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Armed Forces: Medical Care

Volume 699: debated on Wednesday 5 March 2008

asked Her Majesty's Government:

Whether, in advance of their response to the House of Commons Defence Committee's report on medical care for the Armed Forces, they will take action to improve care for personnel leaving the services with long-term mental illnesses after suffering traumatic stress during service. [HL1999]

The Government are considering the committee's recommendations and will submit their formal response to the committee within the next two months. However, I would like to reassure my noble friend that the MoD takes its duty of care to service personnel and veterans seriously and already has measures in place for personnel leaving the services with long-term mental illnesses.

Medical discharge from the Armed Forces due to psychological illness is low; around 150 personnel (less than 0.1 per cent) are discharged annually for mental health reasons, whatever the cause. Once a decision has been taken to medically discharge an individual with mental health problems, the Defence Medical Services mental health team that has been caring for that individual will begin a liaison with appropriate civilian healthcare providers (e.g. the general practitioner (GP) and civilian mental health team) to ensure that transfer of care and patient history takes place. In addition, we have mental health social workers who manage the individual's wider resettlement issues, liaising with relevant civil agencies such as local housing authorities, financial authorities, service welfare and charitable organisations, with the aim of ensuring that the individual's transfer into the civilian environment is as smooth and as seamless as possible.

It is also recognised that, in some cases, it may be many years after discharge before a veteran begins to display mental health symptoms arising from their service. With this in mind, the department announced in a Written Ministerial Statement on 12 June 2007 (Official Report, Commons, 12/6/07; col. 40WS) an extension of the medical assessment programme (MAP), based at St Thomas's Hospital, London, to include all veterans who have served on operations since 1982, including the Falklands conflict. The MAP offers assessment by an expert in the mental health problems arising from military service and will include, where appropriate, a recommendation to the individual and their GP for treatment. Veterans who have concerns about their mental health can seek a referral to the MAP by their doctor; the cost of the assessment is borne by the MoD.

In conjunction with the Department of Health, we also launched in November of last year the first of a number of community mental health pilots. Each site will have a trained community veterans' mental health therapist, and veterans will be able to access this service directly or through their GP, ex-service organisations, the Veterans' Welfare Service or social service departments. Four pilots are now operational (at South Staffordshire and Shropshire Healthcare NHS Foundation Trust, Camden and Islington, Bishop Auckland and Cardiff), with one in Cornwall due to follow shortly. A similar pilot scheme in Scotland, based in the Lothian region, was announced recently by the Scottish Executive. If the pilots prove successful, the model will be rolled out more widely across the UK.

In addition, the MoD provides assessment and treatment for demobilised reservists with operational service since 2003. MoD is also the major donor to the charity Combat Stress, which offers care to ex-service personnel suffering from service-related post-traumatic stress disorder. The MoD has increased the fees that we pay to 45 per cent from 1 January 2008.