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Armed Forces: Post-service Welfare

My Lords, I rise to call attention to the physical and mental rehabilitation of military veterans, and to issues of post-service welfare. I welcome this opportunity to bring before the House an issue on which I think every Member will share the wide public concern at the present time. I am grateful for the number of noble Lords who are determined to speak in the debate. I know that the noble and gallant Lord, Lord Boyce, who takes a keen interest in these matters and speaks with great authority, cannot unfortunately be here. He has a cast-iron excuse; he has to appear before the Iraq inquiry today, so the House will realise why he cannot here. I have also received an apology from the noble Viscount, Lord Brookeborough, who takes a keen interest in these matters because of his military background. He has duties to Her Majesty as a Lord in Waiting at an investiture, so he, too, cannot be here. It is no secret that the issues that we discuss today are in the public mind overwhelmingly because of the consequences of Operations Telic and Herrick. These were the names given to the campaigns in Iraq and Afghanistan. However, I make clear that my observations relate not just to the casualties of those conflicts. I include those who served in Korea in what was a particularly nasty war for many. Some of my contemporaries, and some who I expected to see at university, did not come back from that bloody encounter. The mass Chinese attacks in some ways resembled World War I. As a national serviceman, I saw active service at the time, and some of my colleagues still bear the scars. I include also the veterans of the Falklands. I have seen many who faced the consequences of the Troubles in Northern Ireland, and of the brave work of our forces during that time. I include members of the security forces and of the RUC. Many noble Lords will recall that we are also approaching the 20th anniversary of the ending of the first Gulf War and the liberation of Kuwait. Many casualties occurred in that conflict. I note one thing from recent discussion of these issues. I do not recall any discussion during my time as Secretary of State of the military covenant. It was taken for granted, it was implicit and, if pressed, people recognised that of course there were obligations. However, as the casualties and the challenges that we now face have grown, the importance of that implicit covenant being respected is now being put into written and public form. We now even have the niceties of deciding whether we have a no-disadvantage covenant or a citizen-plus covenant. These are the two alternatives: whether the objective should be that no one should suffer any disadvantage from their service, or whether the nation recognises that in some ways they should have enhanced recognition—citizen plus—for the service that they have given. It is no secret that the pressure that we feel on this has to do with the length of the campaigns. I was involved in the first Gulf War, which was over almost in the twinkling of an eye. The build-up took months, but the whole campaign to liberate Kuwait took barely two months, with an air campaign and what was almost a five-day land campaign to free Kuwait from the Iraq invasion. Now we see that we have spent nearly 10 years in Afghanistan. We have been in Iraq for eight years. Will the Minister confirm the figure I heard that 180,000 service people are now veterans of either Iraq or Afghanistan? That is the scale of the challenge that we face. There is no question that while we very properly pay our respects, and the Prime Minister, the Leader of the Opposition and we in this House express our condolences to those who lose their lives, many of us recognise that the real and lasting tragedy is the scale of the appalling injuries that many come back with. That is of course a consequence of the triumph of medical progress. I saw that in Northern Ireland; if we could get someone to hospital when they were still breathing, there was every chance that their lives could be saved. Many people who previously would never have survived are now coming back with appalling injuries, but medical triumphs ensure their survival. That places heavy obligations and liabilities on their families, and on society as a whole, which has asked them to embark on those dangerous challenges. After the scratchiness of this House too often in recent days, I pay tribute to what the previous Government did. I do not admire the campaigns in which they got us involved, but I recognise that they introduced a number of helpful measures, and I am very pleased that the present coalition Government recognise the importance of carrying on that work. I pay tribute to the incredible skill and wonderful competence of the medical profession, all the way from the combat medics on every patrol to the helicopter that may convey them back to Camp Bastion, to Camp Bastion itself, and to the outstanding treatment that they receive on transfer by air transport back to this country, into Queen Elizabeth Hospital Birmingham and then on to Headley Court. This is a service and a quality. Someone can go out on patrol, and the next thing they know they are waking up 24 hours later in a hospital in Britain, getting the best medical attention that anyone could wish for. Of course, that is when the challenge really develops. In this connection, there is no question that this is not just a job for the Government or the public services. One of the most moving things about recent events is the way in which charities have become such a key part of that activity. I doubt whether there is a single Member of your Lordships' House who has not had some contact with Help for Heroes, Combat Stress, ABF The Soldiers’ Charity or the Royal British Legion. The Royal British Legion has just given its biggest donation in its history, £50 million over the next 10 years, to help some of those centres. Help for Heroes has made huge investments because of the response to its fundraising, which is recognition of public concern. I should declare an interest, because I am an ambassador for Alabaré Christian Care & Support, which has now established five homes for veterans. My sister happens to be the chairman of an organisation called the Community Self Build Agency. As part of a very enterprising idea, it is now getting self-build schemes going to help ex-servicemen veterans with housing, in which they do the building themselves and rebuild their life, their competence and confidence. I am delighted to see the noble Lord, Lord Glenarthur, here. As we recognise the role of full-time servicemen, there is a particular challenge in this situation for reservists. They often come straight out of civilian life, they do not have the comfort and surroundings of the regimental family, and they are often scattered in different parts of the country. They come back from some of the most challenging combat situations and find themselves immediately back on civvie street among colleagues who do not understand anything of what they have been doing. We need to recognise their particular challenges. We need to provide in so many ways, including financially. It is interesting that SSAFA and the Royal British Legion said that 60 per cent of the cases that they deal with are problems with debt management. In this connection, the noble and gallant Lord, Lord Boyce, conducted an important review. I hope the Minister can confirm that the Government are carrying forward the Armed Forces compensation scheme review, because finance is obviously important. Far too many of our servicemen coming home are homeless. We need to give them proper access to social housing and advice as to how to access it. There needs to be proper recognition by local authorities of the priority that they should give to returning servicemen to ensure that they do not get left out. The mental challenge will be with us for a long time. Although some physical injuries are all too apparent, the mental injuries may not be. We know that it may be 14 or 15 years before people become aware of them. The new provisions, which mean, as I understand them, that everyone is assessed on leaving the services for their mental health condition, are very important. We also need an outreach programme to check up on people. I commend Dr Liam Fox and Andrew Murrison, who both have the advantage of being doctors. They have for some time, when in opposition and now in government, taken a particular interest in mental stress. The point that Dr Liam Fox made in an article which some might have read in the Sun today is that people with mental health difficulties are the least likely to go to their doctors. We need to ensure that the Defence Medical Services give the NHS access to the records of patients who become patients of NHS doctors, so that they can be aware of some of the background. I pay tribute to the reservists who are doctors and who have already served in Afghanistan and Iraq, but doctors who have not served need help. I recognise the interest that the BMA is taking in that area to see how we can get more advice to doctors who have to deal with situations with which they have never previously had to deal with their civilian patients. The issue is the strain that people face and the linkage between the Defence Medical Services and the health service, as the health service is now, impressively, gearing up to handle these situations. It is a matter of experience. It stretches all the way to the tragic shooting of the congressman in Tucson, Arizona. People said that her luck—and I hope that that luck will continue—was that one of the surgeons who treated her had experience of serious injuries in Afghanistan and knew the instant action that was needed. That has undoubtedly given her the chance that she has now, which that she would not otherwise have enjoyed. Yesterday we had a further reminder of the tragedy with the 350th fatality in Afghanistan and the name of the serviceman who had lost his life being announced. We do not publish in any great detail the number of those who are wounded, and do not draw attention to the severity of some of those injuries. The Ministry of Defence has invented the phrase ““life-changing injuries””, which, as we know, covers some very serious injuries indeed. Through-life support—not just support when there is public interest, as now, when we are very aware and when Wootton Bassett brings to people's attention so frequently the challenges that we face—is critical. Our duty in this is to recognise the words of the Army Doctrine Publication: "““Soldiers will be called upon to make personal sacrifices—including the ultimate sacrifice—in the service of the Nation. In putting the needs of the Nation and the Army before their own, they forego some of the rights enjoyed by those outside the Armed Forces. In return, British soldiers must always be able to expect fair treatment, to be valued and respected as individuals, and that they (and their ""families) will be sustained and rewarded by commensurate terms and conditions of service … the system’s loyalty to the individual—its obligation in the Military Covenant—is manifested in justice, fair rewards and life-long support to all who have soldiered””." Many have stood on Remembrance Day, as I have on many occasions, saying, ““We will remember them””. That, I think, should be our motto as we look at the through-life support that we owe those who have bravely served our country in appallingly difficult circumstances and who deserve nothing but our fullest support in the years ahead.