Charities: Veterans Care Sector

Mims Davies Excerpts

Thursday 24th March 2016 Commons Chamber

[Johnny Mercer]

I thank my right hon. Friend for his intervention. I will address precisely that point in about two or three minutes’ time.

[Mims Davies (Eastleigh) (Con)]

Does my hon. Friend agree that local authorities must play a part in co-ordinating local charity work and supporting veteran care so that we ensure that our councils work with the armed forces covenant properly to produce tangible local results?

[Johnny Mercer]

I could not agree more that local and national Government should be involved in delivering that. We need to be careful about the involvement of local elected officials in veterans care. There is nothing political about veterans. It is a national issue and one that I wrestle with in Plymouth. We need to make sure that we stay in the lane of delivering a service for veterans, and the local professional side of the council is well placed to do that.

To sum up, the individuals who are suffering most from the changing tides in the debate are the blokes. Too many are falling short. Too many struggle to access care. Every weekend another case is reported in the Sunday papers. While the national debate moves on to Europe, national security, the deficit and other important issues, those soldiers’ lives stand still, awaiting an intervention by somebody who cares. They are the lucky ones: their stories got in the paper, and they inevitably get helped by that knight in shining armour—the Great British public. However, for every one of them, there are many who do not get helped.

What is it really like for someone to be two or three years out of the Army—holding down a civilian job and providing for their family—when they start hitting rougher waters, and the thoughts just will not leave them alone? Where do they go? To whom do they turn? Do they self-refer to a charity and hope for the best? How do they know that it provides care that works? How do they know that it is professional? What happens if the course of treatment it provides does not work? Who will help them through the process? Who really cares?

The pre-Christmas report by the Ministry of Defence on the armed forces covenant made wide reference to what is going into the arena of military support, and that is to be commended. However, the report fails to provide any meaningful statistical reference to the single most important measure of success: what our military community got out of that support. The single biggest shift in mindset that must be achieved is about reconfiguring services around users.

There are problems: waiting times are simply too long; there are distinct regional variations in the services available; there is a huge challenge to veterans navigating a complex set of unclear treatment pathways; and there is a lack of regulation of the quality and efficacy of the treatments being provided by some, with some of the more unscrupulous outfits still receiving Government finance. The truth is that our veterans today use an array of treatments, which vary wildly in effectiveness, professionalism, access points and delivery, and that is especially so with mental healthcare.

I hope I have outlined why this debate is so important and so timely, and why it is tough for those of us who have been through these wars to let go of this issue, for which I am afraid I make no apology. I therefore want to add to the debate—to offer a solution to the Government so that we can get this issue right. I want the Prime Minister, who has always understood this issue, to accept that getting it right in this Parliament is part of his legacy, and I know that he does accept that. Chiefly, however, I want the MOD to really understand the challenge we face in getting this issue right now, and I make that appeal to the MOD today. There will always be better times to reform; there will always be opportunities to duck difficult issues because of the lack of a 100% solution; and there will always be those who have lost focus on who is at the centre of these services—the men and women to whom we owe so much.

How do we fix this? Users should be able to choose the service they wish, but they should be provided with unbiased assistance and helped to navigate their way through a highly complex array of services. We must be realistic in our reform. Currently, many of these services are not evidence-based, and some appear, unhelpfully, to compete for business, while a few are even unsafe or unethical in their approach.

If we are to produce the first-class service that the military service community and, indeed, the nation—having committed so much of its own money—deserve, wide-reaching but fair reform will be needed. That reform must be focused exclusively on the key principles of the following four streams: evidence-based treatment; a cultural shift, with the aim of creating not good veterans, but good citizens who have served; a service configured singularly around the service user, which will include service families; and clear and accessible care pathways.

It is worth noting at this stage that a sustainable model of future veterans care and support in this country cannot simply be modelled on how other nations have done this. We face a similar but subtler challenge in the UK, given our cultural and societal perceptions of serving and retired military service personnel and their families. Let me repeat that key point: veterans care must be singularly and exclusively configured around the needs of the user, with ease of access and dedicated casework management, rather than just signposting, at its core.

What do those four points look like in a little more detail? The future actually looks very similar to the present, but with key organisational, control and attitude changes. We are not looking at a huge demand or fiscal commitment to get this right. The Government must step up and take command of the national veterans challenge. Ultimately, it is the nation’s responsibility to care for our servicemen and women, and that must be realised.

The Government’s role in all this would be clear. They would provide access to service records. They would ensure there was a uniform access process across all providers, taking responsibility for a single point of contact. They would need independently to control the impartial case management of individuals, which would be focused entirely around individuals and their specific needs, which must be met. The Government must commit to providing interoperable case-management software and access to, or information about, NHS and other care providers’ data. Chiefly, however, they must accept some sort of legal responsibility for ensuring that there is that care pathway. The actual delivery of services would remain with the current providers across the charitable and NHS sectors.

What sort of reform is needed in the service charity sector? With our young men and women potentially at vulnerable stages in their lives, approaching almost anyone who can claim to provide a service, there can be no doubt that we need some sort of regulation—with a small “r”—of our service providers, which is something only the Government can do. It is not good enough to ask the veteran to shop around and bounce from charity to charity without resolving his issues. Too much has already gone into the system: too much time has been invested and too many cases have been exposed to allow that to continue.

I and everyone else in the sector are clear: nobody can tell a charity what to do—that is not what these reforms are about—but it would be naive to suggest that the entire sector is optimised at present to deliver care for veterans, which is a nation’s responsibility. With more than 2,500 military charities and funds, it is not realistic to suggest that there is no duplication, waste, bad practice or financial misdemeanours.