Veterans Care Sector: Government Role

Lord Lancaster of Kimbolton Excerpts

Tuesday 25th October 2016 Commons Chamber

[The Parliamentary Under-Secretary of State for Defence (Mark Lancaster)]

I congratulate my hon. Friend the Member for Plymouth, Moor View (Johnny Mercer) on securing this debate. His sterling work and passion in ensuring that our veterans have the necessary support and welfare they deserve are highly commendable. As a veteran himself, he is well placed to speak in the House on their behalf. Since arriving in the Commons in 2015, he has made it his mission to campaign on this area. Although I cannot claim to be a veteran quite yet—I was described by a senior general at the Army Board last week as a “seasoned oak”, so clearly it cannot be long before I can—I do, through my rather more modest service, absolutely recognise the importance of this subject.

Equally, I am grateful to my hon. Friend for his concern about my ever-expanding portfolio, to which the reserves have been added. As a Royal Engineer, I have now been a serving member of the Army Reserve for some 28 years. I confess that I used to say that I looked far too young to have been one for so many years, but I fear that I nowadays do not look far too young. However, I do at least have some basic understanding of that brief, and I have not had to do too much background reading.

Comments have been made about the armed forces covenant—the recognition that the nation, as well as the Government, have a responsibility to ensure that our veterans suffer no disadvantage as a result of their service. There is an implication in those comments that the covenant has not been applied consistently across the United Kingdom. I have had such a concern for some time. That is why I commissioned the Forces in Mind Trust to do a review of the covenant across the United Kingdom earlier this year, and it has recently published a very extensive report that aims to share best practice.

I encourage colleagues in the House tonight to read that report and, crucially, pull out that best practice and encourage their own local authorities to follow it. There are some fantastic things happening across the UK. It will come as no surprise that the local authorities that seem to do things best are those with the greatest proportion of members of the armed forces. I take the opportunity of this debate to send the message: please spread that report far and wide, as it is the means by which we can begin to improve the level of understanding of the armed forces covenant.

The service charities have a crucial role to play. We have been supporting organisations such as Cobseo—the Confederation of Services Charities—which is an umbrella organisation for 250 charities, in its critical cluster work. I will talk about that in greater detail throughout the course of the debate.

My hon. Friend and I agree on many things, but I fear there is one on which we do not. I once again note his request for a separate Department for veterans. I can only repeat what I said in the debate in March this year, that on balance I do not believe that to be the best approach; if it meant I ended up in the Cabinet he might be able to persuade me to change my mind, but I fear it would not be me in the Cabinet. The needs of veterans straddle Whitehall boundaries and national borders because first and foremost our veterans are civilians. As I said previously, although we agree on the end, we do not necessarily agree on the means.

I fear a veterans Ministry would duplicate work that already exists through the Department of Health, the Department for Work and Pensions, the Department for Communities and Local Government and many organisations and Government agencies. I believe that the work of Defence Business Services Veterans UK provides a valuable service bringing together pensions, compensation and welfare support.

[Mr James Gray (North Wiltshire) (Con)]

My hon. Friend is making an important point about whether a Department for veterans’ affairs would be better for veterans or in fact worse. Does he agree that should there be such a Department that would demotivate some of the very good civil servants in the Department of Health, the Department for Work and Pensions and elsewhere who are currently thoroughly committed to the issue of veterans, as if there were to be a separate Department for veterans they might well say, “That is nothing to do with me—give that to them”?

[Mark Lancaster]

To a degree, this goes back to the principle of the armed forces covenant, which is really an agreement between the nation as a whole and our veterans. I would hate to think that we had moved to a position where we were in effect delegating this responsibility to a single Department and allowing others to feel that it somehow was not their responsibility to play a role in supporting our veterans.

The current system, whereby responsibility for veterans is cross-government, is positive. Yes, more should be done to ensure that all are playing their part, but on balance I agree with my hon. Friend that a dedicated veterans Department would be a retrograde step. We need not look too far, when looking at things across the Atlantic, to see some of the problems there. They are not simply financial; the very complex way in which care is given to veterans can be diluted. We also have the advantage of the national health service, which is a very comprehensive health service. That is a very good medium for supporting our veterans.

[Bob Stewart]

I am listening very carefully to the Minister. I also have great respect for the view of my hon. Friend the Member for Plymouth, Moor View (Johnny Mercer). I ask this question. You are the veterans Minister—

--- Later in debate ---

[Bob Stewart]

Forgive me—the Minister is the focus. I am getting seriously carried away—it is the fault of my hon. Friend the Member for Plymouth, Moor View. Thank you, Madam Deputy Speaker.

[Mark Lancaster]

I am certainly the only Minister with the word “veterans” in his title and I am certainly prepared to say that I take the lead on veterans matters. I would argue, however, that all Ministers in government should have our veterans on their mind and do what they can to support them. So, yes I am happy to take the lead, yes I am happy to have the title in my portfolio, and yes I am happy to try to ensure that all my ministerial colleagues also show the same interest. However, I would not want to be Minister with sole responsibility for veterans, for the reasons I gave when I answered my hon. Friend the Member for North Wiltshire (Mr Gray).

I recognise that the Ministry of Defence has a responsibility to ensure that the transition from service to civilian life is as smooth as possible, allowing service personnel process to draw upon the vast array of transferable skills they have obtained in service, but I am not for one second saying that there is not more that could and should be done. I believe firmly that effective transition to civilian life is a major factor in ensuring effective care. I must emphasise that most service leavers transition well to civilian life through our robust and effective resettlement system known as the career transition partnership, which in 2014-15 helped 85% of service leavers to find sustainable employment within six months.

Despite that, I recognise that there is a small percentage of service leavers who do not make a smooth transition. These are the people we must work hard to identify and support. This is also why I am keen to include a question on veterans in the national census. That will help us to identify the veteran community. I assure my hon. Friend the Member for Plymouth, Moor View that I will continue to pursue this energetically with the Office for National Statistics and the chief statistician.

[Mrs Anne-Marie Trevelyan (Berwick-upon-Tweed) (Con)]

On that note, will the Minister ensure that his Cabinet Office colleagues are fully briefed? At the end of the day, the ONS will not make the final decision—the Cabinet Office will determine that. It would be a vital marker for the future.

[Mark Lancaster]

We have a perfect example of why it is so important that the responsibility for veterans runs across the piece in government. As was so rightly pointed out, it is not in my power, as veterans Minister, to force the chief statistician to include this in his survey. If my hon. Friend is right, the Cabinet Office has the right to do that.

Transition is seen as a through-career management process. We are looking at different ways to ensure that from the point that people join the armed forces, they can see that they not only have the possibility of a fulfilling career but are aware that one day they will become a civilian and need to prepare for that. Career transition should start on day one of service and we must communicate this message on the very first day an individual joins. However, where there are veterans who have difficulties in transition, the Government, local authorities and the charitable sector must step in to ensure that they are afforded appropriate support. Alongside the Government, some 2,500 service charities also play a role. Cobseo, the Confederation of Service Charities, of which many charities are a member, has also created various cluster groups to discuss important issues, such as mental health and housing, where they encourage collective working and provide a forum to raise issues and ideas to implement solutions.

To reiterate some of the points made during the debate in March on the role of charities in the veterans care sector, we value our partnership with the charitable and community sectors. They provide and address wider welfare requirements, particularly for the more vulnerable individuals in the armed forces community. Only last week at the MOD, I chaired the ministerial service charities partnership board, a meeting attended by relevant Government officials and Cobseo charities such as SSAFA, Help for Heroes and the Royal British Legion. In recognition of some of the concerns my hon. Friend raises, I reset its role with a focus on co-operation and a strategic approach to discussions, where actions are taken on current and important issues arising in the veterans sector, with a view to ensuring that the MOD, charities and other Government Departments can be held to account. I believe that accountability is important. Frankly, as the Minister with responsibility for veterans, I walk a tightrope when it comes to dealing with charities. Ultimately, I have no power to direct a charity to do anything. Charities are not responsible to Government—they are responsible to their trustees—but I believe that the Government have a role in providing leadership to try to unite the various sectors in supporting veterans. This is a role that I try to fulfil.

On the point about Help for Heroes, it was a charity that started up in 2007. The armed forces had recently re-engaged in Afghanistan and stayed for a further seven years. The support, welfare and treatment initially provided by Help for Heroes bore fruit from the horrendous injuries that our brave service personnel suffered in that conflict. Throughout those seven years and beyond, along with improvements to equipment, we have made great strides in ensuring that the best medical support is available from the MOD, charities and the NHS. I would like to take the opportunity to pay tribute to both Bryn and Emma Parry, whom I have got to know very well over the last couple of years, and thank them for all their service in leadership of this charity. I wish them well for the future.

[Jim Shannon (Strangford) (DUP)]

I had a meeting with a Department for Environment, Food and Rural Affairs Minister, which is why I could not attend this Adjournment debate any sooner.

In Northern Ireland, about 100 veterans have tried to commit suicide over the last year and a half, mainly those who served in Afghanistan. Those veterans are not with any charity or regimental association—they are under the radar. What can be done to reach those people that nobody knows about, but who have been affected very greatly by what they saw during their service in Afghanistan?

[Mark Lancaster]

I intend to visit Northern Ireland shortly. For obvious reasons, I appreciate that there is a unique set of circumstances over there, and I am determined to do my bit to address them. Of course, communication is the key. I shall explain in a few moments how I believe we can help, but the key is making sure that support services are available and communicated. All too often, help is out there, but it is not clear how our veterans access it. I intend to say a few words about that if the hon. Gentleman will bear with me.

I informed the House earlier this year of a plan to improve the care received by the most seriously injured and highly dependent service personnel and veterans. Currently, this support is funded and delivered by a number of separate agencies, including the MOD, the NHS, local authorities and charitable organisations. As such, we have a pilot, which is ongoing, that sees care of this kind co-ordinated and delivered by a new integrated high-dependency care system—I think we need a better name. It produces a joined-up and improved system of care for the individual, reducing strain on local care commissioning groups. The early signs are that this is going well. I am happy, once it is established, to see how to extend it to a wider cohort of veterans.

[Michael Tomlinson]

On that very point, I invite the Minister to look at the Dorset model—I mentioned a few moments ago the work that Andy Gritt is doing in this area—to see whether it can feed into the model that the Minister has just mentioned.

[Mark Lancaster]

I would be delighted to look at that model and see whether we can learn any lessons from it.

The aim is that this system will provide confidence for a small number of individuals and their families that their clinical, health and social support needs will continue to be met when they leave the armed forces and for the rest of their lives.

On the point about a single point of contact for veterans, I have good news for my hon. Friend the Member for Plymouth, Moor View. The armed forces covenant fund has £10 million each year to support the covenant by funding projects that address specific priorities, one of those being the creation of a veterans gateway. The aim of this initiative is to provide a single point of contact via a fully transactional website and one telephone number, together providing an information clearing house that takes into account the needs of all veterans, wherever they may be located. An announcement will be made very shortly on the preferred bidder for this contract, with this facility being launched during 2017. Further to that, there is the armed forces covenant website itself, which both serving and former serving personnel may access.

I am the first to recognise that the support of our veterans and the services that are provided for their welfare are not perfect. Nothing is, but I, like my hon. Friend, and indeed all hon. Members here tonight—it is a very good showing for an end-of-day Adjournment debate—am determined to do more. For example, the Department for Communities and Local Government is doing important work on supported housing, ensuring that local authorities have afforded priority where it is due. The DCLG has also introduced various measures to improve access to social housing for members of the service community, including veterans. That includes changing the law to ensure that local authorities always give seriously injured service personnel and veterans with urgent housing needs high priority in the provision of social housing. As for health, NHS England is introducing new initiatives in mental health services for veterans, the details of which contain expert input from MOD officials. Those are just a few examples of the collaborative work that we are undertaking throughout the Government.

[Maria Caulfield (Lewes) (Con)]

May I make a plea on behalf of NHS workers? Veterans care is a very specialised area, and doctors, nurses and other staff need training and support if they are to care for veterans adequately. We have a great deal to learn from veterans. For example, the McIndoe Centre in East Grinstead was established because of the need to look after veterans who were returning from warfare, and that has benefited the country as a whole.

[Mark Lancaster]

I entirely agree with my hon. Friend. The issue of veterans healthcare is crucial, and I have been looking into the issue of veterans mental health care in particular. I am delighted to see that my hon. Friend the Member for South West Wiltshire (Dr Murrison) has just entered the Chamber. His report “Fighting Fit” involved a great deal of work, and I am pleased to say that we have implemented nearly all his recommendations. Vital work is now being done to enable the medical records of service personnel to be transferred to the civilian national health service so that we can effectively track our veterans.

We must ensure, from the day people join the services until the day they leave, that they are ready for the transition to the civilian world, and collaboration and co-operation are key elements of that. We must continue to work with other Departments, with local authorities and with the charitable sector to build on what we have achieved thus far.

Once again, I thank my hon. Friend the Member for Plymouth, Moor View for raising this important issue.

[Johnny Mercer]

I sense that my hon. Friend is beginning to wind up his speech. Before he does so, let me thank him for his response, and also point out that it is imperative, as far as Conservative Members are concerned, that we do everything on the basis of the evidence that is presented to us. We can talk persistently about the fact that the armed forces covenant is working or about veterans care, but it is clear from the strength of the attendance in the Chamber this evening and from the stories that emerge each week that the current system is not working as well as it should.

I understand why my hon. Friend dismissed my proposal for a Department for Veterans Affairs, but such Departments work elsewhere. My proposal is not based on the United States model; it is completely different. I ask him not to close his mind to the concept, because I think that until we do something like that and fundamentally change the present position, we will not stop the haemorrhage of bad veterans care in this country.

[Mark Lancaster]

Let me say two things to my hon. Friend. First, I do not think that it is just Conservatives who care passionately about this issue; I am confident that Members on both sides of the House care passionately about it, and I have been greatly encouraged by the positive co-operation and constructive support for progress that I have observed on the part of Her Majesty’s loyal Opposition. I hope that that continues, and I am sure that it will. Secondly, I do not have a closed mind about anything. I would like to think that during my tenure as veterans Minister to date—given that I have just praised Her Majesty’s loyal Opposition, it may well come to an end quite shortly—I have demonstrably tried to take a fresh approach to a number of issues, including mesothelioma. I have looked at issues again, and I am currently looking at a couple of issues that are in my inbox.

I do not have a closed mind. All I am saying is that at the moment, on balance, I do not believe that my hon. Friend’s suggestion constitutes the right approach. We have heard this evening about how other areas of government can contribute effectively to the care of our veterans. I also feel—this point was made by my hon. Friend the Member for North Wiltshire—that we should not allow the other areas of government, and society, to feel that responsibility for our veterans has somehow been delegated to a small part of government. I believe—at the moment, on balance—that that would be a mistake.

Question put and agreed to.