Skip to main content

Armed Forces: Severely Wounded Personnel

Volume 711: debated on Tuesday 9 June 2009

Question for Short Debate

Tabled By

To ask Her Majesty’s Government what steps they are taking to ensure that there are opportunities for service personnel severely wounded and disabled on active service to remain with their corps’ regiments or units in administrative or clerical roles.

My Lords, I am grateful for the opportunity to raise the future of our severely wounded servicemen. It is a sad coincidence that this debate is taking place during the Committee stage of the Coroners and Justice Bill when inquests for service personnel are the subject under consideration.

The whole House is united in its praise for our Armed Forces, especially the teeth arms, the fighting troops who over the past 10 years and more have been deployed continuously on operations of a particularly ferocious nature. Our fighting troops have exceeded all our expectations and they are an example to the entire country of unselfishness, modesty and courage in an age when these qualities are extremely hard to find.

Morale is high in the fighting forces. I hope that they all realise that they are held in the highest affection and respect by the public of this country. Such relentless war fighting brings a terrible toll, not only in deaths, but also severe injuries. Due to the miracles of modern medicine many men are alive today who, even 10 or 20 years ago, would have died from their wounds. Some of these wounds are very severe indeed. There are many men in fighting formations, returning from operations having lost two or three limbs and taken other horrendous injuries.

As I have said, morale and esprit de corps is high. It is high because there is essentially immense loyalty and comradeship within the fighting regiments or corps of our Armed Forces. In the majority of cases, severely wounded men want to be with their own comrades. Furthermore, their own comrades want them back. It would be a mistake for anyone to underestimate the fact that this is very much a two-way process. Those severely wounded men need their comrades and their comrades most certainly need them.

I should put on record the gratitude and admiration we all have for the wonderful medial staff who attend to our Armed Forces, both in the theatre of operations and back here in the United Kingdom at places like Selly Oak and Headley Court. These medical teams are an integral part of the family of the Armed Forces. They are hugely trusted and admired within the Armed Forces, as are the physiotherapists and others who help our fighting troops cope with the trauma of warfare. On this matter, I hope that the Minister will be able to tell the House what is being provided for our severely wounded personnel in terms of retraining and re-skilling.

There are no golden rules in dealing with the trauma of war. Each individual has his own way of endeavouring to cope. The traditional British way is to treat adversity with humour and self-deprecation, putting so far as possible the tragedies and atrocities of war out of one’s mind. I understand that the Armed Forces are rightly treating severely wounded personnel sensitively and with understanding. These people have much to offer. They can work in administrative and clerical roles. Furthermore, there are many tasks within a unit that they can perform. Their numbers, understandably, should not count towards the fighting strength of the unit because they cannot be deployed on operations. Nevertheless, there are many roles that they can fulfil back at a unit’s headquarters.

I understand from my own inquiries that the first three or four years following a severe injury are crucial in coping with the physical and psychological change necessitated by severe injury, getting used to artificial limbs and disabilities. Some severely injured troops may wish to leave the service early, but the vast majority wish to stay, certainly for some years. A good many severely wounded troops find that, after two or three years, when their comrades have moved on to different units, been promoted or taken a different specialisation, they themselves feel that it is time for change and often wish to opt to leave the service. The point is that there are no hard and fast rules. Each individual’s needs must be met.

The television, national press and local and regional press throughout the country are greatly supportive of our Armed Forces. Our local papers and regional newspaper in the south-west, the Western Morning News, all do an excellent job, providing the public with news and comment, both locally and from the frontline. I was delighted to see in the library a copy of the Courier and Advertiser of 29 May, a Dundee edition—I believe that this is the local paper of the noble Lord, Lord Lyell—providing an extensive coverage of the 45 Commando Royal Marines medal ceremony. It was instructive to see on the front page of that paper a photograph of a wounded man forming up with his unit to receive his campaign medal with his comrades.

I would like to pay tribute to our national papers as well, particularly the so-called popular press for doing much to highlight the positive contributions that severely injured servicemen make. My attention was drawn to an article on page 13 of the Sun on 1 June this year. Prince Harry was in New York and with him, as his co-ambassador, was marine Joe Townsend, who had lost both of his legs. Many service charities, including the exemplary Help for Heroes, have every reason to be grateful to our wounded servicemen for their selfless dedication in fundraising and the other efforts that they make.

Great British corps and regiments are like large extended families. When you join one of our elite corps or regiments, you are in it for life. In my own corps, there is an expression that is as true today as it ever was:

“Once a marine, always a marine”.

We have our own magazine, the Globe and Laurel, a wonderful magazine, referred to in the services as the “Globe and Buster”. We have a vast network of Royal Marine associations throughout the country and overseas. These also form part of the support network. The irony is that often the very severely injured and wounded are doing a great deal themselves to support others. It is exemplary to see what they do and what they are capable of doing. As I have said earlier, it is two-way traffic. These men are needed in the service.

My understanding is that the additional funding required in respect of the Iraq and Afghanistan wars have come out of central government funds and not Ministry of Defence funding. The funding for this vital work to which I have referred should also come from central Government and not be taken out of the Ministry of Defence budget. We owe all our Armed Forces a debt of honour. We owe those severely wounded and injured a debt of honour that we can never repay. We must, however, spare no effort or cost in supporting them.

My Lords, the phrase, “urgent operational requirement”, is familiar to anyone who knows the terminology of defence procurement. I feel that there is an urgent post-operational requirement to get more help to those returning warriors to whom the noble Lord, Lord Burnett, has just referred. I agree with everything he says and will not attempt to echo it. However, I agree with him that people feel more and more strongly the need to support all our men and women who return from active service, and those who are injured most of all. I was much struck by the turnout to welcome back the recently returned Commando Helicopter Force from RNAS Yeovilton a couple of Fridays ago as they paraded through the west country town near our own home. It is not just a matter of a celebration; it was a matter of concern for those people who had suffered.

The noble Lord, Lord Burnett, is absolutely right that the Government and the taxpayer should do more to help those hurt returning warriors. The charitable and voluntary sectors have a very important role, too. The noble Lord, Lord Burnett, referred to the heroes’ organisation. As always however, it seems that the more visible the need there is the relatively easier it is to raise funds. It is a truism of fundraising, I am told, that it is much easier to raise money—and I do not seek to be frivolous—for guide dogs than it is for Alzheimer’s disease sufferers, let alone the carers of Alzheimer’s disease sufferers.

I suspect that the same is true for injured warriors and the terrible loss of limbs from which many suffer. But for those with mental health problems—sometimes those who have sustained injury have sustained mental health problems as well—I suspect that it is much more challenging for voluntary organisations to raise the necessary funds. On my way home from your Lordships' House at night, I see in the doorways of shops opposite the New Scotland Yard building, that great fortified fortress, some of those who may fall into the returned servicemen category. I am not sure, but I suspect that some of them do.

Not long ago—the noble Lord, Lord Burnett, will probably be saddened to hear this, as I was to see it—I saw an ex-Royal Marine squatting on the pavement in Cheapside in the City of London, hard by St Paul's, begging. I thought that there must be something terribly wrong with the support structure that has allowed someone to end up doing that. I am sure from my observation, not from my discussion, that mental health problems were part of his problem. I suspect that; I do not know.

I know that organisations such as the Royal British Legion and Combat Stress do much, but we now have much larger numbers of individuals requiring help not just with physical injury but with stress and with coming to terms with returning to what is no longer normality for them—and at an earlier stage. The clear public policy benefit of an early “cause not symptom” approach is that it is likely to be quicker, more effective and cheaper. There is little merit in waiting until the returned warrior with those problems has gone all down the ladder to, say, begging on the pavement in Cheapside.

Some returning servicemen may have no physical but deep mental scars. I hope that various of our elite corps to whom the noble Lord, Lord Burnett, referred, would welcome them to come back to help in regimental headquarters, or wherever, with suitable training and help, just as much as those who suffered physical injury. Those mental scars make it difficult for them to cope in broader UK society following their removal from the services’ structure, which has often been their family, as it were, since their teens. That is as true for those with mental problems as it is for those with physical problems. I echo everything that the noble Lord said about those with physical problems. On coming out of the armed services, that can be compounded by a lack of real perceived support, respect or appreciation for what has been done to those people while serving.

The consequences can be very difficult: broken family networks, unemployment and the homelessness to which I have already alluded. I am told that perhaps a quarter of London's homeless are ex-service. It is a deep stain on our nation—of how we have allowed them to fall through the net—for the need in all cases is to develop skills to cope. The noble Lord, Lord Burnett, was surely right to say that regimental headquarters and others welcoming back those who suffer physical disability, albeit for a transitional period of perhaps three or four years until others have moved on, as he illustrated, will help people who have come back with those injuries to cope and eventually to re-enter civilian life on a gentle glide path. We have the same need to help those with mental problems to cope better and to help them with alternative personal support networks to try to deal effectively with the emotional causes rather than the symptoms.

Whatever the case—I am manifestly not an expert in this—new organisations are springing up all the time. There are one or two very effective pioneering charities. I think of the newly formed Warrior Programme. It has already demonstrated significant success in a small number of cases in helping ex-service personnel with emotional and mental health issues. The Warrior organisation, which I commend to the Minister—and others like it—needs two things: first, a little support to trial its innovative programmes on a wider scale; and, secondly, help to make its interventions, along with more established organisations such as the Royal British Legion, available across the services. More money will help, but so will more co-ordination. Access for returning warriors—knowing where to turn at any stage—is very difficult. It needs to be integrated, because the current response, just because so many are trying to help, including of course the MoD, is often fragmented. It is difficult for individuals to find it when they come out. That is a task that we can reasonably ask the Ministry of Defence to turn to. I know that organisations such as Warrior want to work closely with the ministry.

We will, I suspect, see wars continuing. We will also, I am told, in these recessionary times, see more young men and young women joining up, for a whole host of reasons, to the armed services. They may have had an unstable childhood. They often want to escape poverty—they simply want a job. They want security; they want another family which, as the noble Lord, Lord Burnett, so clearly illustrated, the armed services—whether the Royal Marines or whomsoever else—so often provide. Sometimes they simply have a burning ambition.

It is clear to me that the problems to which the noble Lord, Lord Burnett, referred, in connection to physical disabilities, and in the area of mental problems, on which I have concentrated, are likely to multiply in future years. To take just one example, it is good that we have 15 military departments of community mental health across the country, but we need more than the bare, overstretched 13 triservice psychiatrists that we have in the United Kingdom to help those people who have returned from combat with serious mental problems and those derived from stress.

For those who have returned damaged, that sort of help is, to reuse for the second and last time the phrase borrowed from defence procurement, an urgent post-operational requirement.

My Lords, I rise with apologies for the second time in my career in your Lordships' House, because I did not think that I would have the opportunity to be here tonight to support the noble Lord, Lord Burnett. For that reason, I apologise to your Lordships for not having my name on the list, but I shall be very brief and give enormous thanks to one or two Members of your Lordships' House tonight. First, I thank the noble Lord, Lord Burnett, for giving us the opportunity to debate this wide-ranging subject. He and other noble Lords may know this, but I declare an interest as secretary of the House of Lords defence group, which is tactfully known at level five, as the noble Baroness will know, as the warlords, but I am certainly one of the tamer ones. I have to say what enormous help Members of your Lordships' House who are interested in defence receive from the noble Baroness and, at the outset, I would like to say how grateful I am, because many of my remarks have been based on the help that she and the department have been able to give.

I have a minor personal interest. My noble friend Lord Astor and the noble Lord, Lord Burnett, were professional regular soldiers. I am now into my eighth decade, which indicates that I was a conscript for two years of National Service. I served only 19 months of that because, on 20 January 1959, I took a particularly foolish injury when skiing, which caused me to be in plaster for an entire summer and most of the autumn, with remedial treatment. I found that I was not getting better and I spent the summer of 1960 once again in the care of physiotherapists and medics. I am not necessarily one to speak, because two miles from where I had my appalling accident, my noble friend Lord Astor also had an accident, so he, too, will speak from some experience tonight.

I know what I and, I am sure, my noble friend, felt. It was not just the physical repair but, as my noble friend Lord Patten described it, it is what I think he called stress. We find it popularly termed in the media as trauma—that, indeed, is the transatlantic term—but it is pure stress. Now if I, let alone my noble friend, felt it, then think what all of those brave young men and women have had: a serious problem, not only of physical injury but of what my noble friend Lord Patten so eloquently put out.

The noble Lord, Lord Burnett, was kind enough to refer to 45 Commando, and I had the good luck to go to Arbroath on 29 May. What struck me there was that not just older citizens like me, who might have appreciated what I hope I may call our Commando in the county of Angus, but also all the youngsters—younger schoolchildren, college students, teenagers and late teenagers—were really impressed and proud to see all those young men back. Some, alas, were injured, as the noble Lord, Lord Burnett, said, but he pointed out what we were able to see in the Courier. We were, once again, able to see young Marines, using all sorts of prosthetics, as I think they are called, and serious assistance for their appalling injuries, receiving their medals.

Thanks to the noble Baroness and her department, the noble and gallant Lord, Lord Craig, the noble and learned Lord, Lord Mayhew, and I all had the chance to visit Selly Oak in March 2007. I think that was when her department was beginning to take the first steps in returning servicemen with pretty serious injuries. They came back to Selly Oak, which was not receiving the greatest publicity then; happily, we three who were there were able to rebut a good bit of that, and I am confident that enormous improvements are being made. I look forward to hearing what the noble Baroness will say in due course.

Also, thanks to the noble Baroness, our group visited Headley Court in June 2008. I hope that your Lordships will bear with me on this, but we were absolutely shattered by the unbelievable courage and, if I might be forgiven a slightly unlordly comment, sheer guts of all the young men and quite a few young women who were there. They were determined to follow exactly what the noble Lord, Lord Burnett, has said; they wished 110 per cent to return, as far as was humanly possible, to their service life because they missed it and all the points of comradeship that the noble Lord, Lord Burnett, mentioned. They wanted to get that back.

However, as my noble friend Lord Patten said, it is not just the physical injuries; it is the stress. I know that the noble Baroness will be able to give us some encouraging news on that when she replies. For my part, I certainly thank her for everything that she does. I also thank my noble friend Lord Astor and, if I may call him my noble friend, the noble Lord, Lord Burnett, for giving us the opportunity to discuss this tonight. I apologise to your Lordships for I thought that I would be away, therefore I am an intruder. That is enough.

My Lords, I congratulate my noble friend Lord Burnett on securing this debate and, indeed, on his sensitive and comprehensive contribution. He is a former serving officer in the Royal Marines, so his words obviously carry considerable authority and weight. I very much support the thrust of my noble friend’s contribution, but obviously I do not intend to repeat all his arguments.

Our Armed Forces are held in the highest esteem by the general public, by the media and at Westminster. Although we may have political disputes on particular conflicts or procurement programmes or, indeed, on the overall level of defence expenditure, our admiration, respect and appreciation of those who take up arms for our country transcend party politics and unite us all. Sadly, of course, many lay down their lives and make the supreme sacrifice, but many more are wounded or disabled. Lay people are often amazed by the desire of those who recover to operational fitness to return to conflict and fight alongside their comrades, as has been said. Thankfully, medical advances over the years make that increasingly possible.

However, for those who, unfortunately, do not fully recover, it makes much sense to do everything possible to find them a worthwhile role back with their corps or regiment, perhaps in some form of supportive but not combative role. As my noble friend said, that obviously helps their rehabilitation, rebuilds their confidence and self-esteem and, as the noble Lord, Lord Lyell, said, restores a sense of community and comradeship. We have to convince them of what is true, which is that they can continue to play a necessary part in their unit’s efficiency and success. As the noble Lord, Lord Patten, said, we do not want to see our ex-service personnel being homeless, on the streets begging or, perhaps, in prison where so many, sadly, end up. Equally, it has to be to the advantage of their operational colleagues to know that they would be looked after with onward career opportunities were they to succumb to severe wounding or disability themselves.

I have four questions for the Minister. First, is there a single booklet or similar that is made available to such personnel giving details of supportive career opportunities and where and how they can access the relevant training and the financial support to undertake it? Secondly, does the Ministry of Defence have any records of the number of personnel serving in the three services so redeployed after severe injury or disability, whether that be of a physical or mental nature? The noble Lord, Lord Patten, increasingly focused his remarks on the mental situation. Thirdly, how positively are commanding officers encouraged and, indeed, expected to provide career opportunities in the circumstances that we are discussing tonight, albeit acknowledging possible financial constraints and their prime responsibility of delivering an effective operating force? Fourthly, I refer to something that I read relatively recently. Professor Alexander McFarlane, the head of the Australian Centre for Military and Veterans’ Health, said that Australia and America were better at supporting their soldiers when they returned from conflict than we were. I should be grateful if the noble Baroness could look into this fairly serious assertion.

My Lords, the House will be grateful to the noble Lord, Lord Burnett, for raising this important issue. I agree with the noble Lord, Lord Lee of Trafford, that his noble friend’s distinguished service with the Royal Marines fully qualifies him to be taken very seriously by the House tonight. As the noble Lord, Lord Burnett, said, many men are alive today due to the miracles of modern medicine, but many of them are seriously wounded. Most want to be with their comrades and, as the noble Lord said, their comrades want them back. I also agree with the noble Lord that most units and regiments are like extended families—when you join, you are in for life. I am very proud that my former regiment, the Household Cavalry, which has suffered a number of deaths and serious injuries in Iraq and Afghanistan, like the Royal Marines has active associations both in this country and overseas and an efficient support network for the severely injured. I know that the same applies to the Household Division, in which my noble friend Lord Lyell served.

Can the Minister tell the House how many members of the British Armed Forces have been seriously injured in the past 12 months? As the noble Lord, Lord Lee of Trafford, asked, do the Government keep records of the number of service personnel serving with their original regiments or units in administrative or clerical roles since being wounded or disabled while on active service? Are any programmes in place to allow and indeed encourage wounded soldiers who wish to continue serving to stay with their units? We on these Benches welcome any progress to enable wounded soldiers to continue serving.

Although that is paramount, it is also vital that wounded soldiers, after leaving military care facilities such as Headley Court and Selly Oak, have access to proper civilian healthcare. Can the noble Baroness tell the House what government procedures are in place to ease the transition from military to civilian healthcare for disabled soldiers? What programmes are used to facilitate greater co-operation and communication between the Ministry of Defence and the NHS? I should like also to join the noble Lord, Lord Burnett, in paying tribute to our local and national newspapers and the television for highlighting the very positive contributions that severely injured servicemen can make.

Many years ago, Lord Nelson said that this country expects every man to do his duty. Two hundred years on, our soldiers, sailors, airmen and marines are still responding to the call and many are being severely wounded in the defence of this country. The difference is that our Government expect a first-rate military on a second-rate budget. After a decade of Labour’s neglect, our military is overstretched, undermanned and in possession of worn-out equipment. It is our duty to ensure that these brave heroes who fight on our behalf receive proper care and recognition both for operational requirements and, as my noble friend Lord Patten said, for urgent post-operational requirements.

My Lords, this is a debate about severely injured service personnel, but before I turn to the points that have been made, I am sure that the whole House will wish to join me in offering sincere condolences to the families and friends of those who have been killed on operations in the recent past: Marine Jason Mackie, Fusilier Petero Suesue, Sapper Jordan Rossi, Lance Corporal Robert Martin Richards, Lance Corporal Kieron Hill, Lance Corporal Nigel Moffett, Corporal Stephen Bolger and Rifleman Cyrus Thatcher. It is appropriate that we remind ourselves of the ultimate sacrifice that they have each made, and our sympathies are certainly with their families this evening. This is a salutary reminder of the very harsh consequences of the operations in which we are involved, and of course one of the consequences of those operations is the issue of injured service personnel that the noble Lord, Lord Burnett, has raised today.

The whole House has expressed its appreciation to him for securing this short debate to ensure that we are taking the right steps to provide opportunities for service personnel who are severely wounded or disabled while on active service. Noble Lords have mentioned the need to help them remain with their corps, their regiment or their units, in administrative or clerical roles, if they cannot return to their former duties. We are very clear that that is a desirable objective. It is also important that the House realises that we do not think that there is one approach that fits every individual, because these people should be treated as individuals, and the response should be tailored to their needs as much as possible.

We accept absolutely our responsibility to provide effective medical and health support to our people. The support to personnel injured on operations is, I think everyone agrees, of an excellent standard. That is not just my view. The National Audit Office noted in its May report that:

“The Department’s success in delivering lifesaving medical treatment is underlined by the number of ‘unexpected survivors’ following the most severe of injuries”.

Noble Lords have mentioned that those who might have died just five or 10 years ago are being kept alive today by the remarkable services that we now have. We should all pay tribute to the medical teams who are responsible and those who have devised the advances that allow those people to survive.

For hospital treatment, we rely almost exclusively on National Health Service facilities. Serious casualties need, and receive, advanced levels of care across a wide range of medical disciplines that can found only in a major trauma hospital. In addition, by working in the National Health Service alongside civilian colleagues, our medical staff gain the broadest and most up-to-date training and experience, which helps to save lives on military operations.

The noble Lord, Lord Patten, and other noble Lords mentioned mental health care, which is extremely important. We provide comprehensive mental health support to our casualties, including military mental health staff in theatre, at Selly Oak Hospital where most of our seriously wounded are treated, and at military departments of community mental health across the country. Real progress has been made to what, across the board, was a Cinderella service in terms of something that people did not like to talk about. There have been many breakthroughs. Mention was made of Combat Stress. In 2007-08 the MoD paid that society £3.2 million for fees for the care of individual war pensioners, which was a substantial increase and which really helps that organisation to do the work that is necessary. We are making very significant progress in that area.

My Lords, I am grateful to the Minister for giving way. Would she, or if not her because she is very busy then her officials, welcome further discussions with organisations such as the one I referred to, the Warrior Programme, and others, to discuss not just how more public money might be spent, but how these different organisations might knit their care together and make access to that care easier for those people who need help with mental health problems?

My Lords, my honourable friend the Parliamentary Under-Secretary in the other place has regular meetings with many of the organisations concerned and I am sure would respond to any request that was made of him. It is important that we work together with the charitable sector on these issues, not least because it has a very good record in this area, a good history and a great deal of confidence from those who are in the services.

Noble Lords mentioned Headley Court and referred to the visit. It is an important facility and there is nothing quite like it in the National Health Service. It is commonly agreed that there is world-class care for the patients there, providing clinical rehabilitation, training, a centre for rehabilitation and research, and all of it tailored to individual needs. We have to do the best we can. The department recently helped with work that is going on there, and the recent Help for Heroes commitment of £8 million to extend facilities is very welcome. We should pay tribute to the work that has been done. We have to do our best to protect our people when we can, to give them the immediate treatment that they need, and to provide the long-term support that some, though not necessarily all, will need over many years.

The focus of much of this debate has been on retention and on trying to keep people in the military family, if that is what they wish. It is always our intention to retain injured service personnel if it is possible to find worthwhile service employment for them. Each service considers each case individually and works very closely with the medical authorities, taking account of the wishes of the individual service person. This ensures that our personnel are returned to work even if their injury, sickness or disability prevents them undertaking a full range of activities. We want to do this as soon as is reasonable, but clearly we have to do it in such a way that we avoid any employment which would make their underlying medical condition worse.

In the case of the Army, applications to retain or discharge injured army personnel are currently made by commanding officers on a case-by-case basis and on the recommendation of a full medical board to the Army Personnel Centre. Commanding officers are given advice on this and are currently employing injured personnel wherever possible within units, subject to the individual’s wish to remain and having a worthwhile role. Where the wish is not to remain within their current unit, individuals may elect to leave the Army or, provided that they are above the minimum medical standard, transfer to an alternative cap badge—for example, from the Infantry to the Advocate General’s Corps—and, again, this process would be facilitated by the Army Personnel Centre, which is developing and has expertise in this area.

The Royal Air Force follows a similar procedure called the medical boarding process. Where an individual’s permanent medical standard is below that required for their current trade, they may be considered for employment within a different trade, obviously with retraining and reskilling being available where that is necessary.

In the case of the Royal Navy, the majority of personnel with more severe injuries—specifically those injuries sustained while on active service—are young Royal Marines. These young men have led full, active lives and may or may not find the administrative or clerical sectors as fulfilling, meaningful and appealing as their originally chosen career as a marine in a commando unit. Where the Royal Navy is able to make such opportunities available, an individual can choose to remain in service; or they may choose to make a new start in civilian life, and in that case the appropriate help with transition will be available.

The real balance that has to be struck is between the wishes of the individual and how far you can accommodate their levels of injury, health problems and abilities because they may need to do different tasks and will need reskilling.

We have made significant progress. We have outstanding care and outstanding welfare care. It is important that we recognise that that is necessary—it can be an emotive area—and, as I mentioned, we work with some of the charities that have a great deal of experience in this area. We appoint visiting officers to provide information and practical support for families, and specialist welfare workers are appointed to co-ordinate the very often numerous agencies that are involved. There cannot be one package. The noble Lord, Lord Lee, asked whether information was available. Because every situation is different, we have to respond to the specific needs of each individual.

Other points have been raised but there is not time to answer them all. So far as numbers are concerned, the ones that I have are the total of those who have been very seriously and seriously injured in Iraq, which is 222, and in Afghanistan the total figure is 197. That gives some idea of the scale of the problem and the learning curve that has gone on in the recent past.

We give outstanding medical treatment and we regard these people as individuals and try to meet their individual needs. That is important. Everyone has said that we need to ensure that these people are kept within the military family if that is at all possible. That is something we understand and have tried to work for. Provided we can find a worthwhile role for these people, and provided they as individuals want to stay within the Armed Forces, that is what we try to do. As everyone has said, our Armed Forces are the best in the world. Their dedication and sacrifice are unquestioned and it is only right that the care and support they receive should be equal to that. We are committed to ensuring that that is the case.

My Lords, I am extremely grateful to the Minister for her response. Will she write to me on the matter of retraining and reskilling for those individuals who have been so severely wounded?

My Lords, I can give an assurance that that is one area we are very conscious of and many people have already gone through that process. When people are very severely injured, sometimes it is several years before they can be brought back into full employment in any new capacity. There is therefore the medical dimension, including the mental dimension, there can be welfare and family issues, but certainly reskilling and retraining is something that is well looked after and provisions are made wherever possible.

8.25 pm

Sitting suspended.