Service Personnel and Veterans: Rehabilitation

Tonia Antoniazzi Excerpts

Tuesday 22nd November 2022 Commons Chamber

[Tonia Antoniazzi (Gower) (Lab)]

I welcome the opportunity to discuss in this House the rehabilitation of injured and sick service personnel and veterans. The people of our constituencies and of this country send us to this Chamber to represent them, but all too often what we discuss on these Benches seems a million miles away from the realities of those we seek to serve. We talk about the overview of massive nationwide schemes and about budgets in the tens of millions. We find ourselves talking about people as statistics—the percentage who need x, the numbers who have used y. It is only right that we talk about the big picture and the huge issues that this country faces, but I would like to use this opportunity to talk about some of the people we seek to serve: those who have served us and their country.

It is particularly poignant to speak in this House about the rehabilitation of veterans and service personnel in the week following Remembrance Sunday, when Members across the House attended services in honour of those who have given their lives in service. It is important that we all recognise that remembrance is not simply about familiar symbols and services over a few days in November, but about remembering those we have lost, honouring them by doing what we can to support the living, and recognising the reality of their lives.

Last year, I was honoured to be invited to join the armed forces parliamentary scheme. The scheme aims to give Members of Parliament like me, with no experience of serving in the armed forces, an insight into military life. I had zero insight into that world until I took part in the scheme with the Royal Navy and with Royal Marine commandos. Along with some unforgettable experiences, I had the chance to meet service personnel from all walks of life, hear from them about their experiences, see them training and see them in the field. I actually bumped into ex-pupils from the last 20 years of my teaching career, which was quite the occasion.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Lady for securing the debate; I spoke to her beforehand. I fully support what she is saying and what she means. A charity in my constituency called Beyond the Battlefield offers rehabilitation for service personnel and veterans and ensures that their wellbeing is taken into consideration. As well as rehab, it offers incredible mental health support and temporary shelter while veterans get back on their feet.

In Northern Ireland, housing priority has not yet been extended to service personnel, so they are often left in housing need if they become ill or injured. Does the hon. Lady agree that a more in-depth discussion is needed to ensure that veterans are protected through priority housing if they become ill or injured while in service or out of service?

[Tonia Antoniazzi]

It is really important that we continue to have the conversation about housing needs, particularly in Northern Ireland, as the hon. Gentleman knows. I would like to continue to have that conversation with him outside the Chamber in my role as shadow Minister for Northern Ireland. I thank him for his intervention.

One thing that struck me about my experience in the armed forces parliamentary scheme was that there is no standard military job. The diversity of experiences and skills, and of people, was striking.

[Matt Rodda (Reading East) (Lab)]

I am grateful to my hon. Friend for securing today’s debate; I commend what she says. In my constituency, there are many retired Gurkha soldiers. Unfortunately, those who retired before 1997 receive a much lower pension than other colleagues in the British Army. Does my hon. Friend agree that it is very important for Ministers to listen to the issues raised by the Gurkhas? Does she also agree that it is incumbent on Ministers to continue discussions with the Nepalese Government and bring them to a fruitful conclusion?

[Tonia Antoniazzi]

My hon. Friend is right. It is important that the conversation about pensions with the Nepalese Government continues and that he speaks to the Minister and the Secretary of State about it.

Perhaps those in civilian life, like many of us in this House, too often view the armed forces as one homogeneous group. They may have one image of the type of person who enters the forces, or an idea of military life that bears more relation to a Sunday afternoon film than to reality. It is essential that we in this House do not make the same mistake. We must acknowledge both individual needs and the unique position of those who serve and have served as they transition into civilian life, and we need to ensure that the specialised services that support them are well funded and supported to grow.

These include organisations such as the British Training Board, whose goal is to make sure that the training and skills achieved in the armed forces are recognised by civilian employers. It was set up by an Army veteran, Adrian Rabey, who on leaving the service found that the skills he had gained as a teacher and trainer were not recognised by employers, despite having been told the opposite when he was in the Army. A few years later he began to see friends in a similar position and started to work with them and looking at gaps in their qualifications, and he realised that the prior learning they had untaken in the military was not being recognised. Since then, fantastic work has been going on and the British Training Board has successfully helped thousands of serving and ex-military personnel to get recognition for their previous military and public services training and experience, and it has grown to offering career development, coaching and support, which I have seen at first hand. This is a specialist service for a unique set of people, but we cannot rely on people like Adrian alone to fulfil our obligations to veterans.

In 2011 the country made a promise, founded on the unique obligations and sacrifices of those who serve or have served in the armed forces, that they and their families should be treated fairly. The armed forces covenant is in place because we recognised the unique nature of the service given to this country by those in the forces.

[Carla Lockhart (Upper Bann) (DUP)]

I thank the hon. Member for bringing forward this important issue. We have had a number of conflicts since the Falklands in 1982, including the Gulf war, Iraq and Afghanistan, and of course 30 years of troubles and violence in Northern Ireland. Our service personnel served with distinction, with many paying the ultimate sacrifice and others being left with mental and physical scars. Does she agree that, in Northern Ireland specifically, the continual glorification of terrorism is inhibiting the rehabilitation and wellness of our ex-service personnel? We have political leaders saying that it was justified and that there was no alternative, but if we continue to hear language like that our service personnel will never be rehabilitated and will continue to be retraumatised.

[Tonia Antoniazzi]

I thank the hon. Lady for her intervention. I would like to have a discussion about the glorification of terrorism with her outside the Chamber, and I thank her for raising it and putting it on the record.

We must recognise that everyone’s experiences and sacrifices are unique, and that the nature of the support they receive must reflect that. I commend the Government for acknowledging the need for targeted and specialist support through the introduction of the armed forces personnel in transition framework, which should ensure that seriously wounded armed forces personnel with very complex and enduring healthcare requirements who are transitioning into civilian life will continue to receive comprehensive support throughout their lifetime, although I and others would welcome assurances from the Government that integrated personal commissioning for veterans is being implemented effectively.

[Dan Jarvis (Barnsley Central) (Lab)]

I congratulate my hon. Friend on an excellent speech. I am particularly pleased that she has mentioned the integrated personal commissioning for veterans scheme—IPC4V—which I know was set up with veterans such as Ben Parkinson in mind. Ben Parkinson is a hero and I have been in regular contact with him and his family for a number of years. I am concerned that worries have been expressed recently about whether Ministry of Defence funding is still in place to enable charities to provide the vital services that veterans like Ben need, as was the case previously. Does my hon. Friend agree that we must ensure that those veterans’ needs are always met? Soldiers like Ben Parkinson have done their duty to our country, and we must do our duty to them by ensuring that they get the treatment they need for the duration of their lives.

[Tonia Antoniazzi]

I thank my hon. Friend for that contribution. It is essential that that funding is there from the MOD, and I would like to work with him on this. I am sure that the Minister will do so as well.

I said at the start of this contribution that I wanted to talk about people, and I want to talk about a few of the people I have come to know and about their journeys, because it is important that their stories should be heard from these green Benches. I want to tell the House about Pete and the impact that his ambition has had, not just on him but on the support that service people and veterans like him are now able to access though a phenomenal organisation that I have been lucky enough to work with called 65 Degrees North.

Pete Bowker was a lance corporal in the Queen’s Dragoon Guards. When on tour in Afghanistan, the armoured vehicle in which he was traveling was hit by an improvised explosive device. As a result of the blast, Pete lost his right leg below the knee and was discharged in 2012. In 2015, Pete became the world’s first amputee to cross the Greenland ice cap unsupported. Pete was assisted by a team put together by the formidable Richard Morgan, a former Royal Marines commando. When Rich met Pete—that sounds like a film, doesn’t it?—in 2013, as part of a team taking part in a 10-day endurance challenge to raise money for wounded, injured and sick servicemen and women, Pete told Rich about his ambition to cross the Greenland ice cap and how he had struggled to get support for it, so Rich decided to help him, because that is what Rich is like. Even when he discovered that Pete did not know how to ski—imagine that!—which is pretty important for someone trying to get across Greenland, he still carried on.

The expedition to Greenland not only fulfilled Pete’s ambition; it started something bigger. Seeing the impact of the Greenland expedition, the team behind it saw the potential for adventure in rehabilitation, which is how 65 Degrees North began. In the years since, 65 Degrees North has helped more than 100 wounded, injured and sick service personnel and veterans realise their ambitions. Offering this community the opportunity to participate in challenging, unique and, honestly, arduous expeditions, which I do not think I could achieve, supports them to regain their confidence, change their behaviours and tackle PTSD by offering a form of participation centred on rehabilitation in which outcomes are clear, tangible and empowering—that is the word.

[Conor McGinn (St Helens North) (Lab)]

The message is very clear, that service and inspiration does not stop when these individuals leave the armed forces; in some cases, it only begins. My constituent Andy Reid, from Rainford, last month became the first triple amputee from the UK to reach the summit of Kilimanjaro. After being injured in Afghanistan more than a decade ago, Andy set up the Standing Tall Foundation in St Helens. It is not just about helping veterans and those he served alongside; it is open to everyone in the town and borough. People like Andy continue to be an inspiration to this very day, and we should have them in mind in this debate.

[Tonia Antoniazzi]

That is absolutely brilliant. I thank my hon. Friend for his intervention, because constituents like Andy need to know about and participate in such activities. It is all-encompassing.

Listening to the testimonies of those who have taken part in such activities, it is clear that real-life feedback and learning, where they are asked to deal with new situations and to adapt to constantly changing conditions, gives them confidence and helps them to recapture parts of themselves that they felt were lost because of their injury and experience.

Perhaps the most powerful aspect of this approach is how it helps participants to challenge their perceptions of themselves. The research shows that cognitive dissonance has been created between a person’s perceived abilities and their actual behaviours, and it is summed up so well in the words of Zoe, a Royal Navy lieutenant:

“The first time I walked in the door, we had a really nice talk about how the whole idea was to get people outside, build some confidence. It is one of those moments where everyone kind of comes together and says, ‘You said you couldn’t do that and now look at you—you can do it.’ Pulling my head away from, ‘It hurts, you can’t do this. You haven’t been able to walk, let alone climb’ to climbing up a ridge that Royal Marine commandos use to train on the rock weekly essentially obliterated it, because I had no choice. It was like, ‘You’re going to give this a go.’”

When talking to people who have been involved, it is clear how this approach impacts positively on their mental health and wellbeing, and helps change lives for the better. There is no cure-all for PTSD or the other issues that these participants face, but there is clearly a need for tailored support and space for different therapeutic approaches as part of a holistic support model.

I would like to end—I say that, but I am not going to end soon, so do not get excited—with the words of the wife of one of the 65 Degrees North participants, who sums up not only the struggle that far too many service personnel, veterans and their families face when they need support, but the impact that is made when they receive it. We must not forget the families and the partners of our service personnel. She says:

“When Mark first told me about wanting to climb Kilimanjaro with 65 Degrees North I was very wary and I will admit now that I was cynical.

PTSD seems to be the new “trendy” charity cause that people want to be involved in, only to have them let you down. You would not believe the charities we both approached for help, only to find out that it was either not there, not in our area or we didn’t tick the right box to be entitled to help.

I remember the day I was crying down the phone to a certain PTSD forces charity, begging for them to help him, to be told as he is now working in the careers service he isn’t classed as serving in their eyes! So I was told there was nothing they could do, but when I then asked a charity that dealt with veterans, yep you guessed it, they classed him as still serving, so we just slipped through the cracks. I had to watch this man, who had given 28 years of his life, who sacrificed so much, be cast aside by these people, all because he didn’t quite meet their criteria.

So we tried the GP...who had no clue how to help.

After hours and hours of researching I did find someone who was willing to help and it did help…for a short time.

Unfortunately they didn’t seem to realise that PTSD isn’t like a cold, you don’t wake up and suddenly be cured. So PTSD was back...with a vengeance.

So yes, I was doubtful, cynical and feeling very protective that Mark would yet again be failed and let down. But I smiled, told him whatever he wanted to do I’d support him and just thought I’d have to pick up the pieces later. So our weekends became filled with mountain walks, treks up to Pen Y Fan (I actually had frost bite at one point and didn’t I complain).

Time quickly passed and it was time for him to leave…but he didn’t want to go. Fear of failure (like that would ever happen…We are talking bootneck stubbornness here) what if he didn’t like anyone? What if they didn’t like him? What if he got injured? What if? So I dropped him off and told him he’d be fine and did the thing every forces partner does... waited and worried.

But something happened, each time he was able to get in touch he sounded a bit different, calmer, stronger, positive and proud, feelings that PTSD takes from you. There were dark times, times he said he didn’t think he would make it. but he did... he conquered Kili and in doing so took the biggest leap towards a life (dare I say it) free from PTSD.

There are no words I can use to describe the change in Mark since his return, for the first time we can both see there is light at the end of this long, dark PTSD tunnel. That we aren’t alone, there are actually people out there who not only care, but are willing to help and continue to help.

So yes, I was wrong (hey, it doesn’t happen very often)”—

good woman—

“becoming involved with 65 Degrees North was one of the best things Mark has done for himself and for us. If anyone has the chance to help and get involved with them then please grab that opportunity. I promise you, it will change your life.”

I have brought up this charity with the Minister and he has agreed to meet people from it. I am very thankful for that and will arrange for that meeting to happen. I have been honoured to be able to stand in this House and talk about the experiences of soldiers and of these two charities that support our servicemen and women, and veterans, with dignity. For me, “dignity” is the key word.

I also wish to put on record, from my experience and from those of other Members who have been part of the armed forces parliamentary scheme, how unique and brilliant that scheme is. It has changed my whole outlook as a Member of Parliament. It is what should be rolled out for all parliamentarians and all their staff as a matter of course, because it is incredible.

I pay tribute to the excellent work of Commander Susie Moran from the Royal Navy and Lieutenant Johnny Longbottom, who supported my journey through the scheme, which was entertaining. It also helped this Member of Parliament for Gower, in Swansea, south Wales to gain a greater insight into the challenges of our current service personnel and a better understanding of the needs and the rehabilitation of injured and sick service personnel and veterans. I take this opportunity to thank the Minister for his comments, which will be coming, and to thank you, Mr Deputy Speaker.

[The Minister for Defence People, Veterans and Service Families (Dr Andrew Murrison)]

I thank the hon. Member for Gower (Tonia Antoniazzi) for her contribution this evening. She has raised a number of issues. I think there is a great deal of common ground, and I salute her for all her efforts in promoting the welfare of the men and women of our armed forces, our veterans and, in particular, those who require the services of our rehabilitation services.

There is, of course, a raft of support available to our personnel, rightly, to veterans and to their families. In the short time that I have available to me, I will try to outline, in response to the hon. Lady’s comments, some of those as best I can.

Let me start by summarising our rehabilitation offer for serving personnel. Our aim here is to return our regulars and our reserves to active duty as soon as possible. To that end, the MOD’s Defence Medical Services, which I used to be a part of, provides a tiered service, extending from the more minor to the most severe injuries.

First, our primary care rehabilitation facilities offer physiotherapy and exercise rehabilitation—fairly straightforward things. Should additional clinical decision making and diagnostics be required, referral to one of the 13 regional rehabilitation units across the UK is possible. They offer rapid access to imaging services and residential rehabilitation for those with moderate musculoskeletal injuries. When it comes to complex musculoskeletal disorders, complex trauma and issues related to joint and soft tissue disease, patients are transferred to the Defence Medical Rehabilitation Centre in Stanford Hall—known to many hon. and right hon. Members as its previous incarnation, Headley Court in Surrey. DMRC also supports small groups of veterans who require prosthetics through its complex prosthetic assessment clinic.

Since May 2020, a total of 16 patients have attended this service and, since March 2022, eight veterans have undergone cutting-edge direct skeletal fixation surgery for prosthesis before receiving rehabilitation at DMRC. Notably, this clinic is a joint MOD and NHS England endeavour, highlighting how partnership is a key feature of our military healthcare landscape these days.

Another example of this partnership is our defence recovery capability. This MOD-led initiative is run in conjunction with Help for Heroes, the Royal British Legion and Erskine Homes. The care it provides is centred around an individual recovery plan, integrating all aspects of recovery, including medical care, welfare, housing, education, reskilling, work placements and employment issues.

Again, those with more serious conditions can access one of our specialist regional personnel recovery units, receiving one-to-one support from a personnel recovery officer. In our major garrisons, there are personnel recovery centres, such as the naval service recovery centre in Plymouth. I should be clear that these are not hospitals, rehabilitation or physiotherapy centres, but conducive military environments designed to speed up recovery. Indeed, they provide not just residential capacity, but specially designed courses and, in the case of the Battle Back Centre at Lilleshall, adaptive support and adventure training to rebuild confidence shattered by trauma, which touches on the hon. Lady’s oral question to me on 7 November.

Hon. Members will be aware that, unfortunately, the impact of covid-19 precipitated Help for Heroes’ withdrawal from the PRCs in Colchester, Catterick, Tidworth and the NSRC in Plymouth in 2021. However, I reassure colleagues that the MOD has since stepped in to take ownership of these recovery centres and will continue to operate alongside the Royal British Legion and Erskine Homes for the Battle Back Centre and Edinburgh PRC.

I briefly turn to the rehabilitation that we offer to veterans, which is the second part of the hon. Lady’s Adjournment debate today. As of 1 July 2022, some 3% of the UK regular trained armed forces were in recovery, while some 70% seen in recovery returned to duty. The medical care our people receive is world class but, inevitably, not all who receive support can return to work. Nevertheless, we retain a duty of care to all veterans who selflessly serve our nation. The offer begins with our career transition partnership, which plays a critical role in smoothing the transition from military to civilian life. The full core resettlement programme is available to all medically discharged service leavers regardless of service length and is accessible to personnel two years prior to and two years after discharge.

There is also a bespoke service, known as CTP Assist, for the most vulnerable leavers, which is tailored to the individual needs of the client. Hon. Members will be aware that, in the past, service veterans received variable levels of support due to a complex, overlapping patchwork of provision.

[Tonia Antoniazzi]

I appreciate the information the Minister is giving us. On the point about training, is the training subject to any kind of review or standards, such as Ofsted?

[Dr Murrison]

What we do in Defence is probably world-beating—I would like to think so—but Ofsted is involved in assessing training throughout Defence, including in phase 1 and phase 2 establishments. In general, Ofsted’s reviews have been pretty positive, and I am more than happy to share them with the hon. Lady if she would like me to.

I could not possibly conclude a debate such as this without mentioning Operation Courage. Launched in April 2019, the service helps veterans to recover from the hidden harms that conflict inflicts on mind and body. I know the hon. Lady is well aware of that.

Alongside Op Courage is our veteran trauma network, which offers veterans support for service-related physical healthcare problems. The network comprises 18 NHS veteran trauma centres and NHS specialist units, each with its own military and civilian expertise. I accept that that is not enough, and we are working on more to come, in particular a £5 million research fund. This area is a fruitful one for further research to improve the offer we are able to make to our servicepeople and veterans, and in particular to develop innovative surgical techniques, improve rehabilitation from blast injuries and adapt intervention technologies for mild traumatic brain injury, among other things.

I must briefly mention the creation of the National Rehabilitation Centre, which is very exciting. Working alongside the national health service, it will be a 70-bed specialist clinic unit bringing patient care, research, and training and education under one roof. I pay tribute to the former vice-chief of the defence staff, General Sir Tim Granville-Chapman, for his work in that area. I look forward to the NRC’s opening formally in 2024, but in the meantime there is much collaboration between the DMRC and the NRC.

On the point the hon. Member for Barnsley Central (Dan Jarvis) made about IPC4V, he seemed to suggest it was going to be closed down or downgraded, but I can assure him that is not the case. It was only launched in March 2019. He is right to mention Ben Parkinson as an exemplar, and I can reassure him about our commitment to it; we are even scoping extending the reach of the scheme, if that is of any help to him. I am more than happy to discuss the matter with him further.