New Clause 6 - Duty of care for alcohol, drugs and gambling disorders

Armed Forces Bill – in a Public Bill Committee at 9:30 am on 31st March 2021.

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“(1) The Armed Forces Act 2006 is amended as follows.

(2) After section 20(2)(d) insert—

‘(e) the person is dependent on, or has a propensity to misuse, alcohol or drugs.’

(3) After section 20(3) insert—

‘(3A) The Secretary of State has a duty of care to offer a specific pathway for support and treatment for current and previously serving service personnel who experience—

(a) a propensity to misuse, alcohol and drugs,

(b) alcohol or drug dependency, and

(c) gambling disorder.

(3B) The Secretary of State must include in the annual Armed Forces Covenant report—

(a) the number of people accessing treatment and support as set out in section (1), and

(b) the current provisions for rehabilitation facilities for Armed Forces personnel who are experiencing a propensity to misuse or have a dependency on alcohol, drugs and gambling.’”—

This new clause places a duty of care onto the Ministry of Defence to provide treatment pathways to serving personnel and veterans who experience alcohol, drug and gambling disorders and will include the number of people accessing treatment and current rehabilitation provisions in the annual Armed Forces Covenant report.

Brought up, and read the First time.

Photo of Dan Carden Dan Carden Labour, Liverpool, Walton

I beg to move, That the clause be read a Second time.

This new clause would place a duty of care on the Ministry of Defence in relation to finding a pathway to treatment for people suffering with addiction. We are familiar with the existing narrative that many of our armed forces community will, at some stage, struggle with their mental health. While there is agreement that we must prioritise the mental health and wellbeing of our armed forces, alcohol, drug and gambling use disorders—otherwise known as addiction—do not receive the same consideration, and serving personnel and veterans experiencing addiction are being failed by the current system.

In society, we should afford the same attention, resources and support to addiction as to any other mental health matter, because addiction is an illness—an illness with a higher prevalence across the services. The new clause would place a duty of care on the Ministry of Defence to ensure that it has a role to play in finding a pathway to treatment for those men and women who have given service. Combat Stress confirms that military personnel are more likely to suffer from substance misuse problems than civilians, yet there is only one veteran-specific addiction treatment facility in the whole of the UK—Tom Harrison House, in Anfield, in my constituency.

Turning to alcohol, drugs and gambling in times of uncertainty or hardship is normalised in the UK. The latest Office for National Statistics alcohol-specific deaths data show that this is now a national crisis. Our armed forces are a niche community with distinct values that make engagement with local services difficult. Many veterans and their families are isolated and do not receive the treatment they need and deserve. I have met many veterans visiting Tom Harrison House who felt completely let down by the MOD. I am yet to meet one who has received the support they need for their addiction through the Army, Navy or Air Force. Too often—in fact, it is the norm—people have to hit rock bottom to get picked up and offered support. Even then, treatment is not always available. One veteran told me:

“I gave my life to service, I was trained to lack empathy; conditioned to survive; asking for help was a weakness; encouraged to drink and when there was nothing left for me to give, I was discharged, without any re-conditioning, no support; completely alone.”

That experience is unacceptable.

We just do not know how many veterans experience substance use disorders, as there is such limited reporting. The new clause would address that lack of understanding. As it stands, the MOD plays no role in the pathway of support for veterans who require treatment for addiction and other mental health issues, even though we know that the effect of service is often a determining factor in a veteran’s illness. Once personnel have left service, they rely on the NHS and local authorities, and of course the UK’s third sector organisations provide help and support. I absolutely value their work, but the MOD has a responsibility to those men and women that it has shirked for too long. Veterans are expected to use the same pathway as civilians—through the NHS and local authority services—yet drug and alcohol services have been decimated in the past 10 years, with part one of Dame Carol Black’s review on drugs detailing that, in some local authorities, funding for these services has been cut by 40%. We expect veterans to navigate an underfunded system that does not cater for veteran- specific needs.

We know that addiction is often a symptom of deeper psychological problems. Substances are ways to escape and self-medicate. Although co-occurrence of substance use and mental health diagnoses is widely understood, to access mental health services the person must often address the substance use first. The Committee heard at first hand from Combat Stress just how obstructive that is to recovery. This fractured approach leaves too many in prolonged pain and suffering as they continue to fall between the cracks. While the Bill will enshrine the armed forces covenant into law, public bodies having that due regard will not help the many veterans who experience addiction.

Photo of Kevan Jones Kevan Jones Labour, North Durham

My hon. Friend is talking about veterans, but does he agree that there is a big issue with drug and alcohol misuse in the services? The services’ main response is usually to dismiss people with those issues. Does he think more should be done to get treatment for those individuals while they are in service?

Photo of Dan Carden Dan Carden Labour, Liverpool, Walton

I am grateful to my right hon. Friend. We know that levels of treatment do not match the levels of addiction that we believe exist. I will finish on this point. Currently, there is a zero-tolerance approach to alcohol and drug misuse in the forces, and that approach lacks understanding and is outdated. Other professions, including our doctors, the police force, the fire service and pharmacists, provide occupational support for substance use, and our armed forces should follow suit. I hope the Minister will address that issue.

New clause 6 will ensure that these men and women have access to a pathway of support for problematic alcohol, drug and gambling use, and it will allow information on service personnel and veterans’ treatment, and the provision for it, to be included in the annual armed forces covenant report.

Photo of Johnny Mercer Johnny Mercer Parliamentary Under-Secretary of State (jointly with the Ministry of Defence)

This is a really important new clause, and there are some really good points in there. I am grateful to my hon. Friend the Member for Liverpool, Walton for raising these issues, because addiction is something that is particularly close to my heart, and we as a society and a Government need to do more on it. He raised some important issues. I will not just read him the blurb of what is available, because he knows about that. I will address a couple of the points that he made. I cannot accept the new clause, but I will talk about what we can do to address some of these issues.

I pay tribute to my hon. Friend for his lobbying in this cause. I know he has worked hard on it over a number of years. Tom Harrison House is a real beacon of support for those enduring substance abuse and addiction challenges, and I pay tribute to its work. When it comes to the responsibility for providing pathways for veterans, the difficulty that we have with the new clause is that, in this country, veterans are not an individual cohort on their own; they are civilians who have served, who were picked from society and will return to society. So, along the lines of what I have done with Operation Courage to ensure that there is a single front door and clear pathways that people can navigate, we must ensure that there are addiction pathways through these treatment services.

I ask my hon. Friend to come and see me in the Department, and perhaps we can visit Tom Harrison House. This has long been an issue for me. The third sector does amazing stuff in this field, but some organisations will not treat people until they have finished drinking, or whatever the addiction challenge may be, and we have to do more on that. I would like to visit Tom Harrison House and really listen to hear what the people there would do with the current situation. We have a sort of trailblazer going on in the NHS with Op Courage, and I do not see why we cannot do that with addiction services.

My hon. Friend talked about having a zero-tolerance approach in terms of people who have served. We do not have a zero-tolerance approach to those who are using drug and alcohol services; we provide support. I have seen that in units down in Plymouth, where people have received support for alcohol abuse. There certainly used to be a zero-tolerance approach to drugs, but there is not one now. We do what we can, cognisant of the way that society has changed. However, we are very clear that drug use is not compatible with service life, and that position has been upheld and proved time and again.

I cannot accept the new clause because it would essentially give the MOD responsibility for civilian services, but I can try to achieve the same effect by making a joint visit to Tom Harrison House and really understanding where the points of pressure are in ensuring that care pathway for our people, and work together to make sure that we can look after such people, who—my hon. Friend the Member for Liverpool, Walton makes a really strong and valid point—have been quietly shielded out from other services that other people have had access to. It is something that I feel very strongly about.

Photo of Kevan Jones Kevan Jones Labour, North Durham 9:45 am, 31st March 2021

My experience, like the Minister’s, is that there is support within the military for individuals; I think I was the one who changed the policy around zero tolerance of drug use. May I ask about the support for such individuals? There will be individuals who have to leave the armed services because of drug and alcohol issues. What support is given to them? Transition for those individuals to get support in civilian life is important. Is there a specific pathway for people who have to leave because of drug and alcohol problems in the armed services, or are they just left to their own devices? That would be a way to stop some of those individuals falling further into the addictions that have grasped them.

Photo of Johnny Mercer Johnny Mercer Parliamentary Under-Secretary of State (jointly with the Ministry of Defence)

They are not left to their own devices. There is now something called the Defence Transition Services, which were set up last year. They are specifically tailored to put our arms around all those individuals who are leaving service. They are not specifically tailored to those who suffer from addiction. The service is agile enough to deal with all our vulnerable service leavers, particularly those coming out of care and things like that. They can now access Defence Medical Services up to six months after they leave, but there is always more to do in this space. That is why I am keen to see my hon. Friend the Member for Liverpool, Walton at Tom Harrison House.

Photo of Kevan Jones Kevan Jones Labour, North Durham

I welcome what the Minister says, but if he is looking at the broader issue around veterans, could he perhaps also look at the support that he has given to individuals who have to leave because of addiction problems? I accept that there is a transition process, but some more work could be done to look at specific support for those who have to leave because of drug and alcohol-related issues.

Photo of Johnny Mercer Johnny Mercer Parliamentary Under-Secretary of State (jointly with the Ministry of Defence)

Yes, of course I will. I give a commitment to the Committee to work with my hon. Friend the Member for Liverpool, Walton to design the pathways and report back in future on what we can do better. With those assurances, I hope he will agree to withdraw the motion.

Photo of Dan Carden Dan Carden Labour, Liverpool, Walton

I thank the Minister for the way that he has engaged with these issues, and for the work that he has already done. One of the key problems that we have is the poor set of data, and I look forward to working with him to see what we can do in the Bill on those issues. In the light of the Minister’s commitments to meet and his offer to visit Tom Harrison House, I beg to ask leave to withdraw the motion.

Clause, by leave, withdrawn.