Armed Forces: Post-service Welfare

Lord Craig of Radley Excerpts

Thursday 27th January 2011 Lords Chamber

[Lord Craig of Radley]

My Lords, I congratulate the noble Lord, Lord King, on his choice of this topic. Much has changed and is still changing in the support and needs of military veterans. As I will describe, their expectations of support have changed greatly over the years. When I was commissioned into the Royal Air Force 60 years ago, the strength of the three Armed Forces was approaching 700,000—almost 10 times what we shall have as a result of the recent defence review—and the medical and dental services were scaled to match those numbers. In the 1950s, with many service hospitals in this country and overseas, it was normal for most of the clinical needs of veterans and their families to be met by the medical branches of the services. The NHS was in its infancy. The veterans—largely from the First and Second World Wars—would on average have been in their fifties or in their thirties, so few of that large number of veterans were yet senior citizens, with the illnesses and disabilities more associated with old age.

By the 1970s, with the end of national service and the much reduced size of the three services, a major review of the clinical support required for the Armed Forces led to the closure of a number of service hospitals and much reduced staffing of the medical branches. It was no longer feasible, except in overseas locations, to provide medical and dental care for families or any veterans, many of whom felt very let down as a result. However, the National Health Service, by then well established, was there to provide medical care to veterans and their families, so it was wrong for the Armed Forces medical branches, at a cost to the defence vote, to double up on what could be provided by the NHS.

By the 1990s, most of the veterans of World War One had died and the age of the majority of veterans had risen to the sixties and seventies. Life expectancy was greater than before, with more likelihood of illness due to increasing years. To the World War Two number could be added those who had done national service or who had been involved in the many insurgencies and other conflicts of the latter half of that century. More recently, we have had the casualties and veterans of conflicts in the Falklands, the Gulf, Iraq and Afghanistan. Advances in medical care have seen the lives of many casualties of these most recent conflicts saved, but many will need continuous support for the rest of their lives.

A number of government responses have been made to these developments, such as: numerous ministerial Statements about the need to do more; the previous Government’s Command Paper The National Commitment: Cross-Government Support to our Armed Forces, their Families and Veterans; the introduction of a Minister in the MoD with specific responsibility for veterans; the setting up of a dedicated veterans agency; and improvements in the immediate medical support and care of veterans who had been injured and have not yet left their service at Birmingham Queen Elizabeth Hospital near Selly Oak, Headley Court and elsewhere.

Backing up these efforts have been the activities and commitment of the service charities—I declare an interest as an officeholder in a number of these charities, as in my declaration of interests—which have, as always, been very proactive in the interests of veterans. Noble Lords should be aware of the Confederation of British Service and Ex-Service Organisations, whose membership consists of about 180 service and ex-service organisations, including 65 regimental associations. I should like to pay tribute to the able leadership of COBSEO’s current chairman, Air Vice-Marshal Tony Stables, who has done much to motivate and co-ordinate the work of the organisation’s membership in their help and support for veterans. He has been instrumental in winning lottery funding support for the Forces in Mind programme.

However, healthcare provision is but one of the potential needs of veterans, and poor psychiatric health is often associated with other problems of housing, welfare and finance. Important though the support and generosity of the service charities is, it is wrong for the Government to be overreliant on this sector. All should agree that the support of veterans—particularly those who have been injured physically or mentally in the course of their service for the Crown—is primarily the duty of Government. The current arrangements, while an improvement on what went before, still need further restructuring. The MoD, of course, has responsibility for the care and support of servicemen and women who are still on the active list, but with their transition to retired veterans, the link between them and the MoD is weakened and, with the passage of time, can be broken.

In the United States—admittedly with a much larger corps of veterans—a distinct and separate state department bears responsibility for veterans’ affairs and is not an adjunct of the Department of Defense. Inevitably, inside our MoD there are bound to be conflicting pressures for resources and the needs of veterans, whether in pensions, compensation, health or other support, cannot be given the priority that is necessary to care for them properly. Building on the structure of Cm 7424 and its external reference group chaired by the Cabinet Office, could we not have a Minister for Senior Veterans, with the appropriate support and budget within the Cabinet Office? I fear that it is all too clear that the present MoD’s Minister with responsibility for veterans—this is not a personal criticism—is dismissive and given to writing bleak letters of blank refusal to any and every suggestion from members of COBSEO. Of course the financial situation does not make matters easy, but surely this is a transitory problem so far as veterans and their interests are concerned. Some indication that, as the economy recovers, there will be a proactive approach by Government to meeting the long-term support requirements of veterans would be welcome.

With the average length of life increasing, the skills of modern medicine and surgery and the recognition that there will be some without physical signs of disablement who are nevertheless afflicted with mental illness arising from their experiences in operations, there are going to be veterans spread across the length and breadth of the country who will need ongoing medical and other attention. If the Government are serious in their stated intention to do better for veterans—the ones who fought at risk to their lives, but lived through the conflicts—a new approach at senior ministerial level with the right proactive support for veterans’ needs should be found.