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The Report of the Iraq Inquiry
Gen Dannatt wrote that the increasing involvement of charitable organisations was, in his
view, not a response to “a challenge thrown down by the Government, merely evidence
that the nation was beginning to get behind its soldiers and their families”.
Handling complex cases
93.  Lt Gen Lillywhite told the Inquiry that survival rates improved significantly over the
course of Op TELIC.59 He also highlighted the increasing number of Service Personnel
with “complex injuries” that would be seen in civilian life extremely rarely, and for which
civilian medical and social services have not been set up to manage.
94.  Lt Gen Lillywhite also told the Inquiry that since the start of the Iraq conflict, the
MOD had taken a more flexible approach to determining the appropriate date for
discharge, which now depended on the individual’s circumstances.60 He described
that to be “a compassionate response to … very, very serious injuries and sometimes
family situations”.
95.  A particular challenge was managing the transfer of care from the military system to
the NHS, when an individual with complex injuries was discharged.61 The military system
was holding onto casualties for longer, and in some cases to a point where it did not
have all the capability required to care for the individual. However, at that same point,
the NHS was not set up to provide the comprehensive care that was required.
Lt Gen Lillywhite commented:
“So arranging that care package requires individual persuasion, discussion, debate,
with the local authorities in the place where that individual is at home. Of course, the
issue of funding can then come into it …
“So the ongoing care of the complex casualty is throwing up issues that we have not
seen before.”
96.  Lt Gen Lillywhite suggested that individuals with complex injuries should be treated
by the Government as a group with specific clinical needs, in recognition of their service
and on clinical grounds to enable specialist care to be arranged and provided more
consistently.62 He subsequently stated:
“I had general agreement when I was in office that that was what was required, but
it needs giving effect to, and there are ongoing issues that can be only addressed
59  Public hearing, 20 July 2010, page 41.
60  Public hearing, 20 July 2010, pages 52-53.
61  Public hearing, 20 July 2010, pages 47-49.
62  Public hearing, 20 July 2010, pages 41-42.
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