Sexual offences committed by members of the armed forces: Is the service justice system fit for purpose?
Abstract: Recent policy reviews, academic research and high-profile media critiques have repeatedly emphasised the UK military as a hypermasculine culture, seemingly permissive of sexual violence, marked by high prevalence of sexual offences and inadequate justice response. The service justice system has been characterised by low conviction rates and poor treatment of victim-survivors of sexual offences, prompting recommendations that rape should be tried in the civilian criminal justice system rather than the service justice system. Despite notable debate on this matter, the Ministry of Defence (MOD) ultimately rejected this recommendation in December 2021 and instead committed to implementing clear and meaningful change within the service justice system response to sexual offences. In light of this decision, this article interrogates available data about the current service justice system response to sexual offending, and lessons that may be learnt from the civilian criminal justice system, to highlight current obstacles to justice and outline areas in which further research and scrutiny is necessary.
Abstract: Background: Enactment of the Veterans Choice Act (VCA) in 2014 and expansion of Medicaid programs led to greater options for Veterans to receive health care outside of the U.S. Department of Veterans Affairs (VA). However, little is known about how much care women Veterans receive in VA or non-VA settings paid by VA or other insurance types. We explore trends in inpatient care received by women Veterans before and after implementation of the VCA, focusing on hospitalizations, as these patients are often higher risk. Methods: Data for women Veterans were linked to hospital discharge data for 2013-2017 from 11 diverse states. Patient and hospital characteristics by VA and non-VA payer and age group (less than 65 years and 65 years and older) were compared for acute hospitalizations in Pearson's chi-square and analysis of variance tests. We compared the odds of a hospitalization occurring before and after VCA implementation for each specific setting/payer using separate logistic regressions. Results: Our sample included 117,177 acute medical/surgical hospitalizations. For younger women, the most common hospital setting/payer was VA hospitals (36%); older women most frequently received hospital care in non-VA hospitals covered by Medicare (61%). After the VCA, the probability of receiving VA-purchased care increased significantly for older women only. Younger women saw a significant decrease in VA hospitalizations post-VCA. Conclusions: We found that after multiple expansions in non-VA health care options, women Veterans sought more VA-purchased community hospital care.