Social Care and Military Compensation

Gordon Marsden Excerpts

Wednesday 25th March 2015 Commons Chamber

[Mr Gordon Marsden (Blackpool South) (Lab)]

As has now been confirmed several times, this is the last occasion to raise such issues in this Session, and I wish to speak about the unfair treatment of some veterans owing to the disparity in the way that different armed forces compensation schemes are treated when social care costs are calculated. I pay tribute to Poppyscotland and the Royal British Legion, which highlighted that issue with their Insult to Injury campaign. In the past, I have been pleased to work closely with the Royal British Legion, both nationally and locally in Blackpool, and together we delivered a petition with 3,000 signatures calling for stronger punishment for those who vandalise war memorials. I was also pleased to support the Blackpool armed forces covenant and veterans charter in 2011. I wish to touch on that veterans charter and covenant, praying in aid the arguments I will present tonight.

As chair of the all-party group on veterans, which deals with a number of issues, including welfare, I was fortunate to initiate a meeting in Parliament with the Forces in Mind Trust. Its latest report is about support for veterans’ families, and we will hear tonight about veterans who are losing the means to support their families when compensation payments are removed. Fundraising year-on-year by the Royal British Legion and other ex-service organisations, including Poppyscotland, provides extra support for veterans. Locally and nationally, our veterans should not be left by the state in financial circumstances that are unfair. The state must do its bit, particularly when there are unequal Government regulations.

Tonight I will focus on the disparity between the way that the two different compensation schemes operate. Those injured before April 2005 received compensation for particular injuries through the war pension scheme, which provides regular payments based on the severity of injury. Those injured from April 2005 onwards receive support for any disablement through the armed forces compensation scheme—AFCS. That comes in two parts: a lump sum and, in a similar fashion to the war pension, a regular payment for the most severely disabled veterans and ex-servicemen. Those two schemes seek to compensate for the pain and challenge of particular injuries that some veterans receive when serving bravely in our armed forces, but when it comes to how they are processed through the social care system, they are treated very differently.

As of 2012, any veteran supported by the newer AFCS scheme has all that income disregarded while they are means-tested for social care. Although their other forms of income are rightly considered so that they make the same contribution as any civilian to their social care, they will still have left over the income they receive to compensate for the injuries they received in the military. Those on the older war pension scheme, which could cover awards from the second world war up to 2005, receive far less support. Only £10 of their war pension is automatically disregarded, and the rest can be clawed back by local authorities into paying for their standard social care. The full value of the war pension—which of course reflects the level of disablement suffered by that veteran—is on average £80 a week and can be as much as several hundred pounds a week for the most severely injured.

Does the Minister agree that it does not show enormous respect to veterans on the war pension scheme, who have fought in conflicts from the second world war to Korea, the Falklands and in some cases as recently as Afghanistan, if we suggest that the pain of those disabling injuries is worth only £10 a week? What compounds that regrettable diminishment of the veterans’ sacrifice is the apparent injustice and inconsistency in the way the two schemes are treated in social care and the way different arms of Government look at the problem.

Almost all local authorities use their discretion fully to exempt the income from both compensation schemes when council tax or housing benefit is calculated, and central Government have recognised that both types of compensation should be left untouched when the new universal credit is calculated for recipients who have served in the forces. Yet protecting that income for council tax and housing benefit will be in vain if the great majority of it is then lost to pay for social care. As I have said, Government guidelines only disregard £10 of the war pension, and in present circumstances local authorities have not been able to go much further, with only 12% of councils using discretionary funding fully to exempt those on the older scheme. That is completely inconsistent with the way that civilian personal injury compensation is treated in social care means-testing. When saved in a trust fund, that income is fully disregarded by local authorities as they calculate care costs. What is left appears to be a social care system that, however worthy its objectives, fails to meet two criteria of the armed forces covenant that Members from both sides of the House were proud to support.

[Jim Shannon (Strangford) (DUP)]

It is appropriate that the last Adjournment debate of this Parliament concerns our veterans and our soldiers, and I congratulate the hon. Gentleman on securing it. Many Members have a particular interest in the armed forces. In the years that I have been a Member of Parliament, we have had the chance to speak on behalf of our veterans. I know many veterans who suffer from post-traumatic stress disorder and their number, after Iraq and Afghanistan, has increased significantly in the past few years. Does the hon. Gentleman agree that the onus is on the Ministry of Defence, the Department of Health and local government to work together to address this issue? The Minister represents the Department of Health. Other Departments, which are not represented here tonight, need to work alongside her.

[Mr Marsden]

I agree with the hon. Gentleman, who is assiduous in covering veterans’ issues in this House. I pay tribute to the military from Northern Ireland for the sacrifices they have suffered over the years. He is absolutely right. We are pleased that the Minister is here tonight, but the issue can only be solved out of Government silos.

The covenant enshrines the principles of no disadvantage and special treatment. These, in turn, dictate that a person should experience no disadvantage as a result of military service and that it is appropriate in some cases for special treatment to be applied to those who are serving or have served. We have already seen that as a result of failing to disregard the war pension, Ministers are not providing any special treatment for veterans. More fundamentally, however, they end up failing the rule of no disadvantage, too, as the injuries incurred purely as a result of action in the armed forces receive little compensation when income such as the war pension is diverted into providing standard civilian social care.

I am pleased, therefore, that my colleagues in the Labour Front Bench team have pledged, under a future Labour Government, to review the compensation schemes to see where they might be improved. In particular, the focus should be to take a laser-like focus to existing and new rules that affect veterans through the prism of the armed forces covenant. We want to ensure that the principles of no disadvantage and special treatment are met by all arms of government.

All Members have, at one time or another, drawn attention to the strong feelings of many veterans and others about insufficient engagement with the concerns raised in relation to social care and military compensation. I welcome the reports from the Government, the Royal British Legion and Poppyscotland that talks are ongoing about how the two schemes might be aligned, but we need to see results. After all, every year, as more elderly veterans pass away, the group of people who could benefit from a change in the rules diminishes by 5%. Half that group are aged 70 or over. We are running out of time to offer these people the chance to navigate social care in far greater comfort, with access to the full deserts of their military compensation. With a change in the rules, we can put this right, but it needs real Government commitment. I have to say, however, that when we look at the Government’s stated objections so far, they seem to give the impression of delaying progress rather than accelerating it.

Ministers have claimed that some of those on the old war pension scheme also receive top-ups to their pension, which are designed to help to pay for care costs. Only 6% of war pensioners actually receive such care top-ups. More to the point, it is surely not beyond the wit of the Government to devise guidelines that will include those care top-ups in the payment for social care, but not include that part of their income that relates to the pain suffered through injuries received in the field of conflict. This is a position that the Royal British Legion accepts would be perfectly reasonable.

Ministers have also suggested that military compensation could be placed in a trust fund to protect it from social care means-testing. However, given how war pension works, only a small amount is provided as a lump sum. For the most severely injured veterans, most compensation is provided through regular payments that cannot be placed in a trust. It has also been suggested that the war pensions scheme was established before the modern understanding of personal injury compensation, yet it is clearly understood that way, as is evident, as much as anywhere, from the words of the veterans Minister, who said:

“The War Pensions Scheme provides no fault compensation to Service personnel disabled as a result of their service in HM Forces.”

In the discussion of all these disregards, different schemes and allowances, the human effects of these rules and their perceived injustices can too often be forgotten. In my area, the Royal British Legion estimates that 600 veterans in the pre-2005 group could see their war pension eaten up by care costs, and Members across the country will have service constituents who have told emotive tales of the effects of losing their compensation.

Keith Clarke, who is 43 years old, was left paraplegic while attempting to put out a fire on his submarine. He receives a large war pension for the most severe injuries, but £100 is lost every week to meet the cost of his care worker, who visits daily to help him dress and look after his two children, one of whom is also disabled. His only other benefit comes from statutory benefits. He told The Daily Telegraph:

“I feel angry and frustrated. It’s…an injustice to be treated as a second-class citizen.”

Fred Cannon, who fought on the Gold beach at Normandy on D-day when he was 19 years old, was the only survivor of the company to come home, but a severe bullet wound left him with one leg shorter than the other. Now in his 90s, like too many others, he is left with only £10 a week compensation. Then there is the 50-year-old Lancashire veteran who was diagnosed with osteoporosis from his time in the Army. He said:

“Unless the system changes, I’m concerned that I will lose a lot of my pension, which isn’t fair. People who receive AFCS don’t pay for their social care—and rightly so—but why should we pay just because we were injured before April 2005? It doesn’t make sense.”

Of the two principles of the armed forces covenant, it is ultimately not special treatment that veterans want; all they want is not to be put at a disadvantage: to have the injuries they suffered in the armed forces compensated for in their own right and then to make a contribution from their other income towards social care, just as any civilian would rightly do. They want fair treatment for all and a system that does not discriminate on the basis of an arbitrary date; they want to be treated the same in the different means tests that central and local government operate; and they want to be treated in the same way as civilians who receive compensation for personal injury.

Whatever the historical context of the creation of the war pension scheme or the complexities of its operation today, it is surely possible to design a system that will meet the requirements of the proper 21st century fairness that the veterans are asking for. The time has come to go beyond discussions and look for concrete solutions to the disparity between the two different military compensation schemes, rather than focusing on the obstacles to a more just system. I am pleased to note that Labour would review the fairness of military compensation in the light of the armed forces covenant, and I call on Ministers to show a similar political will and commitment.

Many Members will have the date of 7 May on their minds tonight, but many other people will have a possibly more important date—the next day—on their minds. That will be the 70th anniversary of VE-day. I feel honoured that both my late parents served in that conflict, and I am mindful of the debt we owe to those of that generation who remain with us. At this time, we must surely refocus our energies to ensure that we provide all the support that the brave men and women who have served in conflicts spanning the last 70 years deserve, particularly as they make their way through challenging periods of their lives in the social care system.

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

I am grateful to the hon. Member for Blackpool South (Mr Marsden) for bringing this important issue before the House. It provides me with an opportunity to clarify our current position. I hope the hon. Gentleman will allow me first to place the issue in the broader context, particularly the context of reforms in social care.

To make some sense of that broader context, at the turn of this century there were 25 times as many people aged 85 and over than there were at the turn of the last century. Although this is something to be celebrated, it also means there are more people needing care and support, and three quarters of us can expect to need long-term care.

Care and support is an issue that has, I think, been ignored for far too long, and I am proud to say that this Government have taken steps to put that right. The Care Act 2014 is a bold and historic piece of legislation that for the first time places adult care and support law in a single clear statute. The Act puts people at the heart of the system by enshrining the principle of individual well-being at its core. It will ensure that people themselves will be able to shape their care and support, focusing on what they want to achieve and the outcomes that matter to them, and it will support them to maintain their well-being and independence for longer.

The Care Act focuses on acting early to prevent people from reaching crisis points, and will ensure that everyone can access information and advice to help them understand the new system and what it means for them. This means services for the broader community—not just those with assessed needs—further supporting our aim to help people to stay independent for as long as possible. When we do need care, the Act provides for a single threshold for eligibility to care and support in England, ensuring transparency and consistency, irrespective of where we live. I am pleased that this historic legislation will come into force exactly one week from today.

We do not intend to stop there. How we pay for health care and support is just as important as the care we receive. Most people do not realise that care and support has never been free, unlike health, and we have always been asked to contribute what we can afford. Those who have the greatest needs and the longest care journeys risk losing nearly everything simply to meet that cost.

For all the other areas of life where we face such risks, we are protected by the welfare state or we can protect ourselves through insurance. When it comes to care, however, successive Governments have taken a different view. We are often left alone at the point when we are most vulnerable. That is clearly not good enough, and I am proud that we will be introducing the biggest reforms of how we pay for care in over 65 years. We do so through the cap on care costs, which will put an end to the risk of catastrophic costs, and we will provide greater financial help for those who need it most.

The detailed proposals of how the new system will work are currently out for consultation. With just under a week still to go, I am pleased that we have already had over 700 responses and have engaged with over 1,000 people through a series of events helping to ensure that we take account of a wide range of views. The new cap system will play a critical role in helping people to plan and prepare for the risk of needing care and support, and create the right conditions for the financial sector to create new products that could cover these costs.

When it comes to those who have served their country and have made a great sacrifice in the line of duty, this Government have given a very clear commitment to support members of the armed forces community, both serving personnel and veterans. The hon. Member for Blackpool South has illustrated exactly why that is the right thing to do. We have enshrined that commitment in legislation through the armed forces covenant.

As the hon. Gentleman outlined, for those who have been injured in the line of duty there are currently two different schemes that provide compensation, based on when the injury occurred. For those who were injured before the 6 April 2005, there is the war pension scheme; for those injured afterwards, there is the armed forces compensation scheme. While both schemes have the same goals—to offer financial support to those injured in the line of duty—they are ultimately both a product of their time and the social context in which they were developed. Under both schemes, personal injury compensation lump sums are disregarded when deciding how much someone can pay for care, provided the payments are placed in a trust—I noted the hon. Gentleman’s concerns about regular payments—but other sorts of payments may be taken into account.

The war pension scheme was created after the first world war in response to the large numbers whose lives had been irrevocably changed as a result of their service to their country. In 1918, however, there was no welfare state, no NHS and no benefits system. Most people did not have access to private pensions, meaning that for those needing care but without family or friends to support them, the outlook was often bleak. The scheme therefore provided for that. It provides a basic war disablement pension and a variety of supplementary allowances that would be equivalent to the modern benefits system, and it reflects the fact that people needed to pay for both health and care costs.

By contrast, the armed forces compensation scheme introduced in 2005 reflects the fact that we have an advanced welfare state. It therefore looks to the NHS and the benefits system to provide support, just as it would to anyone, ensuring the principle of “no disadvantage” enshrined in the armed forces covenant.

The scheme introduced a modern, fair and simple system that provides a strong basis for the future, but this is a difficult and complex issue. I note the hon. Gentleman’s frustration—as he said, there has been much discussion—but, as I have said, the issue is complex. Depending on the extent of their injuries, veterans can receive a number of different allowances under the war pension scheme, such as constant attendance allowance, an unemployability supplement, comforts allowance, age allowance, treatment allowance, mobility supplement, and medical expenses.

The Royal British Legion broadly accepts that the treatment of war pension scheme payments is complex. I am grateful to it for highlighting its concerns, and for continuing to working with departmental officials to help us to understand the issue better. It is vital for us to understand it fully before considering what is to be done next. We must understand how the two schemes work, and the implications of considering any changes, to ensure that there are no unintended consequences, and we must also understand any cost implications of change. I note what the hon. Gentleman said about the commitment of his party colleagues to reviewing the scheme, but that commitment to a review suggests that they too are cautious, and feel the same need to understand the possible implications.

[Mr Marsden]

I do not wish to intrude on the Minister’s time, and I agree that the process is complex. I recall Churchill’s observation that it was not the end or even the beginning of the end, but it might be the end of the beginning. Will the Minister tell us how far down the line we might be expected to be at this point, and what stage the Government think has been reached?

[Jane Ellison]

I will come to that, and will try to give the hon. Gentleman a bit of reassurance about the advanced and ongoing work that is taking place.

Social care is a priority for the Government, and, in the context of difficult spending decisions, we have taken steps to protect care and support services. For example, we have allocated extra funds for those services during the current Parliament. We have created a better care fund, which, next month, will introduce a £5.3 billion pooled budget for health and care that will provide much needed funding for care and support, and will break new ground in driving closer integration of services.

Although spending on care and support is ultimately a decision for local government, we must be mindful of the overall fiscal position. I think that Members on both sides of the House agree on that. We must ensure that if we change the charging rules nationally, the cost will be met. To that end, my officials are continuing to work with their counterparts at the Ministry of Defence—I hope that that gives the hon. Gentleman some sense of momentum, and deals with his concern about “silo” working—and with the Royal British Legion, with a view to considering the issue during the spending review that will take place after the election.

I hope that the hon. Gentleman—and, indeed, all hon. Members—will welcome the historic reforms that will come into force in just one week’s time. They are very significant in the context of the broader issue of care. This Government have been the first to prioritise care and support. I hope that Members in all parts of the House will feel able to welcome the clear plans that I have set out for the future. As for the specific issue that the hon. Gentleman has raised, I hope he recognises that this is ongoing work which is taken very seriously. His securing of what has turned out to be the last Adjournment debate of this Parliament has underlined the importance of the issue that he has raised. I think that, throughout the purdah period and beyond, the debate will give added momentum to the work that is being done.

Given that this has been the last Adjournment debate of the current Parliament, Madam Deputy Speaker—and you and I have shared a number Adjournment debates—let me take this opportunity to thank you and, through you, Mr Speaker and the other Deputy Speakers. I also thank all the staff of the House, and, in particular, those who have sat through some of our late-night health debates, of which there have been many. However, I especially thank the Chair, and all those who have supported the Chair during these important Adjournment debates, which give us a chance—as tonight’s debate has—to explore important issues in some detail, outside the heated atmosphere that the Chamber attracts on other occasions. I also thank Members in all parts of the House, some of whom are very regular attenders at these debates, for their attendance tonight, and for the interest that they have taken in these important matters.