Examination of Witnesses (Questions 372-379)
DEREK TWIGG
MP, LIEUTENANT-GENERAL
ROBERT BAXTER
CBE, LIEUTENANT-GENERAL
LOUIS LILLYWHITE
MBE QHS, MR BEN
BRADSHAW MP, PROFESSOR
LOUIS APPLEBY
AND MR
ANDREW CASH
27 NOVEMBER 2007
Q372 Chairman: Welcome. This is our fourth
evidence session on the medical care for the Armed Forces and
it is our final evidence session. We are taking evidence today
and we are most grateful to both of the Ministers in front of
us from the Ministry of Defence and the Department of Health.
I think this is a first. No, it is not a first in this parliament—we
had the Secretary of State for Defence and the Foreign Secretary
as well—but we are most grateful to you for coming with
your teams. We have done a second stage of the web forum we have
been running and we have decided to extend that by one further
week, and I will take this opportunity for advertising the address,
which is www.parliament.uk/defcom, so I hope people will get on
to it and start telling us their experiences, bad and good, of
the medical care available to the Armed Forces. Ministers, normally
we do not have an opening statement but, in view of the announcements
that you made on Friday, we think it would be extremely helpful
if you could just summarise what it was that was set out then
because I am sure that those questions and those issues will run
through the whole of this morning's evidence session. Which of
you would like to begin?
Derek Twigg: If I could say briefly,
I announced on Friday the pilot schemes for mental health for
veterans and these will be at six places in the country. We announced
both Camden and Stafford, which are just about to get off the
ground, but there will also be pilots at St Austell, Newcastle,
Cardiff and at a place in Scotland as well. We are spending around
£500,000 on this project in the initial stages. The pilot
will last for two years. Basically, the Ministry of Defence, with
our expertise through defence mental health, will be working via
the veterans units as well as with the NHS providers of mental
health in these locations and that will be really to enable clinicians
in the Health Service to gain a better understanding of the issues
around those who have served in the Armed Forces and the issues
that might arise, which often impact upon their mental health.
Of course, in a number of cases there will be a number of people
working in the pilot areas who have served in the Forces themselves,
but really to build an expertise in centres of excellence around
the country in managing those with mental health who have served
in the Armed Forces. As I say, this will run for about two years.
I went to Camden on Friday and Stafford yesterday. There is great
enthusiasm at those pilots for that and I think a very exciting
project is in place there. In terms of Scotland, I am not able
to say at this time exactly where that will be, but what I can
say to the Committee is that discussions are on-going with the
Scottish Executive. We will, of course, ensure the same funding
that applies to the English and Welsh schemes as well and we look
forward to getting that pilot up and running as quickly as possible.
Q373 Chairman: Minister, do you want
to add anything to that?
Mr Bradshaw: It may be helpful
if I outlined the other part of the announcement that we made
on Friday, which was around extending the priority treatment to
veterans. Priority treatment has existed since 1948 to those veterans
who are pensioned out of the Service because of an injury or a
condition that is service-related, to all veterans for any service-related
condition. This was based on a system that has been up and running
in the constituency of the Secretary of State for Health in Hull
for some time and it will extend the priority from currently 170,000
to potentially five million veterans in the country. Would it
also be helpful if I introduced my supporters?
Q374 Chairman: I was going to say,
now that you have set those out, would you mind very much introducing
your teams?
Mr Bradshaw: Not at all. On my
left is Professor Louis Appleby, who is the Mental Health Clinical
Director for the Department of Health, and on his left is Andrew
Cash, who is the joint Chairman of the DH/MoD Partnership Board.
Derek Twigg: On my right we have
got General Louis Lillywhite, who is the Surgeon General, and
General Robert Baxter, who heads our health services.
Chairman: Thank you very much.
There will be plenty of questions arising out of that, and we
will go during the course of the morning into the detail of what
have you said. Willie Rennie.
Q375 Willie Rennie: If five million
veterans suddenly came forward and demanded priority treatment,
that would obviously create chaos in the system. How many people
do you actually envisage coming forward and taking advantage of
this service?
Mr Bradshaw: The experience in
Hull has not been that it has created chaos in the system. I think
it will depend to start with on how well informed both the individual
patients themselves are of their right but also the response of
the local health communities, and we do not expect that five million
people are suddenly going to come forward and that will create
chaos. In fact, I believe that part of the problem that we have
at the moment is not enough veterans are aware of their right
to priority treatment and not enough Health Service professionals
are aware that veterans have those rights. It is something that
we remind the Service of on a regular basis. We do so annually,
both through our operating framework and through the guidance
we put out, but we would encourage veterans who think they have
a condition and a right to priority service to demand that right
and, if they do not get it, to complain and we believe there will
be fewer problems than there might have been in the past, Mr Rennie,
because, of course, waiting times for the general public have
been dropping dramatically and will be 18 weeks maximum by the
end of next year.
Chairman: Hold on. We run the
risk of getting seriously derailed onto this issue. I have Kevan
Jones, Mike Hancock and Robert Key all wanting to catch my eye,
but I just wonder whether it might be better for us to delay these
questions on priority treatment. I am in the hands of the Committee.
Mr Hancock: We need to follow
it up.
Chairman: We will follow it up.
Robert Key: It does come later.
Chairman: I have a sense from
the Committee that actually you would prefer to get on with it
now.
Willie Rennie: I think we had
better deal with it now.
Chairman: Okay. Willie Rennie.
Q376 Willie Rennie: From the Hull
experience, how many more people came forward and, therefore,
if the same as happened in Hull happened all over the country,
how many people would come forward?
Mr Bradshaw: I am not aware that
there are any concrete figures in Hull, but I am aware that it
has not caused any significant problems and it has been a very
popular initiative.
Q377 Mr Jones: I am concerned with
what you say about Scotland, because we had a very unsatisfactory
evidence session in the Scottish Parliament with the Scottish
NHS who, I have to say, I think Willie Rennie, as a Scottish Member,
described as embarrassing. There was no real comprehension at
the head of the NHS in Scotland that veterans came anywhere special.
So, one of the concerns is that that has not been pinned down,
which perhaps explains how the needs of veterans and also the
needs of service families is going to be more reinforced with
the Scottish NHS because, I have to say, we were not impressed
by what we heard.
Mr Bradshaw: I am not responsible
for the Health Service in Scotland.
Q378 Chairman: Neither of you is.
Mr Bradshaw: I am sorry; I thought
that question was directed towards me.
Q379 Chairman: That is the problem.
Mr Bradshaw: Can I clarify? The
NHS is responsible for the health services that are provided to
veterans; I am responsible for the NHS in England. I understand
that my Scottish counterpart has also announced that they will
be giving priority treatment to all veterans. They have a different
system—they do not have the 18 week target, for example—but
she has announced, I believe, that they will offer priority treatment,
but that is a matter for her, Chairman.
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