The forsaken: how Britain is failing to care for badly injured troops

British troops in Iraq and Afghanistan are suffering serious combat injuries at a record rate, The Independent on Sunday can reveal, leaving the country facing a crisis over their long-term care.

A new analysis of official figures from the Ministry of Defence has shown that British troops in Iraq are being wounded at double the rate of last year, while in Afghanistan the number of wounded this year already exceeds the total for the whole of 2006. This has gone hand in hand with an increase in troops killed on operational duty in Iraq, where 32 soldiers have already been lost in 2007, compared with 29 during the whole of last year. In Afghanistan the toll is 20, compared with 39 in 2006.

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Advances in battlefield medicine and casualty evacuation mean that many more soldiers survive, and with much worse injuries, for every one who loses his life. But anger is growing among military commanders and charities at the Government's failure to face up to the implications of Britain's wars for veterans who will suffer pain, disability and mental problems for the rest of their lives, and for the health system that will have to look after them.

Critics say their treatment violates the Military Covenant, under which soldiers are entitled to expect proper care if they are injured in the service of their country, and proper provision for their families if they are killed in the line of duty.

General Sir Richard Dannatt, head of the British Army, said last week: "We must acknowledge that in some cases we have been found wanting – our systems [both medical and welfare], although generally robust, are not matched to the demands placed upon them. Events have overtaken us at times."

With the end of the Cold War apparently reducing the need for military deployments and spending, Britain decided to close its dedicated military hospitals in 1995. In their place is a scattering of Ministry of Defence units at NHS hospitals across the country, including Selly Oak in Birmingham, where many of the most severely wounded are taken, and the flagship rehabilitation centre at Headley Court in Surrey.

But the wars of the 21st century are straining the system to the limit: since 2001, Britain has lost 223 soldiers in combat and 573 have been wounded in action, of whom 238 suffered life-threatening injuries. There have been more than 40 amputations since the Iraq and Afghanistan wars began – half in the past 12 months. More than 5,000 have been airlifted out, requiring urgent medical treatment.

The number treated at MoD NHS hospital units almost doubled from 24,000 in 2002 to 45,000 in 2004, while at Selly Oak the number of in-patients more than doubled from 511 in 2002 to 1,024 in 2004. During the same period the number of out-patients there rose eightfold – from 513 to 4,116.

Headley Court, which will announce a new 32-bed ward to add to its existing 200 places, is now a victim of its own success, with a backlog of soldiers seeking to go there for treatment. It is the only unit in the country exclusively reserved for military personnel – elsewhere in the NHS, military doctors spend most of their time caring for civilians.

General Dannatt admitted that "the decision to close the military hospitals ... may have looked right at the time, but the legacy challenges we face are severe". The MoD says it has addressed problems at Selly Oak, where service families complained that wounded soldiers had been abused by civilians opposed to the Iraq war, but complaints now centre on what happens after disabled veterans are discharged after initial rehabilitation into the civilian NHS system.

NHS rules say soldiers should be given priority in the health system for long-term care of injuries sustained in battle. But one charity said last night that not only was this not happening, but some doctors were actually biased against former servicemen. "Doctors are the gatekeepers, and they are often stopping priority treatment going through," said Maria Rusling, head of the National Gulf Veterans and Families Association.

Campaigners say the thousands of soldiers returning home with psychological disorders represent a ticking timebomb and that it will take years for the true number of traumatised personnel to become clear. "The intensity and type of operations that British forces are committed to at the moment are actually stockpiling some very significant problems further down the line, particularly in areas like mental health," warned Athol Hendry, director of the Soldiers, Sailors, Airmen and Families Association.