I am grateful to my hon. Friend. He and I have discussed this before. I am afraid that I will not be able to show very much ankle on this occasion, but in my remarks I will certainly touch on where we are with the two commissioned reviews, which will improve matters as part of the process I described. In the meantime, we have invested £40 million to digitally transform veterans’ services and phase out paper, which is so much impeding the quality of the service we want to offer our veterans. We are introducing online verification, which will make it much quicker and easier to establish veteran status, and that is also why we have introduced the reviews to which my hon. Friend refers.
There have been calls for medical checks when people leave active service to allow for the early spotting of traumatic brain injuries, as my right hon. Friend the Member for Tatton rightly touched on. It is an issue that I, as a military medic, have a long-standing interest in. Remarkably, in Afghanistan a British combat soldier was likely to face exposure to between six and nine improvised explosive device explosions, with the consequent risk of mild traumatic brain injury. That is a staggering figure.
Moderate to severe traumatic brain injury should be detected at the time of injury and managed accordingly. The diagnosis of mild traumatic brain injury is generally made clinically on referral to the Defence Medical Rehabilitation Centre at Stanford Hall, which operates a dedicated treatment programme for TBI of all levels of severity.
As for medical assessments conducted at discharge, their purpose is to assess and record the physical and mental health status of individuals at point of departure. All episodes of ill health during service will be reviewed at that time, and an assessment will be made and recorded about whether there has been any interaction between health and work. Our duty of care to people is principally to ensure that any disadvantage that they have suffered as a result of their service is remedied as best we can; that is at the heart of the military covenant, as my right hon. Friend will well appreciate. That assessment, at that time, is part of that duty.
The real sticking point here is that mild TBI is generally not visible on routine clinical imaging. The US has something called magnetoencephalography, which it has deployed to try to detect who has mild TBI and who does not. We have our own Independent Medical Expert Group that assesses these things, and it has assessed magnetoencephalography twice. It has found that magnetoencephalography is not sensitive and specific enough to be of use as a screening test at the moment, but naturally it keeps all evidence under review and that position may well change. In the meantime, our own Defence Medical Services is part of a national civilian and military collaboration called mTBI-Predict, and that is looking for reliable biomarkers, which may include—but are not confined to—magnetoencephalography.
I turn to the possibility of rewording the armed forces covenant to encourage authorities to treat veterans as a priority more energetically. I share my right hon. Friend’s appreciation of the value of our armed forces covenant. Indeed, I wrote the book on it 12 years ago, which is sadly now out of print, although a colleague said he had seen a copy recently in a charity shop. He then went on to spoil the story by saying that he did not bother buying it! Nevertheless, I am particularly proud that this Government, in their very early days, put the covenant into legislation—at about the time that I was writing my book—and that organisations are now able to sign up to it, as so many have, including all local authorities in Great Britain.
We should not forget that the covenant is not about advantaging members of the armed forces community; it is not about placing them at the front of the queue or mandating outcomes. I do not think that is what veterans and the service community want. The covenant is about ensuring that people are not disadvantaged by virtue of having served. That “no disadvantage” enjoinder lies at the very heart of the covenant we have built.
The Armed Forces Act 2021 introduced a new statutory duty to promote better outcomes for the armed forces community when accessing key public services. That duty came into force in November 2022. It requires certain public bodies to have due regard to the covenant’s principles when carrying out specific functions in the key areas of housing, healthcare and education. In other words, it is there to give veterans a fairer hearing and to ensure that service providers have the needs of the armed forces community in mind when making policy decisions. We will evaluate the impact of the new legislation as it beds in; we will report on it annually in the armed forces covenant and veterans annual report; and in any event, as we are bound by statute, we will report on it formally after five years.
All service people, from private soldiers to Chief of the Defence Staff, come to defence from civilian life, and to civilian life they will return. Preparing for that inevitability is not something that should happen in a rush in someone’s last few weeks spent in uniform, but from day one. That is why accredited training, skills and education are so important and is why issues like facilitating spousal employment and encouraging personnel to buy their own homes early have been, and will continue to be, firmly in our sights.
I would like to sound a cautionary note. The tabloid press likes to suggest that the veteran living in a cardboard box underneath the arches is typical. That is a complete 180° reversal of the truth. Overwhelmingly, our service leavers transition brilliantly, as one might expect considering that they are resourceful, enabled individuals with in-demand skills and attributes, but there are exceptions and we should be constantly kicking the tyres to see what more we can do to maximise the resilience of our service leavers.
Our holistic transition policy, published in October 2019, was designed to better co-ordinate and manage service personnel and their families transitioning from military to civilian life. Whether that means helping with the basics, such as registering with a doctor, or offering more intensive assistance for those with complex needs including those related to housing, budgeting, debt, wellbeing, employment and children’s education, it is there for them. Holistic transition builds on the success of the career transition partnership, which has provided employment support and job finding services for the last 20 years. Last year, 87% of service leavers were employed within six months of leaving their service. I want that to improve, but that is 12% higher than the UK employment rate, which validates the remarks I made about the majority of our service leavers being in a good position by virtue of having served. The holistic transition policy gives tailored interventions to service leavers assessed as needing extra help. That is done through the defence transition service. It is one to one, provides tailored information and guidance and facilitates access to support services, including from other Government Departments, local authorities, the NHS and trusted charities.
I underscore the contribution of charities. Some disparage charities and say that it is all the responsibility of the state. I disagree. I think our service charities do an absolutely fantastic job and need to be encouraged in what they do.
Mindful of the compensation touched on by my right hon. Friend the Member for Tatton, in July the Ministry of Defence and the Office for Veterans’ Affairs published a review of the Government’s veterans’ welfare services alongside the statutory quinquennial review of the armed forces compensation scheme. I will not pre-empt the Government’s response to the reviews. That will come later this year—I hope very much not too much later. Suffice to say, those reviews prove that the only way to meet our aspiration of making the UK a truly great place to be a veteran is to continue to listen to what they say, both directly and through their elected representatives as in this debate.
A fortnight ago, I was honoured to be asked to speak in Kyiv at a conference for veterans hosted by the Government of Ukraine. I am pleased that a country that will, as a result of Putin’s aggression, have a large number of veterans, some with the most complex of needs, should, at both ministerial and official level, be looking to the UK for advice and looking at our structures as it works out what it should now do. I find endorsement in that and I am humbled by it.
Question put and agreed to.