On the 3rd January 2011 the Health Minister Mr Simon Burns said the following:
“We remain firmly committed to ensuring that military personnel will continue to receive the standard of prostheses issued by the MOD at Headley Court when they are discharged.

Service personnel risk everything in the service of this country and the NHS must provide the first class care that these brave men and women rightly deserve and help to improve their health outcomes."
The Secretary of State for Defence, Dr Liam Fox, said:

"Britain owes a great debt to those members of the Armed Forces who have made sacrifices to keep our country safe. We have a duty to provide the highest levels of care to those injured in service throughout their lives. I am proud that the Government has set the gold standard in developing prosthetics for our troops at Headley Court, but our veterans deserve the same levels of care.

"I welcome Dr Murrison's report, which I hope will help us to deliver a more comprehensive approach to veterans' care."

Dr Andrew Murrison MP said:
"Following on from my assessment of mental health services for the Armed Forces and veterans and subsequent report, Fighting Fit, I am pleased to be taking forward this review, to look at the ongoing needs and provision of NHS service for veterans who have received prosthetics.

"The provision of prosthetics service for the Armed Forces at Headley Court is recognised as exemplary and it is important to identify and understand possible issues that may arise for NHS providers or veterans when striving to maintain the same level of service in the future."

On the 15th February 2011 The Government:
Announced a review of how the NHS looks after service personnel who have lost limbs on active duty, MP for South West Wiltshire and a former Royal Navy Medical Officer will lead the review. Who’s report is due June 2011.

Dr Murrison went on to say:
“ Amputees rightly get a Rolls Royce service whilst they are still serving, but there is every sign that they will struggle to access the same once they have left. It’s already clear that the military covenant demands more than many civilian limb centres are currently resourced to provide.”

On the 16th MAy 2011 The Government the Secretary of State for Defence Dr Liam Fox MP commended to the House of Commons the following:

With permission, Mr Speaker, I should like to make a statement on the armed forces covenant. The Government have no higher duty than the defence of the realm, and the nation has no greater obligation than to look after those who have served it. The men and women of the three services, regulars and reservists, whether they are serving today or have done so in the past, their families and those who have lost a loved one in service, all deserve our support and respect. That obligation is encapsulated in the armed forces covenant.

The ties between the nation, its Government, and its armed forces are not the product of rules and regulations, nor of political fashion. They are much deeper than that. They have endured for generations and they go to the heart of our national life. The armed forces covenant therefore does not need to be a long and detailed charter. It should be a simple and timeless statement of the moral obligation that we owe. We are therefore publishing today a new version of the covenant, written for the first time on a tri-service basis.

The covenant is enduring, but it will mean different things at different times. The expectations of today’s servicemen and women are, rightly, different from those of their predecessors. Alongside the covenant we have published guidance on what we believe it means in today’s circumstances. It sets out a framework for how the members of the armed forces community can expect to be treated, and the aspirations and expectations that we believe are implicit in the covenant.

The covenant and the guidance do not, however, describe what the Government are doing to put that into effect. That is why I am also publishing a paper, entitled “The Armed Forces Covenant: Today and Tomorrow”, that sets out the practical measures we are taking to support the covenant. The paper brings together the commitments we have already made with the new measures that I am announcing today.

A number of those measures take forward the ideas of Professor Hew Strachan, who led an independent taskforce on the covenant last year. I should like to record the Government’s thanks—and, I imagine, the Opposition’s thanks—for his extremely valuable work. Today, we are also publishing the Government’s full response to his report.

One of Professor Strachan’s most important recommendations was the introduction of a community covenant. That will strengthen communities and build new links between them, local government and the armed forces. I can today announce that we are allocating up to £30 million over the next four years to support joint projects, at a local level, between the services or veterans groups and the wider community.

The Armed Forces Bill, which the House will shortly have a further opportunity to consider, contains provision for an annual report on the armed forces covenant, which is designed to strengthen this House’s ability to scrutinise how we are fulfilling our obligations. In that way, the existence of the covenant is being recognised in statute for the first time, as promised by the Prime Minister last year.

In deciding how best to recognise the covenant in law, the Government have had to maintain a careful balance. On the one hand, we do not want to see the chain of command undermined or the military permanently involved in human rights cases in the European Courts. On the other, we must ensure that the legitimate aspirations of the wider service community, the armed forces charities and the British public for our armed forces are met.

We believe that a sensible way forward—one that will give the right kind of legal basis to the armed forces covenant for the first time in our history—is to enshrine the principles in law, provide a regular review of the policies that will make them a reality, ensure that Parliament has a chance to scrutinise that review through the annual report, and ensure that the report itself is widely informed, consultative and transparent. I believe that it is right for the Government to be held to account on delivering the principles underpinning the covenant by this House, and not by the European Courts. That is what our approach will ensure.

I want to highlight two important aspects. First, the Government will set out on the face of the Armed Forces Bill the key principles that we believe underpin both the covenant and any report on its implementation. Ensuring that members of the armed forces community do not suffer disadvantage as a result of their service, and that where appropriate they receive special treatment, are at the heart of the armed forces covenant. I can tell the House this afternoon that the Government will bring forward amendments before Third Reading to require the Secretary of State to address those principles in preparing his report to Parliament, and to recognise the unique nature of service life.

Secondly, I made clear to the House on 10 January our commitment to consult stakeholders on the annual report. We intend to consult widely in its preparation, and prior to laying it before the House will give external reference group members from outside Government the opportunity to comment on it. We will also publish any observations alongside it.

We are working with the external reference group to update its terms of reference in line with its significant new role. The Government place great importance on maintaining our dialogue with bodies such as the service families federations and the major service and ex-service charities, which tell us what is happening on the ground, and I pay tribute to the invaluable contribution they make to the welfare of the armed forces community. In particular, I pay tribute to the contribution to this debate of the Royal British Legion, which continues to do such outstanding work in support of our armed forces.

The armed forces covenant is not just about words; it is about actions. The men and women of our armed forces judge us by what we do to improve their lives and those of their families. Since taking office, the coalition Government have taken a series of important measures to rebuild the covenant. I shall mention just some of them: we have doubled the operational allowance; we have included service children in the pupil premium; we have introduced scholarships for the children of bereaved service families; and we have taken action to improve mental health care. These measures are especially impressive when set against the background of the dire economic situation in which the Government must operate as a result of the previous Government’s legacy.

There is much still to do, however. I have always been clear that our commitment to rebuild the covenant is a journey that we are beginning, not something we can do overnight, and I believe that the British people understand that. We are continuing to take action, however, and I am today announcing additional measures that will tackle some of the problems experienced by serving personnel, their families and veterans. I have already mentioned the new community covenant grant scheme. However, we are also setting up a new fund of £3 million per year over and above the pupil premium arrangements to support state schools catering for significant numbers of service children. We will also launch a veterans card that will allow access to discounts and privileges.

Furthermore, in helping injured personnel, we will guarantee that veterans suffering serious genital injuries have access to three cycles of IVF, wherever they live. We will also increase the rate of council tax relief for military personnel serving on operations overseas from 25% to 50%. In addition, between now and the summer recess, I expect there to be further announcements that will again underline that this is a priority across the whole of Government, and not just for Defence. Today Ministers are chairing a meeting with key stakeholders to discuss and agree ways to improve access to housing for our service people. The Health Secretary and I are looking forward to the report by myhon. Friend the Member for South West Wiltshire (Dr Murrison) on how to improve further the supply of prosthetics for injured personnel. Also, we will consider how to ensure that the guaranteed income payments made under the armed forces compensation scheme are not required to be used to pay for social care provided by the public sector.

The obligation we owe to our service men and women, set against the commitment and sacrifice that they make, is enormous. In the current financial climate we cannot do as much to honour that obligation, or do it as quickly, as we would like, but we can make clear the road on which we are embarked. Our understanding of the covenant will change over time, as will the way in which the Government and society meet it. The framework we have set out today provides the necessary flexibility to ensure that not only the Government but all of society can fully pay the enormous debt they owe to our armed forces, their families and our veterans. I commend it to the House.
We at Limcare a charity advocating on behalf of the civilian amputee and limb impaired peoples of the United Kingdom. Wholehearted welcome and support the Rolls Royce service provided at Headly Court as mentioned by Dr Murrison MP. However we feel the statements to date could indicate the creation of a three tier Prosthetic Rehabilitation Service within the four home nations of the United Kingdom.

• Tier one – Rolls Royce Military Standards of Provision
• Tier Two – Rolls Royce  Former Military  Standards of Provision
• Tier three – Reliant Robin Civilian Standards of Provision

We cannot support the creation of a multi-level service providing system, based upon prior occupation and not equality of service for all, without exception. The prosthetic providing service of the United Kingdom should be based upon one of the founding principles of the NHS, that is free at the point of use based upon need.  It should never be based upon one’s occupation or former occupation, nor should it be based upon where you happen to reside.

We wholeheartedly agree with Dr Murrison MP. The current NHS Prosthetic Rehabilitation Service is not adequately resourced, funded or equipped to support amputees to the same standard as provided at Headley Court. A service to our Military Personnel which we commend.
A recent Freedom Of Information Act survey conducted by Limbcare of all 43 Disablement Rehabilitation Centres of the United Kingdom in fact only produced a response from 40% of centres. This survey produced the following results:

• 10% Do not offer a team led by Consultant in Rehabilitation Medicine
• 30% Struggle with Consultant Cover
• 53% Do not offer Psychology or Counselling Services
• 26% Have no Occupational Health Services
• 40% Do not have a Specialist Rehabilitation Nurse
• 93% Do not offer a centre based Podiatry Service
• 100% Have no Vocational Rehabilitation Employment Advisor

We at Limbcare cannot continue to support the current status quo, where service levels and provision are dependent upon the location of your home address.

The Prosthetic Service Provision we see today owes much to military conflicts over the past 100 years. During the Great War of 1914/18, the war office set up “Artificial Limb Shops” at Roehampton & Charterhouse, treating some 25,000 veteran amputees. Undergoing many changes over time, notably in 1932 transfer to the Ministry of Pensions, 1948 the creation of the NHS, the 1970 Denny Report and the 1986 MCColl Report, making many recommendations for improvement. Resulting in the transfer of responsibility to the Disablement Services Authority with a remit to transfer services to NHS Trusts from April 1st 1991. The past two decades have seen many changes in Prosthetic Service Delivery, with Prosthetic Services now competing with other NHS services for funding.

The Government, the NHS, the Military, Civilian Service Providers, Commissioners, Charities and to a degree users of Prosthetic Services in the United Kingdom have a golden opportunity to reflect the proud history of Prosthetic development in this country. An opportunity to shape the future model of Prosthetic Delivery to greater heights. Utilizing the expertise and experience of our highly motivated, highly qualified & caring professionals and prosthetic users to design a Prosthetic Service based upon a National Framework Agreement and not Guidance Documents. Acceptable to all four home Nations which is both measurable and accountable. Commissioned at a United Kingdom National Level.

We cannot stand idly by and watch the prosthetic service fragment into a service which no longer serves those who need, and only serves those who through profession, former profession or wealth can afford.  
We shall continue to consult, collaborate and inform with all bodies who seek to further the independence of our peer amputee communities and individuals. This in order to empower and enable our collective voice to be heard.
We ask you, our peers to lend us your voice. Join the growing number of amputees who wish to be heard by Governments and the public. I ask you to support Limbcare in its quest to protect and develop Prosthetic Service Provision within the United Kingdom.