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17 July 2008 : Column 165WH—continued

Derek Twigg: The intention is not to create a huge burden; it is to get it right for the veteran and to establish where they would get the best support. Combat Stress is working with us on that. In any relationship there are always issues when pilots are developed. The whole point of having a pilot is to consider the potential problems that might arise, but we also need to develop a service that fits the model we are looking for. We work closely with Combat Stress and I have listened carefully to its comments. I am sure that that partnership will develop further in terms of how we commission services
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for veterans. I re-emphasise that the connection with the devolved Administrations is also important in relation to mental health issues and that we are working with them on that.

A point about service personnel was made and, as hon. Members will know, there is the reservist mental health scheme in Chilwell, to which reservists can be referred if they have a mental health problem. They could obviously then be admitted to one of our mental health units if necessary. The way we approach mental health generally is to hold pre and post-deployment briefings for our service personnel, which are increasingly led by commanding officers. There is a big issue about stigma that we have to deal with. Although that problem is improving, we must do more work on that and there has to be leadership from the top.

Linda Gilroy: Will the Minister give way?

Derek Twigg: I will when I have made this point. We have deployed medical staff in theatre to provide help if necessary. In fact, I heard about one medic who flies out in a helicopter to a forward operating base if necessary to provide the right sort of counselling or help.

I cannot say that the system is perfect, but I believe it is a good model and we must keep it under scrutiny and assessment. If someone has a particularly difficult problem that needs to be dealt with, they can come back to the UK. There has been a lot of work on the trauma risk management project, which the Royal Marines have used. The Army and others are also going to use that project.

On the decompression period in Cyprus, I was talking to some Scottish soldiers today who believe that it is a good process and that it is the sort of thing that should happen. At the moment, there is no evidence that the process works, but everyone feels that it is a good thing. Again, I have been to see the facilities in Cyprus, which are good—although they need constant attention and improvement. That is something we must do. A number of mental health initiatives are not just for veterans, but our serving personnel.

Linda Gilroy: I thank my hon. Friend for giving way, but in the interim he made reference to what I was going to ask about, which is if he recognises what I refer to as the “buddy” scheme that was developed by some of the Royal Marines based in Plymouth. That is becoming increasingly widely used to deal with some of these issues.

Derek Twigg: Yes. My hon. Friend makes an important point. The Royal Marines have done a lot of work on the issue. It is important that, in the light of experience, we constantly review what we are doing. We know the type of combat experiences that our armed forces personnel are going through at the moment.

The Priory was mentioned. We are asking for bids for the contract in that respect. We are not in a position to announce a decision on that, but we will do so as soon as possible. We have a liaison officer from one of the mental health units at the Priory centre regularly. I am not aware of any specific problems regarding the treatment and care there, but I am always happy to look into an individual case.


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Primary care and governance in clinical care were raised. That is an important point. One of the questions that I asked some time ago was how we know that the DMS provision of medical services is at the level that we expect. We believe that we know it is, and clearly we are seeing the results in trauma care, but we also have to consider services elsewhere, such as in primary care and so on. That is why I asked the Surgeon General to examine the issue and why he has agreed, along with the Healthcare Commission, to do an inspection. The Commission for Healthcare Audit and Inspection (Defence Medical Services) Regulations 2008 were laid before Parliament.

I think that we are of the same mind on the issue. We need to keep a constant watch to ensure that we continue to make improvements. Of course, that does not take away from the amazing care that our service personnel receive. Some of the negative points from the armed forces continuous attitude survey were mentioned in the press last week, but one of the positives was the way in which our service personnel welcomed the medical care that they receive.

With regard to the German issue that the hon. Member for Dunfermline and West Fife (Willie Rennie) mentioned, I am not aware of any particular problem being caused at the moment. However, I will be happy to write to him once I have examined the issue and I will do that as soon as possible.

5.11 pm

Mr. Arbuthnot: With the leave of the House, I shall end the debate with a few short remarks. I thank very much those hon. Members who have played such a valuable role in both the inquiry and this debate. I shall wind up the debate with only three points. The first relates to the charities that have received such honourable mention today, such as Combat Stress, Help for Heroes, SSAFA—there are many others. One view that the Committee strongly holds, perhaps in contrast with
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some members of the public, is that there is nothing intrinsically wrong with medical help for our men and women in the armed forces being provided by charities. There is something very valuable about members of the public being able to express in a tangible way their support for the work that our armed forces do in such dangerous and demanding circumstances, so I pay tribute to the charities that achieve that.

I am pleased to say that my second point has been made already by the Minister. He said in relation to mental health that there is an issue of stigma that we have to overcome. We need to get past that. We need to move on, beyond the stigma attached to mental health, and I am pleased to say that that is gradually beginning to happen in this country. When people go out and do such incredibly dangerous things on our behalf, there is no reason to suppose that they are physically invulnerable, so there is equally no reason to suppose that they should be psychologically invulnerable. In either case, they need the best possible care.

Finally, this debate and our inquiry have shown that often it is the members of the armed forces themselves who are concerned about the medical care that they may receive. When we went to Camp Bastion’s hospital last week, we found that the armed forces were taken round and shown that hospital, which made them realise that it was a proper hospital in the most extraordinary conditions in the desert. As a result, they felt that they would be well looked after if they were wounded, whether seriously or less seriously. They felt that they would receive proper care, so to those members of the armed forces who are listening to this debate—I hope that that is every single one of them, except for those very actively engaged—we can say that they should be reassured and their families left behind at home can also be reassured that their loved ones are in the best possible hands with the Defence Medical Services, to which we all pay tribute.

Question put and agreed to.

Adjourned accordingly at fifteen minutes past Five o’clock.


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