Veterans Strategy

Earl Howe Excerpts

Thursday 15th November 2018 Lords Chamber

[The Minister of State, Ministry of Defence (Earl Howe) (Con)]

My Lords, it is a remarkable and heart-warming feature of your Lordships’ House that across all Benches and shades of political opinion, we find ourselves in almost total unison on the theme so ably introduced by my noble friend Lord Attlee on the obligation that we have as a society to ensure the welfare and well- being of our Armed Forces veterans. The recent commemorations marking the centenary of the Armistice have brought this message into even sharper focus, and while in this country we have a long and proud history of supporting those who have stepped up to protect and defend us, it is morally right that we should continue delivering that support in the best possible way and, where we can, look to do more.

It is against that background that the Government published yesterday The Strategy for our Veterans, a long-term, 10-year vision that outlines what we aim to do to ensure that each and every man and woman who is leaving, or has left, one of our Armed Services feels they are “Valued, Contributing, Supported” in leading a fulfilling and rewarding life.

Much has been done in recent years in pursuit of that end, but the publication of the strategy marks the first time that Governments across the United Kingdom have come together to articulate a joint statement of strategic intent, setting out in clear terms the tangible outcomes we wish to achieve for veterans’ services along with the vision and the principles that will underpin them. Those outcomes, and that vision, are the product of wide consultation with academia, veterans themselves and many of our excellent service charities—the Royal British Legion, SSAFA, Help for Heroes, Cobseo, Combat Stress, Veterans Scotland and others—as well as the three service benevolent funds and the three service families funds.

We estimate that there are some 2.5 million veterans in Great Britain. They are not a homogenous group. They can be former regulars or reservists. They can be younger or older, in good health or in poor health. They hail from every part of the United Kingdom, and from diverse backgrounds. In consequence, their needs and experiences will be very different, a difference that is reflected in the wide range of organisations—public, private and charitable—which are charged with ensuring that the debt we owe to them is properly and effectively delivered.

I say to the noble Lord, Lord Tunnicliffe, that the document is not a blueprint for delivery, it is a strategy. It maps out a direction of travel, clearly waymarked by a number of factors and themes that are relevant to improving the lives of veterans, and it will, in that sense, hold us to account in measuring success. For each of those cross-cutting factors and themes there is an outcome for the year 2028 towards which all UK nations will work to deliver.

In furtherance of those objectives, the UK Government have published a consultation alongside the strategy. The consultation addresses the wide range of ways in which public services are delivered to veterans, but in essence it seeks to ask one overarching question: how can we do better? We in the Government may have our own answers, but it is only those at the sharp end who know what works best and who can tell us where the real gaps are. We want to hear from them.

The various themes covered in the strategy will be familiar. They are the challenges posed by the transition from service to civilian life; the need to find stable and fulfilling employment; the impact of a veteran’s service experience on their state of health; and the need for a home. These and other challenges are ones which we must help our veterans, wherever possible, to take in their stride, but where they falter, we must be there to support them. The consultation picks up on all these themes in greater detail and poses a series of questions on those issues where we most need answers. I encourage noble Lords to submit their views and to alert others to do so.

In addressing some of the many issues and questions that have been put during this debate, I shall begin with one raised by the noble and gallant Lord, Lord Walker, who called for a dedicated veterans ministry. I recognise that governance and collaboration around all these issues could be strengthened, hence the consultation that we have launched, but the key issue, surely, is delivery of policy and delivery of services. At governmental level, the Ministerial Covenant and Veterans Board is co-chaired by my right honourable friends the Defence Secretary and the Chancellor of the Duchy of Lancaster and has ministerial representatives from all government departments and devolved Governments. At ground level, responsibility for delivery is diverse, but in practical terms for a veteran in need of help and advice, Veterans UK and the Veterans’ Gateway will enable any veteran to receive the support they need.

I now turn to a topic which has loomed large in today’s debate, not least for my noble friends Lord Attlee, Lady Browning and Lady Helic and the noble Lord, Lord Tunnicliffe, which is mental health provision. Mental health services are delivered to veterans by the NHS. We in government know that some patients wait too long and that additional resources are needed. The Government are already investing £12 billion in mental health. In the Budget an additional £2 billion for mental health was promised by 2020, and the NHS will invest up to £250 million a year in new crisis services by 2023-24. I hope that gives a sense of how committed we are to the mental health and well-being of the population at large but also of our service personnel and veterans.

We fully recognise that service life can cause stress. We announced in October last year a new partnership with the Royal Foundation that will provide resources for training and education for the Armed Forces community around good mental fitness. In July last year the Defence People Mental Health and Wellbeing strategy was launched. It identifies the need for strong partnerships with the Department of Health and Social Care, the NHS, the devolved Administrations and the charitable sector. The MoD has provided a new 24-hour mental health helpline, which is targeted at serving personnel and their families, allowing them to access support for any mental health problems any time, anywhere, and of course there is the Combat Stress helpline for veterans. As part of the consultation, though, we will look at the idea that was very helpfully suggested by my noble friend Lady Browning; namely, what buddy support is already provided and whether it should be strengthened further. I thought that was a most interesting idea.

As I have said, we take the well-being of personnel very seriously, and we are funding research so that we can continue to do so. The aim of the study currently taking place at King’s College London is to understand the ways in which mental health is impacted during the years following exposure to conflict. The study suggests that the symptoms of PTSD can manifest several years after an individual has deployed, which I am sure we all instinctively knew. That is why the King’s College research is still ongoing. As the senior author, Professor Sir Simon Wessely, who is a world-renowned expert in this field, has pointed out in relation to the most recently published data,

“it would be wrong to say there is a ‘bow wave’, ‘tsunami’ or ‘time bomb’ of PTSD in the UK military and veteran community”,

but we need to analyse and take seriously what is actually happening.

I will answer a number of my noble friend Lady Helic’s questions in writing. However, I shall address the very important issue that she raised at the beginning of her speech: the rate of suicides. Every study conducted by the MoD has found that the risk of suicide among the Armed Forces community, including veterans of the 1982 Falklands War and the 1990-91 Gulf conflict, is lower than among the general population. However, we will commission a new study on the risk of suicide for those who served between 2001 and 2014 covering combat operations in Iraq and Afghanistan. It is important that we get to the bottom of those statistics.

The Department of Health and Social Care has had a national suicide prevention strategy in place since 2012 and that aims to address the causes of suicide for every civilian, not just veterans. Veterans are identified in the strategy as requiring tailored approaches to meet their mental health needs. That has resulted in NHS England’s veterans’ mental health transition, intervention and liaison service, which since its launch in April last year has supported hundreds of veterans and their families. That is complemented by the veterans’ mental health complex treatment service, launched in April this year to support those with the most complex needs, with holistic support for the whole person and their family.

My noble friend Lady Pidding and others referred to the defence holistic transition policy. That is aimed at better co-ordinating the assistance that is out there and to supplement it to prepare service personnel and their families who are about to leave the Armed Forces. That will be launched later this year. My noble friend Lady Browning spoke of the need for advance preparation, and I can tell her that the chain of command will routinely discuss with individuals throughout their career their plans and preparations for life after the military. Immediately prior to leaving the Armed Forces, the chain of command will assess their readiness to leave and refer those needing extra support to the defence transition service. The specialist defence transition services team within Veterans UK will support those who need it most by undertaking a thorough needs assessment to determine the best interventions required by that individual.

I turn to another extremely pressing and important issue: that of homelessness. We take this extremely seriously, and I was very grateful to the noble and gallant Lord, Lord Walker, for his constructive suggestions in this area. I start by saying that this year, there is a new statutory responsibility on the MoD to refer anyone leaving the military at risk of homelessness to the relevant local authority. Under the new defence holistic transition policy, early service leavers who are assessed by their chain of command as needing extra support will be referred to the defence transition service, which will undertake a thorough needs assessment to determine the best interventions required by that individual, including housing.

Housing was also raised by the noble Lord, Lord Tunnicliffe. I can tell him that, in line with the Armed Forces covenant, veterans who have,

“reasonable preference and more urgent housing needs”,

must be given additional preference—high priority for social housing. This requirement applies also to bereaved spouses of Armed Forces personnel and seriously injured or disabled veterans of the regular or reserve service. These are the only groups of citizens whose priority is based on prior employment. I say to my noble friend Lady Helic that the MoD is reviewing options which will assist with housing support for veterans. I take the point ably made by the noble Lord, Lord Tunnicliffe, on the question of supply.

As regards rough sleeping, one veteran on the street is too many. That is why we implemented the Homelessness Reduction Act, which will ensure that service men and women can work with their local authority earlier to ensure that homelessness is prevented. That is also why we published the Rough Sleeping Strategy, backed by £100 million of funding. We are committed to delivering our manifesto commitment to halve rough sleeping by 2022 and end it by 2027.

My noble friend Lord Robathan touched on a sensitive set of issues about the legacy investigations into Northern Ireland veterans. There is broad agreement within Northern Ireland that the current systems and structures to deal with the legacy of the Troubles are not delivering enough for victims, survivors and wider society. The Northern Ireland Secretary launched a consultation on legacy issues on 11 May which closed on 5 October. Her department is carefully considering the many responses to the consultation and will set out in due course how it intends to move forward. We recognise the growing concern about the repeated investigation and prosecution of veterans in relation to historic operations. That is why we established a dedicated team to examine all the options to increase legal protection for these individuals. The team is working with colleagues across government to find the best way forward. Of course, we have not forgotten the need to provide the legal and welfare support to military veterans who are subject to investigation.

I turn to other health-related issues. The noble Lord, Lord Burnett, referred to the problem of adequate advanced prosthetics—a very interesting topic, but one on which I am certainly not an expert. He may be interested to know that the Complex Prosthetic Assessment Clinic was introduced at Headley Court in 2016 for the small number of veterans with particularly challenging prosthetic needs. Since its inception, the clinic has seen 40 individual patients, six of whom have subsequently been treated under the LIBOR-funded direct skeletal fixation technique. That involves the insertion of a titanium implant into the bone, eliminating the need for traditional socket-based technology. As the prosthetic is anchored directly to the bone, it offers greater freedom from the limitations and complications commonly associated with socket-based prosthetic systems. The Government are simultaneously funding research into direct skeletal fixation and we look forward to the results.

The noble Lord, Lord Burnett, also referred to issues around adaptations to housing. As I am sure he knows, there are various grants available to allow disabled people to continue to live at home, including the disabled facilities grant. People can get a grant from their council if they are disabled and need to make changes to their home—for example, to widen doors, install ramps, improve access to rooms and facilities, or install a downstairs bathroom. Having said all that, we shall await responses to the consultation if it is felt that this package of measures that is currently available does not meet veterans’ needs in every case.

My noble friend Lady Fookes, whose work with war widows I have admired for many years, asked about the reinstatement of war pensions. The Government recognise the unique commitment that service families make to the country and we remain sympathetic to the circumstances of those widows who remarried or cohabited before 1 April 2015. However, as my noble friend recognises, this is a complex policy area, and it is taking time to carefully consider the potential options within both financial and legal constraints, and I can tell her that my friends at the Treasury are currently considering the issue actively.

The noble Lord, Lord Burnett, referred to the Armed Forces compensation scheme, which is covered on page 26 of the consultation, as he has probably seen. An independent review of that scheme in 2016 found that it remained fit for purpose and recommended both the uplift of the lump sum tariff awards and a review of the maximum tariff level award for mental health conditions.

My noble friend Lord Attlee, and others, including the noble and gallant Lord, Lord Walker, referred to the need for better data. As most veterans transition successfully from the Armed Forces and do not need help after discharge, it would be inappropriate to mandatorily track all of them; it is much more important to focus on the significant minority who do require additional support. We must respect at the same time that some individuals will not want to maintain a connection with the MoD, or they may not wish to declare their service. However, more data on specific cohorts would certainly aid delivery organisations. An amendment to the Data Protection Act 2018 allows the MoD to verify contact details of the ex-Regular Reserves against HMRC data to check whether people have moved—because obviously we need to know where people are. I can tell my noble friend Lord Attlee that national insurance numbers are used as the unique identifier between the two datasets.

Time is against me. I am conscious that I have not had time to answer a number of questions, but I assure noble Lords whose questions remain in the air that I will write after this debate with as full a response as I can, and copy in all noble Lords. I hope that noble Lords will allow me to conclude on that note. It has been a most constructive debate and I am extremely grateful to all speakers who have troubled to take part, and to share their ideas and their wisdom. A century on from the Great War, our people continue to give their all for our country. Our obligation to do right by them and their families remains steadfast. As the themes and programmes outlined in the strategy are developed further over the coming months and years, for the benefit of our veterans, we will continue to do our utmost to deliver on the debt we owe them.