Armed Forces Bill (First sitting)

Debate between Mike Martin and Neil Shastri-Hurst

Select Committee stage
Tuesday 24th March 2026 Public Bill Committees

[Dr Shastri-Hurst]

The hon. Member makes a valid point. Of course there will need to be a degree of clinical judgment, but the premise that somebody has to start at the bottom of the system by virtue of the fact that they are a dependant of service personnel is inherently unfair, and one that needs to be addressed in the Bill.

[Mike Martin]

Nobody wants a serviceperson or veteran to return to the back of the list. That would be completely contrary to what we are trying to do. Equally, if they were sixth on the list in the old area, we do not want them to be sixth in the new area. Is the hon. Member saying that their degree of clinical severity or urgency, or their triage category, would transfer such that they would slot into the new list at the same level?

[Dr Shastri-Hurst]

I am grateful to the hon. and gallant Member for his intervention. This is about placing a clear, time-bound duty on the Secretary of State to secure continuity of secondary care for dependants within six months. We want their clinical need to transfer horizontally across, as opposed to vertically downwards. That is the nuisance that amendment 10 is intended to address.

Amendment 10 sets out the substance of the regulations that I have suggested that the Secretary of State introduce. They are deliberately straightforward. First, where a patient is already receiving treatment, their status should be preserved when the responsibility for their care is transferred to a different health authority—that is, a horizontal move across. In practical terms, it would mean that a patient should not lose their place in the system because they crossed administrative boundaries. Instead, they should have a seamless transfer of care.

Secondly, the amendment would ensure that patients are not required to obtain a new referral solely by virtue of having moved, which would be ridiculous. The need for a referral is, and should remain, a clinical matter. It should not be triggered by geography and movement. Requiring a new referral in those circumstances adds delay, creates duplication and serves no meaningful clinical purpose.

Thirdly, the amendment calls for clear guidance on the practical steps necessary to support continuity, including the timely and efficient transfer of patient records, the recognition and continuation of existing treatment pathways, and the preservation of procedures that have been booked or recommended. Those are not novel concepts; in many ways, they are already part of good administrative practice. What is lacking is the consistency of application across the country.

It is perhaps worth emphasising what amendment 10 would not do, as much as what it would. It would not confer preferential treatment on service families. It would not seek to move them ahead of others in the queue, nor to secure access to services beyond what is clinically necessary. Its purpose is much more modest: to ensure that service families are not disadvantaged as a result of circumstances beyond their control. That is entirely in keeping with the armed forces covenant, which commits to removing disadvantage, not to creating advantage. In that context, the disadvantage is clear; it arises not from clinical need, but from the intersection of mobility and administrative fragmentation. Addressing it is therefore both entirely justified and absolutely necessary.

There is also a broader point about fairness and the implicit contract between the nation and those who serve. Service personnel accept a range of constraints and obligations that do not apply to the general population. They relinquish a degree of control over where they live, where they move and how they organise their family life. In return, it is entirely reasonable for them to expect that the state will take reasonable steps to ensure that those constraints do not translate into avoidable hardship for their families.

Continuity of healthcare is a particularly important aspect of that understanding. Health is not a peripheral concern; it is central to the wellbeing and stability of service families. Disruption to care can have a cascading effect on education, employment and the overall resilience of the family unit. In that sense, addressing the issue is a matter not only of fairness, but of operational effectiveness. A serviceperson who is worried about the health of their family cannot fully focus on their duties. At a time of critical need, their ability to do so is absolutely essential.

Some may raise questions about the practicalities of implementing such a system, particularly in the context of devolved health systems across the United Kingdom. It is therefore important to be clear about the scope and intent of amendment 10. It would not seek to override devolved competencies or impose a uniform model of service delivery. Rather, it would require that whatever the organisational arrangements are, mechanisms be in place to ensure continuity when patients move between them.

In many respects, the steps required are administrative rather than structural. They involve ensuring that information flows effectively, that existing clinical decisions are recognised, and that waiting positions are honoured, based on clinical need. These are matters of co-ordination, communication and guidance; they do not require wholesale reform of the system.

There are already examples of good practice in this area. In some parts of the country, arrangements have already been put in place to facilitate the transfer of patients between trusts with minimal disruption to their care. The amendment seeks to ensure that such practice becomes the norm rather than the exception.

It is also worth noting that the increasing digitalisation of healthcare records and the development of more integrated healthcare systems provide a foundation upon which this kind of continuity can be built. In many cases, the infrastructure already exists; what is needed is a clearer expectation, backed by regulation, that it should be used to support service families consistently and reliably.