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Baroness Brinton
Main Page: Baroness Brinton (Liberal Democrat - Life peer)Department Debates - View all Baroness Brinton's debates with the Ministry of Defence
(3 years, 2 months ago)
Lords ChamberMy Lords, I will focus my speech on Clause 8 on the covenant. I support the comments made by the noble Lords, Lord Astor and Lord Browne. The creation of the covenant is a serious and enduring undertaking by Ministers and Parliament on behalf of the people of our nation, who understand the sacrifice that we are asking of those serving and their families when they undertake the obligations of protecting our nation and our interests in the world. It is vital because it also recognises that those sacrifices continue beyond the time that they serve, understanding that many of our veterans and their families also face barriers to living what the rest of us would regard as a normal life.
As health spokesperson for my party from these Benches, I will particularly raise the difficult and sensitive subject of the practicalities of delivering the covenant for access to health services, especially but not only mental health. Over recent weeks, I have talked to family and friends who are current or former service personnel deployed in Afghanistan and Iraq. The recent shocking events in Afghanistan have brought back the most difficult memories and experiences for many of those who made sacrifices for us and, they believe, for the Afghan people. For some, their PTSD has been retriggered; for others, there is a sense of helplessness about whether their deployments and the sacrifice of friends’ lives and health over the past 20 years were worth it.
Our service personnel, being ever practical, always just accept the order to “fill their boots”—service speak for “Go ahead and carry on with the task”—and they do. Here, I give a special shout out to the Sandhurst Sisterhood, which has worked tirelessly using and finding contacts to help senior Afghan women at high risk from the Taliban to get to safety. I mention it because much of the recent publicity has focused on our servicemen and far too often we forget that women were deployed to Afghanistan too. They suffered injury, physical and mental, and some did not come home at all.
The long-term mental health difficulties that many service personnel face are intended to be covered by the covenant, with responsibilities for our clinical commissioning groups, GPs and secondary hospital sector. The Minister, in her usual gracious way, helpfully explained the new duty in this Bill for housing, education and health, but the reality is that this new duty is only to “have due regard”, and without any similar duty for central government it is unlikely to be able to be delivered. It does not put a duty on those public services to actually provide the help that is needed. No duty and, as important, inadequate funding from central government mean that, too often, for individual current or former service men and women the covenant is not being fulfilled.
Combat Stress has said that it has had a doubling in calls to its 24/7 helpline from veterans struggling with their mental health. Its specialist clinics are hearing veterans say, “When we went there, we fought a war. Friends died, we struggled, we got blown up, and now they’ve given the country away.” One veteran, Dean, has attended 13 military funerals since he left the Army in 2008, including eight killed in Afghanistan; the others have subsequently taken their own lives. Dean said:
“it just feels as though it was all for nothing.”
Combat Stress is partnering with the NHS on Op COURAGE, but it struggles to support more than 1,600 veterans with severe complex needs a year. Some 75% of Combat Stress’s funding is from voluntary donations, and it believes that there are at least double the veterans needing this key expert service. We know that NHS mental health services are very stretched with extremely long waiting lists at the moment, so the capacity of local services to provide support is limited without guaranteed extra funding.
This last month has reminded all of us of the long- term problems that too many service men and women face. After Afghanistan moves out of the headlines, the covenant’s specialist health services commitment will probably be needed for the rest of our veterans’ lives. It must be a statutory duty, properly funded, including covering central government, to ensure it is not just lip service. I ask the Minister: what costings have been made for the help support needed under the covenant? Will the Government provide that funding?
Finally, in the debate on Afghanistan in August in your Lordships’ House, I said that the Armed Forces covenant needed to be extended to those who served alongside our troops in Afghanistan. The interpreters and members of the Afghanistan army who have been given the right to resettle here under ARAP stood and fought alongside our troops and faced exactly the same dangers. This group should also be able to access the services under the covenant in the same way.
The covenant is a key part of the duty of care that we owe our service men and women. They have and do fill their boots without question. It is time that Ministers, Parliament and our nation filled our boots to deliver a covenant that really works for the men and women who keep us and our world safe.
Baroness Brinton
Main Page: Baroness Brinton (Liberal Democrat - Life peer)Department Debates - View all Baroness Brinton's debates with the Ministry of Defence
(3 years, 1 month ago)
Grand CommitteeFirst, I want to thank your Lordships for what has been a profound and stimulating discussion. I am conscious that much of the debate has centred on fairly technical legal issues, not least in particular reference to the criminal legal system, both for civilian and service justice systems. I shall do my best to address the issues raised.
By way of preface, in response to points notably made by the noble Lord, Lord Coaker, and the noble Lord, Lord Thomas of Gresford, and echoed by the noble and learned Lord, Lord Thomas of Cwmgiedd, we all want a service justice system that is fit for purpose. I think we are all absolutely united in seeking that objective, and that is exactly what the Bill aims to achieve. That offers me the opportunity to say to your Lordships that much had to move at pace, involving a considerable volume of material. I apologise for that, as I know that you have all been deluged, first with the publication of the Henriques report and then the tabling of government amendments to create the defence serious crime unit.
While I think that these are regarded as very positive developments, I understand that it has put pressure on everybody to try properly to assimilate and understand the report and amendments. I took the view that the amendments did not make a lot of sense without the report, and I had to navigate my way through a fairly tangled jungle of clearances to make sure that we could get both things out into the public domain. I felt that it was important that we did that; it seemed to me that the amendments the Government were then able to table to the Bill in respect of the defence serious crime unit provided reassurance and perhaps answered some of the questions raised today. I think that gives a clear signal of intent about the desire to ensure, as a number of noble Lords have observed this afternoon, that the criminal justice system is absolutely fit for purpose and as good as it can be.
I will now address the amendments in this group. I shall do that beginning with Amendment 5 and then move on to Amendment 6—and then I shall speak to the intention expressed by the noble and gallant Lord, Lord Craig of Radley, to oppose Clause 7. Finally, I shall speak to Amendment 7 in the name of the noble and learned Lord, Lord Morris of Aberavon.
The noble Lord, Lord Coaker, said that there has to be confidence in the justice system, and I totally agree with that. He rightly referred to recent statistics, which are deeply troubling—and I make no pretence about that. As he probably knows, there has been ongoing work in the MoD over the last decade to try to address cultures and behaviour, to provide people who have been treated wrongly—whether it is the victims of unacceptable behaviour or of a criminal offence—with the confidence to come forward, and to try to reassure those within our Armed Forces, not least our women, that this is a good and safe place to be. That has been a Herculean struggle; it has been a huge challenge, and I am not going to pretend otherwise. What I can say is that there has been systematic progress of very good work.
The noble Lord, Lord Coaker, referred to the Commons Select Committee report, in which the MoD very readily engaged—and the Secretary of State took the courageous and absolutely correct decision to allow serving women to appear as witnesses before the committee. I thought he was absolutely right to do that, as it is the only way in which we can get evidence out into the open. Very troubling evidence was heard, and some of it was utterly appalling. What I drew comfort from was that, to the end, a very high percentage of the women who gave evidence said that they would recommend a career in the Armed Forces to other women. I felt encouraged by that. There was recognition that, while unacceptable practices and attitudes have existed in the past, there is a discernible recognition that the direction has changed.
In relation to the stats to which the noble Lord, Lord Coaker, referred, they are troubling, but they do tell us that people are now coming forward. One problem that we had was that people would not come forward; they did not have the confidence to do that—and that to me strikes at the very heart of the probity and integrity of, and the confidence that people should rightly have in, the system.
We have been and are reforming the service complaints system. A huge amount of work has been done among the single services to that end.
My Lords, it might help if everybody knew that the noble Baroness, Lady Brinton, who is intending to participate remotely in the next group, has just arrived. There is possibly a little technical adjustment to be made so that she does not find herself inadvertently speaking in the wrong debate.
My Lords, I first apologise for the technical glitch. This is the first week of new remote contributions to Grand Committee. It is such a shame that we always notice the problems rather than the vast majority of smooth remote contributions. I pay credit to all the staff involved in helping those of us who are disabled Peers and can attend only remotely at present.
I commend the Minister for the principles behind the Armed Forces covenant, which are an admirable start to providing that morally binding commitment to current and past service men and women. But frankly, as these amendments seek to point out, it is somewhat patchy at the moment on the services that current and former service men and women would be able to access. Why is one function included and another excluded, when the barriers to accessing services are exactly what the covenant is trying to resolve?
Amendments 8 and 10, to which I have added my name, would add a number of functions to the relevant functions listed under proposed new Sections 343AA and 343AB. Amendment 13, to which I have also added my name, addresses how the Bill can widen the scope to other forms of potential disadvantage for service personnel under the Armed Forces covenant, including employment, pensions, compensation, social care, criminal justice and immigration. The noble Lord, Lord Coaker, has addressed very ably why this is needed, so I want to focus briefly on access to social care as one illustration.
The covenant already recognises that health is a vital service, where serving personnel and veterans can face particular problems, but social care—whether for the serving person or veteran, or for a member of their immediate family—is not. While social care is commissioned by local authorities it can, due to the circumstances of the individual, often involve a number of bodies. Some are within central government, for example on disability benefits; some are public bodies, for example health and local authorities; but some are also private, such as for those who are given a personal budget and will purchase their personal care that way. It can be very difficult and messy to navigate if you are new to it or have had to move.
Let me give an example to illustrate this point. Serving families with a severely disabled child have found it extraordinarily difficult when moving from one posting to another to transfer their child’s essential social care support, without falling off the bureaucratic cliff and having to go through reassessments in their new area, then waiting for the reports from those assessments. No services were given at all, so all help was denied them until the end of this new process. The child’s needs had not changed; their serving parent had merely been posted elsewhere. To be clear, this is not just a bit of social support every now and then. Disabled children, like the one I am describing, may have severe epilepsy or be fed with a tube, or be on ventilators some or all of the time. The help of carers at home supports the unpaid parent carer, who is already on duty pretty well 24/7.
Shockingly, the consequences of not having that help mean that a child might even be taken into care and away from their parents, not because the parents cannot cope but because one of them has been posted elsewhere. Adding social care to the covenant would protect the family and prioritise the ways of continuing the help that they are getting, when the move has made the difficulties entirely apparent.
For service men and women, and veterans, the complexities about access to services if they have mental health problems can be just as acute. Too often, we think of mental health as solely the domain of the NHS and those specialist charities such as Combat Stress, which I have been working with. The reality is that severe mental health problems disproportionately affect access to every part of the individual’s life, including discrimination in employment, access to criminal justice and compensation, and even to pensions, as well as social care. If the principles of the Armed Forces covenant are to ensure the well-being and support for current and former Armed Forces personnel, surely it cannot be possible for certain parts of the public sector to ignore it.
This amendment again applies to the covenant. I thank the noble and learned Lord, Lord Mackay, and the noble Baronesses, Lady Brinton and Lady Smith, for their support on this amendment. It seeks to extend the application of the covenant to central government. Using the test that I always use, I think people would expect that to be the case, but no doubt we will hear from the Minister why the Government seem to be resistant to it.
We all believe that the Armed Forces covenant represents a binding moral commitment between government and service communities, guaranteeing them and their families the respect and fair treatment that their service has earned. The Bill creates new responsibilities for a wide range of public bodies, from school governors to local authorities, to deliver the covenant, yet central government is not included. Amendment 9 seeks to change that. In practice, without it, we would create a situation, which I think sounds farcical, in which a chair of school governors, for example—and you can make other examples up—has a legal responsibility to have due regard to the Armed Forces covenant, but government departments, including the Ministry of Defence, do not. I find that really strange, to be frank.
As the Royal British Legion has pointed out, many of the policy areas in which members of the Armed Forces community experience difficulty are the responsibility of national government or based on national guidance. As the noble and learned Lord, Lord Mackay, said at Second Reading, it is
“questionable whether it will be successful without incorporating central government, with its policy responsibilities,”—[Official Report, 7/9/2021; col. 742.]
into the Bill. The British Medical Association has called on the Government to
“expand the ‘specified persons and bodies’ section under clause 8 of the bill to include … Her Majesty’s Government and Secretaries of State with responsibility for the functions specified within the bill.”
Giving evidence to the Bill Select Committee, General Sir John McColl of Cobseo said:
“I do think that there is a strong argument for the inclusion of central Government functions … At the moment, the central Government traction that we have is that there is a moral requirement for Government to comply with the Covenant. That is fine as long as it works, but in some cases it absolutely does not work.”
It should be a part of this Bill, in primary legislation.
The MoD has said, in defence of not including central government in the Bill, that it was already in many ways subject to a duty of regard to the covenant. Personally, I do not think that is enough; it is insufficient. Central government should be included in the Bill. The Bill Select Committee report said:
“The Committee notes that by excluding central government as a responsible public body, Service accommodation is not covered by the duty of due regard. The Government may wish to consider adding this as an area where the duty applies in the future.”
Again, that is just one example of the Bill Select Committee looking at this and giving a practical example of what happens if central government is not included in the Bill. With those remarks, I will leave it there. I look forward to the Minister’s response, and I beg to move.
My Lords, I have added my name to Amendment 9. As the noble Lord, Lord Coaker, has already said, at Second Reading a number of noble Lords, including me, raised the fundamental problem with the Armed Forces covenant. While local authorities and other public bodies offering key services are listed, there is one glaring omission: central government is not required to have due regard to the covenant, and the noble Lord has just ably explained why that is such a contradiction.
The Government need to understand that in creating the covenant they have created demand and expectation. To use the closing comments by the noble Lord, Lord Coaker, from the previous group on my Amendment 64, if you asked anyone outside the Bill they would think that the Government were already included. That service accommodation is not included is a helpful pointer to why the Government need to reconsider.
Without the same responsibilities for central government and its services to provide the covenant, frankly it is nothing more than warm words. I am sure there are plenty of arguments to say that it should, and probably will, be covered by different parts of government services, but the point is that the amendment can remedy that. The amendment would go further than the Government want to at the moment, but if the Government do not accept that they need to have the same responsibilities as other bodies, frankly they are not truly committed to delivering the covenant.
The police covenant being proposed at the moment in the Police, Crime, Sentencing and Courts Bill has this same lack of responsibility for central government while imposing it on other bodies. I have to say that it is beginning to look a bit worrying.
Baroness Brinton
Main Page: Baroness Brinton (Liberal Democrat - Life peer)Department Debates - View all Baroness Brinton's debates with the Ministry of Defence
(3 years ago)
Grand CommitteeMy Lords, in moving Amendment 48 I will speak also to Amendment 66A, both of which stand in my name and those of other noble and noble and gallant Lords.
I will address Amendment 66A first. Noble Lords will recall that a very similar amendment was tabled and debated during the passage of the recent overseas operations Bill in the previous Session of Parliament. Then and now, the amendment seeks to require the Ministry of Defence to identify a new duty of care to create a new standard for policy, services and training in relation to legal, pastoral and mental health support provided to service personnel, and to include a duty of care update in the Armed Forces covenant annual report.
Noble Lords will recall that our House divided twice on this issue, but the measure was overturned in the other place. In the interests of not losing the whole overseas operations Bill, the amendment was not pressed a final time. In concluding our previous debate on this subject, the Minister stated that perhaps the Armed Forces Bill was
“a more appropriate mechanism for any discussion of the wider duty of care owed to our people.”—[Official Report, 13/4/21; col. 1257.]
It is perhaps therefore no surprise that I am returning to this topic now, although I do not want to take undue time by rehearsing all the arguments made in our previous debate, the majority of which still stand.
That said, I am very aware that the Ministry of Defence has been working hard on duty of care related issues in recent months and I am sure that many serving personnel will already be benefiting from that work. However, the Minister for Defence Personnel and Veterans in the other place, during a debate on the duty of care amendment in the context of the overseas operations Bill, said that he wished to ensure that our care provided was at a gold standard. So I would be very grateful if the noble Baroness the Minister could update your Lordships on progress towards reaching this gold standard.
The initial impetus for Amendment 48 came in the aftermath of Operation Pitting as the final withdrawal from Afghanistan took place—but Op Pitting was only the most recent episode in a long series of operational settings that have put pressure on the mental health of our servicepeople. As with the duty of care issue, I am aware that the Ministry of Defence has been working hard on mental health matters. Nevertheless, I ask whether the Government’s recent mental health MoT announcement will include specialist support for personnel who have been affected by the withdrawal from Afghanistan. Indeed, could the Minister comment on what specialist mental health support has been offered to personnel involved in Operation Pitting?
Among the welcome recent initiatives, in October the Government announced the new annual mental fitness brief for UK Armed Forces. This is to be welcomed. The press release said it would be:
“Available on Defence’s internal learning platform”.
Can the Minister confirm whether face-to-face support will also be offered as part of this?
Very sadly, the tragic end of the mental health spectrum is the death by suicide of both serving and veteran members of the Armed Forces. In October the Armed Forces Minister said that the Office for Veterans’ Affairs had looked at how the frequency of suicide within the veteran community could best be measured and had identified a robust methodology. Can the noble Baroness explain this new methodology today? What frequency rate has been identified?
Furthermore, I was informed by the previous Veterans Minister that a new study was being undertaken to identify the rate of suicides among serving and veteran members of the Armed Forces. Previously, studies have been based on data from the first Gulf War and the Balkans, but the intensity of recent campaigns more than justified a new study. Can the noble Baroness say whether that new study has been completed? If so, what did it reveal? I am not alone in believing that recent operations have led to a tragic upturn in the suicide rate.
While commending the recent improvements in mental health provision, I believe that more can be done. I look forward to hearing the noble Baroness’s response later. I beg to move.
My Lords, I have added my name to Amendment 48. As we heard from the noble Lord, Lord Dannatt, it aims to improve mental health services and to provide additional support for serving personnel, particularly those affected by the United Kingdom’s withdrawal and the Taliban takeover in Afghanistan this year. I also support the other two amendments in this group, Amendments 60 and 66A.
At Second Reading I highlighted Operation Courage, a partnership between the NHS and Combat Stress and other mental health charities, whether Armed Forces-specific charities or local or specific mental health charities. In principle, Op Courage is a really good example of how mental health services for current serving personnel or veterans should be able to provide a strong, signposted short cut to mental health services when and where they are needed.
Combat Stress reports that during August it saw a doubling of calls to its 24/7 helpline. This was on top of already struggling to afford to offer its specialist treatment to around 1,600 veterans with complex mental health needs annually. It estimates that there are at least double that number out there who Combat Stress cannot afford to support.
As a charity, Combat Stress is currently 75% dependent on voluntary donations and the generosity of the public. I think we all know that donations to charities have significantly reduced during the pandemic. I have no doubt that with extra resources it and the other specialist mental health charities can deliver the services needed, because they understand the specific pressures facing serving personnel and the traumas that too many have to learn to live with, both during and after their terms of service.
Leo Docherty MP wrote to all MPs and Peers on 24 September, setting out the support available for service personnel and veterans, their families and the bereaved, should they need it. It was a helpful and informative letter, but it did not refer to when the further £2.7 million will be made available for Op Courage. Does the Minister have that detail available? Is it for spending in a particular period, or does it extend over more than one financial year?
The letter from Leo Docherty did not mention one welcome intervention in recent years: the training of mental health first-aiders in our Armed Forces. The mental health first-aid charity MHFA England says:
“In 2015/16, 3.2% of UK armed forces personnel were assessed with a mental health disorder—over 6,000 people. Many more go undiagnosed and untreated.”
When I have talked to service personnel who have become mental health first-aiders since their return from deployment in Afghanistan, I have heard of how the training that they received enabled them to recognise the warning signs this summer in those they currently serve with, as well as past comrades. One soldier told me that, in August, the community of personnel was able to come together on social media to support and encourage those reliving tough memories or, worse, flare-ups of PTSD. Because of their mental health first-aid training, they were able to help these colleagues to access phone lines—for example, to Combat Stress and other organisations.
How many Armed Forces mental health first-aiders are now in place? Will the extra funding announced in September include training for more mental health first-aiders in the future? Also, can the Minister explain how Op Smart, which was designed to develop mental resilience across personnel in the Armed Forces, sits with Op Courage? Op Smart is much to be welcomed, and is critical to personnel becoming not just self-aware but aware when colleagues may be facing problems. How is Op Smart, and specifically the mental health first-aider programme, funded? The last part of Amendment 48 talks about collecting data. It would be very beneficial to see data on all these issues, including, as the noble Lord, Lord Dannatt, said, on suicide. Can we find such data now? If not, will it be collected and, as the amendment says, included in the annual covenant report?
I return to the extra £2.7 million of funding. Many current and former service personnel who served in Afghanistan and elsewhere, and are currently reliving their traumas, need to access NHS mental health services, including crisis care, right now. Unsurprisingly, these services are facing extraordinary pressure already. The NHS Providers activity trackers show that, for October 2021, referrals remain 10% higher than pre-pandemic levels, with many people having to wait significantly longer than the 18-week target time for their first contact.
In July, NHS England proposed setting new mental health access service standards, working in conjunction with Mind, the mental health charity, and Rethink Mental Illness. The new urgent care proposals would mean that community mental health crisis teams could reach patients within 24 hours of referral. The other key target for mental health liaison teams linked with A&E departments would also be rolled out across the rest of England. Detail on the actual level of funding to deliver this new target is still awaited. For this Bill, I am particularly interested in how all this will fit in with Op Courage. Perhaps the Minister can help me; if she does not have that information at her fingertips, could she write to me afterwards?
This amendment seeks urgent, extra, specific support for Op Courage—and, I hope, for Op Smart too—to ensure that all those people who are serving, or have served, their country do not fall through the net when they need mental health services.
My Lords, I declare my interest as a vice-chair of Peers for Gambling Reform. I rise to speak to Amendment 60 in my name. I tabled it because I am concerned that the Ministry of Defence is not taking gambling-related harm in the military community sufficiently seriously. On two occasions in response to my concerns in this area, the Ministry of Defence has stated that it has seen no evidence, or does not hold information, suggesting that serving personnel are more prone to problem gambling than any other group in society.
At the same time, it was disappointing to hear that evidence from the United States that suggested that serving personnel were more prone to problem gambling did not constitute an evidence base for the UK Armed Forces. This leaves us with a clear impasse, where the Government refuse to accept research from abroad but, at the same time, do not commit to researching whether there is a problem.