Hospitals and churches put on war footing
By Ruth Gledhill, David Charter, Philip Webster and Michael Evans

Timesonline, UK, 3 March 2003

Budget postponed until April because of the conflict in Iraq

BRITAIN has moved on to a war footing with the NHS told to prepare for casualties and the Church of England mobilising to deal with the bereaved.
The Ministry of Defence has briefed the heads of England’s 28 strategic health authorities to identify regional burns and plastic surgery units near to airports to cope with victims of biological or chemical attack, The Times has learnt.

The Church guidelines aim “to assist dioceses in offering pastoral support and care of war casualties and their next-of-kin”.

Both the Department of Health and Church leaders said that neither move meant war was inevitable. But they follow the mobilisation of reservists and the commitment of a 42,000-strong force to the Gulf, the tabling of a second UN resolution condemning Iraq, and the Chancellor’s earmarking of a £1.5 billion war chest.

Gordon Brown is also planning to delay the Budget until early April because of the international uncertainty. The Treasury is expected to announce over the next few days that it will be staged in the fortnight beginning Monday March 31 and government officials insist that the timing should not be taken as a pointer to the likely date of conflict.

It will be the second successive year that the Budget has been delayed: last year Mr Brown moved from the usual date of March because of his absence from the Treasury after the death of his baby daughter.

The advice to bishops issued on Friday is that, during conflict, churches should remain open as much as possible. This reflects a concern that there could be far more British casualties than the 24 who died in the 1991 Gulf War.

“War or natural disasters can be a very traumatic experience even for those not directly involved,” the document says. “Dioceses are therefore asked to consider whether or not churches can be opened for at least part of the day, if not the whole day, and appropriate prayer material readily available.”

The Church’s pastoral response will be co-ordinated from the deanery, the network of parishes just below diocesan level, with one person being designated as co-ordinator. Those near large acute hospitals likely to treat casualties, such as the Queen Elizabeth Hospital in Birmingham, are also being asked to compile a list of available accommodation for relatives visiting the injured.

If someone is killed in action and an emergency war burial is authorised, “pastorally this will mean a situation in which there is a death in the parish but no body”, the guidelines say. “Clergy are asked to consider offering families a service of prayer and remembrance in church. Evidence indicates that people need some form of liturgical recognition of grief.”

A funeral service would be inappropriate because funeral arrangements would be made after the war was over and the body brought back.

The guidelines bear similarities to those issued before the last Gulf War but they also reflect changes in society, with fewer couples being married, and changes in communications technology. An extra emphasis has been placed on the urgency of offering assistance to loved ones of those killed or injured. The guidelines say: “It is imperative that the system is kept rapid, streamlined, straightforward and simple.”

A “triangle of pastoral relationships” will be formed between the bereaved person, the local clergy and the services chaplain or other staff which will remain in place “for as long as possible”. Dioceses are told to be prepared to provide support for up to five years because of long-term psychological effects.

Most bishops, including the Archbishop of Canterbury, Dr Rowan Williams, remain resolutely opposed to war and are privately and publicly seeking ways that it can still be avoided. But the guidelines represent an acceptance that war is almost certain and likely to begin within weeks.

MoD planners met the strategic health authority heads last Wednesday to discuss “how we need to prepare to bring injured Armed Forces back from the Middle East” if there is a conflict.

Hospitals would take casualties where there were spare beds, but those in London and near airports were most likely to be called on first. People requiring longer-term treatment would be flown to a British base in Cyprus before being brought home, probably to the RAF bases at Brize Norton or Lyneham.

Distribution of casualties is likely to be controlled from the medical evacuation unit in Wilton, near Salisbury. Three regional centres for plastic surgery and burns that are near airports have been identified.

War casualties would be treated in the same way as other NHS patients. “It will be priority-based on medical needs,” the Health Department official said. “NHS hospitals are making contingency plans and will be able to cope, but we would have to plan for more capacity if there are a lot of casualties.

“The NHS already has to deal with military casualties, from soldiers who break their ankles in training to victims of road traffic accidents.”