Veterans (Mental Health)

Simon Burns Excerpts

Wednesday 7th March 2012 Westminster Hall

[John Pugh]

I defer to the hon. Gentleman’s experience, and he is probably right in advocating that solution. The question is who will secure that proper mix.

[The Minister of State, Department of Health (Mr Simon Burns)]

Will the hon. Gentleman give way?

[John Pugh]

The Minister is going to tell us.

[Mr Burns]

I am grateful to the hon. Gentleman. Given that I will not have very much time to speak, can I deal with the question of who will commission veterans’ mental health services? It will be the responsibility of the NHS Commissioning Board.

[John Pugh]

I am relieved that it is placed within an appropriate body, although the board has an awful lot else to do.

--- Later in debate ---

[The Minister of State, Department of Health (Mr Simon Burns)]

It is a pleasure to serve under your chairmanship, Mr Dobbin. I am delighted that the House once again has the opportunity to debate an important issue, although it is sad that we are holding this debate against the backdrop of tragic news from Afghanistan. We await the final details of what has happened over there, but we must give full consideration to the families and friends who might be suffering at this terrible time.

I congratulate my hon. Friend the Member for York Outer (Julian Sturdy) on securing this debate. I also thank the other hon. Members who have taken part. The number of hon. Members in the Chamber for a Westminster Hall debate shows how important it is and why a debate is justified after we had one only three months ago.

I congratulate my hon. Friends the Members for Hexham (Guy Opperman), for Rugby (Mark Pawsey) and for Brigg and Goole (Andrew Percy) on their contributions, and I thank the hon. Members for Newport West (Paul Flynn) and for Southport (John Pugh) for theirs, but I particularly congratulate my hon. Friend the Member for York Outer on the measured, informed and caring way in which he introduced the subject. It became clear as I listened to him that it is important to him as both a constituency Member of Parliament and as an individual. That came through during the course of his remarks.

As hon. Members will be more than aware, members of the armed forces put their lives on the line for their country, but it is we as parliamentarians who send them into combat. It is therefore incumbent on us to do everything that we can to protect their health and well-being, that of their families and that of veterans. There is no issue of greater importance for this Government, and I am pleased that my right hon. Friend the Prime Minister has made it one of his priorities.

It is crucial and universally accepted that the health care provided by the Defence Medical Services to serving members of our armed forces is second to none. It is equally important that services are provided for our veterans for the rest of their lives when their health is affected as a result of their service, and that those services should be second to none. That is why I am pleased that in recent years, great strides have been made. I was particularly delighted to see in the Chamber a former Minister who had responsibility for veteran affairs during the previous Administration: the hon. Member for Halton (Derek Twigg), who was here to listen to and participate in this debate. While he served in that post, he had a record of which he could be justifiably proud.

Several Members, including my hon. Friend the Member for York Outer, raised the question of funding. Real-terms funding for the NHS as a whole is increasing, as we all know, but we have invested more than £7 million of funding in veterans’ mental health over the spending review period. I reassure hon. Members that we will continue to fund veterans’ mental health initiatives for the lifetime of this Parliament.

The focus of this debate is on raising awareness of veterans’ mental health. I feel strongly that we are now tackling the issue from a far more informed position than we once did. Thanks to charities such as Help for Heroes, the Royal British Legion, Combat Stress and the Soldiers, Sailors, Airmen and Families Association, awareness of the well-being of the military community is high both in Parliament and, fortunately, among the general public.

I highlight the work of my hon. Friend the Member for South West Wiltshire (Dr Murrison), to whom many hon. Members referred. The report that he produced will push forward the agenda to improve and enhance veterans’ health. My right hon. Friend the Prime Minister asked my hon. Friend to conduct a study on the relationship between the NHS and the armed forces, including former service personnel, in terms of mental health. The result was the report “Fighting Fit”, which I commend to those who have not already read or seen it, although, judging from my hon. Friends’ speeches, a disproportionate number of hon. Members in the Chamber have read it.

I am proud to say that both the Department of Health and the Ministry of Defence have been working on the report’s implementation ever since it was published, which represents a milestone in the effort to improve mental health care for ex-service personnel. For me, one of the strongest themes of the report, and a factor that is particularly relevant to the topic of this debate, is the effect that service care can have on the mental health and well-being of those who have served. Some obvious themes emerged from the findings of my hon. Friend the Member for South West Wiltshire, echoed in research by some of our partner organisations, in particular our strategic partner, Combat Stress. Its research shows that the average ex-serviceperson can take up to 14 years to seek help for anxiety and depression that has developed as a result of their service in the armed forces. Combat Stress put it vividly, and said that

“those veterans suffer terribly in silence, often for years, before seeking help”,

a fact that was echoed in hon. Members’ speeches.

We must keep that in mind when services are designed. The help that we offer must be accessible throughout veterans’ lives, not just when they return from duty. We must also remember that today, we may just as well be designing and delivering care for Falklands veterans as for those who have served bravely in Iraq or Afghanistan. We owe it to all groups of veterans to get things right, to understand that mental health issues can come into an ex-serviceperson’s life long after they have been discharged, and to communicate that message to the public. It should be a key part of any awareness campaign.

“Fighting Fit” makes it clear that some veterans can never bring themselves to seek help—those who will not admit, even to themselves, that they have a problem, and who must rely on close family members and friends to help them move forward. In partnership with Combat Stress, we have launched a 24-hour veterans’ mental health support line run by a charity, Rethink. The helpline is based on the principle of lifelong care and offers support to veterans of any age and at any stage in their lives. Families may also contact the helpline, both for themselves and to talk about a loved one. It allows both groups to receive targeted support from people trained and experienced in dealing with often complex mental health needs.

Both my hon. Friend the Member for York Outer and the hon. Member for Denton and Reddish (Andrew Gwynne) raised the issue of funding the helpline and its future funding. I am extremely pleased to announce that the total number of calls taken by the helpline is now upwards of 5,000. Hon. Members may be aware that we initially launched the helpline as a one-year pilot, which expired at the end of February this year. However, I am pleased to announce today that we are continuing to fund it for the next year and will consider future funding after that. Working closely with Combat Stress and other partner organisations, it will continue.

We are also working to introduce a veterans’ information service over the next two months or so. It will routinely contact service leavers 12 months after they are discharged to establish whether they have any health needs that require attention. The “Fighting Fit” report refers to the service as something of a safety net to help veterans once the support structures available to them during their service lives are no longer readily accessible. To get it right, it is essential that we are able easily to identify veterans, so we are working with the Ministry of Defence to ensure that a veteran’s status is properly recorded on his or her records. However, we must equally recognise that some who leave do not wish to have their veteran’s status recorded, and it is right to respect those wishes.

Returning to the issue of the safety net, there is another key point when it comes to an awareness of mental health issues of any sort. Perceived isolation can have a bad effect on mental health problems. The problem is bad enough anyway, but among ex-service personnel, it is often particularly bad, because the camaraderie that exists within a forces setting is so pronounced. It makes sense that once the institutional support network goes, an ex-serviceperson might feel alone, adrift or isolated. Support services should not necessarily try to recreate that camaraderie. It is often more beneficial in the long term to help veterans come to terms with their change in circumstances. By creating services that are easily accessible and trustworthy, we are going some way towards building an environment in which an ex-serviceperson feels accepted and understood, and in which recovery is more likely.

At the heart of easily accessible services should be a requirement to make them readily available in each local area. Having a service in each area, especially if it has a high military profile, goes a long way towards raising awareness of veterans’ mental health issues in the country as a whole. I am particularly proud of the effort that the Department of Health and my officials have made to spearhead the set-up of armed forces networks in each of the old strategic health authority areas. The networks are groups of representatives from the national health service, service charities and the armed forces who can represent the health and well-being interests of serving personnel, their families and veterans in the local area.

As part of meeting the “Fighting Fit” recommendations, integrated veterans’ mental health services are now being set up in each network area by the local NHS working in conjunction with Combat Stress. The services are at different stages of development, but I can tell my hon. Friend the Member for York Outer, who specifically asked about this, that six of the 10 are already up and running and the remaining four will come online shortly.

We have also increased the number of mental health professionals providing services to veterans, not by the 30 recommended in the Murrison report, but by 50. My hon. Friend will be aware that the recommendation was 30, but we have been able to exceed that, and there are now 50 in place, which will considerably help to provide support and assistance to veterans.

[Gemma Doyle]

Will the Minister give way?

[Mr Burns]

No, I will not, because I am almost running out of time.

The partnership with Combat Stress and the innovative solutions delivered by the NHS at a local level is to be applauded. Regarding effectiveness, we are still in early days, but initial feedback has been positive, with more veterans being identified in the mental health care system and receiving the treatment that they need and deserve.

I want to point to an example of what is happening in the constituency of my hon. Friend the Member for York Outer. The work of Andy Wright with the vulnerable veterans and adult dependants project is particularly noteworthy and warrants praise. I am delighted to report that the project has delivered high levels of patient satisfaction, with 85% being very satisfied with their therapist. It is an excellent example of collaboration, which can only serve to raise further the profile of veterans’ issues more generally.

There is a final and vital aspect of veterans’ mental health and care that I would like to explore, which hon. Members have mentioned, and that is stigma. The title “Fighting Fit”

“recognises the importance of stigma and of making interventions acceptable to a population accustomed to viewing itself as mentally and physically robust.”

Stigma is a big barrier standing in the way of ex-service people getting help, and it is vital that we do everything we can to reduce it. Many Members on both sides of the House will be aware of the “Big White Wall”, an online well-being network for serving personnel, their families, veterans and the general public. It is a social network that allows people with mental health problems from every walk of life to engage with others who have similar problems. The anonymity of the network allows for a free and frank exchange of experiences, with a view to generating a wider sense of support, and it is staffed by professional counsellors. The Department of Health and the MOD are funding a one-year pilot for service personnel, their families and veterans on the “Big White Wall”. I am pleased to say that it has had excellent take-up. Up to 1 March, 2,019 places of the original 2,400 provided in the pilot have been filled. Of those, veterans represent 40%, with 38% being serving personnel and 22% family members.

Launched on the same day as the “Big White Wall”, and in conjunction with the Royal College of General Practitioners, an online e-learning package aims to educate civilian GPs about the conditions from which veterans often suffer. The idea is to reduce the stigma attached and increase the likelihood that GPs will be able to give veterans effective and suitable care. That has been successful with its target audience; the package has had almost 14,000 hits since its launch.

I believe that there is a consensus on both sides of the House that much is being done, but much more remains to be done. The more we as Government can engage with veterans, the public and the media, the more likely mental health issues will be understood more widely. I hope that hon. Members on both sides of the House will continue to work together to help the services reach their full potential, so that no ex-serviceperson ever has anything less than all the support that they need of the highest quality.