(2 weeks, 2 days ago)
Grand CommitteeMy Lords, I join others in congratulating the committee on producing a first-class report, which is frankly more prescient than I expect its members could ever have imagined in their wildest dreams, or perhaps I should say nightmares. To say that the world has turned upside-down at a dizzying pace in recent days is an understatement, but the report’s recommendations remain completely relevant. In essence, we need a completely new response and quickly.
I will say a few words about the current situation before turning to several of the specific recommendations. While I join others in saluting the tireless efforts of the Prime Minister, who has played a critical role on the world stage, I do not believe that we can rely on the USA to be a strong and dependable ally. Indeed, Trump has made it clear that he does not accept a continuing responsibility for the security of Europe. As the noble and gallant Lord, Lord Stirrup, made clear, that has a wider resonance in the USA. Article 5 of the NATO agreement—the glue we have relied on for so many years—is no longer anything like as secure as it was. We are in a new and dangerous situation and our response must take account of this.
The response that the Prime Minister has adopted to try to broker re-engagement between the US and Ukraine while seeking to put together a coalition of the willing to defend Ukraine is to be welcomed. It is clear that the UK and our European allies will have to accept a step-change increase in resources for our own defence, as the report we are debating makes crystal clear because, once one strips away the rhetoric, the reality is this: Trump is imposing huge pressure on a so-called ally to agree to a surrender/ceasefire on America’s terms, which are to cede territory to Russia and mineral resources to the USA without guarantees to ensure Ukraine’s future security. It has paused military aid to and suspended intelligence sharing with Ukraine. It is widely reported that Defense Secretary Hegseth has instructed the US Government to pause all offensive cyber operations against Russia. Ukraine is meant to be grateful.
The key recommendations and conclusions of the report, which I reread last night, are stark and commendably clear. I wholeheartedly endorse them, particularly the focus on a whole-of-society approach.
I turn to a couple of specifics. First, on strengthening industrial partnerships, the report talked about the Government facilitating a broad church of industry engagement to bring in non-traditional defence suppliers such as start-ups, small and medium-sized enterprises and tech companies. It also argued that the Government would need to mitigate the risk of collaborating with commercial partners that lack previous experience in defence. It is currently very difficult for new entrants to the UK defence market to establish and prove the required safety, security, quality, et cetera, to the MoD and regulators. New entrants may also have to work for many years at their own expense before they start generating revenues.
An existing model that could be considered is based on UK advanced manufacturing research centres, involving scientists, engineers, researchers and technology specialists working together to develop innovative technologies, systems and products. This approach could be used for innovative defence for the UK Armed Forces, where the role of government would be primarily twofold: to work with the scientific and research community and lead industrial partners to set up and fund these advanced defence manufacturing research centres; and, crucially, to put in place risk-sharing framework contracts with lead industrial partners to co-finance the development and industrialisation of the most promising concepts. Can the Minister say what thinking the Government have been doing in this area?
One area not really covered in detail by the report is undersea cable attacks. A recent BBC in-depth article set out the extent of Russia’s shadow fleet, used to carry embargoed Russian oil products, and the extent of suspected seabed infrastructure sabotage in both the Baltic Sea and closer to home. Twice in recent months, the surveillance ship “Yantar” was spotted gathering intelligence about the UK’s underwater cable network as part of its hybrid warfare on this country’s critical infrastructure. The UK has around 60 undersea cables that come ashore on its coastline, particularly concentrated around East Anglia and the south-west. Only yesterday, the Times reported that Russia had sent a warship into the English Channel to escort a suspected arms shipment in a sanctioned cargo vessel from Syria for possible use on the front line. These are all very worrying developments. The Joint Committee on the National Security Strategy, on which I sit, recently launched a new inquiry into how vulnerable the UK is to undersea cable attacks. Will the Minister say what assessment the Government have made of this current threat?
I conclude by repeating that assuming the US will side with Ukraine to provide a backstop and security guarantees is a fundamental misunderstanding of Trump’s position. Trump has a huge agenda with Russia, and many suspect that he is looking to strengthen US bilateral relationships with Russia to deliver what he believes to be huge economic and security benefits to the US and also, potentially, to strengthen Russia’s focus and reliance on China. What update can the Minister give us on the use of Russian frozen assets to augment our immediate defence spending, not simply the interest but the capital sums? Is fast-track legislation being considered? Ideas have been circulating for an international rearmament bank that would facilitate access to private sector capital for Ukraine’s ongoing struggles. Do the Government plan to pursue this? On the longer-term move to 3% of GDP for defence spending, what plans do the Government have to set up cross-party discussions to see whether a consensus can be reached on how this might be funded?
(9 years ago)
Grand CommitteeMy Lords, I support the thrust of this probing amendment. Clearly there are enormous differences between trying to deal with people who are still in the services and may be suffering from mental illness and those who have become veterans and, maybe many years later, develop or show symptoms of mental illness. How does that get related to their time in service? There are a number of other practical points that I think have been very well made. I would like to put on the record that I am for this in principle but I can see that there are many difficulties. No doubt the Minister will have a chance to tell us about them.
My Lords, I add my support for Amendment 14 and apologise for my very croaky voice. I do not normally engage in these discussions, but I have a very strong interest in mental health. As other noble Lords have said, with so much focus on mental health now, it really has gone up the agenda. We have had a succession of extremely important reports, most recently the mental health task force report. Parity of esteem between mental health and physical health runs right the way through that report and all the thinking behind it. If we accept that report—certainly in the debates that I have recently taken part in on this subject, the Government have shown their strong support for the reports and the principles behind them, and that is welcome—it is absolutely vital that parity of esteem between physical and mental health is applied equally to members of our Armed Forces, who do the very difficult jobs that they are asked to take on, as it is to the rest of the civilian population. I simply add my support.
My Lords, I hope that it will not surprise noble Lords to hear that I fully share the sense of importance that they attach to mental health and parity of esteem in the way that mental and physical health are treated by our health services. Both these amendments seek to address provision for the care and support of members of the Armed Forces who suffer from mental health conditions while in service. This is something that we take very seriously, as I will go on to explain.
Taking first the issue of compensation for those who suffer from mental health conditions, I should explain that the Armed Forces Compensation Scheme already makes awards for injuries and disorders predominantly caused by service, including mental health conditions. The scheme is tariff based and aims to make full and final awards as early as possible so that individuals can have financial security and focus on getting on with life and living. Claims can be made while in service or when an individual has left.
The AFCS tariff has nine tables of categories of injury relevant to military service, and these include mental health disorders. While the scheme does have time limits for claims, there is also a provision for the delayed onset of mental disorders. The Ministry of Defence recognises that owing to stigma and perceived impact on career, people may delay seeking help. The practical effect of this is that if a person who left the Armed Forces some time ago is diagnosed with a mental disorder as a result of his or her service and makes a claim under the AFCS, a compensation award will be paid as soon as the claim is accepted.
Noble Lords may recall that, having been asked to review the AFCS, including the associated tariffs, the noble and gallant Lord, Lord Boyce, made his recommendations in February 2010. As a result, the Ministry of Defence increased the maximum lump sum award for mental illness from £48,875 to £140,000. This was to accurately reflect the impact of the most serious mental health conditions. In addition to the lump sum, those with the most serious conditions with likely adverse functional effects on civilian employability receive a tax-free guaranteed income payment for life on discharge from the services or from the date on which the claim is accepted. A lump sum of £140,000 attracts a GIP based on 75% of military salary with enhancements for service length, age, rank and lost promotions.
Another of the noble and gallant Lord’s recommendations led to the Independent Medical Expert Group, a non-departmental public body, being established. It advises Ministers on the scientific and medical aspects of the scheme. The noble and gallant Lord, Lord Boyce, identified mental health as an area requiring further investigation. The subsequent IMEG review involved a literature search and discussions with civilian and military experts, as well as with veterans’ organisations. The findings were published in its second report on 17 May 2013. The conclusions and recommendations on diagnosis, causation, assessment of disorder severity and the use of interim awards were accepted and subsequently incorporated into the scheme.
The second amendment in this group would create a specific obligation on the Government to have particular regard in their annual report on the covenant to,
“parity of esteem between mental and physical healthcare”.
As I have said previously, the Government are committed to meeting the healthcare needs of the Armed Forces community. For this reason, the Armed Forces Act 2011 already requires the Secretary of State to include in his annual Armed Forces covenant report to Parliament the effects of membership, or former membership, of the Armed Forces on service people in the field of healthcare under the covenant.
I was grateful for the remarks of the noble Lord, Lord Empey, and I agree with his general point about managing expectations. However, I agree with him only up to a point in this context because I think that the healthcare which we provide to our armed services personnel, both at home and when deployed on operations, is now truly world-class. Last year the principles of the covenant were enshrined into the NHS Constitution for England. That gives a commitment to ensuring that those in the Armed Forces, reservists, their families and veterans are not disadvantaged in accessing health services in the area where they reside. Indeed, we have made several improvements, including: the provision of some £6 million a year to support the provision of enhanced prosthetic devices and services for veterans who have lost a limb as a result of service; the launch of the hearWELL programme to look at hearing loss among the service community; and the allocation of £10 million to address service-related hearing issues among veterans. I know that these are related to physical injuries; nevertheless, I hope that they show the appropriate intent.
With increasing awareness of the issues, we have taken steps to meet the mental health needs of our Armed Forces community. On this specifically, we now have a network of 16 departments of community mental health across the UK, providing out-patient care to the service community. When in-patient care is necessary, it is provided in eight dedicated psychiatric units. Additionally, the Armed Forces covenant gives a commitment that veterans should be able to access mental health professionals who have an understanding of Armed Forces culture, while NHS England is currently completing an audit of veterans mental services, put in place following the Fighting Fit report by my honourable friend Dr Andrew Murrison MP in 2010.
I can therefore assure the noble Baroness that the Government are committed to meeting the health needs of the service community, that we will continue to report on the provision of healthcare in the Armed Forces covenant annual report, and that our work to address mental health needs will be an integral part of that report. However, the principles of the covenant are to ensure that the Armed Forces community are treated fairly in comparison to the civilian population. Parity of esteem is there to ensure that all health services treat mental health with the same importance as physical health, and it applies to everyone accessing NHS services, not just the Armed Forces community. For this reason, it does not need to be legislated for under the covenant.
Given our clear commitment to support those who suffer from mental health conditions and the tangible steps we are taking to do so, I ask that the noble Lord and the noble Baroness withdraw or do not move their amendments—hopefully, reassured.
(9 years, 2 months ago)
Lords Chamber
To ask Her Majesty’s Government what assessment they have made of the support available to serving military personnel with mental health problems, and what plans they have to establish a 24-hour mental health helpline for serving soldiers.
My Lords, the Ministry of Defence is absolutely committed to looking after the mental health of our Armed Forces and provides a range of community-based healthcare in line with national best practice. Out-of-hours care already includes the free 24-hour mental health helpline run by the charity Combat Stress, which receives funding from the MoD, and the Big White Wall, which is a 24-hour online community. There are therefore no plans to provide an additional helpline.
I thank the Minister for his Answer. Will he say whether the Government consider it satisfactory that serving Armed Forces personnel are currently having, and under current plans will continue to have, to rely on support from the charitable sector for urgent mental health issues which occur outside of Monday to Friday normal office hours? With the very best will in the world, those charities will not have access to the in-house mental health records, know about their situations or the medication that they are taking.
My Lords, there is no point in duplicating a service that already works very well. We work in close partnership with Combat Stress, which provides an extremely effective service, and, if necessary, signposts the individual to the right service according to need. There are helplines available for veterans as well, which we run on a 24-hour basis, but we do not see the need and there is no evidence that we should be looking at duplicating that service.