My Lords, it is always a great honour to initiate a debate, especially when it turns out to be so timely, with yesterday’s publication of the Government’s Strategy for Our Veterans and the centenary of the end of the First World War.
In the UK, for a very long time we have had a proud tradition of recognising the unique contribution made to national life by our military veterans. Members of the Armed Forces are almost unique in that they are willing to undertake a mission when they cannot expect all their comrades to come home, or at least not without some life-changing injuries. But we should also remember that it is all too easy to fall into the trap of concentrating on combat operations while overlooking casualties incurred during exercises or training, which nevertheless provide and demonstrate military capability and thus deter and prevent conflict from taking place.
I must declare an interest because, in my own humble way, I am a veteran. There have been some very minor negative effects, but overall my service as a volunteer has been hugely beneficial to me, both for my career and for my standing in society. Exactly the same would apply to the clear majority of veterans. They will have had a great career in the regular Armed Forces, or possibly in the reserves, and then transitioned smoothly into civilian life without difficulty and having taken full and proper advantages of the resettlement facilities on offer. Sadly, for some their career in the forces might not have been so successful. They might have had to leave at a time not of their own choosing; transition might have been difficult; or perhaps problems arose later in civilian life. Any strategy needs to meet the needs of the majority while ensuring that no one is left behind or falls through the cracks in the floorboards. I believe that the strategy goes a long way to achieving this.
The strategy starts with the vision and principles, which I will not rehearse. There are then five cross-cutting factors and six key themes. The first cross-cutting factor is collaboration to provide coherent support. The strategy recognises that the UK enjoys a strong and vibrant Armed Forces charitable sector. I will not weary your Lordships with describing its role, as it is well understood, but sometimes I worry that small charities are being set up to meet a relatively discrete perceived need by a well-meaning team. However, I wonder whether the funding, horsepower and necessary governance might be better used as part of a larger and more efficiently resourced charity. Furthermore, the strategy recognises that there is an inconvenience to veterans of having to repeat their circumstances to a variety of organisations. That is not to say that big charities are problem free, so does my noble friend the Minister have any concerns about the governance of any of the big service charities? If he does, what, if anything, can he do about it?
Closely allied to collaboration between organisations is the cross-cutting factor of co-ordination of veterans’ services. SSAFA has reported to me that, in the past, a veteran might have one difficulty where help and assistance was required. Nowadays, that association finds that if something goes wrong with a veteran, it goes spectacularly wrong with help required from several agencies. This is why co-ordination is so important. What I and many others do not fully understand is which part of the Government and which Minister would step in if and when there is a co-ordination problem with other government departments. I hope that my noble friend the Minister can explain how this will work.
One of the most important cross-cutting factors is data on the veteran community. Given that the clear majority successfully transition from service to civilian life within existing resources, it is clearly vital that we can identify those with problems. For instance, an obvious indicator available to government would be employers’ national insurance contributions because if they cease for a particular veteran before the normal retirement age, this may indicate that something is amiss. It could be a precursor for even more serious problems, such as marriage breakdown and homelessness. My fear is that rules about data transfer between government departments may make it so hard to utilise available data that we simply do not do so.
Another controversy is on the statistics. Do we have enough, are we measuring the correct issues and are the questions the right ones? I am hoping that the noble and gallant Lord, Lord Walker, will say something about the controversial issue of the suicide rate among veterans. Surely whether a suicide victim has a service background should be determined in every inquest and, if positive, reported for data capture.
I think we need to be careful about what we ask and how we interpret the answer. For instance, if I was asked whether I had occasional unpleasant dreams that I could honestly attribute to my military service, the answer would be yes. But the detail of my recurring dream is that I am in uniformed service, the sleeping area is wet and uncomfortable and the food is insufficient or horrible—and your Lordships can imagine what the toilet facilities are like. However, importantly I never dream about death, destruction or anyone being unpleasant to me. Sadly, that is not the case with many veterans who have been engaged in combat. My understanding is that, as one gets older, the ability of the mind to supress and forget unpleasant events gets weaker. SSAFA has told me that it is very concerned that Falkland veterans are starting to present in increasing numbers. Sadly, we can expect even worse problems arising from operations in Afghanistan and Iraq but a long time into the future.
I think another issue with statistics is that it is relatively easy to measure negative outcomes, so we think we know the percentage of the prison population and rough sleepers who have a service background. What is very hard to measure is the number of veterans who have experienced a poor start to life with all the classic negative indicators but nevertheless have a great career in the Armed Forces and then successfully transition to civilian life.
I will be very surprised if some noble Lords do not cover metal health and post-traumatic stress disorder—PTSD. I do not profess to be an expert, but I suspect that three pressures are at play. First, as a society we are much more willing to discuss and present with mental health issues, which is positive. This, of course, applies equally to serving personnel and veterans as well as civilians. Secondly, since we want to offer a career in the Armed Forces to anyone who is fit enough, the start standard for the infantry in particular is not very high. It is therefore not surprising that many recruits have had a very poor start to life. The detailed report of Nicholas Blake QC into the deaths at Deepcut barracks covers this point in some detail and is worth reading. To make matters worse, it is obvious that on operations the infantry will, on average, experience more traumatic incidents than the more technical trades. Thirdly, as I am sure the Minister will agree, we do not really have enough mental health capacity in the NHS to deal with the ordinary civilian population let alone with service-attributable problems.
The last two cross-cutting factors are public perception and understanding and the recognition of veterans. They are different, but closely related. I can do no better than quote directly from the strategy:
“In recent years, a number of studies have identified that public perceptions of Veterans do not always reflect the reality. Many people believe that while military service develops positive attributes … there are also incorrect perceptions that Veterans are inherently likely to be institutionalised, psychological impaired, and less able to build relationships outside the Armed Forces.”
These misconceptions have two very important negative effects. First, they make it very much harder for veterans to secure civilian employment. The SSAFA report The Nation’s Duty indicates that many veterans seeking employment find it better not to say that they have a service background. The second adverse effect is that the gatekeepers of those who might consider a career in the Armed Forces may well advise against joining up.
Turning to recognition, veterans certainly do not want pity, but they want to feel that their service is valued and recognised. Your Lordships will appreciate the dangers in favouring one group in society over another, and thus caution is required in this area. The veterans ID card is a welcome development. I certainly found my Army MoD Form 90 ID card was a very useful and reliable means of ID. While any veterans ID card should not be confusable with a MoD Form 90, it would be good if it was a technically reliable and acceptable form of ID that adds value, not just financial value.
Sadly, I cannot cover the key themes of the strategy in detail apart from veterans and the law. I am currently taking a very close look at our prison system. We all know that a small minority of veterans end up in prison. Members of this group are often among the most vulnerable of veterans with complex needs. However, mentoring programmes have been shown to be very effective.
The other aspect of veterans and the law is not so palatable and it concerns historic inquiries. During the recent Question for Short Debate asked by the noble Lord, Lord Dannatt, I made a forceful intervention and I see no need to repeat it. However, I feel very strongly about the matter and gently remind the Minister that at some point the Armed Forces Act will have to be renewed by means of primary legislation.
I am grateful for the briefings that I have received from NGOs. I hope that other noble Lords will be able to fill the rather large voids that I have left. We appreciate and recognise our veterans community, and we will remember them. I beg to move.
My Lords, I am very pleased to speak in this debate. I will take up where my noble friend Lord Attlee left off about the pursuit of former servicemen who may have committed, or are alleged to have committed, some crimes in the past. The veterans strategy does not address that. It should be in the veterans strategy because, frankly, it is a disgrace that historic allegations which have been investigated in the past are now being dragged out. This is what I intend to look at. I intend to look briefly at Northern Ireland, Iraq and Afghanistan.
I should say that I served in Northern Ireland, where I did a couple of long tours. I never did anything very exciting, although many of my friends did, and I suspect that many of them now fear being reinvestigated. I also served in the first Gulf War, and then worked in the Ministry of Defence and the Northern Ireland Office in the coalition Government. I shall look at government responsibility, parliamentary responsibility, the issue of equivalence, and the passage of time.
Responsibility for sending young men, and now, indeed, young women, to war rests with the Government —the state, if you like—and this Parliament, so we are all to a certain extent responsible. I was involved in voting occasionally on the Iraq war and on the war in Afghanistan. Parliament sends young men to defend British interests as we perceive them to be abroad or, indeed, in Northern Ireland. Those young men and women should expect our support. Who do we send? I will speak from my experience, which is that we send young, scared soldiers who may not have been out of this country before—who may not have been out of England before when they are sent to Northern Ireland—with lethal weapons to places where others are trying to kill them. They are not overpaid lawyers like those who now pursue them around the courts, and they are not policemen. They are not trained as policemen, and they do not necessarily understand all the niceties of the law.
That brings me on to equivalence. These young men—I speak particularly about Northern Ireland—faced terrorists who were trying to kill them. On the one hand, you had public servants doing their duty as requested by Parliament and the Government and trying to do the right thing, and on the other hand, you had terrorists in Northern Ireland acting illegally against our state. There is no equivalence, and the idea that equivalence should be considered is quite wrong.
In Northern Ireland I saw young, scared, jumpy men being shot at and trying to do the right thing. They did not always get it right. Did they behave badly or illegally? Well, sometimes people did. I shall name three cases, the first from Northern Ireland: the Fermanagh pitchfork murders, which the noble and gallant Lord, Lord Houghton, may know about, where people behaved atrociously and murdered a couple of farmers with pitchforks. I am glad to say that those people who murdered, who obviously behaved very illegally, finally went to jail for life. Secondly, the case of Baha Musa in Iraq is well known. The soldiers there behaved atrociously, and indeed several of them went to detention and jail. The third is the very sad case in Afghanistan of Sergeant Blackman, who actually said, and was recorded saying, “This is against the Geneva convention”. There was a big campaign about it. The truth is that he broke the Geneva convention and knew he was doing so, and he went to jail. It seems to me that that is the right way for these things to be handled.
However, do people make mistakes? If you send these young men with rifles on to the streets of wherever it may be, Northern Ireland or Basra, they will make mistakes. They are scared for their lives. I will bring up one case that is currently in front of the courts. Dennis Hutchings is alleged to have shot a young man called John Pat Cunningham in 1974. The man he shot, Cunningham, was alleged to have had a mental age of six or seven; he was challenged on several occasions and ran, and they shot him. Obviously that was a mistake. They did not intend to kill this young man with a mental age of seven. In fact, I believe I may have been the Minister who apologised to the family from the Ministry of Defence for this mistake—for it was a mistake. However, to return to equivalence, there is no equivalence between public servants who make mistakes and terrorists who murder civilians. In Northern Ireland, 9/10ths of murders took place because of terrorists and 1/10th of the deaths took place because of security force work.
On the question of the passage of time—I refer again to Northern Ireland, which perhaps I know most about—there is currently a coroner’s inquest into the Ballymurphy killings, which is referred to by many as the Ballymurphy massacre, of August 1971. As it happens, I know Ballymurphy quite well, having walked round and round it for four months. In 1971 I was at university. To me, the General Strike and Hitler’s putsch in Munich were old history. That is what we are doing now; we are looking down back at 1971 and saying, “What happened then?” Guess what: half the people who were there are dead, particularly the defence witnesses. The Army of course has records but there are no records of whatever happens from the other side. In my own view—I am lucky to be covered by privilege in Parliament—I suspect that the soldiers in Ballymurphy were not fully in control, and I suspect some of the people killed there should most certainly not have been shot, in the same way that those of us who remember the Saville inquiry into Bloody Sunday knew in 1972 that the Parachute Regiment in Londonderry at the time was actually not properly under control. However, what are we to do about this? My own preference on these things is for a statute of limitations, but I am not going to put forward too many views because I want the Minister to think about it.
I turn to the current situation and where things are going at the moment. Relatively recently, in Iraq and indeed in Afghanistan, the British Government were supporting—if one can believe it—the investigations of money-chasing lawyers running around these fields. Phil Shiner, who has now been struck off the solicitors register, and his own company, Public Interest Lawyers, got over £2 million of legal fees paid by the British taxpayer, by us. There is Leigh Day, where the lead solicitor was in fact found to have behaved badly but is now back on the register because he appealed successfully so I will not deal with that. Other people have also been chasing around, trying to find young people in Iraq and Afghanistan who know that compensation is on offer if they can make a case stick against the British Army. We are talking about fighting a war in these places. We are allowing our decency and our liberal democracy to be used against us. Of course soldiers should not misbehave, but at the same time they should not be pursued.
I return to the subject of Northern Ireland. I have talked about the pursuit of public servants. If we look back to 1973, the dogs on the streets will tell you that Gerry Adams, who has always denied being a member of the IRA, was in charge of the IRA in west Belfast. He was arrested about five years ago over the murder of Jean McConville. That is a very tragic story—if noble Lords want to know about it I can tell them, but I do not have time now—of a Protestant woman, the widow of a Catholic in the Divis flats, who tried to help a dying soldier. She was taken away, in front of her 10 children, and murdered, but Gerry Adams will not be prosecuted. We have the case of John Downie, who was given a letter by the Blair Government saying that he would not be prosecuted. Apparently he has now been arrested and charged in the Republic with the murder of two other people. By the way, I knew one of the people in the Hyde Park bombing; Denis Daly was murdered in 1982. However, Downie got off, whereas soldiers are still being pursued for allegations of crimes that took place further away.
I will raise one case from Iraq that I was tangentially involved in. The case of Trooper Williams reflects incredibly badly on the Army establishment, the Ministry of Defence and indeed our society. Trooper Williams, aged 18, discovered along with a patrol a barrow-load of mortar bombs being pushed through, I believe, Basra. They did not shoot; they chased the man pushing that barrow-load of mortar bombs—I think it is reasonable to say that he was going about nefarious activities—into a compound where he got into a struggle with another soldier, and Williams, aged 18, shot the man. He was taken before his commanding officer, the case was considered and, on legal advice, dismissed by the commanding officer. I quote from the letter which I have from the adjutant-general at the time, which said, “We must reopen this case because it would become a cause célèbre for single-issue pressure groups”.
I think that the British Army and the Government should be supporting their own people as far as they might, not looking out for single-issue pressure groups. As it happens, this case, for which Williams spent a year in open arrest, in custody, before going to the High Court, was dismissed by the judge on the first day.
I say to my noble friend, knowing that he knows that a lot of people will agree with me, that the situation is a mess. The Government and Parliament, which send young men and women to war, need to support their public servants, so we need to sort out the situation. Of course those who commit crimes should be punished, but we should not allow this unreasonable pursuit that has taken place 47 years later. That should be in the veterans strategy.
My Lords, I draw attention to my charities as listed in the register of interests, and congratulate the noble Earl on setting this debate in motion at a time when we have been focusing on the Armistice and remembering those who in the last two great wars gave their lives for our freedom. Of course, the numbers—about 2.5 million today—are rather different: far smaller than those of the two wars. It is very important in talking about our veterans to get the numbers in clear perspective. I also welcome the Government’s Strategy for Our Veterans and its associated consultation document.
The issues surrounding our veterans are far from straightforward. They range across a spectrum that includes mental health problems, including depression, suicide, poverty, debt, unemployment, relationship breakdown, alcohol abuse, drug abuse, offending, violence and homelessness. Overwhelmingly, our observations and research show that most veterans in the United Kingdom are fine—but in the media, particularly, the practice has developed of portraying veterans as a homogenous damaged group. It is almost as if everyone who has served has been damaged in some way. This leads to a widespread public perception that is both wrong and harmful. It is important that we in this House do not add flames to this non-existent bonfire.
It is also somewhat bizarre that many people think that nothing is done for veterans. We have a good NHS service, and some fantastic charities support our veterans. Sometimes they fail, but, overall, if a veteran is in some sort of social crisis, he or she will get the help they need. Clearly, if veterans are to be helped, as we have heard, data on them needs to be robust. Here, I commend the Defence Committee’s recent report, which recommended that the MoD, with the appropriate departments of the four nations, works with the charity sector to agree a shared set of methodologies for collecting and analysing data. The strategy has recognised that need, so I hope that it will happen soon.
The two areas which seem to receive most attention in the public debate are homelessness and mental health. The evidence we have suggests that homelessness affects a considerable number after they leave the forces, especially younger people and the so-called early service leavers. The figure suggested is 3%, which means that each year more than 1,000 people require urgent support to find accommodation. Others experience crises in their lives which require action to prevent homelessness later in their lives.
There is still no mechanism to identify those transitioning from the Armed Forces and at risk of homelessness, or the ability to support them effectively. The Joint Service Housing Advice Office is understaffed and provides only a template briefing and no bespoke advice. The Career Transition Partnership works well for most, and best for those who have served longest, but there is no equivalent resource to support the minority of serving personnel who leave with no clear pathway to housing.
Once a veteran becomes homeless, there is little knowledge in the civilian world that there is an enhanced offer for veterans. Local authorities and homeless charities still do not “think veterans”. That is why many veterans become homeless every year and are not getting help quickly enough—although it is also worth pointing out that just over 3% of rough sleepers are veterans, whereas about 7% of the population qualify as veterans, so they remain underrepresented overall.
Despite apparently being a priority group, there is almost no statutory revenue funding for homeless veterans from local or central government. Veterans are the only supported housing sector in the UK where the majority of support costs are paid by charities, who have to fundraise to get the money. This is unsustainable and almost unheard of anywhere else in the wider homelessness sector.
Three significant actions could improve the situation, and I should be grateful if the Minister would take these back to the MoD. First, the transition process should be altered to try to prevent any serving personnel becoming homeless after service. Every leaver, including those who leave during basic training, early service leavers, longer-serving leavers or being discharged from a military corrective training centre, should be asked about their housing options after leaving. Those identified as at risk should be given the best advice to a pathway away from homelessness.
Secondly, local authorities and other agencies in the civilian housing sphere should establish whether a person seeking housing support is a veteran, and then ensure that the veteran has a clear pathway to housing. This would be very much in line with the intent of the covenant. Thirdly, supported housing for veterans should be put on a sustainable financial basis once and for all, preferably on a national basis. A recent piece of research conducted by York University, with a number of charities, concluded that if these three changes were made it would be possible to reduce the incidence of homelessness among veterans to close to zero.
With regard to the mental health of the Armed Forces, the Defence Committee found that is very difficult to prove whether the mental health conditions that some personnel develop are caused by their military service. Non-military factors or underlying mental health conditions exacerbated by military service could all contribute to an individual’s mental health. Further, military service could have a positive effect on an individual’s mental health, although for some this positive effect merely serves to delay the onset of mental health issues when they depart the service.
On the other hand, probable PTSD is a condition, as we have already heard, that affects the Armed Forces in particular, largely because of the intense, violent and traumatic nature of warlike operations and other things that the Armed Forces get up to. At first sight, the numbers seem quite small, at between 3% and 7%,—but the true figures are quite difficult to establish. Alcohol misuse and poverty are far more prevalent, both of which have mental health implications as well as all the other social issues that I mentioned earlier. It goes to show what a complex area veterans’ mental health is.
If the Government’s strategy is serious about helping to build on the Armed Forces covenant, to show that its commitment to our brave men and women lasts long after they have left service, it needs to do more. In my view, it should establish a department of veterans’ affairs so that there is one organisation with clear ownership of our veterans and their future. It should follow the Canadian example of establishing a veterans’ ombudsman and draw up a charter of rights for veterans which would define what their entitlement was in the National Health Service and other relevant areas of our society. Veterans should not have to beg or argue for support in the 21st century; nor should they end up as objects of pity.
Realistically, however, I cannot see such a radical change being introduced. So we are left with the Armed Forces covenant—that promise from the nation that those who serve, or have served, and their families will be treated fairly. It establishes veterans as a very special group. Wonderfully well-intentioned though it is, and even though local authorities and many others have signed up to it, there is no standardisation, no clarity about entitlement and no monitoring. The strategy and the covenant will need more teeth if they are to deliver for our veterans. I very much hope that this new strategy, improved by the outcomes of the consultation document, will provide those teeth.
My Lords, I declare two interests, first as president of the Sussex branch of SSAFA and, secondly, as president of the War Widows’ Association of Great Britain. I am particularly proud to be associated with war widows—a gallant group of women who have suffered greatly over the years and whom I frankly regard as a form of veteran. It is their position on which I want to speak in the debate this evening.
I have heard anecdotally over the years some pretty heart-rending stories from war widows of their difficulties, loneliness and all the kinds of problems that are associated when their lives are suddenly turned upside down by the death of their husband. But recently the War Widows’ Association has engaged on an excellent project to bring together war widows’ stories, with the aid of academics, who have allowed the ladies to tell their story in their own way. This has now been brought together in a marvellous book, War Widows’ Stories. It provides a wonderful fund of knowledge and information which should be of great value to historians of the future and, indeed, to those who are looking at the situation now. It brings home the fact that so often the war widows’ families are largely sidelined in the history of war—collateral damage, shall we call them?
It is very important that we should have a far greater understanding of the role that they have played and do play in all the conflicts of this century and the centuries before. I believe that one of the Army museums—there may be more than one—has actually taken upon itself the idea of showing the contribution of war widows, and I very much hope that major institutions such as the Imperial War Museum will think that this is a very worthwhile project to be developed. Perhaps I could encourage my noble friend the Minister to take a look at the work that has been done and to talk to the trustees of the museum to see whether this could be introduced in a much more forward way.
I turn to another issue of great concern. One of the issues which brought the War Widows’ Association into being was the fact that the miserable war pension was taxed by the Inland Revenue. That was what caused the ladies to come together to fight for what they saw as their rights. It took time, but they got it. However, for many years after that, if they cohabited or remarried, they lost their war pension. After some years, this was put right, from
We do not think there are many—possibly 300—and, of course, they diminish. The longer we leave this, the more they will die and the smaller the problem will become. However, it affects women whose husbands were killed in the first Gulf war, the Falklands War and in Northern Ireland, about which other Members have spoken today. I will quote one lady whose husband was killed in South Armagh in 1973. She said:
“Life was lonely as a young woman with a baby and over time I missed my son having a father and the friendship of a husband. After years alone, I was blessed with a second chance of happiness, but felt sad my pension would be withdrawn on remarriage. I felt this action demeaned John’s sacrifice”.
I fully agree with her, because it is also important to realise that legally the pension is, in fact, compensation for a life lost, and therefore should not be affected by the benefits system. I want to reiterate that—it is extremely important that it is regarded as, and is, compensation, not a normal benefit.
The military covenant has also been mentioned this evening. I will quote again so that I get it right:
“Those who serve in the Armed Forces, whether regular or reserve, those who have served in the past and their families”— my emphasis—
“should face no disadvantage compared to other citizens in the provision of public and commercial services. Special consideration is appropriate in some cases, especially for those who have given most such as the injured and the bereaved”.
Who else are the bereaved but the war widows and their immediate family?
I hope that those wonderful words are carried out, because otherwise they are simply words on paper and worth nothing whatever. So I urge my noble friend to look at the possibility of war widows’ stories being celebrated or commemorated far more widely than they are now; to make absolutely certain that those widows are not left behind by this failure to allow them to keep their pensions on remarriage; and perhaps to rename the war widows’ pension as compensation, which is what it legally and truly is. I look to my noble friend to help in all these matters.
My Lords, it is a pleasure to follow the noble Baroness, Lady Fookes, and to be followed by the noble Baroness, Lady Browning, because they are both loyal and compelling supporters of the Armed Forces and the three of us had the privilege of representing Devonshire constituencies in the other place.
I congratulate the noble Earl, Lord Attlee, on securing this debate. I draw the attention of the House to my entry in the Register of Lords’ Interests and to the fact that I had the honour to serve in the Royal Marines.
The Afghanistan conflict was as hard and perilous as any that the British Armed Forces have faced since the Korean War in the early 1950s. Our Armed Forces exceeded the high expectations that we always have of them. They were extremely patient, brave and restrained. They showed great stamina and fortitude and the whole country was really proud of them and their achievements. However, those achievements came at a terrible cost, with service men and women killed in action, wounded, or seriously wounded. The Royal Marines, though only about 3.5% of the Armed Forces, accounted for 13% of those killed in action and 16% of those seriously wounded. Over 30% of the decorations for gallantry in Afghanistan were awarded to the Royal Marines or former Royal Marines serving as badged men in UK Special Forces.
I am extremely grateful to the chief executive of the Royal Marines Charity, the superb Mr Jonathan Ball, for his assisting me ahead of this debate and for the information he provided me with. The points I shall make are of course relevant to all branches of the Armed Forces, which have also suffered similar, terrible casualties. I wish also to pay tribute to the doctors and all the medical staff in Afghanistan, unsung heroes who saved many lives and literally brought some men back from the dead; and to the helicopter crews who time and again put their lives in peril, especially when called upon to evacuate casualties. Many owe their lives to them. One dreadful consequence of this war has been the terrible price that our service men and women have had to pay in death, wounds and injury. As a country, we owe so much to them. Only the best is adequate for them.
I shall set out the deficiencies of which I am aware. I know that the Secretary of State, Mr Gavin Williamson, and his two Ministers of State, the noble Earl, Lord Howe, and Mr Mark Lancaster, give the highest priority to these matters. First is the provision for transfemoral—that is, above the knee—amputees. In 2015, Blesma, the Limbless Veterans—previously called the British Limbless Ex-Servicemen’s Association—and the Royal Marines Charity commissioned a Royal Marine triple amputee, John White, to write a report on this matter to be submitted to the Government on behalf of approximately 60 veterans from the Afghanistan campaign. Transfemoral amputees face distinct psychological challenges: they cannot use their leg muscles at all and therefore place extreme strain on their back muscles and spines. This leads to change of weight and stump shape over time. Properly made and well-fitted sockets are therefore vital to being able to restore independence and dignity to these severely wounded men. If you do not have perfectly fitted sockets, you get sores, so you do not wear them and so you do not walk.
The report engaged with the fact that veterans were not funded to source treatment and the manufacture of sockets overseas, since the National Health Service will not fund overseas treatment as it cannot be guaranteed. However, despite the creation of the Murrison centres around the UK—which have certainly improved provision massively for below-knee amputees—we simply do not have enough transfemoral amputees to warrant having experts in the UK who can make sockets that are up to scratch. The expertise does exist in the United States, however, and Royal Marine charities—and, I suspect, other service charities—have been paying to send their men to the Hanger Clinic and to Dream Team Prosthetics in Oklahoma at a cost of about £100,000 for a set of sockets and Ottobock legs. The legs come with a three-year guarantee. As I said, I presume that other service charities are paying out the same.
The report requested that veterans be allowed to source prosthetics and sockets overseas to ensure that adequate sockets could be procured. It was presented to Mr Mark Lancaster, the Minister of State, who engaged with the NHS head of procurement to get a commitment from the NHS to pay for advanced prosthetics for these amputees, at the cost of £70,000 a pair. This is a significant achievement, and great credit goes to Mr Lancaster. However, there are still not the skill-set manufacturers of sockets in the UK of a standard that most severe amputees require, so our marines and others are still going to the US at the relevant charities’ expense. In theory this means that the NHS will not pay for the provision of legs if they are fitted to sockets made elsewhere. This has led to the absurd situation of marines and others accepting substandard sockets from the NHS, made at considerable expense, so that they can get the NHS to pay for a new set of prosthetics rather than ask the charity to pay for them to go to the United States. They then simply take the sockets off and replace them with sockets made in Oklahoma. That is a complete waste of money. The solution is that the NHS, in exceptional cases, should be funding the manufacture of sockets overseas, which will cost about £17,000 to £20,000 a pair.
The Government’s preferred solution is osseo- integration —that is, the fitting of prosthetics directly to the remaining thigh bones, as a one-off expenditure. However, this is exceptionally risky as it is a relatively untested solution. If it goes wrong, it can leave a veteran crippled, with no alternative solution possible. There are photographs available for Ministers to see of osseointegrated legs which have bent under body weight. Until this solution is properly evidenced and agreed, there should be the option of doing what our above-knee amputees do.
Secondly, I will say a few words about modifying houses for the physically disabled. The MoD is committed to funding modifications to houses for serving and transitioning medically discharged veterans a maximum of three times. However, needs change over time. Local authorities and the charities are left to fund future adaptations, as the veterans age and inevitably deteriorate over time. There should be a lifetime commitment to support such medically discharged veterans who have lost their health as a result of service.
Thirdly, I will touch on the plight of those with mental illnesses. In April 2017, the new NHS transition, intervention and liaison scheme was launched, which was intended to ensure that those medically discharged with mental ill-health issues were seamlessly transferred to NHS mental health care. In the process of tendering for the cheapest providers, Combat Stress lost a significant amount of government funding because the contracts were awarded to cheaper providers. This caused a cash crisis, thereby damaging Combat Stress’s ability to support those who had already left the service. This has meant long Combat Stress waiting lists of up to eight months before a referee can attend a residential course of treatment. The cheapest provision can of course mean very thin provision, and it is patchy across NHS regions, leading to long waits and the NHS referring cases to charities at their cost. Treatment includes, for example, eye movement desensitisation and reprocessing. This is apparently the most amazing process, as it programmes the brain away from traumatic memory. It costs about £750 for a course with a therapist local to the veteran. It is not expensive or difficult, and this provision should be replicated.
Lastly—I must not take too long over this—I turn to the Armed Forces compensation scheme. Since 2015, Royal Marines charities and others have employed people to assist marines who have received poor and inadequate Armed Forces compensation scheme settlements and face discharge from the Hasler Naval Service Recovery Centre. For the last three years, it has assisted veterans who have already been discharged. Last year, it dealt with 64 cases in the Royal Marines community alone, in each case winning an increased lump sum and often increased graduated income payments.
Service personnel of all ranks and experience, serving and veteran, do not have the knowledge or experience successfully to navigate the claims process and challenge veterans agency decisions that go against them. A root-and-branch review of the default position being adopted by the Armed Forces compensation scheme must be made. The default position should not be that the least possible compensation should be paid. In addition, the MoD should commission a study into the different levels of compensation available through the civil courts, as opposed to MoD claims, and increase the compensation to civilian levels if the MoD falls short.
I hope that the whole House will agree that only the best is good enough for our service men and women. This country—every one of us—owes them a debt of honour which we can never repay.
My Lords, it is a great pleasure to follow the noble Lord, Lord Burnett. As he said, for many years we had neighbouring constituencies in God’s own county of Devon, where the armed services are well represented.
I congratulate my noble friend Lord Attlee on the way in which he introduced this debate. I agreed with just about everything that he said—not for the first time, I am sure. He flagged up to my noble friend the Minister that, because of the diversity and breadth of the strategy, there was a need to keep a focus on the actuality and detail of how it will impact on individual lives. I totally agree with that point.
I should perhaps declare an interest as chair of the Advisory Committee on Business Appointments—a committee to which all senior members of the armed services go for advice when they move from military service to civilian life.
I want to focus on two things, the first being that transition from military service to civilian life. It seems that there are quite a lot of positive things out there, and not just those mentioned in the strategy. Some of the briefings that we received prior to this debate were very encouraging. For example, we have had a briefing from the Federation of Small Businesses, an organisation that I know very well from the years when I did a proper job before entering politics. The federation’s research found that 15% of its members were services leavers, full time and reservist, 15% currently employ service leavers, and 7% have employed, or do employ, reservists. That is extremely encouraging. Starting and running a small business sounds attractive but it is not easy. If you are in a civilian occupation where you can gradually grow a business, that is fine, but the prospect of coming out of military service and becoming self-employed or starting to employ other people in a small business is quite challenging. People need support, training and advice well in advance if they are to make a success of running a small business.
One of the things about transition and the strategy is that I hope we can build as much as possible into those years before somebody leaves military service, in order for that training and groundwork—those building blocks—to be put in place. Obviously, it applies not just to those who want to run their own businesses, but to those going into other occupations. The more we can do to set the groundwork, rather than just giving a few courses and a bit of briefing at the end, the better—that was the past. I hope we can build on the strategy and what is going on now, so that jobs last and people are successful and feel that they have made that transition for their benefit and that of society as a whole as they take their place in civilian life.
Mental health has been raised by several people in this debate, and nobody could be more able to understand our concerns on this subject than my noble friend Lord Howe, who, for many years, was an exemplary Health Minister. He will understand this subject very well. What I will say probably applies not just to people in the military but to the whole mental health debate per se. He will be familiar with me flagging up some of my concerns on this subject. I hear a lot about parity of esteem and more money going into mental health. All that is to be warmly welcomed from the Government. In practice, mental health is so complex that we really have to start addressing the needs of the individual, rather than treating it as if it applies to a group of people who all have the same problems, challenges and symptoms. That point was raised very well earlier.
I cannot stress how important it is that there is early intervention with mental health. This is not easy. When somebody’s mental health starts to deteriorate, it can be symptomatic of things that are temporary or not too much of a problem—things that people will cope with. It can be a recurring pattern where nothing really gets much worse. But equally, when mental health deteriorates it can go into a downward spiral. The lower the person goes down that spiral, the more difficult it is to pull them up and to identify appropriate support and treatment. The impact of mental health problems, not just on the individual but on their immediate family, cannot be overstated.
As a child, growing up in the post-war years in the 1940s and 1950s, I experienced first-hand what post-traumatic stress from the Second World War meant to close members of my family. It is like a tentacle that goes out into the family. People are affected and change their own behaviours when they live with somebody with serious mental health problems. Very often, if they are suffering from post-traumatic stress, it does not present for a very long time, until long after the traumatic event that may have triggered it. In military service, people not only experience trauma on a scale that most of us will never see in our lifetimes, but just witnessing something, whether it has happened to them or to other people around them, can cause serious mental health problems later on.
It is still a problem that getting first appointments and seeing the right people, right across the whole spectrum of mental health care, is so difficult both for former servicepeople and for the civilian population. The noble Lord, Lord Burnett, mentioned that three of us here were MPs in Devon. I remember people whose marriages were breaking up coming to my surgery in Devon to seek my help and advice. Heaven knows why they came to an MP, but when you are an MP, you deal with it all. I used to try to put them in contact with professional counselling and advice services, but the answer would come back, “There is a six-month wait”. If your marriage is breaking up and you have to wait six months, it will usually be done and dusted by then. So it is with mental health. If you have long waits, things will happen: families fall apart; people get into debt; people’s health goes into a downward spiral.
There is one thing I am really keen on, and I hope my noble friend will bear it in mind when looking at the mental health side of the consultation document for the strategy. Apart from the professional help and support given to people who present with post-traumatic stress or any other serious mental health problem, it would be useful for a buddy system to be put in place, which could be done at quite a low cost. Talking therapies have been proved to be invaluable for people with mental health problems. They will still need professional advice from psychiatrists, psychologists and others, but to have a named person as a buddy, even on a voluntary basis, can be invaluable. Sometimes it is even more important to be able to talk to somebody outside the family and away from your circle: talking to somebody just a few steps away from the emotion that goes with it can be invaluable.
My noble friend will know that cancer patients are now given a named person—often a nurse or a volunteer from one of the charities—who will be their buddy throughout their cancer journey. I hope my noble friend will consider looking at a buddy service for those with serious mental health problems, so that they too can have that type of support. It will aid their recovery and aid them in coming forward. That people are reluctant to come forward is another problem. There is a kick-back from the professionals, who say that if the person is not willing to be treated—you get this with mental health problems and with alcohol and drug misuse—then nothing can be done until they are willing. I understand that problem, but I hope my noble friend will feel that the buddy system might help.
I conclude with one further point. I want to support the words of my noble friend Lord Robathan. Like him, I was a signatory to the letter to the Prime Minister last month, in which we again asked her to prevent the legal persecution of veterans, for all the reasons my noble friend set out from his personal experience of serving in the Armed Forces. Nothing could be more damaging to a veteran’s mental health than to have to sit for a long time, waiting to be called to give evidence in a case such as he outlined. I hope we will be able to deal with that as quickly as possible.
My Lords, I fear that my sandwiches are eaten, but my fox is only wounded so I will continue to make my points in my own way.
In my early 20s, as a young officer in the Army, I had the enormous good fortune to be sent up to Oxford to study history. To repay the MoD for its kindness, I felt it only appropriate to choose as my special subject military history and the theory of war. That special subject took me to All Souls College, where I attended tutorials by that great military historian Sir Michael Howard. The theory of war involved studying two set texts. The first was Sir Julian Corbett’s work on the principles of maritime strategy. I have to say that this did not prove of huge use in my subsequent career, other than giving me the ability, occasionally, to embarrass naval officers who had no idea that, in the age of sail, the art of a successful blockade wholly rested on an ability to create the illusion of dispersal, while maintaining the ability to concentrate at any given time.
The second text was Carl von Clausewitz’s classic work, On War. What I most remember from the many revelations that Sir Michael made from this work related to his explanation of the Clausewitzian trinity. That trinity identified that war was the realm of three separate things or ingredients. The first was the ingredient of probability, chance and friction. This was the domain of the Army at war. The second ingredient was that of reason. This was the domain of the Government, whose duty it is to give logic, purpose or sense to war. The third ingredient was that of passion. This is the domain of the people, for it is the people who supply the national motivating spirit that supports both the Government and the Armed Forces. According to the Clausewitzian theory, war most closely approaches its apogee when all three of these elements are mutually supporting and reinforcing. In historical terms, Clausewitz saw this as the situation enjoyed by Napoleon at his height.
In my more recent service life over the past 10 years or so, I have often reflected about the degree to which the Clausewitzian trinity has, to some extent, been fractured in our country. The last decade or so has been typified by government Ministers who occasionally suspect the motivation of their generals, admirals or air marshals; a society that is deeply concerned by the reasoning of their Government when it comes to committing Armed Forces to war; and generals who sense that the passion of the people manifests itself primarily in sympathy for, rather than informed support of, the Armed Forces.
This situation is a direct legacy of having to fight in both Iraq and Afghanistan—unpopular wars. It is a situation that forms a potentially distorting context for a policy on veterans, and it has created the most unfortunate context for successful recruiting. It does so because service life is seen by too many ill-informed people to be a brutalising experience; and too many charities in pursuit of funding contribute to the distorted illusion that service men and women are victims who, particularly in their post-service life, need to enjoy some form of permanent charitable status.
The truth is so very different. For the vast majority of service men and women, a career in the Armed Forces is both a life-changing and a life-enhancing experience. If you doubt me, let me offer you some of the MoD’s most recent statistics. How many people—not in this House but in wider society—recognise that the Armed Forces are the nation’s single biggest provider of apprenticeships, with 19,000 currently on apprenticeship schemes and a total of over 46,000 apprentice start-ups since 2015?
The most recent evidence on the employment of service leavers, mentioned earlier, shows that 82% of those exiting through the career transition workshop were in full-time employment within six months—that is higher than the 75% employment rate of the UK population in the round. The occupational groups that service leavers join are impressive: 22% into skilled trades; 20% into associate professional and technical trades; 14% as process plant and machine operatives; 11% into professional occupations such as teaching, health, media and public service; 8% as managers, directors and senior officials. What about the missing 18%? Forty per cent of those went back into education or the voluntary sector; 6% have retired; 12% are travelling abroad; 9% have medical problems; 8% are looking after their families; and we have lost track of the rest.
All the evidence suggests that employers hugely appreciate the transferable skills of leadership, problem solving, team working, communication skills and self-discipline that service leavers offer. Employers respect the vocational skills of service leavers in areas such as electronics, engineering and project management, and recognise their ability to conform to their companies’ rules, values, ethos and standards. Ex-service leavers are a unique pool of talent that offers many benefits to both society and the economy and they undoubtedly strengthen the workforce of all kinds of different civilian organisations.
Why do I say all this? I do so in an attempt to balance an ill-informed but popular view that service life inevitably leads to a situation that somehow presents a national social crisis. It most definitely does not. But I am hugely aware that a small percentage of service leavers, particularly the wounded, undoubtedly deserve some special consideration. We need a strategy for our veterans that ensures that that special consideration is afforded to a small number who at the end of service life need and deserve some specific help. I wholly applaud the Government’s strategy which recognises this, but I do not want that strategy to distort the reality that service life offers the vast majority of service men and women a life of betterment and advancement. I do not want the wholly justifiable interests of service charities to undermine that simple fact.
I want the passion of society and the reason of Government to support the needs of our veterans, but I also want that reason and passion to support the Armed Forces in being. We need to actively recalibrate society’s understanding of the remarkable benefits of service life. Those benefits are not just for the individuals but for wider society as well.
My Lords, I start by thanking my noble friend Lord Attlee for bringing forward this debate. The Armed Forces are very close to my heart. Three years ago I made my maiden speech in this Chamber about the Armed Forces covenant. Despite our religion, race or creed, despite the party that we support, we came together on Sunday to honour all those who made the ultimate sacrifice for our country and for our liberty. While we commemorated the end of the First World War, we also pay tribute to all those who have served and are still serving in our Armed Forces. We are so grateful for and humbled by our veterans’ sacrifice and service, and for their contribution since leaving the Armed Forces.
Our country’s Government can never serve our veterans in quite the same way that they have served us—but, because we asked them for the greatest sacrifice, we must be prepared to do whatever we can to assist them whenever they need our help. This Government have made meeting the needs of the Armed Forces one of their highest priorities. This is only right: when men and women risk their lives in our defence, they should expect nothing less.
Unfortunately, veterans, particularly those who through no fault of their own have landed on hard times, often feel undervalued for their service. Our support for the armed services must go further than simply wearing a poppy for two weeks a year. So, with that in mind, I am proud that the Government are increasing their support for service personnel, families and veterans by adopting a more holistic approach.
Service families do so much to support their loved ones who are serving in the Armed Forces. We need to make sure that we are able to reinforce this. It is right that we are launching a spousal employment support scheme, helping service personnel’s spouses to find the jobs that they want, and so ensuring that they can support their family while having the opportunity to be rewarded for their hard work. I welcome the creation of a development scheme for those serving to ensure that they have the right personal and professional skills—skills that are vital for succeeding in life both while they serve and after they leave the Armed Forces. Also significant is the launching of this Government’s transition policy, giving those leaving the Armed Forces a helping hand as they move into civilian life. This initiative goes far beyond blunt financial support. It will provide support for resettlement, health and well-being, housing advice and pastoral care.
The Government have a record to be immensely proud of. They created the Armed Forces covenant to stop our service personnel from being disadvantaged. The covenant has created greater awareness across society of the challenges that service personnel, veterans and their families face.
The launching of the Forces Help to Buy scheme has helped more than 14,300 people buy their home. In 2012, the Government changed the law so that former service personnel with urgent housing needs are always given priority for social housing. We have urged local authorities to prioritise Armed Forces members and their families for social housing.
We must continue to do more, particularly by doing what we can to prevent our veterans becoming homeless. While the Ministry of Housing, Communities and Local Government has published guidance for councils on providing homelessness services to veterans, we must not waver in our commitment to halve rough sleeping by 2022 and eliminate it by 2027. I am proud to support a Government with such a commitment to our service personnel. However, with estimates on the number of homeless veterans ranging from 7,000 to 13,000, I implore the Government to do more to support veterans. Seeing anyone homeless or sleeping rough is tragic, but it is even more so when it affects those who have done so much for our country.
This Government have a proud record on commitment to our Armed Forces, but we must not rest on our laurels. We must continue to find new ways to help our veterans and service personnel. The veterans support strategy is evidence of this. I know that this Government will continue not only to respect and honour the dedication and bravery of our Armed Forces but to value them. We must be certain to deliver the support and care that our brave service men and women and veterans deserve.
My Lords, I welcome the debate and am grateful to my noble friend Lord Attlee for initiating it. It is humbling to speak after so many noble Lords who have not only served in, but led and commanded, the British Armed Forces on the battlefield.
In Virginia Woolf’s novel Mrs Dalloway, there is a character called Septimus Smith, who will be familiar to many of your Lordships. In the book, it is 1923; Septimus has returned from the First World War with his life utterly changed. His war experiences have left him incapable of functioning in society and he struggles with his mental health. The people he meets in St James’s Park think that he behaves oddly and cannot relate to him. He ends his life in a violent way. He dies not on a battlefield in a foreign land but in his homeland, which is now at peace.
A hundred years have passed since the First World War. We have seen technological advances beyond anything that could have been imagined in 1914 or 1918. We have deepened our understanding of mental health issues and developed vastly the medical care available to treat them. Yet service men and women today still battle misunderstandings and mental health challenges not dissimilar to those faced by the fictional Septimus. The recent reports that 40 former or current service men and women are believed to have taken their lives this year are shocking. They too died a violent death, not on a battlefield in Afghanistan, Iraq or elsewhere, but here in today’s Britain, among us.
The past three decades have seen the Armed Forces exposed to the most intensive and sustained combat conditions and the highest casualty rates since World War II. I want to put on record my admiration and gratitude for all those who serve our country in uniform and the sacrifices they make on our behalf. I therefore welcome the Government’s efforts to ensure not only that veterans of the UK Armed Forces are recognised for their service, but that we seek to go a step further in understanding them and upholding their status in our society, based on not only recognition and appreciation, but respect.
I welcome the work done over the past eight years by this Government and their predecessor, the coalition Government, on the Armed Forces covenant, which was enshrined in the Armed Forces Act 2011, and the Ministerial Covenant and Veterans Board. I also welcome the leadership shown by the Secretary of State for Defence in establishing this new veterans strategy. I pay tribute to my noble friend the Minister and my right honourable friend the Minister for Defence Personnel, Welfare and Veterans, Tobias Ellwood, for their tireless work to improve the support available to veterans, in particular the focus on mental health and homelessness—complex issues that need strong and focused attention.
I also want to pay tribute to the work done by Lord Ashcroft, who, until a few months ago studiously and imaginatively worked on the Veterans’ Transition Review and subsequent updates. His contribution was a crucial factor in the recent advances made by the Government, local authorities, the devolved Administrations, the charity sector and the Armed Forces in the area of veterans policy.
I welcome the Government’s efforts to ensure that all these initiatives, which have been developed separately until now, are brought together under one umbrella, and their determination to counter any perception that service in the Armed Forces has a damaging effect on personnel, notwithstanding some problems that we must address.
I welcome the collective commitment that has been shown, but want to address three points. First, as we rightly seek to help and support those who fought and are now trying to reintegrate into civilian life, we must not forget the families of those who did not come home. There is no compensation for losing a parent, but we can show our collective gratitude to those who paid the ultimate price. I am therefore particularly pleased to see the Government continuing the scholarship programme for children whose parents died in service. How many students have benefited from the scholarships since they were announced in 2010? What lessons have been learned to ensure that the scholarships are more widely available to those who need support for their education? Is there a plan to have the scheme upgraded and widened so that more children can benefit? Should the scheme be extended to the families of service personnel who have taken their lives?
The second issue is accommodation. I welcome the Government’s commitment to aid the transition of service personnel to civilian life and understanding of the vital part that the access to suitable housing plays in this process. Yet some service personnel still fall through the support net and find themselves homeless. What thought has been given to whether surplus service living accommodation can be used to house service personnel who have become homeless or are living in accommodation not suitable for their needs, at least during their transitional period?
Finally, the Armed Forces are a reflection of our wider society, which is sadly blighted by the hidden problem of domestic violence and domestic abuse. I suspect that most of us know somebody who has been affected by it. I can imagine the stress of a battlefield only exacerbating this problem in some cases. I welcome the Ministry of Defence’s launch earlier this year of its first defence domestic abuse strategy to tackle domestic abuse in the Armed Forces and defence civilian communities. Will this apply to veterans’ families as well?
The Government can be proud of the effort invested and the outcomes achieved in ensuring that veterans and their families are given more of the support, help and respect that they deserve. This is our collective duty. Time will tell whether what has been put in place is enough. We must therefore strive always to do more and better.
My Lords, I, too, thank the noble Earl, Lord Attlee, for introducing this debate. We have been discussing the challenge of veterans for a decade now. When I saw the title of this debate, I thought, “Well, let’s see where we’ve got to in actually achieving things”. The core achievement to date has been the Armed Forces covenant, which has had pretty widespread approval. It is therefore useful to measure how the Armed Forces have fared under its care.
It is important to realise what the covenant says. It is on one page and begins:
“An Enduring Covenant Between”.
The language is all quite flowery—there are three paragraphs—but right in the middle is a paragraph which, if it does not have teeth, has clarity. I fear that I have to tell noble Lords that it is not only not the best, it is almost the opposite. In fact, this paragraph says two things: that veterans “should face no disadvantage” and that in some circumstances there should be “special consideration”. It is against those tests—unless we want to change them—that we have to judge how well the Government are doing. So let us look at some areas.
Housing has been a real problem, particularly the way that local authorities behave, and the Government have worked hard on it. The progress report on the covenant is contained in an annual report, the last of which was published in December 2017. It said, talking about how local authorities had been instructed:
“The package included: ensuring Veterans with urgent housing needs were always given priority for social housing; encouraging councils to take account of the needs of the Armed Forces Community in their policy making, and introducing regulations to ensure councils did not disqualify Service personnel who had recently left the Services and did not meet the local connection test”.
We had a debate about a year and a half ago, in which I said that my test of this is Rushmore. Rushmore, for those who do not know, is Aldershot and Farnborough under a fancy new name. Its housing policy 18 months ago did not refer to veterans. I have looked it up and it now says precisely the things that the covenant calls for: the Government get a tick for that. There is a problem though. It says that veterans effectively have fair access to social housing. The problem is that there is no social housing. The problem with fair access to very little is that it is very little. It is the basic housing issues in this country, especially social housing, that we have to get right for all our citizens, including veterans.
Veterans are also part, sadly, of the scourge of rough sleeping. The data suggests that the incidence is about the same as in the general population, but I agree that there should be no rough sleeping, for any of our citizens. If we can tackle that issue then we will indeed do the right job for veterans.
The next area I looked at was training. There are lots of references in various bits of literature to how wonderful service personnel are, how well adapted to exciting jobs in the real world, but the individuals who illustrate this are frequently reasonably senior people who have done well. Does the system look after the private infantryman who has done four years and comes out at the age of 22 or 23? I fear not, and I hope that the Minister can disabuse me. Where would that individual traditionally have looked to in order to get some qualifications, because it is perfectly reasonable that people with life experiences do not have qualifications? He would have looked to adult education. Adult education has had its funding cut by £3 billion in recent years. There used to be 5.2 million people in adult education: the figure is now down to 1.9 million. Again, I am sure that service veterans are getting fair access to this, but they are getting fair access to one-third of the provision they would have received but a few years ago.
I then went on to look at mental health, which is a very interesting area. There have been clear improvements in recent years, making access to mental health services fairer and making sure that the transition between the military and the NHS is good. However, let us not kid ourselves that this is anything other than “not disadvantaged”. Indeed, the 2017 report on the covenant talks of,
“access times and outcomes at least as good (and sometimes better) than for the general population”.
It is commendable that it is being achieved, but it is all that is being achieved.
Let us move on to the second promise in the covenant. The precise words in that extremely powerful paragraph are:
“Special consideration is appropriate in some cases, especially for those who have given most such as the injured and the bereaved”.
We have talked about the bereaved and those injured, in the physical sense, but are there other senses of injury? If we look at mental health in the total population, the incidence of mental ill-health in veterans is not grossly dissimilar to that of the general population but—and it is an important but—on PTSD, the picture is different.
A press release from Kings College London has said:
“New research from Kings College London suggests the conflicts in Iraq and Afghanistan may have led to an increase in the rate of probable Post Traumatic Stress Disorder … among members of the UK Armed Forces”.
It went on to say:
“The higher rates of probable PTSD is primarily seen among ex-serving personnel who deployed to Iraq and Afghanistan. Among those who deployed to the conflict, the rate of probable PTSD for veterans was 9% compared to 5% for veterans who did not deploy. The rate of probable PTSD among currently serving personnel was also 5%, which is close to the rate … in the general population … Among ex-serving personnel who deployed in a combat role to Iraq or Afghanistan, 17% reported symptoms suggesting probable PTSD compared to 6% of those deployed in a support role”.
It is clear that this illness is related, at least statistically, to combat experience. That seems to fall in the general territory of special consideration. When one looks at what PTSD is all about, it is terrifying. I looked it up on the NHS website and I am not sure how people survive it, with their,
“Re-experiencing … flashbacks … Avoidance and emotional numbing … Hyperarousal … Angry outbursts … depression … Drug misuse”,
et cetera. Here, surely, is the case for special treatment.
Unfortunately, according to the Defence Committee, the situation does not really seem to come up for special treatment. The committee said in its report:
“We are particularly concerned that the Armed Forces Covenant principle of priority treatment when a condition is service-related is not being consistently applied across the UK. The Department of Health and Social Care considers that the NHS founding principles on equality and clinical need constrain how it can provide priority treatment to veterans. This difference in interpretation is confusing not just to veterans but also to clinicians; this may add to veterans’ perception that the health service is failing them”.
It seems to me that this area falls classically into the second part of the covenant’s promise and that the Government are failing in not addressing it directly.
In many of the areas where service veterans suffer, the problem is that the general population is suffering, be it housing, training or mental health. I accept that the Government have achieved their objective of not disadvantaging veterans in many areas and have made good progress in recent times. We have to address the fundamental supply of those areas and be much better at being sensitive to the second promise, where special consideration should apply.
My Lords, it is a remarkable and heart-warming feature of your Lordships’ House that across all Benches and shades of political opinion, we find ourselves in almost total unison on the theme so ably introduced by my noble friend Lord Attlee on the obligation that we have as a society to ensure the welfare and well- being of our Armed Forces veterans. The recent commemorations marking the centenary of the Armistice have brought this message into even sharper focus, and while in this country we have a long and proud history of supporting those who have stepped up to protect and defend us, it is morally right that we should continue delivering that support in the best possible way and, where we can, look to do more.
It is against that background that the Government published yesterday The Strategy for our Veterans, a long-term, 10-year vision that outlines what we aim to do to ensure that each and every man and woman who is leaving, or has left, one of our Armed Services feels they are “Valued, Contributing, Supported” in leading a fulfilling and rewarding life.
Much has been done in recent years in pursuit of that end, but the publication of the strategy marks the first time that Governments across the United Kingdom have come together to articulate a joint statement of strategic intent, setting out in clear terms the tangible outcomes we wish to achieve for veterans’ services along with the vision and the principles that will underpin them. Those outcomes, and that vision, are the product of wide consultation with academia, veterans themselves and many of our excellent service charities—the Royal British Legion, SSAFA, Help for Heroes, Cobseo, Combat Stress, Veterans Scotland and others—as well as the three service benevolent funds and the three service families funds.
We estimate that there are some 2.5 million veterans in Great Britain. They are not a homogenous group. They can be former regulars or reservists. They can be younger or older, in good health or in poor health. They hail from every part of the United Kingdom, and from diverse backgrounds. In consequence, their needs and experiences will be very different, a difference that is reflected in the wide range of organisations—public, private and charitable—which are charged with ensuring that the debt we owe to them is properly and effectively delivered.
I say to the noble Lord, Lord Tunnicliffe, that the document is not a blueprint for delivery, it is a strategy. It maps out a direction of travel, clearly waymarked by a number of factors and themes that are relevant to improving the lives of veterans, and it will, in that sense, hold us to account in measuring success. For each of those cross-cutting factors and themes there is an outcome for the year 2028 towards which all UK nations will work to deliver.
In furtherance of those objectives, the UK Government have published a consultation alongside the strategy. The consultation addresses the wide range of ways in which public services are delivered to veterans, but in essence it seeks to ask one overarching question: how can we do better? We in the Government may have our own answers, but it is only those at the sharp end who know what works best and who can tell us where the real gaps are. We want to hear from them.
The various themes covered in the strategy will be familiar. They are the challenges posed by the transition from service to civilian life; the need to find stable and fulfilling employment; the impact of a veteran’s service experience on their state of health; and the need for a home. These and other challenges are ones which we must help our veterans, wherever possible, to take in their stride, but where they falter, we must be there to support them. The consultation picks up on all these themes in greater detail and poses a series of questions on those issues where we most need answers. I encourage noble Lords to submit their views and to alert others to do so.
In addressing some of the many issues and questions that have been put during this debate, I shall begin with one raised by the noble and gallant Lord, Lord Walker, who called for a dedicated veterans ministry. I recognise that governance and collaboration around all these issues could be strengthened, hence the consultation that we have launched, but the key issue, surely, is delivery of policy and delivery of services. At governmental level, the Ministerial Covenant and Veterans Board is co-chaired by my right honourable friends the Defence Secretary and the Chancellor of the Duchy of Lancaster and has ministerial representatives from all government departments and devolved Governments. At ground level, responsibility for delivery is diverse, but in practical terms for a veteran in need of help and advice, Veterans UK and the Veterans’ Gateway will enable any veteran to receive the support they need.
I now turn to a topic which has loomed large in today’s debate, not least for my noble friends Lord Attlee, Lady Browning and Lady Helic and the noble Lord, Lord Tunnicliffe, which is mental health provision. Mental health services are delivered to veterans by the NHS. We in government know that some patients wait too long and that additional resources are needed. The Government are already investing £12 billion in mental health. In the Budget an additional £2 billion for mental health was promised by 2020, and the NHS will invest up to £250 million a year in new crisis services by 2023-24. I hope that gives a sense of how committed we are to the mental health and well-being of the population at large but also of our service personnel and veterans.
We fully recognise that service life can cause stress. We announced in October last year a new partnership with the Royal Foundation that will provide resources for training and education for the Armed Forces community around good mental fitness. In July last year the Defence People Mental Health and Wellbeing strategy was launched. It identifies the need for strong partnerships with the Department of Health and Social Care, the NHS, the devolved Administrations and the charitable sector. The MoD has provided a new 24-hour mental health helpline, which is targeted at serving personnel and their families, allowing them to access support for any mental health problems any time, anywhere, and of course there is the Combat Stress helpline for veterans. As part of the consultation, though, we will look at the idea that was very helpfully suggested by my noble friend Lady Browning; namely, what buddy support is already provided and whether it should be strengthened further. I thought that was a most interesting idea.
As I have said, we take the well-being of personnel very seriously, and we are funding research so that we can continue to do so. The aim of the study currently taking place at King’s College London is to understand the ways in which mental health is impacted during the years following exposure to conflict. The study suggests that the symptoms of PTSD can manifest several years after an individual has deployed, which I am sure we all instinctively knew. That is why the King’s College research is still ongoing. As the senior author, Professor Sir Simon Wessely, who is a world-renowned expert in this field, has pointed out in relation to the most recently published data,
“it would be wrong to say there is a ‘bow wave’, ‘tsunami’ or ‘time bomb’ of PTSD in the UK military and veteran community”,
but we need to analyse and take seriously what is actually happening.
I will answer a number of my noble friend Lady Helic’s questions in writing. However, I shall address the very important issue that she raised at the beginning of her speech: the rate of suicides. Every study conducted by the MoD has found that the risk of suicide among the Armed Forces community, including veterans of the 1982 Falklands War and the 1990-91 Gulf conflict, is lower than among the general population. However, we will commission a new study on the risk of suicide for those who served between 2001 and 2014 covering combat operations in Iraq and Afghanistan. It is important that we get to the bottom of those statistics.
The Department of Health and Social Care has had a national suicide prevention strategy in place since 2012 and that aims to address the causes of suicide for every civilian, not just veterans. Veterans are identified in the strategy as requiring tailored approaches to meet their mental health needs. That has resulted in NHS England’s veterans’ mental health transition, intervention and liaison service, which since its launch in April last year has supported hundreds of veterans and their families. That is complemented by the veterans’ mental health complex treatment service, launched in April this year to support those with the most complex needs, with holistic support for the whole person and their family.
My noble friend Lady Pidding and others referred to the defence holistic transition policy. That is aimed at better co-ordinating the assistance that is out there and to supplement it to prepare service personnel and their families who are about to leave the Armed Forces. That will be launched later this year. My noble friend Lady Browning spoke of the need for advance preparation, and I can tell her that the chain of command will routinely discuss with individuals throughout their career their plans and preparations for life after the military. Immediately prior to leaving the Armed Forces, the chain of command will assess their readiness to leave and refer those needing extra support to the defence transition service. The specialist defence transition services team within Veterans UK will support those who need it most by undertaking a thorough needs assessment to determine the best interventions required by that individual.
I turn to another extremely pressing and important issue: that of homelessness. We take this extremely seriously, and I was very grateful to the noble and gallant Lord, Lord Walker, for his constructive suggestions in this area. I start by saying that this year, there is a new statutory responsibility on the MoD to refer anyone leaving the military at risk of homelessness to the relevant local authority. Under the new defence holistic transition policy, early service leavers who are assessed by their chain of command as needing extra support will be referred to the defence transition service, which will undertake a thorough needs assessment to determine the best interventions required by that individual, including housing.
Housing was also raised by the noble Lord, Lord Tunnicliffe. I can tell him that, in line with the Armed Forces covenant, veterans who have,
“reasonable preference and more urgent housing needs”,
must be given additional preference—high priority for social housing. This requirement applies also to bereaved spouses of Armed Forces personnel and seriously injured or disabled veterans of the regular or reserve service. These are the only groups of citizens whose priority is based on prior employment. I say to my noble friend Lady Helic that the MoD is reviewing options which will assist with housing support for veterans. I take the point ably made by the noble Lord, Lord Tunnicliffe, on the question of supply.
As regards rough sleeping, one veteran on the street is too many. That is why we implemented the Homelessness Reduction Act, which will ensure that service men and women can work with their local authority earlier to ensure that homelessness is prevented. That is also why we published the Rough Sleeping Strategy, backed by £100 million of funding. We are committed to delivering our manifesto commitment to halve rough sleeping by 2022 and end it by 2027.
My noble friend Lord Robathan touched on a sensitive set of issues about the legacy investigations into Northern Ireland veterans. There is broad agreement within Northern Ireland that the current systems and structures to deal with the legacy of the Troubles are not delivering enough for victims, survivors and wider society. The Northern Ireland Secretary launched a consultation on legacy issues on
I turn to other health-related issues. The noble Lord, Lord Burnett, referred to the problem of adequate advanced prosthetics—a very interesting topic, but one on which I am certainly not an expert. He may be interested to know that the Complex Prosthetic Assessment Clinic was introduced at Headley Court in 2016 for the small number of veterans with particularly challenging prosthetic needs. Since its inception, the clinic has seen 40 individual patients, six of whom have subsequently been treated under the LIBOR-funded direct skeletal fixation technique. That involves the insertion of a titanium implant into the bone, eliminating the need for traditional socket-based technology. As the prosthetic is anchored directly to the bone, it offers greater freedom from the limitations and complications commonly associated with socket-based prosthetic systems. The Government are simultaneously funding research into direct skeletal fixation and we look forward to the results.
The noble Lord, Lord Burnett, also referred to issues around adaptations to housing. As I am sure he knows, there are various grants available to allow disabled people to continue to live at home, including the disabled facilities grant. People can get a grant from their council if they are disabled and need to make changes to their home—for example, to widen doors, install ramps, improve access to rooms and facilities, or install a downstairs bathroom. Having said all that, we shall await responses to the consultation if it is felt that this package of measures that is currently available does not meet veterans’ needs in every case.
My noble friend Lady Fookes, whose work with war widows I have admired for many years, asked about the reinstatement of war pensions. The Government recognise the unique commitment that service families make to the country and we remain sympathetic to the circumstances of those widows who remarried or cohabited before
The noble Lord, Lord Burnett, referred to the Armed Forces compensation scheme, which is covered on page 26 of the consultation, as he has probably seen. An independent review of that scheme in 2016 found that it remained fit for purpose and recommended both the uplift of the lump sum tariff awards and a review of the maximum tariff level award for mental health conditions.
My noble friend Lord Attlee, and others, including the noble and gallant Lord, Lord Walker, referred to the need for better data. As most veterans transition successfully from the Armed Forces and do not need help after discharge, it would be inappropriate to mandatorily track all of them; it is much more important to focus on the significant minority who do require additional support. We must respect at the same time that some individuals will not want to maintain a connection with the MoD, or they may not wish to declare their service. However, more data on specific cohorts would certainly aid delivery organisations. An amendment to the Data Protection Act 2018 allows the MoD to verify contact details of the ex-Regular Reserves against HMRC data to check whether people have moved—because obviously we need to know where people are. I can tell my noble friend Lord Attlee that national insurance numbers are used as the unique identifier between the two datasets.
Time is against me. I am conscious that I have not had time to answer a number of questions, but I assure noble Lords whose questions remain in the air that I will write after this debate with as full a response as I can, and copy in all noble Lords. I hope that noble Lords will allow me to conclude on that note. It has been a most constructive debate and I am extremely grateful to all speakers who have troubled to take part, and to share their ideas and their wisdom. A century on from the Great War, our people continue to give their all for our country. Our obligation to do right by them and their families remains steadfast. As the themes and programmes outlined in the strategy are developed further over the coming months and years, for the benefit of our veterans, we will continue to do our utmost to deliver on the debt we owe them.
My Lords, I am grateful to all noble Lords who have contributed to the debate. I am particularly grateful to my noble friend the Minister who, once again, has not disappointed us in the House.
The noble Lord, Lord Burnett, raised an issue about prosthetics of which I was not aware. I do not believe that the service charities should be funding prosthetics; they should be funded by central government. Service charities should be funding things that central government should not be funding. We will have to see how that issue progresses in the future. In the meantime, I beg to move.