My Lords, for reporting purposes serious UK operational casualties are usually categorised as having either serious or very serious wounds and injuries. Between 2003 and 2009, 222 UK casualties in Iraq were included in these categories, while the number for Afghanistan between 2001 and November this year was 591. We constantly invest in staff, facilities, patient welfare and treatments, including rehabilitation, to ensure that casualties get the best possible medical treatment and ongoing care.
I do not wish to get into an argument over statistics, but clearly the Minister’s figures cannot possibly at this stage include people who will suffer from mental illness, which, as we know, emerges over time. However given that many of these casualties will require care for anything up to 60 years or more and that the care is of a specific nature which cannot inevitably be supplied by the Armed Forces, what strategy is in place to ensure that the National Health Service, which will have to bear this burden, is adequately resourced? The resources will have to be not only financial but professional, with specific knowledge required to treat these casualties whose sacrifice ensures that we continue to enjoy the freedoms which sadly we so often take for granted.
My Lords, the noble Lord asks an important question. I assure him that my department takes this issue very seriously. The continued care of veterans injured while in the Armed Forces remains a key component of the military covenant. When personnel leave the services, responsibility for their healthcare is transferred from the Ministry of Defence to the NHS. We are working closely with the Department of Health to ensure that any service-related medical needs are met throughout their civilian lives. For example, the NHS is introducing national specialist prosthetic and rehabilitation centres to address the long-term needs of amputee veterans. It also recognises concerns about their mental health and is introducing a nationwide network of new veteran-focused mental health outreach and assessment teams.
My Lords, I can answer my noble friend. In Iraq, of the 222 UK casualties listed as having serious or very serious injuries, 25, that is 11%, were members of the Reserve Forces. In Afghanistan, of the 591 UK casualties listed, 22—4%—were reservists. Those reservists who sustained wounds or illness while mobilised will be retained in service prior to being demobilised and returning to work, to ensure that they receive the best possible welfare support and care and are eligible for the full range of Defence Medical Services care. Once reservists have been demobilised, their local reserve unit continues to ensure that they have access to welfare services.
My Lords, when we were in government there was a rule that no one would ever be fired from the services as a result of wounds sustained in the course of duty. Anybody in those circumstances always had a choice of taking a compensation payment and an immediate pension if he or she preferred or taking a compensation payment and remaining in service. I will never forget the occasion when, talking to someone doing an important job in Camp Bastion, I suddenly realised that what he had in place of a left leg was a wheel. Is that rule still in force and will the Government commit to maintain it?
My Lords, I very much welcome what my noble friend said in Answer to the noble Lord, Lord Empey, about servicemen who suffer severe mental stress. But will he confirm that this does not in any way reduce the need for the very splendid voluntary organisations that work in this field—I mention in particular Combat Stress—which do splendid work with people who often have very long-term mental illness problems following service?
My Lords, is the Minister aware of the number of members of the Armed Forces coming home from Iraq and Afghanistan suffering from life-changing levels of post-traumatic stress disorder? Is he aware that in Northern Ireland anyone who has served in the Armed Forces and who is seriously ill in this way is not able to avail themselves of the services offered by Combat Stress—that applies only in England—since it will not deal with a person who is regarded as too unstable, following repeated hospital admissions? For those former soldiers, there is only very limited treatment available on the NHS, with no appropriate therapeutic interventions. I raised a case three years ago of a former soldier who was hospitalised repeatedly for very long periods over three years, was self-harming and had no therapeutic help. Is there nothing Her Majesty’s Government can do to assist such former soldiers in Northern Ireland?
My Lords, I also very much welcome what the Minister has said so far. In helping the Afghan army and police develop responsibility for their own security, what efforts are the Government making for the rehabilitation and long-term care of people in those forces who have suffered life-changing injuries? For example, are processes in place to pass on all the knowledge and expertise gained over the years at Headley Court? What plans are there for the trauma hospital at Camp Bastion after 2014?
My Lords, the noble Lord is aware that a number of wounded and sick servicemen have fallen out of the net and live rough in our cities. The coalition Government have decided to remove, and make redundant any minute now, some 25,000 servicemen. The numbers who will fall out of the net will increase. What is required is a national plan to bring these people back into the fold, involving the Ministry of Defence, other departments and the National Health Service, as the noble Lord, Lord Empey, said. What are the MoD’s plans to cater for this?
My Lords, most veterans, including the seriously wounded, make a successful transition to civilian life and require little if any assistance after service. The MoD is working very closely with other government departments, the devolved Administrations and voluntary and community sector organisations to address all issues faced by ex-service offenders and homeless veterans.