That an humble Address be presented to Her Majesty, That she will be graciously pleased to give directions that there be laid before this House a Return of the Accounts of the Contingencies fund, 2006-07, showing:
(1) a balance sheet;
(2) a cashflow statement and;
(3) notes to the account; together with the Report of the Comptroller and Auditor General thereon. [Mr. Roy.]
The Parliamentary Under-Secretary of State for Defence (Derek Twigg): With permission, I should like to make a short statement before answering the question. I am sure that the whole House will join me in sending sincere condolences to the family and friends of Guardsman Daryl Hickey, who was killed by small arms fire in Helmand province Afghanistan on Thursday 12 July.
Defence medical services mental health staff deploy on major operations to provide assessment and care to personnel in theatre. In the UK, community-based mental health care is available at 15 Ministry of Defence-run regional departments of community mental health, plus satellite centres overseas, while in-patient care, when necessary, is provided regionally in specialised psychiatric units under a contract with the Priory group.
Given the numbers of service personnel returning from the conflicts in Iraq and Afghanistan with mental health traumas ranging from depression and anxiety to post-traumatic stress disorder, and given that there may be many more whose conditions could take years to manifest themselves, does the Minister agree that unless measures are taken now substantially to expand the provision of a dedicated Army mental health specialist team, rather than just relying on NHS and voluntary-sector provision, important as they both may be, Britain risks facing a mental health time bomb in the decades ahead among soldiers and veterans?
Derek Twigg: The support that is given pre- and post-deployment is quite significant, in terms of advice, including on what signs serving personnel should look for. There is also good support in theatre, with psychiatric support and even a visiting consultant. There is significantly greater awareness these days of mental health problems and a greater ability to talk about them. As I said in my answer, we also have departments of community mental health care throughout the country and significant support, if needed, via the Priory unit.
Mr. Eric Joyce (Falkirk) (Lab): Have my hon. Friend or any of his right hon. Friends at the Ministry of Defence had any contact with the organisation Combat Stress? If so, have they had a chance to discuss its future funding?
Derek Twigg: My hon. Friend makes an important point. Combat Stress is obviously an excellent organisation and it does a superb job in supporting those who develop mental health problems, often later on, after leaving service. We funded it last year to the tune of £2.9 million and we are in discussions this year to give it a significant increase in its funding.
Mike Penning (Hemel Hempstead) (Con): I, too, pay tribute to the 1st Battalion Grenadier Guards, my own former battalion. It is having a desperately difficult time, with so many of its guardsmen coming home injured or, sadly, dead.
The Minister is aware that soldiers are disproportionately represented among the homeless, especially in London. What is the Ministry of Defence doing to go out and see how many soldiers are homeless and living rough, and what are we doing to alleviate the problem?
Derek Twigg: A study conducted recently of former armed forces personnel showed that there has been a substantial drop in rough sleepers in London. Also, we have a number of schemes throughout the country, in Yorkshire and Aldershotwe are also looking at Colchesterto provide spaces for homeless service personnel and to work with them. In addition, the Compass scheme in London works with the Royal British Legion and does an excellent job. I have visited the scheme and talked to a number of the ex-soldiers and RAF personnel there, who were full of praise for the work and the support that the scheme had given them, not only by providing them with accommodation, but by helping them to get back into work and in some cases start up their own businesses.
Mr. Lindsay Hoyle (Chorley) (Lab): My hon. Friend must be aware that we have to learn lessons from the Falklands war, the Gulf war and every other conflict, in that the support from mental health services has not been there. That support has also not been seamless for the people who have left the services. What will he do to ensure that that neglect does not continue and that support is provided not only while people are in the services, but when they leave?
Derek Twigg: My hon. Friend makes an important point. There are clearly lessons to be learned from the past. There is a lot more knowledge these days about mental health and post-traumatic stress disorder, and about the ways in which we approach these matters. We have been looking into a number of ways of improving the system for former armed forces personnel, including better funding for Combat Stress, the extension of the medical assessment programme that I announced a few weeks agowhich will go back to include the 1982 veterans of the Falklandsand the reservist mental health scheme for those who are deployed in Iraq. We are also looking at a new pilot scheme involving the Ministry of Defence, the health services and Combat Stress that will develop centres of excellence to support those who develop a mental illness as a result of their service in the armed forces.
The Secretary of State for Defence (Des Browne): We provide an excellent level of care for our service personnel who have been wounded on operations. This includes: life-saving emergency care in the front line, in our field hospitals and in NHS hospitals in the UK; the excellent facilities at the defence medical rehabilitation centre and our regional rehabilitation units; and treatment for those whose mental health has been affected.
Mr. Benyon: As the wounded come to terms with the consequences of their injuries, their thoughts turn to issues such as housing, and to whether they will be allowed to remain in the armed forces, and if not, to what provision exists to assist them in moving into civilian life. Will the Secretary of State give the House an assurance that everything that can be done for our woundedmany of whom have severe disabilitiesis being done in respect of informing them of their entitlements and providing assistance in getting back into civilian life? Will he also give his support to any civic or community group that recognises the heroism and sacrifice of these injured servicemen as they try to return to their civilian lives?
Des Browne: I agree with the hon. Gentlemans assessment of our responsibility to those who return injured from theatres of combat. He will know that, because of the advances that have been made in rehabilitative care, such people are increasingly able to continue with their Army careers. That is a function not only of advances in clinical care and rehabilitation processes but of the way in which the services interact with those people. Caseworkers are involved, as is a programme known as pathway care, which is doing work in this area. In all these programmes, we work with the voluntary sector and other agencies including local authorities and the NHS, and I have no difficulty in giving the hon. Gentleman the commitment that he asks fornamely, that we will continue to do so. He also asks for a reassurance that everything that can be done is being done. I cannot give him that reassurance, because I am absolutely certain that we will find ways of improving what we have already improved as we proceed along these lines, and we intend to do that.
Mr. David Crausby (Bolton, North-East) (Lab): I recognise the fantastic work that is being delivered by the NHS at Selly Oak hospital in Birmingham. The introduction of military-managed wards has been very much welcomed by our service personnel. Will my right hon. Friend assure me that such wards will be the norm, so that our service personnel will have the support of their comrades at these difficult times?
I assure my hon. Friend that we are pleased with the progress that has been made on the military-managed ward at Selly Oak hospital. That hospital treats our casualties in a world-class way, and I am pleased that, at least in regard to clinical care, that
view is shared by those on all the Front Benches in the House. There has been some debate about whether we could improve the environment in which injured military personnel could recuperate, and we have made improvements in that regard. So much so, in fact, that General Sir Richard Dannatt, the Chief of the General Staff, said in March:
There is nowhere better in the country, nowhere more expert at polytrauma medicine, than that hospital in Selly Oak. Thats why our people are there.
Mr. Nicholas Soames (Mid-Sussex) (Con): Would the Secretary of State accept that it is a great failing of the Ministry of Defence that more is not known about the great triumph, success and heroism of British soldiers, particularly those who have been seriously wounded? Will he note the point made by my hon. Friend the Member for Newbury (Mr. Benyon) about the need for the wider community to recognise the astonishing achievements and heroism of the wounded? Does not he agree that they should be invited to race meetings, motor racing, boxing fights, and so on, so that people can see them, welcome them and give them appropriate recognition for their astonishing achievements?
Des Browne: I absolutely agree with the hon. Gentleman. I am pleased to advise the House, and those who might have missed this, that a significant number of those who have been injured in combat were recently guests of, I think, the British Motor Racing ClubI shall almost certainly get this wrong, and I do not want toat the recent Formula 1 race. Whoever it wasand I should know exactly who invited themis to be commended for their generosity and for their reasons for choosing to honour those people.
May I say to the hon. Gentleman and to the House that I regret the change made some time agothere were reasons for itwhereby soldiers, airmen and sailors who are off duty do not appear in uniform on our streets? If more of our armed services were able to appear in uniform, people would have a better chance of relating to them. If I can increase the numbers who are able to do that, it will go a long way to address the hon. Gentlemans point.
Mr. David S. Borrow (South Ribble) (Lab): With the best will in the world, it is inevitable that not all servicemen and women injured in combat can be treated in military-run wards. Some will be placed in civilian-run wards because that is the best place for them to be. Will my right hon. Friend assure me that, when soldiers are placed in civilian-run wards, they will receive the sort of care that is appropriate for individuals who have been injured in combat? Will recognition be given to the special nature of the trauma and difficulties that they have gone through in receiving their injuries, as that can be very different from injuries sustained in civilian life?
My hon. Friend is right in identifying the challenge that we would face if we had to bring in all those in the services receiving in-patient treatment, as they would barely fill two hospital wards on any typical day. In those circumstances, it is impossible to
imagine how the re-establishment of a military hospital, for example, could provide the excellence of clinical care that those people would receive in NHS hospitals. A relevant example is the opportunity to bring 16 trauma specialists to one bedside in Selly Oak hospitalthat cannot be done anywhere else. We continually address the challenge of generating the environment that is commensurate with the circumstances that have caused the injuries to these young menand it is young men more often than not. I will do everything I can to ensure that we continue down the path that we have embarked upon.
Dr. Liam Fox (Woodspring) (Con): As we have discussed in the House before, better body armour inevitably produces fewer fatalities, but more disabilities than in previous conflicts. The concept of the MODs duty of care therefore needs to extend more than ever beyond the time actually served in the military. It needs to extend to those with chronic disability, in the knowledge that the NHS will give themwhatever the effects on targetsthe priority that they deserve. Those with psychiatric damage need to know that the appropriate military psychiatric help will be available years later when it is needed. Why, unlike in the US, do we still have no guidelines on traumatic brain injury? Does the Secretary of State understand how unacceptable it is to the House when we read in yesterdays papers about a young man, Lance-Corporal Twiddy, who said:
Once you are discharged, the MOD doesnt want anything to do with you?
Des Browne: I am sure that the hon. Gentleman will understand why I shall desist from responding to the circumstances of one particular individual, but he has my assurance that I will personally look into the circumstances of the young man whom he identified and find out whether that was the caseif so, I will do everything I can to see that it is no longer the case for that individual.
On the more general issue of traumatic brain injury, we are studying developments in the US: as we speak there is a liaison officer out there and we want to learn from what the US has done. The hon. Gentleman has a medical background and training that I do not have, so I am not in a position to assess that, but I rely on others to do it for me. Recently, evidence from the US has shown that, when it comes to the care of veterans, they have something to learn from us, too.
With approximately 10 per cent. of the British Army not being British, I am sure that the whole House is grateful to the thousands of young men and womenmainly from Commonwealth countries,
but from a total of 57 countrieswho are serving in Her Majestys armed forces. As to South Africa, is the Minister satisfied that, as a result of South African Government legislation, South African citizens will still be able to serve in the British armed forces?
Mr. Ainsworth: We are aware of problems with the proposed legislation in South Africa and my right hon. Friend the Secretary of State has spoken to the South African Minister of Defence on the telephone and written to him about it. The result of those conversations provides some degree of reassurance about what the South African Government intended to do. However, we are not there yet and nothing is pinned down. We are still concerned, as are the people directly concerned. We are trying to keep them informed of the situation and if there are any developments we most certainly will inform them.
The Secretary of State for Defence (Des Browne): From a peak of about 45,000 personnel deployed to Iraq during major combat operations in 2003, we have drawn down progressively to 8,000 prior to handing over three of our four provinces. Since then, we have reduced in stages to 5,500. The commanders on the ground assess that that is the right number of troops to discharge our current responsibilities. As I have made clear, we expect to see further reductions as we hand over to the Iraqi security forces in Basra city.
Mr. Kidney: I thank my right hon. Friend for that answer. I welcome recent troop withdrawals and look forward to more soon. My question is about the safety of troops during withdrawal. Is a transitional period between active patrols and returning home envisaged, during which troops will be, as it were, confined to barracks? Will that be at the Basra air base? As I am sure he is aware, that base is subject to dozens of rocket attacks every day. If there must be such a transitional period, could our troops be safely elsewhere in the region but close enough to be on call if needed?
Des Browne: It is not envisaged that our troops will be confined to barracks, as it were, at any time. Operational decisions in relation to force protection are a matter for commanders. Invariably, such operations, which are known as layered, include attempts to interdict those who try to attack the base. I reassure my hon. Friend that no effort is spared to ensure that the best possible protection is provided to our forces deployed on operations. In the last year alone, we have invested millions of pounds in new equipment, including body armour and armoured vehicles. In relation to indirect fireIDFa number of kinetic and static capabilities have been deployed better to protect our personnel from such attacks. For reasons of operational security, I cannot elaborate on that or on the equipment employed. Unfortunately, however, the effects of indirect fire attacks can never be mitigated completely. We ought to expect those to continue in the current environment.