March deaths: Widow calls for change of culture at MoD
Three soldiers would be alive if regulations on heat illness had been followed
THE widow of one of three army reservists who died after collapsing during a 16-mile SAS test march has called for a change in culture at the Ministry of Defence after a coroner ruled that neglect played a part in the deaths.
Recording narrative verdicts at an inquest in Solihull, senior Birmingham coroner Louise Hunt said all three soldiers would have survived if Ministry of Defence regulations on heat illness had been followed.
Describing parts of the planning and conduct of the special forces march as inadequate or not fit for purpose, the coroner said insufficient supplies of water also contributed to one of the deaths.
Lance corporals Edward Maher and Craig Rober ts were pronounced dead on the Brecon Beacons after suffering heatstroke in July 2013.
Corporal James Dunsby died at Birmingham’s Queen Elizabeth Hospital from multiple organ failure more than two weeks later.
After the inquest, Cpl Dunsby’s widow, Bryher Dunsby, said her “chivalrous, loyal” husband would have been “hugely disappointed” by the behaviour of the MoD, “for which he had fought and to which he ultimately lost his life”.
She added: “No part of the armed forces can be beyond scrutiny or above the law, but unless and until those at the top acknowledge and accept responsibility for the failings of their organisation, cultures will not change and the mistakes of the past will be repeated.
“So, looking forward to the future, it is my ardent wish and plea that as an institution the MoD has the maturity to look at its failings and to want to improve.
“I so dearly hope that pride and ego will not continue to blind individuals from implementing the changes which so evidently must be made.”
Cr iticising the “chaotic” response to the men’s collapse and accusing special forces’ commanders of a catalogue of serious mistakes, Ms Hunt said the risk assessment carried out was “inade- quate”. She added: “There was a failure to implement an adequate medical plan to allow for treatment of any heat illness casualties.”
A GPS tracker system in place at the time of the march - with a “slow man” function disabled - was not fit for purpose, the inquest also heard.
Claiming there had been a failure to learn from a previous fatality on an SAS test march in 2008, Ms Hunt added: “There was a culture of following what had gone before without giving any consideration to specific risks.
“The (special forces) signals regiment took their lead from, and was subservient to, the lead regular unit. They do not think for themselves.”
Ms Hunt said those who organised the march failed to appreciate that candidates would push themselves to the limit with a “do or die” desire to succeed.
Ms Hunt also identified a lack of build-up marches for reservists as a contributory factor in the deaths.
The coroner also ruled that if the reservists had been afforded “basic treatment of cooling, hydration, rest and removing kit” the men would have survived.
All three men died as a result of a “failure to properly organise and manage” the march on Saturday July 13, 2013, the coroner said.
‘‘ The (special forces) signals regiment took their lead from, and was subservient to, the lead regular unit. They do not think for themselves