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Health Support

Volume 461: debated on Monday 18 June 2007

1. What assessment he has made of the adequacy of the support his Department provides for those diagnosed with adverse health conditions as a consequence of military service. (142909)

With your permission, Mr. Speaker, I would like to make a short statement before answering the question. I am sure that the whole House will join me in sending sincere condolences to the family and friends of Lance Corporal James Cartwright, who was killed in Basra, Iraq, on Saturday.

The Ministry of Defence provides a high level of support for serving personnel diagnosed with adverse health conditions, however they arise. That can range from life-saving surgery in our field hospitals, or UK NHS hospitals, to rehabilitation at the world-class defence medical rehabilitation centre, or our regional rehabilitation units, and comprehensive in-patient and community-based treatment for those whose mental health has been affected. For those who have left the forces, health care is provided primarily by the NHS. We work closely with the relevant authorities to enable a seamless transfer for those who are medically discharged from the services.

I add my condolences to those connected with Lance Corporal Cartwright.

The Ministry of Defence is generally quite good at providing medical services for serving soldiers—once the helicopter arrives—but the service is inadequate for the ex-military, especially those with post-traumatic disorders. The fact that hundreds are likely to contract those disorders after coming back from Iraq and Afghanistan has been described as a ticking time-bomb. This is not about NHS or private treatment. However, surely dedicated specialist help needs to be easily accessible to the ex-military with post-traumatic stress disorders? Will the Minister take responsibility for setting that up?

The NHS has always had responsibility for the treatment of veterans. We have worked closely with Combat Stress, which provides a good service and support. We have funded it to the tune of about £2.9 million and will significantly increase its funding this year. I announced last Monday the extension of the medical assessment programme, through which former service personnel who served from 1982 onwards, which includes those involved in the Falklands campaign, will be able to go to St. Thomas’ hospital for a medical assessment that will be carried out by Dr. Ian Palmer, an expert in military psychiatry. I believe that that has been widely welcomed as a positive step forward. We are working with Combat Stress and the health service to determine how we can develop pilot schemes that will enable the NHS to draw on expertise and help as it treats former personnel who might have developed a mental illness as a result of their time in the services.

I recently had the pleasure of welcoming home 2nd Battalion the Rifles after their distinguished tour of duty in Basra. Its members’ concerns were selflessly for their colleagues and comrades who had been injured in service. They asked me to ask the Secretary of State to undertake work to ensure that when such people return to the United Kingdom, their recovery takes place in “observably military circumstances”—a true military facility. Will the Minister consider that, especially in the context of Birmingham?

I am quite convinced that our armed forces personnel who have been injured and wounded in Afghanistan and Iraq are getting world-class treatment and care at Selly Oak. That is provided by our military medical personnel, who include 26 nurses—the number will rise to 39 in the summer—welfare support and liaison officers, and military clinicians. However, the fantastic NHS clinicians and nurses also do an absolutely wonderful job of supporting and working with our injured personnel. We are just about to finish work on a partition to bring about a greater military ethos in the ward. Our personnel are getting world-class treatment, although we can always learn from events and any complaints will be investigated. The chiefs of staff are considering whether to move to a new military ward as part of the new hospital building.

My hon. Friend referred to the “seamless transfer” to the NHS. Will he give the House a guarantee that all patients’ medical records will be available? Surely the MOD has a responsibility to ensure that any injuries collected in service are seen to before the person goes back to a normal state of living. Will he guarantee that the duty of care will be maintained until that point?

My hon. Friend makes an important point. It is important that there be a seamless transfer from military medical support and treatment to the NHS, so we are working closely with our NHS colleagues to ensure that that happens. Additionally, we are looking at how we can make further improvements by examining whether there are gaps or improvements that can be addressed by the MOD, the NHS and the service charities that work with injured personnel and those who leave the forces owing to a medical condition. I guarantee my hon. Friend that I will continue to press for further improvements to ensure that our military personnel get the best possible treatment and care.

Will the Minister review the way in which the mental health charity Combat Stress is financed? He is right to say that it has a wonderful record, but the charity can receive money from the Ministry of Defence only for those who are in receipt of a war pension, and many servicemen and women do not show symptoms of stress until up to 14 years after they have been discharged from the services. The problem is therefore going to grow, and a brilliantly cost-effective way of dealing with it would be through that well established charity, which he visited in December and I visited with the Defence Committee last Thursday.

As the hon. Gentleman says, the charity Combat Stress does excellent work and I thoroughly enjoyed my visit to see exactly what it does. As I said, we fund the charity to the tune of £2.9 million and we are going to give it a significant increase in funding. Perhaps I did not make this clear in my previous answer, but we are considering setting up pilot schemes around the country to enable the NHS, Combat Stress and the MOD to see how we can improve the support for former service personnel who suffer mental illness as a result of their service, and part of that work will cover commissioning. That has been welcomed by Combat Stress, but there is more work to be done. I hope that we will be able to make an announcement on those pilot schemes in the not-too-distant future.

Will my hon. Friend say a little more about the support available to those who serve in the Territorial Army? I recently met a young man who is soon to go to Afghanistan for a year. My hon. Friend will have seen the criticism of the support on their return for those who serve in the Territorial Army. Will he reassure me that he is looking as closely at the support available to our territorial soldiers as he is at the support available to regular servicemen and women?

I thank my right hon. Friend for that question. A study by King’s college London showed that there were more reservists than regulars suffering from mental health problems. Although the difference was not significant, it was large enough for us to examine the issue to see what more we could do. Often, such people do not go back as formed units or to friends back at a barracks or base; they go back to communities around the country.

Last year, we announced the reservist mental health assessment scheme, which we run from Chilwell in Nottingham, where reservists who served from 2003 can go for a full mental health medical assessment and for treatment, if that is needed. Of course, we will work closely with their GPs and any other commissioners. I believe that that has been a successful step forward, but we always keep open our options to do more.

The Minister may be aware that the funding of a number of the mental health trusts across the country is threadbare. When someone is transferred from military care to NHS care, we must ensure that funding is available within the area where that person wishes to reside. Will the Minister discuss the matter with the Secretary of State for Health to ensure that funding is provided for those mental health trusts?

The hon. Gentleman makes an important point. My hon. Friend the Member for Tamworth (Mr. Jenkins) made a similar point about transfer and the importance of making sure that there are links between the military medical services and the NHS. Of course we speak to our colleagues at the Department for Health—for example, my right hon. Friends the Secretaries of State for Health and for Defence had a meeting a few months ago to discuss how to continue to co-ordinate and improve medical support for armed forces or ex-armed forces personnel. The pilot schemes I mentioned earlier are important in providing the NHS with expert help to determine the best way to care for and treat those who have developed a mental health condition as a result of their time in the armed forces.

First, I associate the Conservative party with the condolences in relation to those who have lost their lives on operations overseas or here at home.

I apologise for the absence of my hon. Friend the Member for Woodspring (Dr. Fox), who is returning with the Minister of State, Ministry of Defence, the right hon. Member for East Kilbride, Strathaven and Lesmahagow (Mr. Ingram), from the Falklands, where he attended the commemorative services. I also apologise on behalf of my hon. Friend the Member for Aldershot (Mr. Howarth), who is also on a defence visit.

With your indulgence, Mr. Speaker, may I also say “well done” to the Government for the events they staged to commemorate the Falklands conflict? They were a fitting tribute to those who fell retaking the islands.

The Under-Secretary mentioned the medical assessment programme, which the Ministry of Defence described in a press release last week as being “vastly expanded”. In that area of policy, it is important that service personnel are able to have confidence in what the Ministry says. Describing a programme as “vastly expanded” when the increase in the number of medical personnel consists of one doctor being transferred from working part time to working full time is an example of the Government being guilty of spin. Does the Under-Secretary think that such an increase in the number of personnel really is a vast expansion of that service?

First of all, may I thank the hon. Gentleman for his kind comments about the Falklands commemorations, and the Opposition parties for their support in developing the commemorative event? I believe that I am right in saying that the veterans thought that it was a great event that did them justice, and that they thought that it was in the right tone, so I thank the hon. Gentleman for what he says.

Dr. Ian Palmer is a widely respected consultant psychiatrist who has vast experience and has served in the armed forces. Of course, he has much experience from the military medical point of view. We are increasing his hours from one day a week to five days a week. That is a significant increase in the resources that we are making available, and we will make further resources available if that is needed. I might just make the point that in the end we did not have to use all the resources that we provided for the reservist mental health scheme. As I am sure the hon. Gentleman will accept, we are not sure about the numbers of people who will use the service. The key thing is to get it off the ground, and to ensure that our veterans know that it is available and that they can use it to get their mental health assessment and medical assessment. That service was not there before, and it is a major step forward.