read the full report, including the circumstances of the death, on the Courts and Tribunals Judiciary website.

Source

judiciary.uk, Prevention of Future Deaths reports, 2023-0186

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8 Oct 2026

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Contains public sector information licensed under the Open Government Licence v3.0. Source: Courts and Tribunals Judiciary, judiciary.uk. Open Government Licence v3.0