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Julian Sturdy (York Outer) (Con)
Given the nature of this afternoon’s debate, I should like to pay tribute to the soldiers missing and believed killed in Afghanistan. Our thoughts and prayers are with their families at what must be an incredibly difficult time.
It is always a privilege to serve under your chairmanship, Mr Dobbin, and indeed to initiate a debate in this Chamber. I feel, however, an even greater sense of privilege due to the special nature of this debate. Like many Members on both sides of the House, I am a great supporter of our armed forces family. From serving personnel to veterans, those brave men and women have served our country with dedication, and they deserve admiration, respect and parliamentary attention.
I should like to discuss veterans’ mental health, which is one of the few subjects that quite rightly commands political unity on both sides. The work of successive Governments over recent years has given the issue great momentum, and early in the debate I should like to commend the previous Government on the work that they did on behalf of veterans. I also congratulate the Minister on the way that the current Government have championed this worthy issue.
My interest in the mental health of veterans comes from my frequent correspondence and discussions with one of my constituents who is the mother of a veteran. Her dedication to improving the provision and information provided to veterans is inspiring, and I hope that she will take heart from today’s debate.
In recent years, efforts to tackle the cruel stigma that is related to mental health issues more generally across society have begun to make a difference to many of those who suffer from what is often an invisible illness. Indeed, it has been estimated that one in four people in the country suffer from some form of mental health issue each year. The Mental Health Network, which is part of the NHS Confederation, has carried out excellent work, and over the past few years, it has been heartening to see the Ministry of Defence and the Department of Health working closely with the Royal British Legion, Combat Stress and others in the voluntary sector to provide a range of improved services for veterans who suffer from mental health problems.
Let me take the opportunity to praise the work of all charities up and down the country that work day in, day out with members of our armed forces family. In particular, I should like to champion the Royal British Legion and Combat Stress—two charities that play a vital role in delivering key services to veterans and serving armed forces personnel. Together, those charities offer vast experience, unquestionable compassion and unwavering dedication. With approximately 22,000 armed forces personnel leaving the service and returning to civilian life each year, we must appreciate the wide-ranging mental health issues that can be provoked by experiences in war-torn countries and dangerous conflicts around the world.
Over the past 10 years, British troops have been involved in a range of conflicts from Iraq and Afghanistan to Bosnia and Sierra Leone, and the bloody experiences of those wars cannot fail to leave a mark on those who confront them. When we think of the sacrifices made by armed forces personnel, it is right to consider not only the often terrifying physical risks undertaken, but the mental strains that are placed on our brave servicemen and women.
It has been estimated that more than 27% of veterans suffer from a common mental disorder. For those armed forces personnel who leave the service each year having experienced direct action in recent operations, the transition from service life to civilian life is often traumatic. For many, the future is uncertain, and owing to the stigma that surrounds mental health issues, many sufferers fail to seek help on leaving the services. If they do seek help, it is often at a dangerously late stage. A Mental Health Network briefing last year suggested that, on average, veterans do not come forward for mental health support until 14 years after their discharge. Sadly, homelessness and alcohol or substance abuse is more prevalent among veterans when compared with others of similar age or social background.
I have three main objectives in this debate: first, to commend the superb work that has been carried out on behalf of veterans who have suffered from mental health problems in recent years; secondly, to seek assurances about the continuation of parliamentary support for such work to be maintained on a more permanent basis; and thirdly, to ensure that our provision for veterans is coherently delivered in the best possible manner.
The previous Government’s “New Horizons” strategy document bound the NHS and the MOD to improve access and support for the early treatment and prevention of mental health illness among servicemen and veterans. The current Government, led admirably by the Prime Minister, launched the military covenant, which enshrines into law the Government’s duty to support the entire armed forces family. The covenant makes a new commitment to provide
“extra support for veteran mental health needs.”
Soon after taking office in 2010, the coalition Government asked my hon. Friend the Member for South West Wiltshire (Dr Murrison) to produce a report on veterans’ mental health. He should be congratulated on his truly outstanding work and recommendations, and I encourage any hon. Member who has not yet read the report to request a copy from the Library.
My hon. Friend’s “Fighting Fit” report received favourable backing from the Government, and rightly so because it includes a raft of measures to ensure better provision for veterans and their families. Among 13 action points and four principal recommendations, the report specifically calls for
“An uplift in the number of mental health professionals conducting veterans outreach work… A Veterans Information Service (VIS) to be deployed 12 months after a person leaves the Armed Forces… trial of an online early intervention service for serving personnel and veterans.”
As part of the Government’s initial response, a dedicated 24-hour mental health support line for veterans was launched in March 2011, operated by the charity Rethink on behalf of Combat Stress and funded by the Department of Health. In addition, the number of mental health professionals was doubled from 15 to 30.
With the “Fighting Fit” report, the Government’s military covenant and the previous Government’s valuable work, much effort has been made to deal with this issue. The objective now, however, is to ensure that that wide-ranging support, financial assistance, e-learning provision and information literature continues and is focused in the most effective way possible.
I have a number of questions for the Minister to which I hope he will respond, although I accept that some information might require communication with his colleagues in the Ministry of Defence. First, will funding for the dedicated 24-hour support telephone line continue after the one-year trial, which I believe is soon coming to an end? I believe that having someone on the end of a telephone at any hour of any day who is willing to listen, able to support and trained to understand must be of tremendous reassurance and assistance to affected veterans. The continuation of funding for that telephone service would indicate a clear commitment to veterans, and I urge the Minister to push for that support to continue.
With an eye on the future, I ask the Minister to outline the time scales involved in implementing the new veterans service to which the Government have made a commitment. A key issue as we discuss the future of such support is the difficulty of keeping in touch with veterans. As discussed earlier, many leave the service and move on to temporary accommodation or work. It is impossible to provide meaningful support if we do not know where veterans now live or work. Will the Government do more to track and store information about veterans, and will that information be shared with key partners?
Mr James Gray (North Wiltshire) (Con)
I congratulate my hon. Friend on securing the debate. Does he agree that there is a particular problem with regard to the Territorial Army and reserve forces? Many of them are spread out across the nation, and we do not know where they are. At least, regulars have the regimental family around them, even after they become veterans. People from the TA are often out in the wide world without anyone to provide such support.
Julian Sturdy
I agree. It is also worth noting that reservists tend to suffer more from mental illness, if they have experienced conflict, than regular soldiers, so it is probably even more important that we understand where the reservists are and can monitor that and target help towards them.
Guy Opperman (Hexham) (Con)
I congratulate my hon. Friend on securing the debate and I support the laudable aims that he is describing. Given the established difficulties with keeping track of individual soldiers and the difficulties with giving the necessary support post discharge to all manner of servicemen and women, is it not time that we started to consider the possibility of a veterans agency that brings together all these things and provides a co-ordinating review and a hub point for all these services?
Julian Sturdy
I agree. As I said, there is a real problem about the joined-up thinking that needs to be done. A tremendous amount of work and services are out there, but we need to bring that all together, under one roof. I will come on to that later if I can.
There remains a real danger that too many veterans will slip through the net because they fail to be registered for initial support on leaving the service and get lost in the system thereafter. The best way to ensure that support gets through to veterans is to keep up to date with veterans, as has been said.
Having touched on the increase in mental health nurses across the strategic health authorities covered by an armed forces network, I ask the Minister to outline the initial effect that the Government believe those nurses are having. Is there sufficient demand for the increased services? Do we need to consider increasing the numbers further? Ensuring that Government provision is frequently reviewed in such a manner will help to keep the ball rolling on this very important subject.
Without wishing to ask too many questions, I should be grateful to the Minister if he confirmed how many of the 10 health networks have now developed integrated services for veterans with specific mental health problems. As I said, ensuring that our provision is targeted correctly and effectively in supporting veterans is key.
I should now like to deal with the online package of interventions for veterans. In response to a recent written question tabled by my hon. and learned Friend the Member for Sleaford and North Hykeham (Stephen Phillips), the Minister, who I am delighted to see will respond to this debate, stated that the uptake of membership of the Big White Wall among the armed forces family is exceeding expectations. It would be interesting to know whether uptake among veterans is also high. Although I am a great supporter of online interventions, my slight fear is that information, assistance and forms of community engagement are all present and accessible online, but only if someone actively searches for them. With respect to veterans who suffer from mental health problems, we cannot expect all of them to be able or even willing to carry out such research. Are those leaving the service provided with the relevant links and information before they leave?
James Morris (Halesowen and Rowley Regis) (Con)
I, too, commend my hon. Friend for initiating the debate. Does he agree that there is a key role to be played by local authorities in providing the information for veterans that he is describing? David Herbert, a constituent of mine in Halesowen, was instrumental in bringing together a veterans charter in the Dudley borough, precisely to signpost veterans towards key information in the local area, including information on provision of mental health services.
Julian Sturdy
I thank my hon. Friend for that timely intervention. I agree that local authorities have a key role to play, and I agree with the point about the veterans charter, which could go a long way towards delivering what we need, because ultimately we must signpost services correctly. That is the real point. As I said, there are great services out there, but I fear that if we do not signpost them to veterans effectively, we might be missing a trick.
Nic Dakin (Scunthorpe) (Lab)
The hon. Gentleman has done a service to the House and to people outside it, particularly veterans, by initiating this debate today. One of my constituents, Charlie Brindley, is a veteran and a champion of veterans’ causes. Does the hon. Gentleman agree that we should look for the best way of using such people as champions to assist us in reaching veterans and dealing with the difficulties in relation to mental health even more effectively?
Julian Sturdy
I agree. We must use the experience of such people to help us in this process. Signposting is the key. We have the strategy, but we need to bring things together in a coherent manner that best serves veterans such as those whom hon. Members have mentioned in their constituencies.
As I have said repeatedly, the work carried out in this field recently has been outstanding, yet we cannot rest on our laurels. We need to engage more public interest. We must continue to provide direct funding and support and to monitor each initiative to ensure that it is proving effective. There are so many different strands of support. My final plea is that all the excellent provision be kept together in a specific and coherent strategy. We have already in the debate heard about a number of different ways in which that might be done. If the provision is too loose, too disjointed or too sporadic in its implementation, we run the risk of undermining the general force of the positive work in this area.
I appreciate that a number of hon. Members would like to contribute to the debate, so I shall briefly conclude my thoughts. The work carried out by charities such as Help for Heroes, the Royal British Legion, Combat Stress and so many others literally saves lives. I applaud every one of them. Likewise, hon. Members on both sides of the House who have championed our armed forces should be proud of the work achieved in recent years to assist veterans who suffer from mental health problems. However, our work in scrutinising the present Government and future Governments must never cease. We have a duty to monitor and assess and to push those at the very top to ensure that veterans are at the top of our leaders’ agendas.
I save my last words for both serving and retired servicemen and women. I have never served in the armed forces family, and I expect that only those who do will truly understand the pressure, sacrifice and honour that such service entails. I do not pretend to understand what it must be like to face danger and even death on foreign shores on behalf of Queen and country. However, I can assure all veterans that I shall continuously do my best to ensure that they are never forgotten once their service is completed, that their needs are met by the country to which they gave so much and that their dedication and commitment are rewarded, acknowledged and, indeed, celebrated.
Paul Flynn (Newport West) (Lab)
It is a pleasure to serve under your chairmanship, Mr Dobbin. I congratulate the hon. Member for York Outer (Julian Sturdy) on securing this debate. Sadly, we do not give anything like the attention we should to the consequences of our decisions to go to war. There are even instances where attempts seem to have been made to suppress knowledge of those consequences. In the past, it was possible for me as a Back Bencher to read out the names of all those who had fallen in the Iraq war and later in the Afghan war. Such practice is now expressly forbidden by the rules of the House. If I attempted to read out those names and their ranks today—I think that they would make a greater impression than any speech that I could make—it would take about 25 minutes to complete the list. The House has decided that it does not want to hear that, so it will never happen again.
There was an attempt to change the system of announcing the names of the fallen at Prime Minister’s Question Time. The names were announced on a Monday and a Tuesday, but MPs protested, saying that they wanted to hear those names announced at a time when hon. Members and the press could give them their maximum attention, so we have now gone back to the original time. I believe that the country wishes to understand the consequences of war.
I want to mention the case of a constituent of the hon. Member for Carmarthen West and South Pembrokeshire (Simon Hart). If I have the hon. Gentleman’s permission to mention the details, I will be happy to relay the story. The case of Sergeant Dan Collins has moved everyone. He went to war at the age of 29. He was optimistic and courageous and had a brilliant record of service. He was shot on two occasions and on two other occasions, he was damaged by improvised explosive devices, but the incidents that tormented him the most were the deaths of two of his friends, one of whom died in the most dreadful circumstances, having lost a number of limbs. The sergeant was holding him as he died. It was that incident that tormented him. He had fine treatment from his family, a loving girlfriend and help from the local charity, Healing the Wounds. Tragically, he took his own life earlier this year—he had attempted to do so before.
If today’s tragedies are confirmed, the number who have fallen is 404. Sergeant Dan Collins will not be numbered among those and neither will many others. The results of the Afghan war will be seen not just in the numbers of the dead and the civilian dead, who are uncounted, but in the 2,000 soldiers who are now broken in body or mind. It is right that we should do all that we can to treat them with the greatest care.
We should say a word of thanks to the Welsh Government, who have taken this matter very seriously. Recently, the Welsh Minister for Health, Lesley Griffiths, announced that she was setting up a £500,000 fund to ensure that every health authority in Wales has a specialised doctor with experience in dealing with veterans to deal with those who come back from the war. It is absolutely right that we do not disguise or shy away from the consequences of our actions.
In my time in Parliament, we went to war in Iraq on the basis of weapons of mass destruction that did not exist. We stayed in Afghanistan mainly on the pretext of a terrorist threat to the United Kingdom from the Taliban. That threat did not exist; there were threats from al-Qaeda, but not from the Taliban. We are now being told that we should contemplate war against Iran on the basis that it has missiles carrying nuclear weapons with a range of 6,000 miles, which do not exist.
Jim Dobbin (in the Chair)
Order. May I remind the hon. Gentleman that we are talking about the mental health of veterans? The scope is getting a bit too wide.
Paul Flynn
I am grateful for your patience, Mr Dobbin. Finally, when we establish a code of conduct and a covenant between us and the soldiers, our main duty should be to put as the first line a pledge that we will never go into a war that is unnecessary. That is our duty in this House. If we are to avoid fatalities and more people being mentally damaged, our main task is to resist those who cry for war.
Guy Opperman (Hexham) (Con)
It is a great pleasure and a privilege to speak in this debate today. I have been in this House for nearly two years and I have not had the opportunity to raise the issue of the mental health of veterans in the way in which we have done today. I pay great tribute to my hon. Friend the Member for York Outer (Julian Sturdy) for securing this debate and for the measured and eloquent way in which he has brought the issues to the House.
I join my hon. Friend and other colleagues in passing on our respective condolences to the service men and women, and to the families of those who died in Afghanistan so recently. I endorse everything that both the Prime Minister and the Leader of the Opposition said. It is an utter tragedy and one of the largest losses of life for many a year. I remain of the view that the sooner we bring our troops home from Afghanistan, the better it will be.
This debate is certainly overdue. I want to make a declaration. I send out my thanks and support to the various charities, volunteer groups and individuals who provide support. I echo the words of support for the Royal British Legion and Help for Heroes. If I need to declare that I have raised funds for such groups while serving as a Member of Parliament, I do so. I certainly need to make a declaration that I have represented, as defence counsel, multitudes of soldiers facing criminal charges, which was a salutary and depressing experience. Many of the soldiers had committed criminal offences, which they had no desire to commit, because they were suffering from mental health problems and fundamentally from post-traumatic stress disorder.
I represented a Royal Marine who had broken down in a supermarket after he had been unable to get together the right amount of money at the till. He felt that the lady behind the counter, who had been perfectly civil to him, had not been as co-operative as she should have been and it all became too much. The nature and the prevalence of post-traumatic stress are such that it is always the very smallest things at the end of the process that result in the demise of the mental strength of people who have quite happily stormed up Tumbledown ridge, gone across the Gulf deserts and fought repeatedly in a way that very few of us in this House can even contemplate. It is how we provide support that is important. As defence counsel for some of these lads and, on one occasion, a woman, I saw very strongly how their spirit was broken. I have also seen, over the last 15 to 20 years of lawyer practice, plenty of examples of these people falling through the system.
Andrew Percy (Brigg and Goole) (Con)
My hon. Friend is making an important speech about how people fall through the net. My neighbour, the hon. Member for Scunthorpe (Nic Dakin), mentioned Charles Brindley, who has been trying to do some work around GPs. Many GPs do not seem to be aware of the military assessment programme that is available. Often if someone presents with a mental health issue, the GP is not trained or aware of the services and support that can be made available. Does my hon. Friend agree that we need to ensure that GPs are better educated and better trained in dealing with such individuals?
Guy Opperman
I entirely endorse that point. Although it is incumbent upon Members of this House to raise the profile of this issue and to try to disseminate information about the types of health care support that exist, it is also incumbent upon the relevant health trusts and authorities to ensure that in future a degree of information is passed down the net to individual GPs and action teams, particularly those teams dealing with alcohol abuse, so that the organisations in the regions are able to support the veterans who are out there.
I have worked with a charity called Veterans in Action. It involves some constituents of mine in Northumberland but it also involves servicemen and women who are based in Lancashire and all over the country, who are attempting to do various things. For example, they have a pilot project with the Lancashire Drug and Alcohol Action Team that involves meeting up with GPs to work with them and trying to do exactly the sort of thing that my hon. Friend the Member for Brigg and Goole (Andrew Percy) has outlined.
However, the worry is that, although individual groups in our constituencies are all doing very good work to provide a degree of assistance to veterans, there is no overarching body providing global support. What often happens, therefore—for example it has happened with Veterans in Action, which was set up in my constituency and is now working throughout the country—is that the individual soldiers effectively get fed up with the process and decide to provide support themselves.
I supported what the previous Government did. They were working to do a great deal more than had previously been done. Successive Governments have improved care for veterans over time. But the “Fighting Fit” report and the work done by my hon. Friend the Member for South West Wiltshire (Dr Murrison) have clearly taken things to the next stage and a better level.
I will digress slightly, because in my constituency I have the Albemarle barracks and the Otterburn ranges, troops from my constituency are serving on a regular basis in Afghanistan with the 39 Regiment Royal Artillery, and the Ridsdale ranges provide all the weapons that are tested before the soldiers use them. I also have a large number of constituents who have served in the forces. For example, many Falklands veterans live in my constituency and have come to see me because of the experiences that they have suffered and the lack of support that they have experienced. That was under a different Government and, frankly, I am not here to criticise any Government. However, there is no question but that the degree of support given to the Falklands veterans was limited compared with the support that we are giving to the veterans who are returning from Afghanistan now. Things have got better.
Simon Hart (Carmarthen West and South Pembrokeshire) (Con)
Further to the point made by the hon. Member for Newport West (Paul Flynn), I wanted to say that in the 30 years following the Falklands conflict—it is rather timely to make this point, this year being the anniversary—more soldiers were reported to have committed suicide after the conflict than had actually died in the conflict itself.
Guy Opperman
It is interesting, is it not, that today is 7 March and on 7 March 1982, exactly 30 years ago, about three and a half weeks prior to the Argentine invasion of the Falklands, which happened on 2 April 1982, the British ambassador in Argentina wrote a cable from Buenos Aires to the then British Prime Minister, saying that matters were escalating. It is very well known, and it was reported in the Franks report that assessed the Falklands war, that “contingency plans” needed to be made. That was not enough and a war began, then escalated. I certainly will not go down the route taken by the hon. Member for Newport West (Paul Flynn) by digressing further. However, the point is that the treatment of the veterans of the Falklands war was not as good as the treatment of veterans now, partly because there were difficulties at that time in understanding what post-traumatic stress disorder was.
From a health standpoint, PTSD is not confined to victims of conflict. There are also plenty of victims of PTSD who were involved in normal, day-to-day accidents and disasters, whether it is industrial health accidents or factory accidents; people can have PTSD arising from those things. We need to change the way that PTSD and other aspects of the mental health of veterans are visualised, because it needs to be recognised that PTSD and other mental health conditions are just as much a disease or condition as breaking an arm or suffering from cancer, and it is just as difficult to solve or treat.
I move on. I endorse entirely what was said about the current situation, and I will abbreviate my comments to making an assessment of the current situation. Various studies have shown that a very large proportion of our veterans are suffering from PSTD. At present, approximately 24,000 veterans are in jail, on parole or serving community punishment orders. That is the astonishing number that emerges if we assess how many veterans are going through our criminal justice system. It manifestly shows that, for whatever reason, we have not done enough.
Let us also bear in mind that American studies have shown that approximately 30% of the US troops who were in Vietnam suffered from PSTD, or about one in three. That is an absolutely staggering number. Therefore, although we might look at the respective troops coming home from Afghanistan, and at those who fought in Iraq and other conflict zones, and think that they are all right, three out of 10 soldiers will genuinely suffer PTSD. They may suffer it in year one after their return. Year 14 is the average length of time that it takes, but it can take as long as 25 or 30 years, and throughout all of that time, their individual families are suffering and going through particular difficulties.
I applaud the “Fighting Fit” report and the work that is being done. However, I regret to say that that is not enough. Personally, I do not consider that it is enough. I accept entirely that we are in straitened times and that, with every budget, we have to consider the way in which things are dealt with. Nevertheless, I very much hope the Minister will give the sort of assurances that charities and individual soldiers’ organisations seek about their future, and that there are commitments on an ongoing basis to the matters outlined in “Fighting Fit”, so that those charities and organisations have the reassurance that genuine efforts will be made to ensure that their funding is sustained; that mental health systems are structured properly; that the recommendations of the inquiry into medical examinations while soldiers are still serving are properly implemented; and, given that we are introducing all these ideas from “Fighting Fit”, that there will be proper assessment of those ideas after they are introduced. I agree that organisations such as the Big White Wall are not necessarily being utilised in the way that was envisaged; they are being utilised, but not necessarily in the way that was envisaged.
I would very much like to see an overarching body for veterans. I would like a veterans agency to be considered by the Government, and the Government to consider whether there is a possibility of bringing together certain parts of the NHS, the Ministry of Defence and social services and housing elements, which make up so much of all the difficulties that our servicemen suffer, and dovetailing that with the health services that are provided in prisons.
We can look at the way that people are dealt with in terms of health services in prisons. I have extensive experience of going to see clients who are former servicemen and who have received a custodial sentence or who are held on remand. There was absolutely no doubt that they were hopelessly unable to deal with the difficulties of a custodial sentence, or the difficulties of being detained, at that particular time, in circumstances that they would normally have been perfectly able to deal with.
Mr Gray
I have agreed with much of what my hon. Friend has had to say, but I have some difficulties with the notion of the establishment of a new agency to carry out the functions that existing Government bodies are required to carry out at the moment. If there were a veterans agency, would there not be a risk that people at the Department of Health or the Ministry of Defence would shrug their shoulders and say, “Someone else is doing this for us, leave it to them”, and that the services received by veterans would be significantly worse than they are at the moment?
Guy Opperman
I accept there is always a risk that, if we create some new body, we will be in a position whereby everybody passes the buck and says, “Well, they’re sorting it out”. However, I am clear that every single MP could come to this House and say, “I have individual examples of people in my constituency, or stories that I have heard of former servicemen.” Those servicemen are continuing to slip through the net—they are unaware of the individual aspects of the services that are available to them—and the Government are not necessarily acting as an overarching body to ensure that they are aware of those services.
Let me give some examples. There is very good evidence from the “Fighting Fit” report and other studies that follow it up that there should be a leavers pack for soldiers and, for example, an ability for veterans to be monitored after they have been discharged. All those services are good, but they stop after a certain period and the Government do not go back to those individuals to ask, “Are you actually all right? Are you in a position to cope with the vicissitudes of your life and your existence on an ongoing basis?” That is the sort of thing that I would like done. I concede that it may be possible to do such things in the present Departments, but there must be more joined-up thinking, because the problem is ongoing, and there are examples.
I am conscious that other Members wish to get into the debate, so I will abbreviate my comments. I want to talk about the work of Veterans in Action, a classic charity, which is run by individual veterans. For a number of years, they have been providing in-depth support, which they have found is, sadly, lacking in the system. They tell me that there is no generic way to collect veterans’ information and that it is collected very much on a local, case-by-case basis. Similarly, they say it is extremely difficult to get organisations to work together. They also tell me that the Big White Wall is not being used as it was intended to be and that people are using the Combat Stress helpline as a first point of contact.
A great many smaller, third sector organisations and charities set up by veterans are having similar problems. With no national directory or local directories of such organisations, it is immensely difficult for individual veterans who are constantly moving around—who have problems with housing and with all the dislocation that goes with that—to harness the efforts of such organisations. Therefore, just as successive Governments have done amazing work looking after individual veterans’ health in conflict zones, we should do more to look after their mental health after they have left those conflict zones.
Jim Dobbin (in the Chair)
Order. I intend to call the shadow Minister at 3.40 pm.
John Pugh (Southport) (LD)
I congratulate the hon. Member for York Outer (Julian Sturdy) on opening this important debate.
I must admit that I am not a natural when it comes to defence-orientated debates. I do not come from a garrison town and I have no experience of the forces—I suspect I am naturally too insubordinate to fit into them. However, I have a genuine interest in this issue. It is spurred not so much by constituency cases, although a soldier came to see me who was severely traumatised by the conflict he had endured, and the atrocities he had seen, in Aden. It was an awfully long time ago, but it had scarred his whole life, traumatising him, driving him to alcoholism and creating huge mental health issues. I also dealt with a case in which a gentleman who had been advised by the Ministry of Defence to assist it with research at Porton Down on the common cold subsequently had a lot of worries that were quite unrelated to his exposure to the common cold.
What really sparked my interest, however, was my experience on the Public Accounts Committee, which produced a series of interesting reports on and around this area that showed up some quite distinctive and worrying issues. The report I want to dwell on was called “Ministry of Defence: Treating injury and illness arising on military operations”. It showed quite categorically that the forces were excellent at dealing with people’s physical ailments in the theatre of war and subsequently—the profile and the results were good, and the medical treatment was exemplary. When it came to mental health, however, there were some very odd results. For example, it appeared that American and British soldiers exiting the same theatres of war had widely disparate experiences in terms of their mental health, with more Americans reporting themselves, or being reported, as having mental health problems by a considerable margin.
Even more strangely, the figures coming out of the British forces for mental health problems showed soldiers were experiencing no real anxiety at all; in fact, they showed that troops were in just as good mental health as the ordinary population, which was odd. During the PAC inquiry, I told Sir Bill Jeffrey, who was permanent under-secretary at the time:
“I think we would all accept that war is extremely stressful and people see some horrid, fearsome things that would disrupt the psychology of almost anybody. What surprises me”—
then and now—
“is that the referral of the Forces appears to be lower than the referral rate of the population as a whole.”
I put it to him that that was intrinsically implausible:
“You would have thought there would be more mental health issues amongst a population of people who see quite traumatic scenes than amongst those who do not.”
More brutally, I said the rate of referrals
“is actually lower than the population at large. In other words, it would appear…that in the confines of Committee Room 15”,
where the PAC was meeting,
“we are far more vulnerable to mental health stress than people in the operational theatre of war.”
It can be pretty torrid in the PAC at times, but I suggest that result shows that something is going awry in the forces’ reading of troops’ mental health post-war.
Equally puzzling was the disparity between people coming out of the Iraq and Afghanistan theatres of war. Lieutenant-General Baxter, who was then the deputy Chief of the Defence Staff, explained:
“I think you have to look at the nature of combat…When you are being shot at and you can shoot back, it is a lot less stressful than when you are being bombed or suffering indirect fire.”
I do not know whether that is true, but it invites serious questions about the level and quality of screening when people are discharged.
Other reports that the PAC produced at the time were equally troubling. They showed, for example, that squaddies were far less well prepared for the outside world than they could have been when they were discharged. There were also troubling statistics, with which we are all familiar, about high rates of alcohol problems, imprisonment and homelessness among people leaving the forces.
That is all very troubling, and the causes are fairly complex, but one thing is absolutely clear: the screening of soldiers exiting the theatre of war was very poor in the British forces. Often, it was done simply through self-completed questionnaires, but people do not ordinarily volunteer any deep psychological problems they may think they have in such a questionnaire.
There was also evidence in the PAC report that I quoted that support for people in the theatre of war was relatively poor. The most that they seemed to get out there most of the time was three community nurses, along with one consultant psychiatrist every three months. If people showed up with problems in the theatre of war, those problems were unlikely to be fielded especially well. There are particular issues here, and we must be prepared to face up to them. One, although I have only anecdote to go on, is that some people enter the forces because the structure that they provide is exactly what their personality needs. When they leave the forces, however, that structure simply disappears. Often, their homes will have gone, and their families will sometimes have gone, too, so they find themselves in difficult territory.
A second suggestion is that there is necessarily a culture of mental toughness in the forces, so people are slow to own up to whatever problems they may have. Those problems might therefore go unrecognised and be submerged for quite some time, and that is at the root of some of the problems that were so well analysed by the hon. Member for York Outer.
We in this place have clocked these problems, and quite a lot has been done about them. Since 2010, when the PAC report I quoted was produced, there has been a surprising amount of really good progress. On 6 April 2010, the previous Government committed themselves to providing £2 million of new funding. They can be credited with increasing the number of helplines and endeavouring to increase the education and training of GPs. We also pay tribute to the Murrison report, which represented excellent progress. Before that, the Ministry of Defence even did some research, which helped everything along. There is strong cross-party commitment to recognising these problems and doing something about them. In a sense, therefore, Parliament can justifiably credit itself with having done something about a very real and clearly identified problem.
I would like to conclude by thinking about where we go from here. My concern is that most of the solutions that were proposed following the previous Government’s deliberations and the Murrison report involved something along the lines of specialist health service commissioning. I do not want to talk about the difficulties of the legislation currently going through Parliament, but such specialist commissioning is an issue. The hon. Member for Hexham (Guy Opperman) has advocated as a solution getting round specialist commissioning to some extent by means of an agency that is a one-stop, catch-all arrangement. Creditable though that suggestion is, it will not get us out of the business of specialist commissioning, because the problems will show up locally in many diverse settings. I wonder whether the Minister will say something about that.
Derek Twigg (Halton) (Lab)
When I was the Defence Minister with responsibility for such matters, we set up pilot schemes with the NHS, with which Combat Stress was involved. Delivery issues are important, because in most respects the treatment is exactly the same whether the patient is a civilian or not, but some members or former members of the armed forces would prefer to talk to someone with experience in the armed forces. That is why we involved such people in the pilots.
On the other hand, other people from the armed forces did not want to see someone who had also been in the armed forces, because as far as they were concerned that life had finished, or they wanted to move on, or they had had a bad experience. It is a difficult issue to come to terms with, and that is why there is a need to mix and match support and clinical help. It is important for people to have that choice.
The Minister of State, Department of Health (Mr Simon Burns)
Will the hon. Gentleman give way?
Mark Pawsey (Rugby) (Con)
I congratulate my hon. Friend the Member for York Outer (Julian Sturdy) on bringing forward such a sensitive topic, and I associate myself with his remarks about today’s tragic news about the loss of life in Afghanistan.
Like many hon. Members who have attended the debate, I am encouraged to participate following a meeting a month ago with a constituent of mine, Mr Paul Marston, an ex-serviceman. He expressed serious concern about the lack of recognition for servicemen leaving the armed forces who are affected physically and mentally. That prompted me, as it did many other hon. Members, to look into the situation.
Approximately 22,000 armed services personnel leave the service to return to civilian life every year. There are an estimated 5 million veterans in the UK. For many of those people, who are used to support within the armed forces family, it is often difficult to cope outside the military framework. Veterans face a range of problems associated with mental health, to which my hon. Friend the Member for Hexham (Guy Opperman) drew our attention, ranging from the failure to hold down employment and problems in their personal lives to alcohol or drug misuse and contact with the judicial system. Given the contribution that veterans have made to our country, it is vital that the Government should do all in their power to provide a dedicated mental health service for veterans.
I have a further interest in the matter, as a member of the armed forces parliamentary scheme. Like many other hon. Members, when I first arrived here I knew nothing about the armed forces, and through that scheme I have had the pleasure of visiting troops abroad and have learned something of their lives at first hand. I have met some of them at Camp Bastion in Afghanistan. I have recently returned from a trip with the scheme to the Army training centre in Kenya, where I met soldiers taking part in a hot climate training exercise in preparation for a tour of Afghanistan later this year.
Having met the servicemen and listened to my constituent and other people, I welcome the Government’s commitment to act on the review carried out by my hon. Friend the Member for South West Wiltshire (Dr Murrison). I understand that there were four key recommendations, including an increase in the number of mental health professionals providing outreach work for veterans and the introduction of a veterans information service, deployed 12 months after a person leaves service.
The Government have also, of course, published the armed forces covenant, which sets a framework on how the armed forces community can expect to be treated. It includes improving veterans’ access to mental health services, such as building a greater focus on mental health into discharge and examination. My constituent made the point to me forcefully that early intervention is the key. We need to ensure that veterans with post-traumatic stress disorder or other mental health-related issues are spotted early, and I am pleased that the Government recognise that.
It is important to work to remove the stigma that is in many ways attached to mental health trauma, particularly for veterans. Such awareness could be raised by a national memorial to those who suffer mental health problems because of combat. That is not my idea, but the idea of Mr Marston, who is frustrated by the treatment of veterans. I pay tribute to his dedication to that cause. He has told me about a new veterans contact point close to where he lives, but says there is little awareness of it in the veteran community, or even the wider community. That facility has the potential to be of massive benefit to all ex-servicemen, but Mr Marston believes that it has not been sufficiently publicised.
Mr Marston would like the idea of such a monument to be pursued, and he has registered an e-petition on the No. 10 website, calling for such a memorial to injured soldiers. There are, of course, many memorials to those who have fallen in war, but the one suggested by Mr Marston would be particularly for those who suffer from physical or mental health problems, and it would raise the profile of veterans with health issues. It would also be a worthy endeavour in itself. I acknowledge that that is outside the area of responsibility of the Minister who is responding today, but it will be of substantial comfort to Mr Marston and many of his colleagues to know that consideration is being given to recognising in that way the contribution that veterans have made.
Andrew Percy (Brigg and Goole) (Con)
I was not planning to speak, Mr Dobbin.
Andrew Percy
I will speak only for three or four minutes, which I think will give the shadow Minister and the Minister longer than they were expecting; but as there was not a line of hon. Members waiting to speak, I thought that I would add my voice to this important debate. I apologise, Mr Dobbin, for not dropping you a note.
I congratulate my near neighbour, my hon. Friend the Member for York Outer (Julian Sturdy), on securing this important debate on a vital issue. There are no party politics involved; we all agree about the sort of services that we want provided for ex-service personnel. I just want to tell the story of a constituent of my neighbour, the hon. Member for Scunthorpe (Nic Dakin). He is the gentleman whom I mentioned earlier, Charles Brindley, who is the vice-chairman of the Royal British Legion in Brigg, in my constituency. He has been trying to put together a project in the area to establish better mental health and support services for veterans. He is trying to co-ordinate through the councils, and I am pleased that North Lincolnshire council has taken him up on his offer of working with it.
There is so much involved in trying to bring everything together. The e-mails that we have had from Charles Brindley and the discussions that we have had with him have been quite enlightening. He has been trying to work with the Prison Service, and he found out that one prison does not have a dedicated individual to respond to ex-service personnel there. He has been trying to work with the primary care trusts and GPs on the very point that I raised with my hon. Friend the Member for Hexham (Guy Opperman): raising GPs’ awareness of what is available through the NHS for ex-service personnel. He has also been trying to work with other organisations that I would not even have thought of, such as Age UK, which has told him that older people may now be starting to present with mental health problems that go a long way back.
A range of organisations and institutions come across ex-service personnel at different points in their lives and provide them with services, and the fact that they are not necessarily always joined up concerns me. Some of what is happening can certainly be brought together under the auspices of the local authorities, but I echo the idea of a dedicated veterans agency. The example that is probably most similar to what we want are the incredibly dedicated services, including specialist health services, provided to veterans in the United States, where veterans seem to be provided with a lot of support that we in this country sadly do not give.
As many Members have said, it is often far down the line that mental health problems start to rear up. This summer, I met one of my ex-pupils walking through the town centre. I had not seen him since I taught him when he was about 16, and I asked him what he had been doing since then. He said, “I’ve been out in Afghanistan.” I think he was in a Yorkshire regiment. He said, “I got shot. I’ll show you.” He then rolled up his trouser leg to show me his bullet wounds. I asked him if he was okay, and he said, “I’m absolutely fine. I’m going to get paid out now. I’m going to get a better pension, and I’m going to get a house. Everything’s fine.” He may think that he is fine now, but in 10 or 15 years’ time, with his career in the military effectively ended, a mental health problem, as we know, could rear its head. What will there be to support that individual then? He is getting a lot of support from the Army at the moment—he had no criticism of that—but in 10 or 20 years’ time, that support might not be there, or he might not know how to access it.
Jessica Lee (Erewash) (Con)
I hope that my hon. Friend will agree that another consequence of delayed stress and trauma for veterans can be the impact on their family relationships. Representing families in courts, I have seen over the years that that has caused difficulties. It has been largely a case of fathers having a less meaningful relationship with their children and being less able to take responsibility for them.
Andrew Percy
I entirely endorse what my hon. Friend says. We have probably all seen examples in our surgeries of military service sometimes leading to breakdowns, which are then presented at our constituency surgery for assistance. I am reminded of the old saying: while the physical wounds may heal, the mental scars never quite go away. So I endorse what has been said by other Members today.
John Pugh
One of the themes in the debate today has been whether we do or do not have a veterans agency. Somebody said that the veterans agency is an American model, but the Americans do not have our GP system. Even with the existence of a veterans agency, is there not a problem with how that then interacts with the GP, who will often be the first port of call when problems occur?
Andrew Percy
That is exactly the point that the hon. Member for Hexham (Guy Opperman) accepted. In creating anything, there will always be interaction problems. We all know where we want to be; how we get there is probably a bit more difficult. Now that the shadow Minister and the Minister will have a little more time, I am sure that they will expertly plot a course forward to deal with these issues.
Andrew Gwynne (Denton and Reddish) (Lab)
As always, it is a pleasure to see you in the Chair, Mr Dobbin. I congratulate the hon. Member for York Outer (Julian Sturdy) on securing this important and topical debate. We have heard the sad news today that six of our service personnel are missing and presumed dead in Afghanistan. It is a poignant reminder of the reality of serving in Her Majesty’s armed forces. Our thoughts and prayers are with the families at this time.
I note that we had a similar debate on this subject last year, proposed by my right hon. Friend the Member for Salford and Eccles (Hazel Blears). It explored many of the important issues surrounding the mental health of veterans. It is right that we should again take the opportunity to discuss the welfare of our serving personnel and veterans and the impact on their families. For veterans’ mental health, we need to look at the true picture of how people are affected after they have left service. Indeed, we should be paying as much attention to the issues that face service personnel and their families when they leave the armed service as when they are actually in service.
The UK’s armed services are among the best in the world, and we can rightly be proud of them. We owe them a great deal of gratitude for the work that they do in our name. The charity, Combat Stress, has shown that a significant minority of servicemen and women suffer from mental ill health as a result of their experiences. A study in May 2010 into personnel who had served in Iraq and Afghanistan showed a 4% prevalence of probable post-traumatic stress disorder. An estimated 180,000 troops have served in those two operations: if 4% develop PTSD, that equates to 7,200 more sufferers.
The study also highlighted a prevalence of 19.7% for common mental disorders, and 13% for alcohol misuse. We must look into ways in which we can deal with that and ensure that the right facilities and support are in place to diagnose and treat such conditions. Admittedly, improvements have been made in recent years. Mental health pilot schemes have improved support and treatment for personnel suffering from mental health problems.
In 2007, the Labour Government extended priority access to NHS services to all veterans whose medical conditions or injuries were suspected of being due to military service. Priority access had previously extended only to those claiming a war pension, and efforts were made to raise awareness of that. As has been mentioned in the debate, we now have the armed forces covenant enshrined in law, which I think all hon. Members welcome.
The interim report on the covenant summarises the Government’s approach, taking forward recommendations in the report by the hon. Member for South West Wiltshire (Dr Murrison), “Fighting Fit”, which I also welcome. I understand that the report’s recommendations were rolled out over the past year, many of which were introduced as pilot programmes to be reassessed after their initial trial periods. I would welcome an update from the Minister on the pilots and also an assurance that his Department has been promoting them among serving personnel and veterans’ communities.
Most Members will have met ex-service constituents who have been directly affected and heard about their experiences, some of which we have heard in the debate today. We should rightly recognise the important work done by organisations such as Combat Stress, which provides an invaluable service to veterans around the country. Its centres and outreach work allow veterans to get the help and support that they need in a specialised environment, along with other veterans who are going through similar experiences.
The Enemy Within campaign run by Combat Stress seeks to tackle the stigma that, unfortunately, as we have heard today, can be a barrier to people getting the support and help that they need. Currently, they have a caseload of more than 4,800 veterans, including 228 who have served in Afghanistan and 589 who served in Iraq. The majority are ex-Army: 83.5%. Their youngest veteran is just 20. The invaluable work of Combat Stress and other organisations, such as the Royal British Legion, is to be warmly welcomed, but the Government should also take on their fair share of the responsibility. It is important that we do not view the services offered by the voluntary and charitable sector as any sort of replacement. That work should complement, not replace, the services that the Government offer.
Indeed, as we already know, the charitable sector is facing an incredibly tough time at the moment. Even though organisations such as Combat Stress and the Royal British Legion have continued to have generous support from the public, we should not assume that those services will always exist and always have enough funding to run. The Government should decide which services they have a duty to provide and should fund them properly. The Government need not always be the vehicle to deliver those services, as we have heard, but they can fund experts such as Combat Stress and the Royal British Legion to do so on their behalf.
The Government should also consider how mental health services for veterans can be guaranteed, when their national health service reforms are creating so much uncertainty. I share the concerns of the hon. Member for Southport (John Pugh), although I am reassured by the Minister’s reply that a single commissioning body, the NHS Commissioning Board, will be responsible. I think that that is the right way forward.
Clearly, those in the armed forces are trained to do a tough job and rightly have to develop a tough mental attitude. This, of course, can mean that it can be harder for people coming out of the services to admit that they have a mental health problem, let alone talk about it. We should also take into account how long it can take people actually to get the support that they need. Combat Stress has suggested that the average length of time is 13 years. In some cases, it has taken veterans 40 years to seek out the help and support that they need. That is far too long, and we should do all that we can to shorten the time and to let people know that help is available for them now.
Combat Stress has also provided detailed evidence involving cases of individuals who have faced marriage break-up, unemployment, social isolation or substance abuse because they were unable to deal with their mental health problems. However, as with all mental health conditions, a great deal of stigma still surrounds it, which can make it much harder to talk about openly. Until we tackle that stigma, it will be difficult to make significant changes.
I appreciate that it is hard to establish the level of need without a tracking system. As we know, there is no record of how many veterans are being treated for mental health problems on the NHS. Clearly, if we cannot quantify the problem, it is difficult for the Government to quantify the true cost of treating mental illness among former members of the armed forces.
Nor should we overlook the impact of deployments on the mental health of our reservists, as has been mentioned. As we know, the Government’s Future Force 2020 plan showed that the role of reservists will increase significantly in the coming years, mirrored by reductions in the number of regular service personnel. It must make sense for the Government to ensure that support is in place for reservists prepared to take on those extra responsibilities.
Tom Blenkinsop (Middlesbrough South and East Cleveland) (Lab)
I commend my hon. Friend for his speech. Is there not a problem in the offing, given that the Army is being reduced to 82,000 soldiers and certain regiments are being disbanded? We need to know what the NHS Commissioning Board and the Department of Health are doing to aid those who will soon be former soldiers entering civilian life and to determine their mental health issues and what type of help the NHS can provide.
Andrew Gwynne
I absolutely agree that we must ensure that ex-service personnel are supported. I am sure that the Minister will respond to that in his closing remarks.
One recommendation in the report “Fighting Fit” stated that a veterans’ information service should be deployed 12 months after a person leaves the armed forces and that regulars and reservists should be followed up approximately 12 months after they leave. Will the Minister update us on how that is developing, and what plans the Government have for the future funding of the Combat Stress-led 24-hour support telephone line for veterans? Will the Department provide an evaluation of how the funding for “Fighting Fit” has been spent, what it has achieved and what will happen for future funding? What additional steps is the Department taking to raise public awareness of issues that relate to veterans’ mental health?
Gemma Doyle (West Dunbartonshire) (Lab/Co-op)
While my hon. Friend is on the subject of funding, is he, like me, keen to hear from the Minister whether he supports our call for a £1 million fund for research into legacy issues from Afghanistan and Iraq, with a focus on mental health? That could be paid for by a reduction in generals in the forces.
Andrew Gwynne
I am grateful to my hon. Friend. The Labour Front-Bench defence team has made that commitment, which is laudable. Redistributing part of the saving to serve veterans’ mental health shows that the issue is a priority for us.
This debate has provided us with the opportunity to explore the issue of our veterans’ mental health and welfare. I pay tribute to Combat Stress, the Royal British Legion and other groups that, along with many service organisations and charities, play an outstanding role in supporting the whole armed forces family, for which we should thank them. I congratulate the hon. Member for York Outer on securing the debate. We must ensure that our servicemen and women receive support after their tour of duty is finished. Surely, we as a nation owe them that.
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.
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.