Jamie Cooper begged for his colostomy bag to be emptied. In all, he asked three nurses. One said she had no idea how to help. Another promised to pass on his request. His parents watched the plight of their wounded soldier. He may as well have begged for his dignity.
Cooper had served, and nearly died for, his country. Shrapnel had sliced through his stomach after a mortar attack in Basra last November. He remains the youngest British serviceman wounded in Iraq. Now the 18-year-old was struggling to have his faeces removed at the Birmingham hospital that treats the most seriously wounded from Iraq and Afghanistan. Finally his parents could take no more: they emptied the bag themselves.
'We went to the store room, helped ourselves to the necessary equipment and proceeded to clean out the colostomy bag - a task too onerous for staff,' Phillip and Caroline Cooper wrote in a letter last month to senior military leaders and NHS staff, which has been obtained by The Observer.
The Royal Green Jacket rifleman remains at Selly Oak Hospital, the sprawling NHS complex in south Birmingham where the most serious of Britain's returning wounded are treated. The lucky ones arrive at ward S4, where nurses attend to two six-bed bays in a 'military-managed' unit. Some are treated alongside civilians, removed from the camaraderie of wounded colleagues. Six months after the heated row over the suitability of placing wounded troops in mixed-civilian wards, Selly Oak is facing far more serious allegations. Letters obtained by The Observer have been called into question the treatment afforded to Britain's injured troops. The claims have provoked fresh consternation over how Britain treats its war-wounded and uncomfortable questions for a government embroiled in two bloody conflicts.
Weeks after the scandal surrounding shoddy conditions at America's flagship military hospital, the Walter Reed Army Medical Center in Washington, the British government faces its own crisis over a hospital where hundreds of wounded service personnel have arrived since the Iraq invasion four years ago.
An extraordinary sheaf of letters sent to the Ministry of Defence and the NHS and passed on by military sources to The Observer chronicles a series of alleged failings in basic care and services given to UK soldiers. Among them are claims that troops have been denied pain relief after wards ran out of supplies. On one occasion, wounded soldiers were allegedly forced to wait more than 12 hours for pain-relieving medication.
One letter of complaint from anxious parents, dated 24 February, suggests that wounded soldiers may be suffering more than is necessary in Selly Oak.
The operation on their son finished at 8pm and left their son in 'acute agony'. His ordeal had only just begun.
'The pain team is only on duty 9am to 5pm and it was only at 10.30am the next day that his pain was addressed. Presumably the call-out is too expensive,' wrote one couple from Oxfordshire.
In separate correspondence, Alex Wheldon of 45 Commando Royal Marines claims that his pain relief in Selly Oak 'arrived two-and-a-half hours late' and even then was incomplete. Another 45 minutes passed before the corporal received his designated dosage.
Other letters suggest soldiers may have received the wrong tablets. On another, 12-hour pain-relief tablets were not issued because supplies were exhausted. Wheldon, who spent weeks in ward S4 earlier this year after being shot fighting the Taliban, describes a fellow soldier from Afghanistan in such agony on the ward that it 'brought tears to his eyes'. Wheldon alleges that hospital staff implied the soldier's suffering was imaginary. 'Certain staff seemed to think it was a psychological problem and made him go and speak to a 'shrink. But it was physical,' he adds.
Cooper, too, is alleged to have suffered pain and humiliation during his treatment. In one instance, four days before last Christmas, the teenager was denied pain-relief because of a lack of qualified trained staff, according to the letter from his parents.
Though help was eventually forthcoming, they say, the problems remained. 'When they [the pills] were administered, Jamie was given the wrong tablets,' his parents wrote. The family, from Bristol, says that, during their son's stay in Selly Oak, his colostomy bag was twice allowed to overflow. During the night of 29 November, he was forced to lie in his faeces. His wounds, according to his parents' testimony, actually worsened following his life-saving operation, the pressure sores on his heel deteriorating so much that he required skin-grafts.
Twenty days from now, the last of Britain's military hospitals will close. Little more than a decade ago, Britain had eight such institutions. During the First World War, there were 20, with at least 9,200 beds reserved for soldiers.
'We will be the only country in the civilised world without a dedicated military hospital', said Hampshire councillor Peter Edgar, who is campaigning against the imminent closure of the Royal Naval Hospital Haslar in Gosport.
The withdrawal of MoD funding comes as casualties steadily mount in Afghanistan and Iraq. Four British soldiers have been killed in Helmand in the past eight days. So far, more than 5,500 wounded have been airlifted back to Britain for treatment.
About 800 are understood to have passed through Selly Oak. Wheldon had seen enough after three weeks in ward S4. His complaints, written during his stay at the hospital, are not merely his own. His detailed litany of concerns are echoed by 'every' other patient soldier he met at Selly Oak, headquarters of the Royal Centre for Defence Medicine.
All were exhausted during their time at the hospital. Wheldon managed a maximum of four hours' sleep because of the incessant clattering of bins and trolleys by auxiliary nurses and civilian staff throughout the night. The repercussions, wrote the corporal, were more damaging than simply a lack of rest.
'The military men from Afghanistan and Iraq jump with shock,' Wheldon said. 'A sudden crash or bang goes through you, especially for us who have been mortared or been under heavy fire. It is a subconscious reaction which isn't very pleasant.'
Wheldon describes how an army sergeant once almost leapt out of his bed with fright. It is indicative, he writes, of a perceived lack of respect and understanding by the NHS towards armed forces families in Selly Oak. 'An army patient in my bay, a casualty from Iraq, had not seen his wife or baby son for five months. They were due to arrive, after a four-hour journey, earlier than the visiting time allows. He was told they would have to wait until the designated time.'
Wheldon's mother also complained of shabby treatment. Her letter, dated 16 February, claims that the visitor room for military families 'appears to be more of a store room for large equipment' and that it was so cramped 'there is not really enough room for more than one family'. And it was grubby, she notes: 'Could it not be cleaner? The overall impression I have got is one of untidiness and grubbiness on the ward'.
Cooper contracted MRSA twice while he was in Selly Oak. His parents were left in little doubt that 'there is a need to reinforce simple measures in hygiene'. Yet, still no one knows how many British troops have caught the infection after returning to Britain. The MoD, in a parliamentary answer last week, explains that no central figures are available.
Food given to wounded troops is also described as inadequate in the letters. On arriving at Selly Oak, Wheldon was told that a decent diet would promote healing. He writes of 'stale sandwiches' and being forced to buy his own meals at the hospital canteen. Some issues seem easily avoidable. Wheldon describes how one soldier was told by a Selly Oak consultant before an operation that 'his military career could be over'. He adds: 'A simple sentence like that, can, and did, have a profound effect on the man's mental state.'
Perhaps Wheldon could count himself fortunate in one respect. At least he had comrades for company. Cooper's misery was compounded by his isolation in a room with no television or radio for distraction. 'We would, if possible, have taken our son into private care. However, if we had done so, then he would have been classed as AWOL,' his parents wrote.
Sometimes, though, company can prove troublesome. The Oxfordshire parents describe how their son was rudely disturbed one night in Selly Oak. 'It is outrageous that an injured soldier should be disturbed at night by a disorientated geriatric trying to get into his bed in error.'
Isolation can sap a soldier's spirit. In a letter dated 5 March to Prince Charles and senior commanders, a parent from Doncaster claims that her son is suffering after being sent to an NHS hospital in Putney, rather than the military's rehabilitation centre.
The woman recently gave up her career to look after her seriously wounded 22-year-old son, who is in 7 Parachute Regiment, Royal Horse Artillery. 'Surely there is a place at Headley Court [a specialist military treatment centre] for a boy such as Ben, who has sacrificed so much for his country?'
Wheldon received a reply from the head of the Royal Centre for Defence Medicine on 22 February. It admits that 'many of the matters you raise are known' and said they would be investigated.
Days earlier, the Coopers received a response. A formal investigation is under way into their complaints. 'Your son will never be just another statistic to RCDM,' they were assured.
Some remain unconvinced. As Wheldon concludes: 'We've just spent four months fighting in the chaos of another world, where every day you risk losing your life at any moment. There's no way we would ever ask for sympathy; that is not our style. All we ask for is understanding'.
The letter from Jamie Cooper's parents:
To Miss Julie Moore
C.E.O NHS Trust
Selly Oak Hospital
Birmingham
Dear Madam,
It is with regret that we find ourselves having to write to you in regards to our son Jamie Cooper, who is a patient at Selly Oak Hospital and has been for over two months. Jamie is a serving member of Her Majesty's Forces and was the victim of a double mortar attack whilst serving in Iraq. By the grace of God and the work of an excellent Surgeon our son's life was saved. Thus to the significance of this letter. Since our son's return we have had a catalogue of errors in regards to Jamie's ongoing care. We detail the problems below:
1.29 November 2006 at the Queen Elizabeth Hospital. Jamie's colostomy bag was allowed to overflow.
2.1 December 2006 Jamie was moved to Selly Oak. He was placed with dementia patients. The duty nurse administered drugs via a syringe into Jamie's abdomen using water to dissolve tablets. This water was taken from his own drinking mug instead of using clean sterilized water.
3.4 December 2006 His colostomy bag was allowed to overflow once again.
4.6 December 2006 An inflatable pressure mattress deflated leaving Jamie in considerable pain.
5.Mid-December Jamie developed a pressure sore on the heel of his left foot. Nerve pain relief tablets were not given on schedule.
6.21 December 2006 Pain relief tablets were not administered due to lack of qualified trained staff on the ward.
7.29 December 2006 The family were informed that Jamie had MRSA.
8.8 January 2007 The pressure sore on Jamie's heel had reached a point where the wound had become so deep it had to be skin grafted.
9.1 February 2007 We were informed that the MRSA had now spread.
10.10 February 2007 Jamie asked that his colostomy bag be emptied. The bag was not emptied. Two other members of staff were asked to do this for him, one said that she did not know how to perform this task. The bag was not emptied. We decided to do the job ourselves.
Taking these events into consideration, we do not feel confident about the care that Selly Oak can offer a serving soldier. All servicemen and Women should receive first class care if injured whilst carrying out their duty at the behest of the country's leaders. All that we are parents want, as any parent would, is for our son to be given the treatment he deserves.
Yours faithfully,
Mr and Mrs P.D.Cooper
