Veterans (Mental Health)

Guy Opperman Excerpts

Wednesday 7th March 2012 Westminster Hall

[Julian Sturdy]

I agree. It is also worth noting that reservists tend to suffer more from mental illness, if they have experienced conflict, than regular soldiers, so it is probably even more important that we understand where the reservists are and can monitor that and target help towards them.

[Guy Opperman (Hexham) (Con)]

I congratulate my hon. Friend on securing the debate and I support the laudable aims that he is describing. Given the established difficulties with keeping track of individual soldiers and the difficulties with giving the necessary support post discharge to all manner of servicemen and women, is it not time that we started to consider the possibility of a veterans agency that brings together all these things and provides a co-ordinating review and a hub point for all these services?

[Julian Sturdy]

I agree. As I said, there is a real problem about the joined-up thinking that needs to be done. A tremendous amount of work and services are out there, but we need to bring that all together, under one roof. I will come on to that later if I can.

There remains a real danger that too many veterans will slip through the net because they fail to be registered for initial support on leaving the service and get lost in the system thereafter. The best way to ensure that support gets through to veterans is to keep up to date with veterans, as has been said.

Having touched on the increase in mental health nurses across the strategic health authorities covered by an armed forces network, I ask the Minister to outline the initial effect that the Government believe those nurses are having. Is there sufficient demand for the increased services? Do we need to consider increasing the numbers further? Ensuring that Government provision is frequently reviewed in such a manner will help to keep the ball rolling on this very important subject.

Without wishing to ask too many questions, I should be grateful to the Minister if he confirmed how many of the 10 health networks have now developed integrated services for veterans with specific mental health problems. As I said, ensuring that our provision is targeted correctly and effectively in supporting veterans is key.

I should now like to deal with the online package of interventions for veterans. In response to a recent written question tabled by my hon. and learned Friend the Member for Sleaford and North Hykeham (Stephen Phillips), the Minister, who I am delighted to see will respond to this debate, stated that the uptake of membership of the Big White Wall among the armed forces family is exceeding expectations. It would be interesting to know whether uptake among veterans is also high. Although I am a great supporter of online interventions, my slight fear is that information, assistance and forms of community engagement are all present and accessible online, but only if someone actively searches for them. With respect to veterans who suffer from mental health problems, we cannot expect all of them to be able or even willing to carry out such research. Are those leaving the service provided with the relevant links and information before they leave?

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[Guy Opperman (Hexham) (Con)]

It is a great pleasure and a privilege to speak in this debate today. I have been in this House for nearly two years and I have not had the opportunity to raise the issue of the mental health of veterans in the way in which we have done today. I pay great tribute to my hon. Friend the Member for York Outer (Julian Sturdy) for securing this debate and for the measured and eloquent way in which he has brought the issues to the House.

I join my hon. Friend and other colleagues in passing on our respective condolences to the service men and women, and to the families of those who died in Afghanistan so recently. I endorse everything that both the Prime Minister and the Leader of the Opposition said. It is an utter tragedy and one of the largest losses of life for many a year. I remain of the view that the sooner we bring our troops home from Afghanistan, the better it will be.

This debate is certainly overdue. I want to make a declaration. I send out my thanks and support to the various charities, volunteer groups and individuals who provide support. I echo the words of support for the Royal British Legion and Help for Heroes. If I need to declare that I have raised funds for such groups while serving as a Member of Parliament, I do so. I certainly need to make a declaration that I have represented, as defence counsel, multitudes of soldiers facing criminal charges, which was a salutary and depressing experience. Many of the soldiers had committed criminal offences, which they had no desire to commit, because they were suffering from mental health problems and fundamentally from post-traumatic stress disorder.

I represented a Royal Marine who had broken down in a supermarket after he had been unable to get together the right amount of money at the till. He felt that the lady behind the counter, who had been perfectly civil to him, had not been as co-operative as she should have been and it all became too much. The nature and the prevalence of post-traumatic stress are such that it is always the very smallest things at the end of the process that result in the demise of the mental strength of people who have quite happily stormed up Tumbledown ridge, gone across the Gulf deserts and fought repeatedly in a way that very few of us in this House can even contemplate. It is how we provide support that is important. As defence counsel for some of these lads and, on one occasion, a woman, I saw very strongly how their spirit was broken. I have also seen, over the last 15 to 20 years of lawyer practice, plenty of examples of these people falling through the system.

[Andrew Percy (Brigg and Goole) (Con)]

My hon. Friend is making an important speech about how people fall through the net. My neighbour, the hon. Member for Scunthorpe (Nic Dakin), mentioned Charles Brindley, who has been trying to do some work around GPs. Many GPs do not seem to be aware of the military assessment programme that is available. Often if someone presents with a mental health issue, the GP is not trained or aware of the services and support that can be made available. Does my hon. Friend agree that we need to ensure that GPs are better educated and better trained in dealing with such individuals?

[Guy Opperman]

I entirely endorse that point. Although it is incumbent upon Members of this House to raise the profile of this issue and to try to disseminate information about the types of health care support that exist, it is also incumbent upon the relevant health trusts and authorities to ensure that in future a degree of information is passed down the net to individual GPs and action teams, particularly those teams dealing with alcohol abuse, so that the organisations in the regions are able to support the veterans who are out there.

I have worked with a charity called Veterans in Action. It involves some constituents of mine in Northumberland but it also involves servicemen and women who are based in Lancashire and all over the country, who are attempting to do various things. For example, they have a pilot project with the Lancashire Drug and Alcohol Action Team that involves meeting up with GPs to work with them and trying to do exactly the sort of thing that my hon. Friend the Member for Brigg and Goole (Andrew Percy) has outlined.

However, the worry is that, although individual groups in our constituencies are all doing very good work to provide a degree of assistance to veterans, there is no overarching body providing global support. What often happens, therefore—for example it has happened with Veterans in Action, which was set up in my constituency and is now working throughout the country—is that the individual soldiers effectively get fed up with the process and decide to provide support themselves.

I supported what the previous Government did. They were working to do a great deal more than had previously been done. Successive Governments have improved care for veterans over time. But the “Fighting Fit” report and the work done by my hon. Friend the Member for South West Wiltshire (Dr Murrison) have clearly taken things to the next stage and a better level.

I will digress slightly, because in my constituency I have the Albemarle barracks and the Otterburn ranges, troops from my constituency are serving on a regular basis in Afghanistan with the 39 Regiment Royal Artillery, and the Ridsdale ranges provide all the weapons that are tested before the soldiers use them. I also have a large number of constituents who have served in the forces. For example, many Falklands veterans live in my constituency and have come to see me because of the experiences that they have suffered and the lack of support that they have experienced. That was under a different Government and, frankly, I am not here to criticise any Government. However, there is no question but that the degree of support given to the Falklands veterans was limited compared with the support that we are giving to the veterans who are returning from Afghanistan now. Things have got better.

[Simon Hart (Carmarthen West and South Pembrokeshire) (Con)]

Further to the point made by the hon. Member for Newport West (Paul Flynn), I wanted to say that in the 30 years following the Falklands conflict—it is rather timely to make this point, this year being the anniversary—more soldiers were reported to have committed suicide after the conflict than had actually died in the conflict itself.

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[Guy Opperman]

It is interesting, is it not, that today is 7 March and on 7 March 1982, exactly 30 years ago, about three and a half weeks prior to the Argentine invasion of the Falklands, which happened on 2 April 1982, the British ambassador in Argentina wrote a cable from Buenos Aires to the then British Prime Minister, saying that matters were escalating. It is very well known, and it was reported in the Franks report that assessed the Falklands war, that “contingency plans” needed to be made. That was not enough and a war began, then escalated. I certainly will not go down the route taken by the hon. Member for Newport West (Paul Flynn) by digressing further. However, the point is that the treatment of the veterans of the Falklands war was not as good as the treatment of veterans now, partly because there were difficulties at that time in understanding what post-traumatic stress disorder was.

From a health standpoint, PTSD is not confined to victims of conflict. There are also plenty of victims of PTSD who were involved in normal, day-to-day accidents and disasters, whether it is industrial health accidents or factory accidents; people can have PTSD arising from those things. We need to change the way that PTSD and other aspects of the mental health of veterans are visualised, because it needs to be recognised that PTSD and other mental health conditions are just as much a disease or condition as breaking an arm or suffering from cancer, and it is just as difficult to solve or treat.

I move on. I endorse entirely what was said about the current situation, and I will abbreviate my comments to making an assessment of the current situation. Various studies have shown that a very large proportion of our veterans are suffering from PSTD. At present, approximately 24,000 veterans are in jail, on parole or serving community punishment orders. That is the astonishing number that emerges if we assess how many veterans are going through our criminal justice system. It manifestly shows that, for whatever reason, we have not done enough.

Let us also bear in mind that American studies have shown that approximately 30% of the US troops who were in Vietnam suffered from PSTD, or about one in three. That is an absolutely staggering number. Therefore, although we might look at the respective troops coming home from Afghanistan, and at those who fought in Iraq and other conflict zones, and think that they are all right, three out of 10 soldiers will genuinely suffer PTSD. They may suffer it in year one after their return. Year 14 is the average length of time that it takes, but it can take as long as 25 or 30 years, and throughout all of that time, their individual families are suffering and going through particular difficulties.

I applaud the “Fighting Fit” report and the work that is being done. However, I regret to say that that is not enough. Personally, I do not consider that it is enough. I accept entirely that we are in straitened times and that, with every budget, we have to consider the way in which things are dealt with. Nevertheless, I very much hope the Minister will give the sort of assurances that charities and individual soldiers’ organisations seek about their future, and that there are commitments on an ongoing basis to the matters outlined in “Fighting Fit”, so that those charities and organisations have the reassurance that genuine efforts will be made to ensure that their funding is sustained; that mental health systems are structured properly; that the recommendations of the inquiry into medical examinations while soldiers are still serving are properly implemented; and, given that we are introducing all these ideas from “Fighting Fit”, that there will be proper assessment of those ideas after they are introduced. I agree that organisations such as the Big White Wall are not necessarily being utilised in the way that was envisaged; they are being utilised, but not necessarily in the way that was envisaged.

I would very much like to see an overarching body for veterans. I would like a veterans agency to be considered by the Government, and the Government to consider whether there is a possibility of bringing together certain parts of the NHS, the Ministry of Defence and social services and housing elements, which make up so much of all the difficulties that our servicemen suffer, and dovetailing that with the health services that are provided in prisons.

We can look at the way that people are dealt with in terms of health services in prisons. I have extensive experience of going to see clients who are former servicemen and who have received a custodial sentence or who are held on remand. There was absolutely no doubt that they were hopelessly unable to deal with the difficulties of a custodial sentence, or the difficulties of being detained, at that particular time, in circumstances that they would normally have been perfectly able to deal with.

[Mr Gray]

I have agreed with much of what my hon. Friend has had to say, but I have some difficulties with the notion of the establishment of a new agency to carry out the functions that existing Government bodies are required to carry out at the moment. If there were a veterans agency, would there not be a risk that people at the Department of Health or the Ministry of Defence would shrug their shoulders and say, “Someone else is doing this for us, leave it to them”, and that the services received by veterans would be significantly worse than they are at the moment?

[Guy Opperman]

I accept there is always a risk that, if we create some new body, we will be in a position whereby everybody passes the buck and says, “Well, they’re sorting it out”. However, I am clear that every single MP could come to this House and say, “I have individual examples of people in my constituency, or stories that I have heard of former servicemen.” Those servicemen are continuing to slip through the net—they are unaware of the individual aspects of the services that are available to them—and the Government are not necessarily acting as an overarching body to ensure that they are aware of those services.

Let me give some examples. There is very good evidence from the “Fighting Fit” report and other studies that follow it up that there should be a leavers pack for soldiers and, for example, an ability for veterans to be monitored after they have been discharged. All those services are good, but they stop after a certain period and the Government do not go back to those individuals to ask, “Are you actually all right? Are you in a position to cope with the vicissitudes of your life and your existence on an ongoing basis?” That is the sort of thing that I would like done. I concede that it may be possible to do such things in the present Departments, but there must be more joined-up thinking, because the problem is ongoing, and there are examples.

I am conscious that other Members wish to get into the debate, so I will abbreviate my comments. I want to talk about the work of Veterans in Action, a classic charity, which is run by individual veterans. For a number of years, they have been providing in-depth support, which they have found is, sadly, lacking in the system. They tell me that there is no generic way to collect veterans’ information and that it is collected very much on a local, case-by-case basis. Similarly, they say it is extremely difficult to get organisations to work together. They also tell me that the Big White Wall is not being used as it was intended to be and that people are using the Combat Stress helpline as a first point of contact.

A great many smaller, third sector organisations and charities set up by veterans are having similar problems. With no national directory or local directories of such organisations, it is immensely difficult for individual veterans who are constantly moving around—who have problems with housing and with all the dislocation that goes with that—to harness the efforts of such organisations. Therefore, just as successive Governments have done amazing work looking after individual veterans’ health in conflict zones, we should do more to look after their mental health after they have left those conflict zones.

[Several hon. Members]

rose—