Army Size

Dan Poulter Excerpts

Tuesday 5th July 2022 Westminster Hall

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

I beg to move,

That this House has considered the size of the British Army.

It is a great pleasure to serve under your chairmanship, Mr Davies. The subject of this debate is more relevant this week than many others. After the NATO summit in Madrid, at which the Secretary-General called for a “fundamental shift” in the alliance’s deterrence and defence, there is an increasing realisation that British defence policy needs some urgent updating. When Russia began its bloody and brutal invasion of Ukraine, the world changed. Not only is it the largest armed conflict since world war two, but the rules and norms that govern war are being torn up daily by the Kremlin. Today, all our thoughts and prayers are with the families of those killed and injured in the barbaric attack on the supermarket in Kremenchuk, and with the people of Ukraine as they face even more hostilities.

What should UK defence policy look like in the face of this new geopolitical reality? The answer is an approach that reflects the new world we live in, where alongside our friends in Europe, we take more responsibility for our own defence and that of our allies across the world. There is plenty in the integrated review and the defence Command Paper that I agree with: clearly, the Army must modernise, and the £24 billion that will be spent on emerging technology will help us tackle new types of threats. However, the lesson from Russia’s invasion is that we cannot continue to slim down the size of our Army. We must be clear-headed and steely-eyed when it comes to assessing the threat we face from Vladimir Putin. That means a renewed commitment to our conventional military capability and an end to cuts.

[Dr Dan Poulter (Central Suffolk and North Ipswich) (Con)]

I congratulate the hon. Gentleman on securing the debate. I agree with much of what he has said and, I am sure, what he is about to say. Does he agree that one thing we are going to have to look at much more seriously now is putting more boots on the ground in other NATO countries, particularly those in the eastern parts of Europe that face towards Russia?

[Mr Sheerman]

I totally agree. I got into some trouble in certain quarters when I said that early on in the conflict; it was not something people wanted to hear at the time.

The Minister will know that I have consistently challenged the Government on this issue—I have form. Over the past 10 years, I have warned against cuts to the size of the Army. In 2013, I said that cuts to capacity would seriously restrict the ability of our country to defend itself. At the time, with the number of armed personnel at around 140,000, I felt as though we were retreating from being a significant player in the western alliance. In 2016, that number went down to 100,000, and there I was in the House, warning the Government that their course of action simply was not the right one. We now face the grim reality of soon having a limited capacity of 72,000 armed personnel. The fact of the matter is that those numbers are nowhere near good enough for a key player in NATO. As the Minister knows, I usually engage in constructive criticism, but it is crystal clear that the Government have their heads in the sand on this issue—or more specifically, the Prime Minister does.

Veteran Suicide

Dan Poulter Excerpts

Wednesday 3rd April 2019 Westminster Hall

[Dr Dan Poulter (Central Suffolk and North Ipswich) (Con)]

It is a pleasure to serve under your chairmanship, Sir Henry. I pay tribute to the hon. Member for Portsmouth South (Stephen Morgan) for securing this debate. I agree with much of what he said. He is right to say that, historically, there has been a disconnect between what the MOD and the NHS do in providing better care for veterans. When I was a Health Minister, I worked with the then Minister of State for Defence, my right hon. Friend the Member for Rayleigh and Wickford (Mr Francois), to improve mental health support, first aid training and other support and help available to armed services families. We also worked to support the MOD in better tracking veterans immediately after discharge from the services. I entirely agree with the point the hon. Gentleman made about one year not being enough.

To put the debate in context—it is important that we have the right evidence and data to support the making of informed decisions about veterans’ care—overall suicide rates for those serving in the armed forces are low, with the exception of males in the Army aged between 16 and 19. Evidence suggests that elevated suicide rates among 16 to 19-year-olds are related to issues such as Deepcut-type events and difficulties adjusting to life in the armed forces, as opposed to being deployment-related.

In the US, veteran suicide rates are definitely higher than population suicide rates, but just as in the UK, and perhaps surprisingly, they do not appear to be deployment-related, and there is much speculation as to why higher rates of suicide are experienced by US veterans, as compared with UK veterans.

[Bob Stewart]

Soldiers who are between 16 and 19 can deploy on operations only for two of those years. I totally understand that there will be other reasons involved, but soldiers cannot go on operations until they are 18 years old.

[Dr Poulter]

I defer to my hon. Friend’s considerable experience as a long-standing and distinguished soldier with a long-standing and distinguished record of service in our armed forces. I had the pleasure of serving in the NHS with a number of Ministry of Defence or armed forces doctors. I certainly know that they pay particular attention to these issues now, and the MOD has put a lot more into the training and support available to their doctors to better support veterans.

We have good data on suicide rates among Falklands veterans and veterans from the 1991 Gulf war. There is no evidence to suggest that the rates of suicide among that group of veterans are any higher than those in the rest of the armed forces; in fact, there is evidence that the rate of suicide among those groups is lower than expected population rates.

We do not have reliable evidence for the more recent Iraq and Afghan conflicts—the hon. Gentleman alluded to that in his remarks. There is a lot of anecdotal evidence and evidence emerging from coroners’ reports, but anecdote is not hard evidence. We need to work much harder on that to ensure that we have the hard evidence to make the right decisions.

In terms of gathering that hard data, the announcement by the Minister, my right hon. Friend the Member for Bournemouth East (Mr Ellwood), that the MOD has agreed to carry out definitive research by tagging all those who have served in Telic and Herrick is very much to be welcomed. That work is starting with defence statistics, but it is difficult to know how and when it will be completed—these days, it is challenging and bureaucratic to get data out of the Office for National Statistics, and that is hampered by general data protection regulation issues. However, the work that Professor Simon Wessely and his team at the Institute of Psychiatry, Psychology and Neuroscience are doing with the MOD will happen and should give us the answer. Hopefully it will build a strong evidence base for improving veterans’ care in future.

Finally, we need better to join up what happens when veterans leave the Army and register with the NHS. The current situation is not right, and we need to improve it. The MOD should compulsorily register veterans with civilian healthcare services when they are discharged from the armed services. To my knowledge, that does not happen, but it should happen routinely, because it would help serving men and women transition back into civilian life. It would also flag up to GPs that somebody is a veteran and has a serving record.

It is important that we get the data right. Anything that the Minister can do to help with the issues surrounding GDPR, make the ONS data more speedily available for population-based comparisons and support the work of Professor Simon Wessely and the IoPPN, would be greatly welcome.

Oral Answers to Questions

Dan Poulter Excerpts

Monday 12th May 2014 Commons Chamber

[Heidi Alexander]

One person’s definition of “essential” might not be the same as that of another person.

The Lords amendment tinkers at the edges of clause 119. Although it offers some marginal improvement on the Government’s original clause, it does not go far enough. I would vote for deletion again if I could, but parliamentary procedure does not afford me that opportunity. There is no doubt in my mind that this clause, even with the latest amendment, will allow more fast-track hospital closures in future. It removes the protection that existed in law, which allowed Lewisham council and the Save Lewisham Hospital campaign to take a case against the Government and win.

The latest amendment may guarantee another layer of consultation, but it contains no overall guarantee that services will not be closed at successful hospitals to balance the books elsewhere. Is the Minister or the right hon. Member for Sutton and Cheam able to say unequivocally that had this amended clause been on the statute book at the time of the TSA regime in south London, the future of Lewisham’s A and E and maternity service would have been secure? They cannot, because it is not the case.

In conclusion, I do not accept that their lordships’ amendment provides the protection that some believe it provides. The amended clause still extends and augments powers for TSAs and NHS bureaucrats. Even with the increased checks and balances contained within their lordships’ amendments, the TSA process is still a chaotic and rushed mechanism for closing hospital services. It plunges local health economies into desperate uncertainty and takes power away from the public and clinicians.

I do not believe this is the way to make the sorts of changes our health service requires to meet the challenges of the 21st century. I have maintained that position throughout the passage of the Bill and I make no apology for sticking to my convictions to the end. The public do not want more fast-tracked hospital closures, but this Bill legislates for them.

[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

Before I turn to the amendments, I want to put on record my thanks to hon. Members for their contributions to today’s debate. I also want to express my thanks once again for all the contributions made by hon. and right hon. Members throughout the passage of the Care Bill and, indeed, for the contributions made by noble Members of the other place.

The hon. Member for Lewisham East (Heidi Alexander) made a characteristically robust contribution in standing up for her local health care services. I also pay tribute once again to the contribution made by my right hon. Friend the Member for Sutton and Cheam (Paul Burstow), not only today, but at the Bill’s inception, during its scrutiny by the Joint Committee and throughout its passage through this House and the other place. He has done a tremendous amount of work to ensure that the Bill is much better than it used to be. He deserves considerable praise for what he has done and the help he has given the Government in securing a Bill that is not just fit for purpose, but which will make significant changes and improvements to our health care system.

It is worth bearing in mind that the Bill represents the most significant reform of care and support in more than 60 years, putting people and their carers in control of their care and support for the first time. The Bill will also put a limit on the amount that anyone will have to pay towards the costs of their care. It is a very big step forward and one that was long overdue. The Bill also delivers key elements of this Government’s response to the terrible events that took place in Mid Staffordshire and the recommendations of the Francis report by increasing transparency and openness and helping to drive up the quality of care across our NHS and social care system. I am pleased that the Government were able to table amendments that have been accepted in the other place, and I hope that those amendments will enjoy support in this House today.

Before I turn to the substantive amendments tabled by the hon. Member for Copeland (Mr Reed), I want briefly to address the points made about human rights legislation and the issue of direct payments. It is important to highlight that like clause 48 of the Bill, as originally drafted, and section 145 of the Health and Social Care Act 2008, which was the preceding provision, Lords amendment 11B relates to providers of social care registered with the Care Quality Commission, covering personal care provided at home and in residential care settings. The amendment covers physical assistance—for example, prompting someone to take their medication, dress, eat, drink and perform activities of daily living—but not non-personal care. To answer the question asked by my right hon. Friend the Member for Sutton and Cheam, I am happy to confirm that when self-funders start to receive support from the local authority, they will indeed be covered by the Human Rights Act 1998.

To turn to the amendments tabled by the hon. Member for Copeland, it is worth highlighting to the House that, contrary to what he asserted, the TSA regime—let us remember that the regime was laid down by the previous Labour Government—has been substantively improved by the amendments made to the Bill. In particular, clause 118, which has been debated as clause 119 at various points, will extend the requirements on the trust special administrator to consult not just the public, staff of the failing trust and its commissioners, but other provider trusts, their staff and their commissioners, local authorities and local healthwatch organisations. There is therefore a comprehensive duty of consultation and engagement in the TSA regime, and that will be further strengthened by the amendments we are now discussing.

Amendment (a) to Lords amendment 40B and amendment (c) to Lords 40C amount to wrecking amendments and, as I shall outline, amendment (b) to Lords amendment 40B is unnecessary and unworkable. Amendment (a) to Lords amendment 40B and amendment (c) to Lords 40C would mean that the recommendations of a trust special administrator could not restrict access to any services of another affected trust. Like previous ones, they are in effect wrecking amendments that would make it impossible for the administrator to do their job.

Both Houses recognise that the NHS is a network and that no hospital is an island, and have already agreed that clause 118 must allow the administrator to take a holistic view of the local health and care economy to find the very best solution for a failing trust. That is of course in the best interests of local patients. As my right hon. Friend the Member for Sutton and Cheam outlined in Committee, it is right that a trust and its patients in particular are not thrown to the wolves when the quality of care is unsustainable or letting patients down, but that a holistic and broader view of the local health care economy can be taken. That was the previous Government’s intention in setting up the TSA regime, and it is our intention now. The previous Government were not the first Government who did not necessarily make their legislation accord perfectly with the intentions they outlined in impact assessments for the TSA regime. That is why we are now in the position of having to correct and improve the regime through the Bill.

The amendments tabled by the hon. Member for Copeland would undo the effects in relation to the trust special administrator’s regard to the wider health economy, and they would reverse the effect of clause 118, such that the administration regime would not be able to create a complete and workable solution to intractable problems or failures of patient care in the NHS. I am sure hon. Members will agree that that would be entirely undesirable, and that it would not be in the best interests of NHS patients, who must be protected where a hospital cannot deliver safe or sustainable care.

Amendment (b) to Lords amendment 40B would give the trust special administrator significantly less time to finalise his or her draft recommendations about the future of a failing trust by requiring the publication of all correspondence between the administrator and commissioners at least 10 working days before publication of the draft report. Hon. Members will be aware that we have extended the time for the trust special administrator to draw up the report from 45 to 65 days and for the consultation from 30 to 40 days, because those processes need to be done properly.

I remind hon. Members that transparency is already built into such processes at every stage. The administrator is required to publish the draft report submitted to Monitor and is expected to include in it the commissioners’ statement in agreement or disagreement to the report. Following consultation, the administrator’s final report is submitted to Monitor for a decision. That report, which Monitor must publish and lay before Parliament, again needs to present to the regulator the views of all affected commissioners. The administrator is required to attach to the final report a summary of all responses to its draft report that were received during the statutory consultation. That would include the views of all affected commissioners as respondents and explain what consideration was given to those responses. There is full transparency at every stage of the process. Quite apart from being wrecking amendments, the Labour amendments are therefore completely unnecessary.

[Liz Kendall (Leicester West) (Lab)]

Wrecking amendments? They are saving you from yourselves!

[Dr Poulter]

The administrator, working closely with all affected commissioners and providers, may need to communicate in writing in the 10 working days before the draft report is published and submitted. Amendment (b) would therefore significantly reduce the time available to the administrator to develop and finalise the draft report and seek commissioners’ agreement. The hon. Member for Copeland said that he was concerned about that process, but his amendment would make it more difficult.

Clause 118 will extend the time that is available to the TSA to develop the draft report. Amendment (b) would reverse that. That is irrational, undesirable and goes against the very point the hon. Member for Copeland made about having time to consider the best interests of commissioners and the local health economy. I thought that that was an unintended and unwanted consequence of the amendment, but having heard the comments of the hon. Member for Leicester West (Liz Kendall), I am not so sure. However, I hope that the hon. Gentleman will not press the amendments.

In conclusion, the Government are committed to a TSA regime that is workable, transparent and in the best interests of patients. In cases of exceptional and significant care failure, lives are put at risk if a problem is not dealt with swiftly and effectively. It is for that reason that we are strengthening the regime in the Bill. I am very proud of the Bill and the opportunity that it offers to improve the health of and, the quality of care for, many people, particularly the frail elderly, those with disabilities and those with long-term care needs. It represents the most important step forward in integrating and better joining together health and social care for well over a generation. I hope that hon. Friends and hon. Members will support the Bill and the amendments that have been made to it.

Question put and agreed to.

Lords amendments 11B and 11C in lieu of words left out by Commons amendment 11 agreed to..

Lords amendment 32A to Commons amendment 32 and consequential Lords amendments 32C and 32D agreed to.

Clause 118

Powers of administrator etc.

Amendment (a) proposed to Lords amendment 40B.—(Mr Jamie Reed.)

Question put, That the amendment be made.

Oral Answers to Questions

Dan Poulter Excerpts

Monday 14th March 2011 Commons Chamber

[Dr Fox]

Decisions on the footprint of the United Kingdom’s armed forces are made primarily on the basis of military effectiveness. However, notwithstanding the level of cuts that must be made in order to balance the books, I personally ascribe great importance to maintaining a footprint throughout the Union. [Interruption.] What we are hearing is a very boring record. The difference between the main parties and the nationalists in the House is that we believe in maintaining a footprint throughout the Union, whereas they do not believe in having UK armed forces at all.

[Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con)]

T10. I am sure that the Minister will agree that while our British forces are in Afghanistan, it is important for them to contribute to the development of a strong humanitarian legacy of basic health care, education and clean drinking water for the people of Afghanistan. What steps is his Department taking, in conjunction with the Department for International Development, to help to secure that legacy?

[Dr Fox]

We work very closely with DFID on all those issues. As my hon. Friend correctly implies, if we are to have a sustainable legacy in Afghanistan, it cannot simply involve the strength of the armed forces or the police; there must also be strong governance and a strong infrastructure.

Oral Answers to Questions

Dan Poulter Excerpts

Monday 8th November 2010 Commons Chamber

[Dr Fox]

No.

[Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con)]

T10. Aid agencies in Afghanistan have expressed concern that offering cash rewards in exchange for information puts Afghans, their families and their communities at risk from anti-Government groups. Can the Minister assure me that this practice is not being followed by British commanders?

[The Minister for the Armed Forces (Nick Harvey)]

In operations in the environment of Afghanistan, our forces must of course work in co-operation with both Afghan authorities and local people to obtain information that is essential to the security of our personnel and others working in the international security assistance force. I am aware that any form of co-operation with ISAF may put people in danger of reprisals, but clearly we rely heavily on such information.