Britain’s Armed Forces are the pride of our nation. From the beaches of Normandy to the mountains of Afghanistan, our servicemen and women have stood firm in defence of our freedoms.
Yet, in an age of rapidly evolving threats – from drone swarms and cyber-attacks to grey zone aggression and information warfare – the way we fight has changed. Despite this, some aspects of military life remain tied to a world that no longer exists.
That is why the Strategic Defence Review 2025 rightly acknowledges the need for a rethink of the rigid medical rules that have, for too long, blocked too many capable people from serving their country.
Let’s be clear: this is not about lowering standards. It’s about updating them. It’s about adopting a pragmatic approach and asking a simple question – can the individual in front of us do the job?
At present, thousands of potential recruits are ruled out before they even get started, simply because of pre-existing conditions that have little or no bearing on the roles they could perform. Meanwhile, serving personnel who pick up manageable conditions can find themselves discharged, even when they still have valuable skills to offer.
During my service as a British Army Medical Officer, I often met individuals eager to serve but barred from doing so. Conditions such as Raynaud’s phenomenon, a history of splenectomy, or substandard eyesight would rightly be cause for caution in front-line combat units – but should not be automatic disqualifiers for remote roles such as drone operation, cyber defence, or intelligence analysis. The blanket exclusion of individuals based on conditions that are irrelevant to specific roles fails to reflect the diversity and complexity of today’s operational landscape.
In the past, this may have made sense. For decades, Britain has fielded one of the most professional and principled armed forces in the world. But professionalism must not be confused with rigidity. If we are to match talent to task, our personnel policies must evolve in step with the character of modern warfare.
Ukraine’s defence forces, under existential threat, have adapted with pragmatism. They have assigned people based on what they can do, not what they can’t. They have brought in civilians with specialist skills – cyber experts, drone operators, engineers, linguists – and put them to work where they are needed most. Many would not have met the old-fashioned standards we still cling to in Britain. But they are making a difference on the battlefield. That’s what counts.
We need to take the same approach. Because today’s conflicts are fought not just with rifles and tanks, but with code, intelligence, and complex logistics. That means we need people who are technically skilled, strategically minded, and digitally fluent – irrespective of whether they’ve got a perfect medical record.
Our allies have already started moving in this direction. The US military has widened the list of conditions it considers waiverable. Israel operates a tiered system, where medical expectations are tailored to the role. This is just smart policy. If someone is flying a drone from a secure facility in the UK, they don’t need to run a six-minute mile. They need focus, skill, and a steady hand.
And yet, here in Britain, we are turning away thousands of potential recruits – many of whom want nothing more than to serve their country. It is not only a waste of talent; it is a strategic own goal.
The numbers speak for themselves. In 2022–23, over 1,500 regular personnel were medically discharged – that equates to roughly four per day. At a time when recruitment targets are being missed, this is unsustainable. It is time to stop shutting the door on those who are ready, willing, and able.
So, what needs to change?
First, the Ministry of Defence should review the current medical standards in detail – identifying what’s essential across the board, what’s specific to certain roles, and what’s just plain outdated.
Second, we should test a more flexible approach in areas like cyber, intelligence, and engineering. That means letting people with the right skills in, even if they don’t tick every box on a medical form.
Third, we must rethink how we treat those already serving. If a soldier develops a condition that stops them from continuing in their current role, that should not be the end of the road. Instead, we should actively look to move them across to another service role where they can still contribute. It is common sense, and it keeps valuable experience in uniform.
Fourth, recruitment needs a refresh. We must highlight the full range of roles available – not just front-line infantry, but the many other trades and specialisms that make modern defence work. If people see themselves reflected in the image of our Armed Forces, more will come forward.
This approach must apply equally to our Reserve Forces. Doctors, engineers, IT professionals, and linguists who perform at the highest levels in their civilian lives should not be excluded from part-time service due to rigid standards designed for full-time regulars. If they are fit enough to do those jobs Monday to Friday, we should be finding ways for them to serve at weekends – not putting barriers in their way.
This is about making the Whole Force concept a reality: Regulars, Reservists, civilians, and contractors working together, backed by a medical model that reflects their differing roles and responsibilities.
Some will say this is risky. But risk lies in doing nothing. The world is getting more dangerous, not less. Our adversaries are moving quickly. If we do not modernise, we fall behind.
This is not about making our Armed Forces softer. It’s about making them smarter. It’s about having the right people in the right jobs, no matter what’s on their medical history.
If someone wants to serve their country, and they have the skills we need, then we should find a place for them. That’s not weakness – it’s strength. It’s the strength of a nation that understands how to harness every ounce of talent in defence of its freedom.
In the 21st century, victory won’t go to the biggest army – it will go to the smartest. Britain must be ready. Reforming our medical standards is a vital step in that fight.
Dr Neil Shastri-Hurst MP is the Member of Parliament for Solihull West & Shirley, and Parliamentary Private Secretary to the Shadow Health and Social Care Team. A former trauma surgeon, Medical Officer in the Royal Army Medical Corps, and barrister, he brings frontline experience in medicine, the armed forces, and law to Westminster.
What the author fails to understand is that everyone in the Army is first and foremost a combat soldier. In times of situational need everyone is expected to pick up his or her weapon and use it. Case in point, the Glorious Glosters. Every clerk, cook and driver ended up in the trenches fighting off the Chinese. Similarly, it is standard military doctrine these days for SF to attack behind the enemies lines. Mr. IT Clerk cannot guarantee he is safe 20-30 miles behind the front line.
The same argument, by extension, goes to the civilianisation of a lot the tail.
Historically the tail had basic combat training.
Except, when have we expected medics, doctors and nurses to carry weapons?
And a bod in a bunker flying drones or doing what IT bods do are not going to take rifles and aim them at an incoming hypersonic missiles, or you know something I don’t?
Said IT bod or drone pilot could be sent to somewhere like Cypress (right next door to todays sh*t show), Afghanistan, Bahrain, Africa (BATUK) etc. Plus, a drone pilot is going to be RAF so that doesn’t really count. I worked with a whole bunch of guys from the Intelligence Corp which I think is a good comparison. They were, and are in the field a lot more than folks would realize. I get what the author is trying to say, but you can’t always guarantee they will be safe in a bunker all their career. If they want to expand GCHQ, fine, but that’s not the Army. IMO if you can’t ever deploy then you need to look at your career choices.
DB: seriously?
Doctors, Nurses, and ESPECIALLY Medics carry weapons.
I’m getting old!
I mean they where carrying weapons at least as far back as the Falklands, and for sure regularly by the 2003 invasion or Iraq so… yeah
Lack of edit function is missing. Also pretty sure even as far back as WW1 Medics and Doctors where required to qualify in musketry and pistol shooting annually as they might be required to carry weapons on campaign against “non civilized types”. I don’t think there was ever a blanket “Medics never carry weapons” position in the army.
There’s no reply to your later comments.
However, my question was ”Have we expected…” and yes, I’m wrong, a young female medic was awarded for her bravery in Afghanistan however, in my TA time, I only interacted with Medical branch at the Cambridge in Aldershot. My bad.
I’m not sure how you feel like I didn’t address “have we expected”?
Eh!why do you think every soldier is issued a personal weapon and has to classify every year if they are not expected to use it?
Please see above.
At last a sensible view on such things, i hope it helps retention etc. Combat units will not fall apart etc because of it they said that about women, gays, beards none had that effect its rubbish.
Something Ukraine has reminded us of also, is that 36 is an absurdly young cutoff. Fit men in their 50s are fighting off Russia. A 50 year old who is in shape is absolutely as capable as a young’un still. I’ve met old men fitter than me in my time, and I’m not unfit (I’m actually mid application). I’m 35 and I’m absolutely aiming to train hard, race easy.
The 36 cut off is generally more about VFM for the Army than the ability to actually preform it’s job.
Agreeing broadly with what Spartan said. Very few careers in the Army do actually have zero possibility of ending up on the front line. OMI’s in the course of their careers can often end up attached to patrols as HUMINT collect sources, or are embedded into certain CHQ’s (and CHQ’s are frontline) as advisors to coy commanders. Medics might spend part of their career in a DPHC unit, or working a store in a third line SQMS department, and then the next day get attached to a Company of Paras as a their medic. A nurse might be working in a Field Hospital, and then be operating in a ground MERT role on their next posting. RLC blanket stackers might be working in 104 Log brigade enabling theatre supply and then be running convoys through hostile territory in Helmand to resupply PB’s.
Can there be changes to the medical standards? For sure, there probably should be. But it needs to be based on the understanding that there are very few career streams in the army that have zero chance of operating on or near the front line.