The death of an army cadet from a heat-related illness has prompted criticism over the Army's training policies.

It has been asked to explain its approach to the health of trainees after the death of Graham Holmes, 23, from Edinburgh, who had been on a fast march, followed by an assault course.

The cadet died in a hospital intensive care unit two weeks after collapsing at the end of the exercise at the Royal Military Academy Sandhurst (RMAS). An inquest jury returned a verdict of accidental death in June last year.

His death was caused by exertional heat illness (EHI), though the weather was mild - the temperature on the day of his collapse was 18°C.

Dr Alan Porter, a retired GP, says in The Lancet medical journal that his collapse was not due to dehydration, but due to enormous heat load generated by the failure of sweat to evaporate because of his heavy clothing.

The recruit, who had collapsed suffering from EHI on a previous occasion, was wearing a double-layer of battle fatigue clothing - long trousers, T-shirt and combat jacket - and was carrying a pack, rifle and helmet.

Critical

Dr Porter asks whether the RMAS has a protocol for cadets with a history of EHI. He is also critical of instructors who are unable to deal with cadets who lag behind or collapse during exercise.

He says the forced march is irrelevant to modern battle conditions. "Training should reflect the real world and not some fanciful mental construct hallowed by tradition," Dr Porter said in The Lancet.

And he added: "I shall be sending a copy of my paper to all the junior commanders and instructors at RMAS, but not to the Commandant and the senior commanders. I have hitherto failed to influence the latter.

"Perhaps good sense will prevail in the end if the junior commanders can be persuaded that the training exercise responsible for heat illness is not only irrelevant but also foolhardy and irresponsible."

A spokesman for the Ministry of Defence said that an internal board of inquiry had investigated the circumstances surrounding the cadet's death and had made a series of recommendations.

He added: "The purpose of the board of inquiry was to see if incidents of this nature could have been avoided and to make recommendations to prevent it happening in future.

"It is not in our interests to have our own people collapse and, in this case, tragically die.

"But physical training is of necessity hard and demanding. We are training people to go into a battlefield and fight."