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Firefighters: Mental Health Support

Volume 651: debated on Tuesday 18 December 2018

[Sir Roger Gale in the Chair]

I beg to move,

That this House has considered mental health support for firefighters.

I am grateful for the opportunity to speak out on behalf of members of the fire service. In so doing, I do not wish for a moment to minimise the effect of shock and trauma on our other emergency services, or on the victims, the bereaved and survivors, for whom I hope to speak out at a future date.

We must never underestimate the potential danger of untreated or poorly treated mental health issues. Nearly half the 39 people who died in an accidental fire in 2017, excluding Grenfell, had mental health issues. I am personally devastated to have to report that very recently, a member of our community in north Kensington has sadly taken their life. We have all failed that person, their family and their friends.

I was acquainted with several firefighters before the terrible events of 14 June last year, and since then I have spoken to many others. As a councillor in Kensington and Chelsea, I was active during a cross-party campaign in 2012-13 against the fire service cuts of the previous Mayor of London. I visited our fire stations and spoke to their teams. I analysed breakdowns of response times to specific fires from specific fire stations. I looked in detail at fire deaths statistics, which, though diminishing, reflected a new method of calculation that meant that only those poor souls who died on the scene of a fire were counted, not those who died subsequently in hospital.

In submissions to the then Mayor, we demanded that particular stations under pressure were not closed and that staff budgets were not cut. Most of our demands fell on deaf ears, although it seems that our campaign to save north Kensington fire station from closure was heard, as it was saved. The red watch from that station was first on the ground at the Grenfell Tower fire.

Following the cross-party work I carried out in the Royal Borough of Kensington and Chelsea, I was appointed by the current Mayor of London to the London Fire and Emergency Planning Authority. During my time there, we monitored pilot schemes on co-responding, whereby firefighters respond to medical emergencies, particularly cardiac arrests, when an ambulance is not available. Co-responding is unpopular among firefighters, not only because their responsibilities increased as their pay was frozen, but because they were concerned about a lack of training to deal with some of the issues that they were called to deal with.

Some felt it was inefficient to send a fire engine worth half a million pounds to a medical emergency purely because it was equipped with a defibrillator. Many told me that they were emotionally unprepared for some of the things they had to deal with, such as suicides. One told me of an incident where, for 40 minutes, while waiting for an ambulance, they carried out resuscitation on a child who had clearly already died. That officer told me that they had been put on light duties for a long period while they struggled to process what had happened.

I have talked to many of the firefighters who attended Grenfell Tower, many of whom are still struggling emotionally and some of whom may choose to leave active duty altogether. I have had a full briefing from the London fire brigade and I am aware of the new focus on mental health awareness, which is fully supported by the commissioner.

Do you agree that stress, anxiety and depression are now common features in the fire service—especially the London fire service—according to organisational listings? That should not be the case.

I concur absolutely with my hon. Friend. The London fire brigade has appointed additional counsellors and set up Mind blue light champions, who are volunteers from within the service who can signpost colleagues to the counselling and trauma service.

I congratulate the hon. Lady on securing the debate. She raises a pertinent point, which we should all pay attention to. She mentions the appointment of counsellors, which is absolutely crucial. The way to help someone to avoid mental health problems is for them to have somebody to talk to when they are experiencing the problems. There is no point in them just sitting there and experiencing the problems on their own; they need somebody to share them with and to help them.

I concur absolutely with the hon. Gentleman.

I hear that firefighters who came from fire stations near the fire are getting a higher standard of care than those from further afield. Call centre staff—many of whom spoke to people trapped by the fire, as we heard during the inquiry—are also traumatised, and some are not getting the support they need.

Let us remember that more than 300 firefighters were involved in the rescue attempt at Grenfell, and that it was not one single, terrible, catastrophic event. The fire raged for more than 12 hours, in which firefighters continually risked their lives in their attempt to save the lives of others. Some of the scenes they saw, and the choices they had to make, are with them every day.

Despite that, the psychological help that those brave men and women, including the call centre and support staff, so clearly need is very uneven. Some have received talking therapy. I have previously told the House that I have received that treatment myself, and it did not help me at all, although I accept it may help others. That treatment is available within the fire service.

Some people have been fortunate enough to receive eye movement desensitisation and reprocessing therapy, which I am told has been helpful, but it is usually available only from the Fire Fighters Charity, so capacity is limited—we are dependent on charity. Some have had very little treatment. I am told that many firefighters from stations across London who attended the fire have not had the support they need, and certainly not the emotional support from the community that many local officers have benefited from.

Three days after the fire, I dropped into one of our fire stations late at night. I drank tea and heard their stories. The team, who had fought back-to-back shifts on Tuesday and Wednesday, had had no time off. All leave had been cancelled. They were emotionally drained and physically exhausted. All I could think was, “Where is the back-up they’d need if there was another Ladbroke Grove train crash now?”. The terrible answer is that there is none.

Cuts to frontline staff mean that, even after a disaster such as Grenfell, there may be no capacity for compassionate leave. While nearly 20% of staff have been lost since 2010, incidents have decreased by just 12%, so fewer operational firefighting staff are attending more incidents each.

Even though the Government continue to state that a decrease in staffing is based on demand, do you agree that incidents have increased by 14% since 2014? We need to invest more in our fire services and our emergency services.

I concur absolutely with my hon. Friend; thank you.

Pay restraint and a squeeze on pensions mean that many firefighters have to work second jobs on their days off to pay their household bills. My specific experience relates to the London fire brigade, but I am aware that those issues affect fire services across the country.

I know my hon. Friend is talking about her own experiences, but when I was first elected in 1997, I visited the fire station in Stroud. Then, their appliances were always staffed by eight members, but they would go out with seven. When I talked to them recently, they were talking about going out with four on an appliance, and sometimes three. That is the result of cuts; they have an immense impact. Does she agree that they really affect the stress that firefighters are under?

I agree absolutely with my hon. Friend. The cuts and the shortage of staff are huge issues.

Mental health support is still often seen as an afterthought or an add-on and its provision is expected to be funded from the ever-diminishing funding that services receive. The mental health charity Mind tells us that an incredible 85% of fire and rescue personnel have experienced stress and poor mental health at work. That figure has risen by one third in the last six years. Although fire and rescue personnel are more at risk from mental health problems because of the nature of their work, they are less likely to take time off, which can affect their home life as well as their physical health.

Mind also tells us that repeated exposure to traumatic events, physical injuries, increased workload and financial pressures are affecting fire and rescue services personnel more and more. For the first time, the most common cause of absence in the London fire brigade is stress, anxiety and depression. That cannot continue. Surely, we have a duty of care to support those who risk their lives to save ours. It is not enough to expect each service across the country to tackle this growing problem individually with no additional financial support. Firefighters should be able to rely on us to protect their mental health, so they can be at their best when we need them.

We have seen how firefighters as well as call centre staff have had to relive those hours in painful detail under relentless questioning at the inquiry, and we have heard how that has retraumatised them. We have also heard how retired firefighters watching footage of the Grenfell Tower fire on television or online have also been retraumatised, demonstrating that trauma follows people into retirement unless it is properly dealt with by qualified psychologists.

We depend on firefighters to save and protect the public from flooding, building collapse, road traffic accidents, train crashes, passengers under trains and terrorist attacks, as well as fire. I therefore ask the Minister to increase funding of the fire and rescue services that we depend on, so that support for their mental health can be delivered fairly across the country. We rely on fire and rescue personnel to save and protect us from danger. It is time for them to be able to rely on us, to ensure that they have the help and support they need.

Just before we continue, may I gently remind Members that we speak in the third person? “You” means me, and I am not a participant in this debate.

It is a pleasure to serve under your chairmanship this afternoon, Sir Roger.

I thank the hon. Member for Kensington (Emma Dent Coad) for raising this very important issue. I do not have a confession, but from the outset I have to declare an interest—that would be the best phrase—as I served for 31 years with Strathclyde Fire and Rescue Service, and it was a proud journey through my working life. In retirement, I became a local councillor who sat on the fire board, so I continue to have a great fondness and a great respect for the firefighters of today, although I am—quite clearly, for those who can see me—a firefighter from yesterday. I joined in 1974 and served until 2005.

Frontline firefighters—whether they are whole-time, retained or volunteer firefighters—who respond to emergencies, and those with specialist roles within the fire service such as fire investigators, frequently encounter seriously injured or even fatally injured persons in their day-to-day work. Preservation of the scene, particularly if it is a potential crime scene, may mean that anyone who is declared medically deceased must remain in situ, with firefighters having to work in close proximity to them.

Some incidents result in multiple fatalities. I will touch on some in the west of Scotland, but there are many others that I could cite between John O’Groats and Land’s End. For example, there was the Chinook disaster on the Mull of Kintyre, in which 29 individuals died. The first responding appliances to that incident were carrying retained personnel; they were not full-time professionals, but men and women who held down everyday jobs. There was the Lockerbie air disaster, in which 270 persons lost their life, 11 of whom were in the town of Lockerbie, particularly but not exclusively in Sherwood Crescent. Again, the first responding appliances to that disaster were carrying retained personnel, and I absolutely applaud the work that retained personnel do. There was the Rosepark care home fire in Uddingston not so very long ago, in which 14 residents died, and that was a modern facility, and there was the Stockline plastics factory explosion in Glasgow, which was attended by whole-time personnel; nine people died in that fire. That is to name but a few incidents, none of which I personally attended. However, having been part of the fire service, I have followed the stories about them with great interest.

There are also incidents that firefighters endure in which our colleagues are injured, or even fatally injured, in fires. It does not happen that often, but when it does, what a sad and dark day it is. We can even go way back to the Cheapside disaster in Glasgow in the late 1960s, in which I think 15 firefighters and four salvage personnel lost their life. That was an exceptionally horrific incident, but we have improved safety a lot since then.

Such repeated experiences without appropriate ongoing support from external counsellors or medical professionals may result in some firefighters and other emergency responders—I do not exclude other emergency responders who suffer similar pressures—succumbing to stress-related illness, leading to absence from work and, in the worst cases, to their being medically retired; indeed, as the hon. Member for Kensington said, they may even lead to firefighters taking their own life, which in itself is an absolute tragedy.

Believe me: firefighters give their all at incidents, both physically and mentally. They have to be constantly alert at an ongoing incident—alert for their own safety; for the safety of their colleagues; and for the safety of the general public. If the outcome of an incident is not what firefighters would wish for, their initial adrenalin rush turns to what I would describe as a devastating disappointment that they have not achieved their goal or what they had hoped for. Their bodies and minds must cope with sudden emotional changes.

There are also occasions when the judicial process exacerbates firefighters’ exposure to potential stressors, in that the police and, in Scotland, the Crown Office and Procurator Fiscal Service may be reluctant for immediate debriefs of crews to take place until they have met with individuals and taken their statements, to ensure that their evidence is not compromised. It is an added stress when firefighters have to speak to people in authority about what has taken place. We have seen on our televisions the grilling of some of the officers at the Grenfell fire. Those individuals did their very best that night, yet they are being grilled through the courts service and various inquiries.

Debriefs have immense value, not simply so that crews can learn lessons in relation to how an incident went—what they could have done better, and so on—but to provide individuals with the opportunity to express their feelings to their peers. They may not wish to burden—or may not be able to burden—their family and friends with those feelings, or confidentiality might prevent them from offloading those concerns on those outwith the service. All of these things may be worse for retained or volunteer firefighters, who live in the very communities that they serve; on many occasions, they may know the victims of an incident.

I will touch on two poignant road traffic crashes that illustrate that. In one incident, a firefighter said hello to four young individuals at a shopping centre in a small town. He knew the four individuals and their parents. An hour after a courteous conversation with the four individuals, his pager was activated and he responded to a road traffic crash in which two of those young individuals had died. As one would expect, he conducted himself professionally, but weeks, if not months, later that incident came back to haunt him. I am pleased to say that he received assistance from Strathclyde Fire and Rescue Service, and he made a full recovery.

There was another incident that had a good outcome. The driver of a retained appliance approached a road traffic crash and spotted his wife’s car; it was his wife who was trapped. As I say, there was a good outcome, as she made a full recovery. I attended that incident and it was quite a tense situation. I give credit again to those who serve their own community.

What my hon. Friend is saying is very powerful. Does he believe that there is more that the fire service can do—I encourage my own local fire stations to do this—to have public exhibitions of what they do and show how they go about their work, because once the public understand that, there is a tremendous amount of additional support for the fire service and for the actions that they take? It would help if we gave firefighters a lot more encouragement to do that.

I thank my hon. Friend for that intervention. Yes, a lot is already being done to encourage people and to raise awareness. The fire service in Scotland used to have an annual event at the old Strathclyde regional station, with the slogan, “Reckless driving wrecks lives”, where we brought along fifth and sixth-year schoolchildren. All the emergency services took part. We also make home safety visits now and we are very much part of the team that tries to prevent these events before they happen, through accident and fire reduction. Also, let us not forget the introduction of a very simple thing in people’s homes, which is the smoke detector. In Scotland, we fit them free of charge for anyone who approaches us, and they are worth their weight in gold; they are very effective. A lot has been done on the preventive side. It is a failure if the fire engine goes out; we should prevent all the fires and reduce the number of accidents.

Recently, while out driving in my constituency with a staff member, I turned to them and told them that we had just passed the site of a fatal road accident. The accident had happened 30 to 35 years ago, but decades later I could still vividly envisage the two deceased persons in that vehicle. What triggered that, I really do not know. For some people, there will be no trigger; regrettably, an incident will live with them and haunt them for the rest of their lives constantly. I am able to put such an experience back in the box and reflect on it; perhaps I am very fortunate in that way.

It is so important that rescuers themselves do not become later in life the people who have to be rescued from extensive mental trauma. Let us be proactive and protect, to the best of our abilities, our firefighters from mental trauma or mental harm. The Health and Safety Executive defines stress as

“the adverse reaction people have to excessive pressure or other types of demand placed upon them.”

That can apply to a lot of emergency responders, including the police, but it applies to firefighters in particular.

Most people, including most firefighters, can cope with the challenge of work demands, but when other life pressures are added accumulatively—for example, debt problems or marital problems—sometimes it just gets too much to bear and a tipping point is reached. Many workplaces offer stress management courses. In my time in the service, we introduced welfare officers as far back as the 1990s, along with external counselling. I am sure that continues today, probably in an improved way. Many workplaces also have in-house occupational health staff. The hon. Member for Kensington mentioned the fire service benevolent fund, which has been going for more than 100 years and is now called the Fire Fighters Charity. It offers invaluable support through its psychological rehabilitation service for serving and retired firefighters.

While people may be screened and tested for underlying illnesses, susceptibility to stress, as I understand it, may not be immediately apparent and the individual themselves may not know or wish to admit—that is one of the very sad things, and it was a very male-dominated service when I was in it, although I am pleased to report that that was changing for the better when I left—that their illness may be stress-related, given the previous stigma around mental health issues. To some degree that stigma remains.

When we see someone with an injury to their leg or a broken arm, we can see the physical injury, but we cannot see or feel a mental injury. Firefighters may wrongly perceive such an admission as a weakness on their part. It certainly is not. According to the mental health charity Mind, 37% of firefighters think colleagues would treat them differently in a negative way if they conceded or admitted that they had a mental health issue. The black humour and banter of my days—days gone by, fortunately; it is no longer politically correct, and that is quite right—was once a release valve and coping mechanism behind closed doors for firefighters, but they still have the camaraderie and they still work as a team. That is a form of therapy in itself, and it has immense value. When a whole-time firefighter returns to the station, they have that group. It is different for retained and volunteer firefighters. They return to their partners and wives individually, and that gives a different dimension to the situation.

According to Mind, 85% of people in the fire and rescue services—it is an inordinately high number—experiences stress and poor health at work. They are twice as likely as the wider workforce to identify problems at work as the main cause for their stress. Statistics obtained by Members of the Scottish Parliament through a freedom of information request indicated that in 2016, 137 employees of the Scottish Fire and Rescue Service—firefighters, control room staff and support staff—were recorded as taking sick leave due to stress. Regrettably, those figures appear to be on the rise, as the figure for those recording stress as a reason for absence was 77 in 2015 and only 27 employees in 2014. That is despite an apparent fall in the number of fires and incidents. We are doing well on fires, but we have got road accidents, factory accidents and farming accidents—there is a whole range of special services. We need to discover what has changed since 2014. What are the root causes and contributing factors? Most importantly, we need to address them.

An article in a recent Fire Brigades Union magazine, Firefighter—I am an out-of-trade member and I still receive it—highlighted a need for ring-fencing moneys within NHS budgets for mental health. That is a prudent thing to request. The Prime Minister said last year:

“I want to use the power of the government as a force for good to transform the way we deal with mental health problems right across society, and at every stage of life. Tackling the injustice and reducing the stigma associated with mental health conditions is a priority for me, which is why today I set the goal of providing 1 million members of the public with basic mental health awareness and first aid.”

That goal has to be welcomed. I understand that NHS England got a top-up of £50 million over five years, which is most welcome, but I do not know whether that will be enough to address the issues and the incident of Grenfell, the consequences of which will be felt for years to come, sadly.

When we consider how much it costs to train and equip a firefighter, together with the potential costs of their ill-health, such as absence or early retirement—they may even go to the extreme of taking their life—surely it makes economic sense to invest in appropriate support measures. Firefighters are the finest example of an asset to society. They serve it on a daily basis, and they must be properly supported. Should they stretch out their hand for help, we must grasp it and give that help. Better still, let us prevent them from needing to do that in the first place.

It is a pleasure to serve under your chairmanship, Sir Roger. I thank the hon. Member for Kensington (Emma Dent Coad) for securing this debate, thereby giving us all an opportunity to participate in it. It is always a pleasure to follow the hon. Member for Ayr, Carrick and Cumnock (Bill Grant). He has vast knowledge from his life as a firefighter over the years, and we all appreciate the wealth of experience he brings to these debates.

I want to focus on where we are with mental health support for firefighters and give some examples of what we are doing in Northern Ireland. When we have debates such as this on issues that cross the whole United Kingdom, there is an opportunity to contribute to the wealth of the regions of the United Kingdom of Great Britain and Northern Ireland.

During the worst of the troubles, which went on for 30 years, firefighters worked alongside soldiers, sifting through rubble and making bomb sites safe. They saw sights that they never thought they would have to deal with. Like our soldiers, the sights they have seen and the work they have done can never be rightly understood by anyone who has not done it. The hon. Gentleman has done it. Friends I speak to have done it, too. Like our soldiers, firefighters deserve the utmost respect and support. The terrible danger that they willingly face to save others is incredible. Their efforts, courage and sacrifice deserve the utmost honour to be given to them.

I take this opportunity to think of all the firefighters who have paid the ultimate price for their heroism—some have—and to remind their families that we have not forgotten their sacrifice. I have a very good friend who is a wee bit older than me who was a firefighter during the worst of the troubles. Even today in our discussions he will often tell me stories of what took place. Sometimes he tells the stories because he wants to just talk about them. Some of those memories are from 30 or perhaps 40 years ago, but they are very real to him on the day he tells them and reminds people of what took place. Often, he will just shake his head when he is asked about his work. Sometimes he cannot talk about it, but the fact is that it is good for people to talk about things. For mental health, it is vital to have an accessible support network in place.

I read a media report recently that stated that the number of firefighters taking long-term sick leave because of mental health problems has soared by almost a third in the last six years. The hon. Gentleman referred to that. The study was carried out in the light of the Grenfell tragedy, which the hon. Member for Kensington referred to, but it is comparable to the situation UK-wide. Indeed, in 2016-17—the hon. Member for Ayr, Carrick and Cumnock had a different figure, but this excludes the back room—97 Scottish fire staff took long-term mental health sick leave. In Northern Ireland, that figure was 111 for active firemen on the frontline.

I always remember another good friend of mine telling me a story. The hon. Members for Ayr, Carrick and Cumnock and for Kensington referred to some of the horrors that firefighters see. The troubles are one part of that, but road traffic accidents are another. The ones that probably leave a lasting mental scar are those that involve children. When my friends tell me their stories, it is heart-rending how the incidents have affected them. Another friend said, “You know, Jim, so-and-so”—I will not mention his name—“just had a total breakdown.” These things affect people in different ways, but what we are really saying is that road traffic accidents, whether it is children, women or men who are killed, can and do leave lasting effects.

There have been many traffic accidents over the years. I remember one very well, where a young boy from my neighbouring village died and another young fellow had life-changing health issues as a result, and still has them today. Whenever it involves local people, we can understand what they are thinking, and we can think about the firemen who have seen horrible things in that road traffic accident and about how it affects them.

There is a feeling within the fire brigades that more must be done to raise awareness of the fact that it is good to talk. One such action is firefighters from Northern Ireland aiming for a Christmas No. 1, after teaming up with colleagues from across the United Kingdom to release a charity single. I am not sure whether hon. Members are aware of that. The group is known as the Fire Tones—what other name could they call themselves? The group has released its version of Band Aid’s “Do They Know It’s Christmas?” to raise money for the Fire Fighters Charity and the Band Aid Charitable Trust. The charity provides physical rehabilitation for firefighters recovering from injury or illness, as well as mental health support for those who have experienced psychological trauma, as many have. The single has been released on iTunes, Spotify and Amazon Music, and can also be purchased from Tesco. I will buy a copy this year, and would urge other Members to get one as well and, by doing so, to help the charity.

In 2017, the Government provided an additional £1.5 million to pay for mental health support through Mind’s blue light programme, to ensure that our emergency services and workers have the counselling and the emotional support that they require. However, the fact that firefighters are fundraising suggests that they are not seeing the benefits of that and so, as is becoming normal, they are teaming up with other charities to fill the gap. It is good to do something physically, and it is important to do so.

The Northern Ireland Fire and Rescue Service has teamed up with two other local charities, Northern Ireland Chest Heart and Stroke and MindWise, on a new initiative called “Healthy Body, Healthy Mind”, to raise awareness of the importance, which we know well, of people keeping both their mental and physical health in good shape. On the Northern Ireland Fire and Rescue Service website, Group Commander Keith Black, occupational health and wellbeing, explains:

“As Firefighters, we know the importance of maintaining physical fitness throughout our careers. What is equally important, however, is our mental fitness”.

Someone can run a mile or 10 miles, but they need to have the mental capacity as well. Keith Black continued that

“through this new initiative we hope to remove some of the fear people may have about talking about their mental health, both amongst our own staff and in the wider public.”

Part of that initiative was the station-to-station cycle, the brainchild of firefighter Noel McKee, who is also a trained counsellor. Noel and three other firefighters cycled to every fire station, and together with the charity partners delivered a talk at two secondary schools each day of the 10-day cycle.

It is wonderful that people are attempting to fill the breach and to fill the gap through voluntary, charitable work to raise money and awareness. However, I believe that more should be done by this place to see dedicated support as a matter of right for the 111 long-term sick firefighters in Northern Ireland, and for the hundreds of others who are struggling to process the job that we called on them to do. I always look to the Minister for a constructive response, which I know I will get. I sincerely urge him to look at how we can step up to the mark in this House in the way that we are asking our firefighters to step up to the mark in real life.

I congratulate the hon. Member for Kensington (Emma Dent Coad) on securing the debate, and in particular on the way in which she dealt with this very sensitive subject. She shocked us all when she told us about the individual who has subsequently taken their own life; our thoughts go out to their family and friends.

I also congratulate my hon. Friend the Member for Ayr, Carrick and Cumnock (Bill Grant) on 31 years in the fire service. He has some particular expertise that I could not possibly cope with and it gave me something further to think about. I am the chairman of the all-party parliamentary fire safety and rescue group, and the hon. Member for Kensington, who probably never sought such high office, is co-vice chair of the group. We are absolutely delighted that she has joined our group, and in a short time has demonstrated, by today’s debate, that she is making a real contribution.

I remember hearing the hon. Lady’s maiden speech last year, when she was a newly elected Member. Maiden speeches can be challenging for all those who have to make them, but the way she coped with the situation that she was in with her constituents was very telling. She has done a first-class job since in raising the whole range of concerns resulting from that horrendous disaster. We all witnessed the repeated efforts of firefighters entering and re-entering the tower to undertake rescues of people trapped by the fire. We can only begin to imagine, as my hon. Friend the Member for Ayr, Carrick and Cumnock said, how the firefighters must have felt when they returned home after attending those events.

It is acknowledged that firefighters have a stressful and traumatic job, and when they undertake the job they are advised that that is the way it is. However, I still think that we owe them a huge debt of gratitude for everything that they do, and we must do even more to support them than we are already. I remember three terrible incidents that firefighters attended in Basildon, when I was the Member of Parliament for that constituency.

I say gently to hon. Members, “Never take your children canvassing.” I took my eldest daughter canvassing. She was not asking anyone to vote for me, but she happened to come along—I think my wife and I had an issue; someone had to look after her. We knocked, but no one came to the door. It was in a tiny, rural part of the constituency. We knocked next door, and all of a sudden there was smoke. We went to the original door that we had knocked on, and we saw a human being alight. The fire service was absolutely fantastic. My daughter and I were in a state of shock, but they dealt with the situation and were absolutely brilliant.

There were two other incidents, both involving children. Firefighters found four children in a hut in a playground. They had lit a match and lost their lives. I remember another traumatic one, which was unbelievable. A gentleman had had some sort of breakdown. His wife had gone out and she came back to find that he had smothered their five children. It was not the police, but firefighters who attended. However tough a person is, I do not think that those experiences can be got over easily. That is why this subject is so important.

The Minister will probably correct me, but my understanding is that individual fire service authorities are responsible for ensuring that they have appropriate health and wellbeing support for their staff. The Fire Brigades Union has advocated for all fire authorities to have specific mental health policies. I do not know whether the Minister can enlarge on that and give us a report.

I am also advised that support is available to firefighters from various charities and professional bodies, including the Fire Fighters Charity and Mind. My hon. Friend the Member for Ayr, Carrick and Cumnock touched on the fact that research from Mind has found that 85% of people in the fire and rescue services have experienced stress and poor mental health at work. That is a truly shocking figure, which is totally unacceptable.

Her Majesty’s inspectorate of constabulary and fire & rescue services has committed to assessing how the fire authorities meet the wellbeing needs of their staff as part of the inspection question set for the year 2018-19. As my hon. Friend also touched on, NHS England announced on 9 October that up to £50 million would be made available over five years to provide ongoing physical and mental health services for those affected by the Grenfell fire, including long-term screening.

This is the season of good will when we all go round our constituencies and hypothetically appear as Father Christmas for one day. Last week, I visited our local fire station in Leigh-on-Sea twice—once to see the staff stage a community event at which they built the best Santa’s grotto ever, and then formally in a suit to thank them for all that they do. The best Christmas present they could have would be for my hon. Friend the Minister, as a result of this debate, to pledge that our Government will do whatever they can to ensure that our firefighters receive the best possible help for their mental health needs. They do a wonderful job on our behalf and risk everything. We have to bear in mind that they have their own lives and their own families to go back to, who know the scars that they bear.

It is an absolute pleasure to serve under your chairmanship once again, Sir Roger, and to speak in this important and timely debate. I thank the hon. Member for Kensington (Emma Dent Coad) and congratulate her on bringing it to Westminster Hall. She detailed the background thoroughly, set out what needs to be done and spoke poignantly about the traumatic impact of the Grenfell tragedy on her constituency and on the firefighters who attended the scene. I thank her for doing that. I am sure they are watching the debate and will note how seriously we take this issue. We are working collaboratively to take these issues forward and ensure that we get the best practice to support them.

My father-in-law was a firefighter in Edinburgh for almost 30 years, and he is extremely pleased that we are having this debate. Firefighters go out and do their job every day, and do not ask for much from us. They put their lives on the line, and never know what they are going out to each day. It is important that we recognise that they put themselves on the frontline and never know what they will come across. Their work can not only traumatise but retraumatise them, as they repeatedly go out to incidents. It is incumbent on Members of Parliament to recognise the traumatic impact of their role and that of the other emergency services. We must therefore provide adequate services in a timely manner to ensure that firefighters are supported.

I apologise for arriving a little late, Sir Roger. Does the hon. Lady agree that part of the problem is that we have 11,000 fewer firefighters in the service because of cuts, and that 40,000 days have been lost due to mental health? That puts extra pressure on the firefighters who are still in the service. Perhaps it would be a good idea for the Government to issue a minimum ratio of counselling services to firefighters so they know that they can access a counsellor whenever they need one.

I thank the hon. Gentleman for that important intervention. It is extremely important that firefighters and all emergency service personnel can access timely treatment when they need it. My experience from working in the NHS and my father-in-law’s experience is that shortages put additional stress and strain on those who do the job every day. Days lost due to physical or mental ill health put additional pressure on those who continue to keep the service going. Like all emergency services, the fire service is a vocation as well as a job. People in the emergency services always do much more than we expect them to do every day of their working lives. It is therefore incumbent on us to support them to the best of our ability right across the United Kingdom.

I worked as a psychologist, including with key emergency services and at the high-security State Hospital in Scotland. I know that, right across the emergency services, people put themselves on the frontline to protect the public. We must recognise that some of the issues that they have to deal with are out of the ordinary for most people. The images that they see and their experiences can stay with them for decades—right into retirement. When they are in the workplace, they may not want or feel able to seek help, but support should be available at any time, including in retirement. These symptoms may come to the fore in the form of post-traumatic stress, and individuals may feel ready to access treatment at any time.

Mental health services are a priority for the Scottish National party Government in Scotland. The Scottish Budget this month reflected that: it included more than £1 billion of funding for mental health, and funding for 800 additional mental health workers. That is a recognition of the fact that the public have become more aware of mental health. Today, we are speaking about mental health services for a specific group of workers. I would be interested to hear from the Minister whether there are examples of best practice that we can roll out throughout the United Kingdom. I am also interested in hearing about his collaboration with the Scottish Government and the Minister for Mental Health in Scotland on emergency service workers.

Cognitive behavioural therapy and EMDR, which the hon. Member for Kensington mentioned, are treatments recommended for trauma, and other forms of counselling are helpful in tackling symptoms of anxiety and depression and other presentations that come from trauma. What kinds of specialist treatments are being made available to firefighters and other frontline emergency service personnel? We must ensure that they access the treatment that is recommended for the conditions that they present with.

I always enjoy listening to the contributions of the hon. Member for Strangford (Jim Shannon). He said that the experiences of firefighters are similar to those of veterans; they may live with those experiences for a long time. Firefighters may work alongside soldiers and other service personnel who work together in this realm and have experiences that most of us do not have. Will the Minister comment on whether there are any peer support mechanisms that might be helpful? My husband served in the armed forces, and I am aware that veterans often find it extremely helpful to speak to others who have had similar experiences. Professionals do not always advocate such treatments, but it can be extremely helpful to speak to other people and have peer-to-peer support groups that are supported financially and resourced so that they can speak to others who have had similar experiences. I think that could be helpful.

When I was reading about the background to this debate, I found that stigma is an issue. With mental health issues in general, there is stigma attached to coming forward. We think of firefighters as being strong, working on the frontline and dealing with whatever happens—we have that stereotype. Added to that are the west of Scotland stereotypes that men should not come forward and speak about emotions and feelings. We are breaking that down, slowly but surely, but I think it is still there, so I can understand that the research is saying that 37% or so of firefighters feel unable to come forward to discuss their emotions, and the impact. We need to do more to break down the stereotypes and attitudes, and to increase mental health awareness—and actually mental health is on a continuum, with an impact on everyone. Then we will all feel able to come forward, but particularly those who are exposed, and re-exposed, to trauma.

I have been reading about the blue light programme, which I understand was funded from March 2015 until 2018. Will the Minister comment on the funding for that programme moving forward into 2019 and on whether, once again, there is any best practice implementation guidance from it that could perhaps be rolled out across the rest of the United Kingdom?

I thank the hon. Member for Ayr, Carrick and Cumnock (Bill Grant), who served for decades as a firefighter, and who brought his experience into the debate, for his service and dedication in that role—and subsequently in his role as an MP. He spoke about retained firefighters, which is important. Retained firefighters perhaps do not have the same level of training or support as other firefighters, and I should like to be assured that services—mental health support, but also other support—are available to them at the same level.

I also thank the hon. Member for Strangford, who paid a special tribute to those who have given their lives in the service. That is an extremely important point. He spoke about the tragedy of firefighters having to deal with the deaths of children, and the lasting impact on them, which we can all understand.

The hon. Member for Southend West (Sir David Amess) chairs the important all-party parliamentary fire safety and rescue group, which is considering the issues in question, and I thank him for that work. I am sure that it will be extremely important for us to work collaboratively across the House to take matters forward, and to continue to work on improving services for all and getting the best practice that people deserve.

I thank everyone who contributed to the debate. I am keen to work with the Minister and to take part in a collaboration between the Department and the Scottish Government, to make sure that across the United Kingdom best practice is followed on service access, treatment and research.

It is a pleasure to serve under your chairmanship, Sir Roger. I congratulate my hon. Friend the Member for Kensington (Emma Dent Coad) on securing the debate. I am pleased that she was successful in applying for it. In view of her expertise, given that the Grenfell disaster happened in her constituency, no Member is better placed to lead the debate.

When I took the shadow fire and emergency services post, I wanted to visit as many fire services as possible to learn at first hand what firefighters’ main concerns are. I expected to hear about problems with funding, staffing, pay and pensions, but I was taken aback by the deep concern about mental health. Firefighters are on the frontline. It is their job to deal with life-threatening situations. I acknowledge that it is highly demanding and stressful work, but it is also invaluable for our communities. Mind, the mental health charity, has done some great work in supporting firefighters through its blue light programme. Its workplace criteria for identifying the potential for mental illness correspond to the risks that are posed to firefighters daily: the repeated exposure to traumatic events, the potential for physical injuries, workload pressures, suffering loss, and worries about money. Invoking those criteria helps to explain why the potential for mental illness in the fire service is extremely high. The distinct lack of direct central Government action and focus, when the evidence is clear, is astonishing.

I acknowledge that the responsibility for ensuring the health and safety of firefighters rests with individual fire and rescue authorities, and the Chief Fire Officers Association supports them in that work through its lead on fire and rescue occupational health matters. I am sure the Government will point to the commitment of £7 million to pay for mental health support through Mind’s blue light programme. That is positive, but in 2017 the number of fire and rescue staff taking long-term sick leave because of mental illness had risen by nearly a third over the previous six years. Mind has found that 85% of fire and rescue personnel have experienced stress and poor mental health at work, and firefighters are twice as likely to identify problems at work as the main cause of their mental health problems. However, that does not only affect the firefighters; there is a big impact on their families.

Fire services work hard to ensure that the support infrastructure is available. I have heard of brilliant examples of that happening, including in the London Fire Brigade and Tyne and Wear Fire and Rescue Service, but the evidence shows that more has to be done to provide support to fire services. I do not doubt that the Government have acted, but any action cannot be separated from their wider attack on the service. Their ideologically-based austerity agenda has put more pressure on emergency services, and firefighters are bearing the burden. I am told time and again by the Minister that the number of fire incidents is decreasing but, as we know, that is not the full story. The overall number of incidents that the fire service responds to has decreased by 12.6% between 2010 and 2018. However, 11,854 firefighters have been cut in the same period, which equates to 20% of frontline staff. Therefore, on average we have fewer staff responding to more incidents, and incidents have risen every year since 2014. Workload pressures have increased over the past eight years, and if the Government want to be effective they must consider a staffing review as part of their policy to address mental health issues.

The effects of sustained cuts have put a considerable amount of pressure on the workforce, but that pressure is also changing. National discussions are being held regarding the expansion of the role of the firefighter to include emergency medical response. That may be a positive step if it is properly funded and if training is made readily available. However, I am not optimistic that central Government will ensure that that happens. I am not opposed on principle to EMR, but it must be properly funded. It will increase firefighters’ exposure to traumatic events and potential of losses of life. If they are not prepared for that change, it could be catastrophic for their mental health.

As a nurse, I saw such events at first hand. I assure Members that if someone is not prepared to deal with such incidents, the consequences for their wellbeing could be devastating. I was a cardiac nurse for 12 years and had an advanced life support qualification. I used to carry a cardiac arrest bleeper, and we used to run across the hospital to arrests. At that time—this is going back five to 10 years—the success rate was about 20% of resuscitations. That was in hospital, so we were getting there quickly. When a firefighter arrives at a cardiac arrest more time will have gone between what we used to call down time and the start of resuscitation, so the chances of success will be lower. At least we were successful a proportion of the time. By virtue of the way their work will happen in the community, the firefighters will see more fatalities; they will have to deal with that regularly, so it is an even more important factor in their mental health.

I thank the hon. Lady for her good work in cardiac services. That was in a controlled, measured environment, but the challenge for firefighters and ambulance personnel is that they operate in a quite unnatural environment, whether they are attending an accident at a farm or factory, or a car accident. They are exposed to the weather and elements, and there are other road users, and so on. That is an added dimension; it is not a controlled environment, although we would do our best to control it on arrival.

Absolutely. I completely agree with the hon. Gentleman. After someone has attended an arrest situation unsuccessfully, they go through an algorithm and they know they have done everything properly, but they still feel bad about losing that person. My point is that going to more arrests with a lower likelihood of success—because of all the things that the hon. Gentleman mentioned—involves much greater pressure. When I was a nurse we had occupational health, and there has to be something like that for firefighters—proper support.

I have been told numerous times during visits that firefighters have less time to train because of their workload. That is another thing that is very important. People going to an arrest must feel they know what they are doing. I am very concerned at the possibility that if outstanding issues are not fully addressed and firefighters are not effectively prepared for a sustained change in their role and responsibilities, their wellbeing could be damaged.

Our firefighters are heroes, and their pay must be properly addressed. As I have said time and again, they cannot spend a pat on the back. Mind has identified money worries as a contributing factor to mental illness, and considering the sacrifices made by our firefighters, the last worry they should have should be about their pay packet at the end of the month—my hon. Friend the Member for Kensington made a good point about some firefighters needing a second job, which is utterly disgraceful.

The Grenfell disaster and its consequences for our firefighters are terrible. The work that the Fire Brigades Union and the London Fire Brigade are doing to support firefighters is outstanding, and includes support for the 80 fire officers giving oral statements at the Grenfell inquiry. As the “Journey of Recovery” report highlighted, alongside all those affected, firefighters who were at the scene may be at risk of PTSD. The consequences are clear: stress and depression have been identified as the main source of LFB sick leave post Grenfell. I commend the Government’s commitment of £50 million to tackle mental health post Grenfell, but what proportion of that money will specifically be invested in support for LFB firefighters? Eighteen months after Grenfell, those firefighters still line the route every month for the silent vigil, and they are to be commended.

I do not accuse the Government of not caring, but I believe that more could be done, and they must recognise that cuts to central Government funding and staffing levels have a subsequent effect on a workforce. Let us not get into the old argument about allocated and unallocated resources, or who is responsible for austerity—the fire service must be properly resourced. I recognise that the Minister has asked Her Majesty’s inspectorate of constabulary and fire and rescue services to assess how well services understand and meet the wellbeing needs of their workforce, and how that can be improved. Will he provide an update on that and say when we can expect additional investment or support? How much of the £7 million committed to Mind’s blue light programme is included in existing fire service resources, and how much is new money? I look forward to hearing his response.

It is a pleasure to serve under your chairmanship, Sir Roger, and may I say to the hon. Member for Kensington (Emma Dent Coad) how sorry I am to hear about the recent death of her constituent?

I congratulate the hon. Lady on securing an extremely important debate. As she made clear—this was corroborated by my hon. Friend the Member for Southend West (Sir David Amess)—her long-standing interest in the fire service predates her arrival in this place, although it has continued here, and I know from our conversations that she has a genuine interest in issues of mental health. This debate has highlighted an important and growing issue, which, as she rightly said, is not restricted to firefighters. All our emergency services face similar challenges as a result of increasing pressure on wellbeing, and there is a greater recognition across those services about the need for the Government to step up and fulfil, in the words of the hon. Lady, their duty of care. She is right: we do have a duty of care, which I will now speak about.

I also pay tribute to the firefighter of yesterday, my hon. Friend the Member for Ayr, Carrick and Cumnock (Bill Grant). He entered the fire service on the same day that my dad entered Parliament, and his contribution was extraordinarily valuable. Many contributors to this debate spoke not from notes but from personal experience, whether as a nurse or someone with a father-in-law in the service. This was a particularly good debate, despite the terrible experiences behind it, and my hon. Friend’s contribution was extraordinarily valuable since he provided insights into the strain on body and mind that comes from seeing and hearing things that no one wants to see or hear. He also mentioned the surges and changes in emotional state that firefighters have to cope with, and he made the point—as did others—that the trauma remains and comes back.

Anyone listening to the testimony from firefighters at the Grenfell public inquiry will have heard not just about those who performed so admirably under the most unbelievable conditions when going up and down those stairs, but about those who sat in the call room taking terrible calls under unimaginably difficult circumstances. Anyone who has spoken to some of those firefighters will know that that experience will stay with them for the rest of their lives. Some of them will need support, and some will need to be told they need support—many Members mentioned the continued stigma that is attached to our emergency services, where the tradition can still be one of taking pride in coping and being fine, with the best therapy being more work. I think we recognise as a society, and certainly as a Government, that our heroic emergency service workers need more practical support that is relevant to their state.

The hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) made an important point about the need not only to make services available, but to make available services that are right for each individual, and I am sure the hon. Member for Kensington will agree. Certainly, in my work with Grenfell victims, I have been disappointed at times to discover cases of individuals receiving treatment that is not right for them in that situation. That point was well made, as was the point raised by my hon. Friend the Member for Ayr, Carrick and Cumnock about the landscape and nature of the workforce in the fire service, which is changing slowly and becoming increasingly diverse, and we must think hard about those changing needs.

My hon. Friend, and others, welcomed the Prime Minister’s statement of ambition and resource regarding more money for local mental health issues, which I think has cross-party support. I observe from my time in this place since 2005 that one of the great sea changes in this House has been a growing acceptance of the need for mental health to have parity with physical health, and decisive steps have been taken on that journey. Those steps have not gone as far as many of us would like, but they are decisive none the less. Again, that is part of a greater national societal awareness about the importance of mental health and the growing risk, and the demand for mental health support, not least for our emergency service workers.

Let me try to provide reassurance that the Government recognise the importance of this issue and stand ready to support and challenge the leadership in the fire service regarding the exercise of its duty of care. First, I confirm the point made by my hon. Friend the Member for Southend West, because there is now a requirement in the recently revised fire and rescue national framework for England, which sets out the Government’s expectations for a fire and rescue authority. It contains a new section on what should be considered part of the workforce strategy, and it states explicitly that each fire authority should have in place a people’s strategy that includes information on the availability of wellbeing and support services. I understand that most fire and rescue authorities, including the LFB, have workforce strategies in place, which is a good step forward.

My second observation is that although our fire service is widely recognised around the world as being among the best, we have an insufficient understanding of what good looks like. The creation of the Fire Standards Board, and the intention to create a more comprehensive and coherent set of professional standards—including in the area under discussion—is an important development. As the hon. Member for East Kilbride, Strathaven and Lesmahagow said, we need to know what good looks like in this context.

The third element is extremely important. Indeed, arguably the most important reform that we are introducing in our desire to seek continuous improvement in the performance of our fire service is independent inspection. That is similar to what we have introduced and strengthened for the police service, and with independent inspection and an increasingly clear framework of agreed standards, we will get a better picture of what is going on out there, and we will be able to compare and contrast the performance of fire services. With independent inspection comes greater transparency and greater accountability to the inspectorate, to the local fire authority, to the police and crime commissioner—where appropriate—to the Home Office and to Parliament. In our experience with the police, that framework of transparency and accountability is what really drives change. That is exactly the framework that we are setting up.

Various contributors to the debate talked about Mind’s blue light programme, and they were right to do so. I pay tribute to those who are working to deliver it. Since 2014 we have provided £7 million to pay for mental health support through the blue light programme, which was topped up after Grenfell. It provides advice through a network on mental wellbeing, stress and anxiety, seeking help for a mental health problem, supporting a colleague with a mental health problem, post-traumatic stress disorder and supporting someone as a friend or family member.

In addition—to speak to the point on the need for proper information about what works—every fire and rescue service in England now has access to a toolkit or framework called Oscar Kilo, which is also available to the police. It provides support and guidance for those who are responsible for wellbeing in each service, to assist them in developing and building robust, efficient and effective wellbeing support. As well as a framework of accountability and transparency, there is one of specific tailored support through the blue light programme and the Oscar Kilo toolkit. Those who are responsible for wellbeing and the local strategies have access to good information about what works, and that will grow.

Another entirely valid point was made about the need to ensure that the fire service has adequate resources to do its job. If we have insufficient capacity, or that capacity is too stretched, that will have an impact on wellbeing and people’s sense of confidence and professionalism in the job that they do.

I therefore confirm that fire and rescue authorities overall will receive around £2.3 billion in 2019-20. Single-purpose fire and rescue authorities will see an increase in core spending power of 2.3%, in cash terms, and an overall increase of 0.3% since 2015-16. Bearing in mind that the debate is sponsored by the hon. Member for Kensington, in the Greater London Authority core spending power increased by 6.3% in 2019-20 compared with 2018-19, with an overall increase of 11% between 2015-16 and 2019-20. Reserves stood at £57.8 million in March 2018.

Although we have a healthy disagreement with the Labour Front-Bench team, we maintain that our fire services are adequately resourced for the demand that is placed on them. However, I have always made it very clear, and I continue to do so today, that as we move towards the next stage of fire funding—the comprehensive spending review next year—we are updating our understanding of demand, because the past is not necessarily a guide to the future. We will approach the Treasury with our bid for police and fire funding on an informed basis, to be absolutely sure that over the next three or five years—whatever the time of the CSR—our fire services have the resources they need to do the incredibly difficult job that they do, which includes ensuring provision for adequate support of wellbeing and the welfare of the most important assets in the system, which are our people.

On that note, I will close. I put on record the Government’s thanks to our firefighters for their work. At this time of year, when most of us are out there eating, drinking and making merry, our emergency services are working extremely hard to keep us safe. Our firefighters and police are the ones who run towards danger when most of us run away from it. As we have seen at Grenfell, at the terrible fire recently in Nottingham and on motorways up and down the country, they are often called to events that are absolutely terrible—in particular when they involve children—and will probably stay with them for all their lives. It is right that we as a Government are challenged to answer for what we are doing about our duty of care, but it is also right for us to take the opportunity to place on record our thanks.

I thank all my hon. Friends and other hon. Members for their contributions, especially on a day when so little is happening elsewhere.

I want to reflect on some of the very helpful contributions, in particular with reference to fire investigators and retained firefighters—of course, in London we do not have any, but they give fantastic service in other parts of the country, at huge expense to themselves. We heard a lot about stigma. Although the situation is better than it was, people still expect firefighters to be Hollywood superheroes, when we know they are flesh and blood, like us. We heard a lot about mental scars, such as flashbacks, which can be with people forever, and about the difficulties of dealing with that kind of thing in the long term.

Different kinds of mental health support are available. I have heard a lot about peer support. A local psychiatry officer said that what the firefighters went through at Grenfell was due more than anything to the longevity of the incident—it was not just one incident; it went on for the best part of a day—and that the effect on them was more akin to the experience of torture victims, rather than of people who went through something else traumatic. Things like peer support are hugely helpful in such cases, but she did not feel that it had been explored in that context. I hope that that will be taken into account.

I thank the Minister for his contributions on people strategies and what good looks like. I am afraid, however, that setting standards and targets will not really hack it in this case. Without the funding to support it, independent inspection and monitoring of what is already in place is not enough, because we know that enough support is not there at the moment. People are struggling.

I will buy the firefighters’ record, but the idea that they have to fundraise for the charity that they will then rely on—they have to support it—is gutting, actually. I feel very strongly that we should aim for a world without charity, and where we do not need charity. In the interim, however, charity should be backing up the statutory services and certainly not replacing them. We are in a very bad state when we have to rely on charities to do things that Government should provide.

To summarise, existing services are clearly inadequate. We hear that from community members and firefighters. Today, we have heard lots of comments to back that up. We must indeed honour the brave men and women who keep us safe, but we cannot do that with words of praise alone; we have to act to take better care of them. Will the Minister please review and increase the funding, or work towards ways of doing so, rather than only setting standards and targets that are unobtainable under the existing funding regime? We need to tackle the issues that have been laid out today, and I hope he will reflect on that.

Question put and agreed to.


That this House has considered mental health support for firefighters.

Sitting suspended.