(7 years, 3 months ago)
Commons ChamberRead Hansard Text Read Debate Ministerial Extracts
Mr Adrian Bailey (West Bromwich West) (Lab/Co-op)
I have secured this debate following the experience of one of my constituent’s, former rifleman Lee Bagley, of No. 5 Platoon, B Company of the 2nd Battalion the Rifles. Former rifleman Lee Bagley had his right leg amputated below the knee in September 2012 following an incident that took place on the night of 24-25 February 2010. His experience during the 31 months between the date of incident and the amputation highlights issues of duty of care, which he and I believe need to be examined, and lessons that need to be learned to ensure that no serviceman has to go through the experience that he has had to endure.
Rifleman Lee Bagley returned from a tour of Afghanistan towards the end of 2009 and subsequently underwent further training in Northern Ireland. On 24 February 2010, the platoon was accommodated by the infantry school at Brecon to rendezvous with platoon commanders before flying to Belize at 5pm on 25 February 2010 to undergo jungle training.
On the afternoon of 24 February, the commander ordered the platoon to attend a night out in Brecon town as a reward for having completed an intensive training package in preparation for the forthcoming exercise and to benefit from some team bonding, particularly for those new members of the platoon who had just completed a strenuous tour in Afghanistan.
On the morning of 25 February, at approximately 2am, the platoon was leaving a bar and getting into taxis to head back to Dering Lines, the local barracks, when one of the platoon members was seriously assaulted by 10 to 12 civilian personnel. Along with fellow members of the platoon, Lee Bagley rushed to the aid of his colleague and was also assaulted. A number of the attackers jumped on Lee’s leg. The original victim of the assault went immediately to accident and emergency, but Lee returned to his camp. He did not receive any immediate medical treatment and it was only later that day that he started to complain about the pain and swelling in his leg to his platoon commander who took him to accident and emergency en route to visiting his colleague who was already in hospital.
The platoon subsequently flew out without Lee. Lee was then flown to Ballykinler barracks in Northern Ireland where he had to visit the hospital in Downpatrick as requested by the chief medical officer at the camp.
From 25 February 2010 to 27 October 2010, Lee received physiotherapy in Northern Ireland, but failed to make any progress. He attended the rehabilitation unit at Aldergrove on 20 July and received an MRI scan on 22 July.
Jim Shannon (Strangford) (DUP)
I have requested permission to participate in this debate. Does the hon. Gentleman agree that a duty of care, as exemplified in this case, also exists for those who fought under Operation Banner in Northern Ireland? Some 30,000 British soldiers were deployed and 1,442 died in combat. Does he think that the Ministry of Defence needs to show greater awareness of its duty of care in future with regard to operations in which British soldiers are placed in uncompromising situations to offer assistance, whether that care is legal, physical or emotional?
Mr Bailey
I thank the hon. Gentleman for his intervention. I think that my subsequent remarks will make it clear that I agree with the thrust of his comments.
The British Army website states:
“All wounded, injured and sick soldiers will be assigned a Personnel Recovery Officer (PRO) either from their unit or through the Personnel Recovery Units for more serious injuries.
Their role is to assist the soldier in their recovery by co-ordinating all the support needed from agencies such as the Ministry of Defence, Army Primary Healthcare Services, Service Personnel Veterans Agency, housing contacts, and specialist charities.
The PRO will visit the soldier if they are on recovery duty at home, or arrange an appointment with them at the Personnel Recovery Unit at regular intervals to monitor their progress and update their Individual Recovery Plan as well as their records on the Wounded Injured and Sick Management Information System.
The frequency of visits will depend on the needs of the individual, but at a minimum soldiers will be visited once every 14 days, with their recovery plan and needs accessed every 28 days.”
After a couple of months’ treatment, it should have been obvious that Lee Bagley’s injuries required the assignment of a PRO, but that did not happen.
On 27 October 2010, Lee Bagley was sent home on sick leave for the next five months. He was, in his words,
“sofa surfing with his mom or partner’s family at their homes”
in the Black country. During that time he had great difficulty accessing information on his future treatment. Some of his telephone calls to his unit in Northern Ireland went unanswered, and when he did get though he was told that he would be informed in due course. After three months, he was asked to return to Northern Ireland for 24 hours, because his sick-at-home grading was due to expire. He then returned home.
When Lee Bagley eventually obtained an appointment for 4 February 2011 at the Defence Medical Rehabilitation Centre at Headley Court in Surrey, he did not receive the correspondence, so he missed it. He eventually had a revised appointment on 25 February. From 27 October 2010 to 25 February 2011, he was at home waiting for that appointment. That raises a significant issue. Lee Bagley had complex injuries that were not obviously responding to treatment. Why was he sent home without access to specialist support for that length of time? Every day in the national health service, we hear tales of people who are unable to leave hospital because of inadequate intermediary care, but here we have an example of a soldier who was sent home without a fixed abode and with no access to the specialist support that his condition warranted.
That appears to be in complete contravention of the advice given in the Army General Administrative Instruction volume 3, chapter 99, Command And Care Of Wounded Injured And Sick Personnel, section 99.111a, which states:
“Soldier at Home or Resident Address. The first recovery visit must be completed by the end of Day 7. No more than 14 days may elapse between subsequent visits.”
Again, this clearly did not take place.
The Army website outlines what needs to be done for soldiers with long-term injuries:
“Soldiers who are likely to need more than 56 days to recover will be graded as Temporarily Non-Effective (TNE). At this point units can also apply for the soldier to be transferred to a Personnel Recovery Unit (PRU), where the soldier can receive dedicated recovery support rather than remaining on their home unit’s strength.”
Surely he should have been classed as TNE by 27 October and an application should have been made for transfer to a PRU. That did not happen until 14 November 2011, the following year, when he was assigned to the PRU at 143 Brigade in Telford.
Lee Bagley eventually had his amputation on 28 September 2012, nearly a year later. He subsequently had one month at Tidworth House, and then further admissions at Headley Court. He was discharged from the Army in 2014 after a year of complex trauma admissions and prosthetic care. I must make it clear that his criticisms of his treatment do not extend to the period after 14 November 2011, when he was allocated to the PRU, and his subsequent discharge; he has nothing but praise for the exercise of the duty of care that he received once he had been admitted to the PRU. However, he does feel—this seems to be backed up by the evidence—that for six months he was a forgotten man.
This is someone who was injured coming to the rescue of a comrade who had been severely assaulted. If it had happened in theatre, he would have been praised and possibly given a formal commendation. Instead, he went back to his barracks and received no attention at all, until it became obvious that he needed to go to hospital. Subsequently, it took almost a year, both in hospital in Northern Ireland and then at home on sick leave, before he was admitted to Headley Court in Surrey. It was then another six months before he was admitted to the personnel recovery unit.
It seems unbelievable that there was such a delay for injuries that were serious enough ultimately to justify amputation. Whether the delays in admission to the PRU contributed to the amputation is a matter of clinical judgment. Even if it did not, any soldier going through that experience is entitled to believe that the Army would exercise its duty of care with the utmost professionalism and diligence, and that everything possible would be done to prevent the loss of his limb. Lee Bagley’s experience from 27 October 2010 to 14 November 2011 has left him with severe doubts that that is so.
Lee Bagley is entitled to know: why he was not appointed a personnel recovery officer earlier in his treatment programme; why he was sent home without any support; why he found it so difficult to obtain information while at home; why he did not receive the dedicated personnel support that he was entitled to; and why it took so long for the duty of care to be transferred to the PRU. He deserves answers to those questions.
I am sure that everyone recognises that our young people who join the armed services, exposing themselves to danger in order to protect us, deserve and have the right to expect the best possible medical care, whether in theatre or in other circumstances.
Every soldier injured, whether in battle or on other duties, should be able to have confidence that the medical response will be exercised with the utmost professionalism and diligence, and that everything possible will be done to secure recovery. That is why I have secured an Adjournment debate. Our soldiers have the right to expect the best possible care in any circumstance. I do not want the experience Lee Bagley has endured to be repeated for anyone else.
The Army has a huge volume of regulations covering the processes designed to deliver the best possible medical support, but somehow, despite all the regulations and guidance, Lee Bagley failed to get the support he needed. He and I hope that raising these issues on the Floor of the House will ensure that, in future, these regulations are implemented in a way that can be recognised by the patient and that secures the confidence of the public.
The Parliamentary Under-Secretary of State for Defence (Mark Lancaster)
It is a pleasure to respond, and I start, of course, by congratulating the hon. Member for West Bromwich West (Mr Bailey) on obtaining this debate about his constituent, ex-Rifleman Lee Bagley, and the Ministry of Defence’s duty of care following an injury he sustained during a night out in Brecon on 24 February 2010. Perhaps I may also take this opportunity to remind the House of my interest as a member of the Army Reserve.
I should like to begin by offering my personal sympathies to Mr Bagley. The injury he suffered has had a profound and life-changing impact on him. I can only begin to imagine the pain and anguish he has been through.
Let me turn to the specific points raised. The hon. Gentleman will recall our correspondence back in 2015, when he wrote to me about this case. In particular, his constituent raised similar concerns to those that have been raised today, and I advised at the time that, should Mr Bagley feel there were failings in the way his unit treated him, he should consider raising them through a formal service complaint. I advised that although such a complaint would be outside the usually permitted time limit of three months, Mr Bagley was able to make representations about why his complaint was not submitted within the time limit. My officials advise that Mr Bagley has so far not submitted a service complaint—something he is still within his rights to do. I take this opportunity to encourage Mr Bagley to submit a complaint, and I would certainly be pleased if it were admitted, because it would be appropriate to address this issue through the independent service complaints ombudsman.
I am sure the hon. Gentleman will appreciate that, given that the events in this sequence occurred up to seven years ago, and given the time available to prepare for this debate, it is difficult to piece together without an investigation—something that could be done by the service complaints ombudsman—the detail of every decision and action that was or was not taken by Mr Bagley’s unit. There are a number of factors that make things difficult, not least the changeover of unit staff since 2010. I am not, therefore, in a position to determine during this debate, at relatively short notice, whether the care provided to Mr Bagley by his unit was sufficient or to address the specific questions the hon. Gentleman raised at the end of his speech.
The hon. Gentleman will also be aware that 2009 and 2010 were particularly tough years in the Afghanistan conflict, and Mr Bagley’s unit, the 2nd Battalion the Rifles, was at the heart of the action. Very sadly, this meant it suffered a significant number of fatalities and casualties during that period. I am not trying to make excuses, but those are the facts as they stand.
What is clear, however, is that the Army has in place specific guidelines, as outlined by the hon. Gentleman, regarding the command and care of wounded, injured and sick personnel. These are set out in Army General Administrative Instruction, volume 3, chapter 99. AGAI 99 has been updated a number of times since 2010, but a brief outline of the timelines within which wounded, injured and sick personnel can expect to be looked after is as follows. Service personnel should be recorded on the wounded, injured and sick management information system on day 14 of their sickness, and a unit recovery officer assigned. On day 21 of sickness, the first visit of the unit recovery officer should have been completed. Personnel should have regular recovery visits thereafter, with no more than 14 days between visits, and a unit care review meeting every 28 days to review the case. If the individual remains sick at the 56-day point, they should be graded as temporarily non-effective. Clearly and unequivocally, it is unacceptable if this policy is not properly followed. If an individual feels that their chain of command is not complying with it, they should raise a complaint.
Mr Bagley was injured at a time when the MOD had acknowledged that it could and should do even more to help not only our wounded, injured and sick personnel, who deserve nothing but the best care, but to ensure that those who were caring for and administering them were appropriately resourced. That is why in 2010 we began developing the defence recovery capability—an MOD-led initiative delivered in partnership with Help for Heroes and the Royal British Legion, alongside other service charities and agencies. The defence recovery capability ensures that wounded, injured and sick armed forces personnel have access to the key services and resources they need to help them either return to duty or make a smooth transition into civilian life.
It is only right and proper that where personnel are injured while carrying out their duties, or develop an illness that can be linked to their service in the armed forces, they are properly compensated. Such circumstances are covered by the armed forces compensation scheme, which provides compensation for any injury, illness or death caused by service on or after 6 April 2005. The war pension scheme compensates for incidents up to this date. The rules of the scheme are not prescriptive in terms of when awards can be made—they allow for a variety of circumstances—but the key is whether the injury or illness has been caused by service. Personnel do of course have a right of appeal if their claim under the scheme is turned down or they are unhappy with the level of award made.
Despite the concerns raised by the hon. Gentleman, I understand that Mr Bagley’s injury was sustained during a night out—in other words, he was off duty. There is no evidence that he was compelled by the service to go out for the evening in question. As a consequence, his claim under the armed forces compensation scheme was rejected, and this decision was subsequently upheld by the first-tier tribunal.
I should stress at this point that when a member of the armed forces has to be medically discharged, as in Lee Bagley’s case, the armed forces compensation scheme is not the only means by which they can receive financial assistance from the Ministry of Defence. Personnel can also receive an ill-health pension under the armed forces pension scheme, irrespective of whether their injury or illness that led to them being medically discharged was attributable to their service. I can confirm that Mr Bagley is in receipt of such a pension.
Mr Bailey
It is perfectly true that, parallel to this issue, ex-Rifleman Lee Bagley has been pursuing compensation, but I deliberately focused my comments on the duty of care rather than the legalistic process that surrounds the compensation issue, and that is what I really want brought out today.
Mark Lancaster
That is a perfectly reasonable intervention. I hope that I have already explained to the hon. Gentleman how, since 2010, quite a lot has been done through the development of the pathways that we have discussed. The great joy of these debates is that they are an opportunity for the House to discuss, using individual cases, the fact that we do have a duty of care and how the system can be improved.
It would be wrong of me to close without stating that the Ministry of Defence ensures that armed forces personnel can serve safe in the knowledge that when they leave active service they will be well supported to translate their acquired skills, experience and qualifications into the second career they aspire to. Personnel who are medically discharged are entitled to the highest level of resettlement provision through the Career Transition Partnership’s core resettlement programme. The MOD also offers specialised support for wounded, injured and sick personnel, and those with the most complex barriers to employment, to ensure that they receive the most appropriate support within their recovery pathway.
I can confirm that Mr Bagley made full use of the Career Transition Partnership, and that the assistance it provided helped him to secure employment immediately after leaving the British Army. That said, I know that no level of practical help or compensation could ever make up for the distress and turmoil that he has suffered as a result of his injuries. I should like to close by reiterating my sincere sympathy for him.
Question put and agreed to.