Armed Forces Covenant

Debate between Madeleine Moon and Douglas Chapman

Thursday 22nd November 2018 Commons Chamber

[Douglas Chapman (Dunfermline and West Fife) (SNP)]

Let me echo the comments made by the esteemed Chair of the Select Committee and congratulate our colleague on the NATO Parliamentary Assembly, the hon. Member for Bridgend (Mrs Moon), on her elevation in becoming the NATO Parliamentary Assembly president. I am sure she will serve in that role with great distinction. All I can say is—I was there when it happened.

[Mrs Moon]

I would not want people to think I had already got above myself, in not being here for the start of the debate. I had a visit from members of Parc prison, in my constituency, who went to the Ministry of Justice to be given an award for their work with young prisoners with autism, and I felt they deserved my time. This was not a case of neglecting this debate; I got here as quickly as I could and I do apologise to colleagues.

[Douglas Chapman]

I welcome the opportunity to speak in this important debate on a topic that affects every Member of this House. Those who are serving or who have served in our armed forces are owed a great debt of gratitude by us all, and they deserve to be supported and looked after, both in service and after they have left.

The core principles of the armed forces covenant set out to ensure that these individuals suffer no disadvantage compared with other citizens when it comes to accessing services and that, where appropriate, they are given special consideration. However, according to some of the personal accounts I have heard, that is not always their experience. We have heard a long list of other examples from people across the country for whom this is not their experience either. We know that that must change, and I welcome the Minister’s recognition that change was inevitable and that continuous improvement in the support for veterans was required.

The Ministry of Defence is currently struggling to recruit and retain the personnel we need. This year, the British Army was 4,000 troops short of the 82,000 it was set to have; only 7,500 were recruited. It is 2,000 shy of the 10,000 required to maintain troop numbers. The total number of trained personnel based in Scotland dropped by almost 2% in 2016, to 9,970; with a drop of almost 19% in the officer ranks. Across the rest of the UK, the picture is no better, with an astonishing 10% drop in the number of new recruits. The Public Accounts Committee report published in September reported skills shortages in more than 100 critical trades. All of this leads us to see a jigsaw that will undoubtedly have an impact on existing personnel, through increased workloads and pressure, not to mention an alarming lack of capability to respond to the changing threats facing the UK.

On remuneration, the Government say that they are moving away from the 1% pay cap for public sector workers, which is to be welcomed. However, the Defence Committee noted that

“no additional funding will be made available to the MoD for increases above this level for Service personnel”.

Those who serve in our armed forces are exceptionally skilled and committed people, and they absolutely deserve better than what they are getting at the moment. Furthermore, if we are to have any hope of attracting the talent and skills we need to the services, the MOD has to do better than the decidedly unattractive package currently on offer.

Other Members have talked about housing. For years, service personnel and their families have had to put up with poor maintenance standards that would simply not be tolerated in the local government sector. In June, the Defence Committee stated:

“The record of CarillionAmey, the Ministry of Defence and the Defence Infrastructure Organisation (DIO) in managing Service accommodation has been lamentable.”

This disrespect of armed forces personnel and their families is one of the reasons that people are increasingly leaving the services. Ministers must urgently grip the dysfunctional organisation and lay out an action plan for radical improvement.

[Mrs Moon]

One of the issues brought to my attention by John Allison is the problem with local authorities’ residency rules for allowing people to move from the military into areas where they might not have had a previous residence in order to set up home. That is resulting in people being denied housing accommodation. This should have been dealt with in the armed forces covenant. Does the hon. Gentleman agree that we need to ensure that we do not have a homelessness problem among our veterans when they leave the military?

[Douglas Chapman]

The hon. Lady makes a valid point, and I will discuss what is happening in that regard in Scotland a bit later in my speech.

Ministers must get a grip of the current situation if they are to convince service personnel and their families that they are valued and that their housing needs will be cared for appropriately in future. The welfare of families is often challenged directly by the difficult lifestyles of those who serve, and considerations relating to the continuity of education for children, support for spouses, financial advice and family accommodation must be taken more seriously.

I would suggest that veterans in Scotland have a somewhat different experience of accessing public services from those south of the border, and I make no apology for that. It is a thoroughly good thing, and if we can learn from other parts of the UK in order to improve matters for everyone, surely that is the best way forward. The Scottish National party Government in Edinburgh established a £1.3 million Scottish veterans fund to support projects that provide a wide range of advice and practical support to veterans. As well as having a Minister responsible for veterans in the Scottish Government, we have appointed a Scottish veterans commissioner—the first such position anywhere in the UK. Our commissioner produced a report on veterans’ health and wellbeing earlier this year, the recommendations of which the Scottish Government are taking forward.

Members have mentioned the importance of armed forces champions, and I want to say a big thank you to my local authority armed forces champion, Councillor Rod Cavanagh from Fife Council, who does a tremendous job. I am sure that his commitment and efforts are being replicated across the country by our other armed forces champions to keep the needs of their armed forces at the heart of local government, alongside the work that we do here to keep these matters at the heart of central Government.

The care and health of our veterans is of huge importance, particularly in the area of mental health, which the Minister spoke enthusiastically and sincerely about. Our society is becoming more open to discussing mental health issues in general, but we must ensure that the specific concerns of veterans are included within this evolution. The armed forces charity SSAFA found in 2016 that 40% of working-age veterans said that they were suffering from depression, that 36% felt they had a lack of hope or purpose, and that 30% reported mental health problems. SSAFA also found that loneliness and isolation were widely reported. I welcome the £10 million of further support allocated to addressing the mental health needs of veterans at the last Budget, and I hope that that line of funding continues to be a priority area for addressing the needs of veterans.

I should like to return to the question of housing and homelessness. There are varying estimates of the number of veterans who might be homeless, ranging from 7,000 to 13,000 across the UK. It is shameful in this day and age that homelessness should be the future for any citizen, never mind for people who have served their country. Members may be aware that, in Scotland, all local authorities have a duty to provide permanent accommodation for all applicants who are unintentionally homeless. The code of guidance on homelessness in Scotland states that housing applications from veterans should be treated sympathetically and that close links should be made between the armed forces and local bodies to help to support those re-entering civilian life. The Scottish Government have also recently updated their Scottish housing guide for people leaving the armed forces and for ex-service personnel, which contains advice on all accommodation options for veterans.

There are a lot of really good organisations already providing support to armed forces personnel and veterans in Scotland, and we all know who they are, but I would welcome the development of a more comprehensive support network for veterans and, in particular, for those who feel that they have absolutely nowhere to turn. I look forward to seeing the new tri-service defence holistic transition policy when it is published next month, and I hope that it will go some way towards filling the gaps.

My SNP colleagues and I support the creation of an armed forces union to accommodate the wide range of interests, concerns and identities within this community. We owe our armed forces personnel a voice in the development of policies that serve and support them and their work, and this should take the form of a permanent organisation that can readily represent and consult current and former personnel. The body should be able to be truly representative. It would not be a trade union in the sense that people would be able to go on strike. Rather, it would be like the bodies that support police officers, for example. Such a body could support our armed forces personnel to enable them to raise genuine concerns and areas of interest affecting all serving personnel in a mature and adult way, to ensure that their voice was heard.

The armed forces covenant has provided a central focus for developing a veterans policy, but there is still much more work to be done. We need to do all we can to ensure that our veterans and serving personnel feel included in the decisions that are made on their behalf to help them back into civilian life. I speak for all my colleagues on these Benches when I say that we stand ready to support any measures that the Minister might wish to bring in, so long as the issues around pay, housing and support for our armed forces personnel and veterans are at the heart of the discussions.

Lariam

Debate between Madeleine Moon and Douglas Chapman

Thursday 27th October 2016 Westminster Hall

[Mrs Madeleine Moon (Bridgend) (Lab)]

I beg to move,

That this House has considered the Fourth Report from the Defence Committee of Session 2015-16, An acceptable risk? The use of Lariam for military personnel, HC 567, and the Government response, HC 648.

Before I turn to the overview of the report and the conclusions of the Select Committee on Defence, I want to put on record our thanks to those who gave us the impetus to investigate the issue and contributed their knowledge and their time. I apologise if I leave anyone out. Our thanks go to Trixie Foster and the retired Colonel Andrew Marriott for their persistence in raising the issue and co-ordinating a detailed submission; to defence correspondents who took the matter up; and to Forces TV whose work brought in more evidence. I thank the Library for its research and our Clerks, who do a magnificent job, as well as the witnesses who appeared at our three evidence sessions, including from the drug’s manufacturer, Roche.

I would also like to put on record my personal thanks to the Committee for agreeing to pursue the issue for the sake of the approximately 25% to 35% of personnel who have taken Lariam who have been directly affected. The Committee was determined to ensure that the Ministry of Defence would examine the damage to lives and the failure of the duty of care, and to make the necessary recommendations to protect our armed forces personnel in the future.

Lariam is one of several antimalarial drugs that the MOD uses to protect military personnel against malaria. None of the alternatives is without its problems, but Lariam has been the subject of concern for a long time. The inquiry set out to establish a clear picture of the impact of its use in the UK armed forces. I think it is fair to say that the Committee was shocked and surprised by what we found. I will leave others to go into details, as it is my role to give an overview of our principal conclusions and recommendations.

From the evidence we received from individuals and the statistics that the MOD provided, we were shocked that Lariam is still being used so often despite the well-known problems. We were told by the drug’s manufacturer that the MOD accounts for one fifth of all its UK sales. At a minimum, 17,368 personnel were prescribed the drug between 2007 and 2015. There may well be more, but one of our findings was the haphazard nature of MOD medical record keeping. Note to the Minister: it was particularly unhelpful when the MOD published its first 10-page statistical bulletin on Lariam on the day we took evidence from the Minister.

The MOD receives advice from the Advisory Committee on Malarial Prevention alongside the advice from the manufacturer. Roche is clear in its guidance that every individual who is prescribed Lariam should undergo an assessment with a medical professional to identify any contra-indications that might make them more susceptible to side effects. We questioned whether the ACMP’s advice was appropriate. It was clear to us that the general advice that it offered was not tailored to the specific needs and circumstances of the military. It fell short and put military personnel at risk. We concluded that the MOD should work with the ACMP to develop specific guidelines, similar to the US so-called “Yellow Book”.

[Douglas Chapman (Dunfermline and West Fife) (SNP)]

Is the hon. Lady now confident that the MOD will be able to deliver on the duty of care and the commitment to proper prescribing of Lariam, especially when a large number of troops are leaving at the same time?

[Mrs Moon]

If I am perfectly honest, no. I think that the medical care that is offered continues to fall short, but I hope that the Committee will be able to address the issue again in future and ask for further updates. Of course, we have the opportunity to hear from the Minister today what further progress has been made.

Alongside our findings about the ACMP, we looked at whether Lariam was appropriate to where personnel were sent and the work that they do. The Minister and the Surgeon General told us that geographical location was a consideration in prescribing Lariam. By contrast, other witnesses made it clear that there is nowhere where Lariam should be the preferred drug, particularly given that there is increasing resistance to it and there are alternatives available. Geography aside, and linked to our earlier concerns about the ACMP advice, we sought to clarify whether Lariam, given the known side effects, was appropriate at all in a military setting. A military deployment is a world away from a tourist sightseeing or sitting by a pool. The physical and mental strain of being deployed in stressful situations does not need to be exacerbated by the severe side effects that Lariam can induce.

Dr Nevin gave evidence of an alarming potential negative impact on military performance and operations. There were cases of service personnel experiencing

“episodes of panic resulting in abnormal behaviour”

and incidents of servicemen becoming confused and being found “wandering aimlessly”. There were incidents of tension and anger, episodes of severe mental and physical exhaustion and nausea, lapses of concentration and episodes of short-term memory loss, ill temper, dangerous driving, confusion and suicide ideation. That is a grim picture of medically induced problems for military personnel on deployment.

We explored whether other nations gave Lariam to their armed forces. Our research uncovered a mixed picture, but a tendency towards either no longer using Lariam at all or using it only as a drug of last resort. That all added weight to our recommendation that greater clarity is needed in determining when to use Lariam, and that attention should be paid to whether it is appropriate for military personnel.

At the heart of our inquiry was the question whether the MOD was fulfilling its duty of care by following the clear guidance on prescribing Lariam. Did every individual undergo the Roche-required individual medical assessment prior to deployment? Was it realistic to think that the MOD could ensure that that happened, particularly for a large-scale, short-notice deployment? Alarmingly, there was evidence that individual assessments were not happening. Lariam was included in pre-deployment kit; it was handed out on parade; or the MOD relied on an assessment of medical records only for prescription. We felt that that was a fundamental failure in duty of care. We concluded that, aside from the need to consider the practicalities of arranging assessments, prescribing Lariam should only ever be a last resort bounded by strict conditions. Linked to that, we uncovered concerns about non-reporting of contra-indications; military personnel appeared unwilling to admit to conditions such as a previous history of depression, because of fear of a negative impact on their career. That underlines even further the need for individual assessments.

Several witnesses reported that personnel were so concerned by the reputation of Lariam that they discarded their medication and were potentially left with no antimalarial protection at all. That came even from the very top. I believe Lord Dannatt has announced that he refused to take Lariam and would throw it away. We were deeply disturbed by that and recommended that the MOD should monitor compliance rates.