Welsh Affairs Committee - Minutes of EvidenceHC 131

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Oral Evidence

Taken before the Welsh Affairs Committee

on Tuesday 15 May 2012

Members present:

David T.C. Davies (Chair)

Geraint Davies

Jonathan Edwards

Nia Griffith

Susan Elan Jones

Jessica Morden

Mr Robin Walker

Mr Mark Williams


Examination of Witness

Witness: Lieutenant Colonel Peter Poole, MBE MILT, Director of Strategy, Policy and Performance, Combat Stress, gave evidence.

Q124 Chair: Good morning, Lieutenant Colonel Poole. Thank you very much for coming along today. Time is a bit short, so I am going to launch straight into questions, if that is all right.

Lieutenant Colonel Poole: Absolutely.

Chair: Thank you. Jessica Morden.

Q125 Jessica Morden: Could you start off by telling us a bit about how Combat Stress was formed and what you do generally?

Lieutenant Colonel Poole: We were formed in 1919. At that time we were the ExServicemen’s Welfare Society. After some time it was found that a lot of the people that were being helped had mental health problems and we became the ExServices Mental Welfare Society. Only about 12 years ago did we become Combat Stress because it is easier to use than the full title. We are a charity. We provide mental health and welfare support to veterans of all three services and the merchant navy as well. We are charitably funded, to a very large extent, from the exservice benevolent organisations, from other trusts and we get some money from the Government. War pensioners, with a war pension generally about the 30% level, are eligible for treatment and travel. They get their travel paid to one of our treatment centres, but only after they have been individually reviewed by the Service Personnel and Veterans Agency. The Scottish Government decided that they did not want to differentiate between war pensioners and other veterans, and they fund every veteran living in Scotland for treatment where it is required.

Finally, we are funded by the award of National Specialised Commissioning for the most seriously affected veterans-224 of them. The payment for that is about £3.2 million. That is what we are and that is what we do.

Q126 Jessica Morden: Thank you very much for that. How many staff do you have and how do they break down into the different roles?

Lieutenant Colonel Poole: We have just over 260 staff altogether. We have a chief executive officer supported by six directors; we have 14 community outreach teams who are four strong-one welfare officer, one welfare support and two clinicians; our three treatment centres have two psychologists, two psychiatrists, four nurse therapists, plus a number of care assistants in the staff; we have a fundraising communications team of about 18, but that does go up and down; we have an IT section and a finance team, together, they amount to about nine.

Q127 Jessica Morden: What issues are you treating or supporting people for and what is the kind of age profile of the people that you are seeing?

Lieutenant Colonel Poole: Let me start with the age profile. That is probably the best thing. They range from 19 to 99, quite frankly, but the majority are in their early 40s. We provide welfare, but not just on our own. We do that in collaboration with all the other exservice charities. If you like, we are a facilitator for getting them the help that they need. We do that because people with a relationship, financial, housing or whatever problem are unlikely to benefit from clinical treatment until those issues have been resolved first. The clinical treatment that we provide varies but covers the whole range of what I would term-I am not a clinician, I have to make clear-the lower level clinical difficulties. PTSD is clearly one of the ones that we do but we can also help with anxiety, depression and adjustment problems.

Q128 Jessica Morden: Finally, do you agree with the MOD’s definition of a veteran or do you think that needs to be looked at again?

Lieutenant Colonel Poole: For us, sickness and injury can occur at any time during a soldier’s career, from day one to the day that he/she leaves, whereas wounding may well be a little further down the scale of that. In general, I agree with the definition for veteran.

Q129 Nia Griffith: I would like to talk about the pros and cons of residential centres. First of all, I would like to look at the controversy as to the pluses and minuses of the use of these centres and, secondly, at the issue of access for Welsh veterans to such centres.

Lieutenant Colonel Poole: I am sorry, but I could not hear the "secondly".

Q130 Nia Griffith: Secondly, I would like to look at the access for Welsh veterans to such centres. Could you tell us what you feel are the main advantages of having a residential centre and a period in which a veteran spends time there?

Lieutenant Colonel Poole: Being in a treatment centre does provide them with the rapport with other veterans. That is quite important. They can connect through the social interaction between the two of them and get confidence from that. It also allows us to provide treatment which is longitudinal rather than individual treatment sessions spread over a time. There are things that we can deal with, like sleep and eating and so on, when they are in the residential setting. That is quite important.

From the Welsh point of view-and I might say I made a note here of the number of Welsh veterans we have, which is 275 on our books at the moment-the veterans do find attending the treatment centre helpful. They attend the Audley Court Remedial Treatment Centre which is in Shropshire. There are, of course, great benefits from providing treatment in the community and, understandably, we recognise that, particularly for those who are employed or those whose circumstances do not allow them to get to the treatment centres. Of course, we have actually set up our outreach teams, two of them operate in Wales, one in the north, which takes in a little bit of the west midlands, and one in the south which, similarly, takes in a little bit of the west midlands as well.

Q131 Nia Griffith: They go to the residential centres. Who has designed the courses and set up the provision?

Lieutenant Colonel Poole: We have two, what I would term, major courses that we provide in our treatment centres. The first is this intensive programme, of which I spoke earlier. It is an intensive PTSD rehabilitation programme. It was designed by Professor Mark Creamer in Australia. They did very much the same sort of thing, and we have adapted it to meet the needs of the people in this country. The outcomes from that particular project in Australia were that a third of the people got better and needed no more help at all; a third were improved and were able to live life generally without too much intervention; and for a third it did not make that much difference but they were a little bit better. So two thirds of them showed significant improvement.

Q132 Nia Griffith: If you have them in a residential centre and they then go back to their own communities, do you anticipate that they will come back at any stage to that residential centre?

Lieutenant Colonel Poole: They may well. Some will decide that they now feel completely well and do not need to come back. They will tell us if they require no more help from us. We never strike them off our books. The end result is that they are absolutely able to come back at any time and we will look after them. With our community and outreach teams we follow up to make absolutely sure that they are coping well and that things are better for them.

Q133 Nia Griffith: Can we clarify, in terms of funding, if they come to a residential centre, who funds their place there?

Lieutenant Colonel Poole: We do. If they are Welsh, we fund it.

Q134 Nia Griffith: Combat Stress, itself, actually funds it.

Lieutenant Colonel Poole: Yes, we do.

Q135 Nia Griffith: Can you confirm that it does not matter whether they are living in Wales or they are living in England; they would still be able to attend one of your centres?

Lieutenant Colonel Poole: At the moment any veteran can attend our treatment centres no matter where they live. Currently the six week programme is running at Tyrwhitt House, and it will be set up at Audley Court -I think I am right in saying-by the end of the summer this year. The Welsh veterans who come, who are not war pensioners, will be funded by us for that treatment. If they are war pensioners, we are able to claim some money from SPVA, but that will not be for the sixweek programme. The Welsh veterans will still do the sixweek programme.

Q136 Nia Griffith: So it is not a matter of having different health services in the two countries and one being funded and one not being funded. I am a little puzzled about the suggestion in your submission that the residential setting is only available for veterans in England.

Lieutenant Colonel Poole: No. As to the residential setting for the sixweek programme, the £3.2 million that we get from the Department of Health and the National Health Service in England, funds veterans living in England. We will be paying for veterans from Wales. Until the programme is available at Audley Court we will not be able to get more than 224 in, subsequently we will be able to take all people who really need it.

Q137 Susan Elan Jones: You have covered a fair bit of our preprepared question on it, but-I think the correct pronunciation is-Professor Bisson, Director of the All Wales Veterans Health & Wellbeing Service, has spoken-

Lieutenant Colonel Poole: Jonathan Bisson, yes.

Q138 Susan Elan Jones: -about his desire to establish psychosocial rehabilitation programmes in Wales, assisting individuals with their mental health difficulties as well as looking at other issues. That sounds pretty similar to your well-being and rehabilitation programme. Could you tell us what the similarities and differences are?

Lieutenant Colonel Poole: I think it is very similar. They do very much the same thing. It is tremendous that that is happening because wherever we can add more facilities for people to seek help that seems to me to be absolutely right. My one concern, of course, is that there will always be those who will go and seek help from us and then go and seek help from Jonathan Bisson. My view about that is that if we are able to work more closely then we will be able to make sure that that does not happen. Similarly, there are some veterans who quite like going to the National Health Service and there are some for whom that is not the way they would wish to go. Therefore, we are able to provide-or we would be able to provide-some osmosis between the two schemes to ensure that what is available fits the veteran according to their needs.

Q139 Mr Walker: I would like to ask about the resettlement process. We have heard some concerns in our earlier evidence about the quality of the resettlement process for service leavers before they are discharged, and in particular for early service leavers. Do you have any comments on that or any concerns of your own about the way the resettlement process works?

Lieutenant Colonel Poole: It is really difficult. I have been involved in a number of studies about early service leavers and so on. In fact, interestingly, the MOD did set up a study-of which I was part, as were most of the other exservice organisations-where we really tried to keep closely in touch, particularly with the early service leavers. It is not easy. They tend to go to ground. Radically, I have often wondered whether or not we would be better to keep in touch with their mothers because they are more likely to know where their son, daughter or whoever is. There is an issue with the business of resettlement. It boils down, I think, to the business that sometimes the services provide most resettlement to the people who least need it, whereas some of the people who most need it do not get as much. I can understand the thinking behind it and that those who have served longer deserve more, but if we look at need rather than at what people deserve, perhaps there is a different way of going about that.

Q140 Mr Walker: Do you feel that the resettlement process picks up on any of the psychological issues that your organisation is dealing with further down the line?

Lieutenant Colonel Poole: I think it is beginning to. There have been definite improvements in that particular area. I think, too, that the stigma is beginning to recede and people are coming forward more quickly than perhaps they were before. We see this because we are getting Iraq and Afghanistan veterans considerably more swiftly than we ever did with the Falklands veterans and so on. Everybody is going to leave the service at some stage or another. To put off resettlement until the last few years before they leave is perhaps a bit too late. Maybe resettlement should start a little earlier. After all, there is nothing more certain than that one is going to leave eventually.

Q141 Mr Walker: We have talked quite a lot about resettlement before people leave, but what about in the months immediately after they leave? Do you think there are any improvements that could be made?

Lieutenant Colonel Poole: Certainly the veterans’ information system, which is going to be brought in a little later this year, will provide, if you like, a marker and a signpost for where veterans can go for help. I think that will be a good thing. Clearly, the most important thing, as far as we are concerned, is whether or not anybody who is suffering from a mental health illness is registered with his GP. There is work being done at the moment to ensure that National Health Service numbers are the same so that when the guy leaves he can be joined up with a GP immediately. That will certainly also help to ensure that veterans are looked after medically when they leave.

Q142 Mr Williams: I want to turn now to the coordination of services in Wales. We have had evidence from the BMA and the Royal College of Nursing. They have suggested that there are unresolved issues of responsibility for the provision of healthcare services, whether it rests with the MOD, the NHS, the UK Government, our Government in Cardiff, the local government sector or the voluntary sector. Is that a problem?

Lieutenant Colonel Poole: My understanding is that the responsibility for healthcare for everybody rests with the National Health Service. There are issues concerning veterans when they leave, and this is probably going to get more interesting, I might say, as we turn to a more reservist force. I see some difficulties there, particularly in the mental health area. Exactly when is that person going to be subject to being treated by the Defence Medical Services, when by the National Health Service and, from our point of view, when are we going to be allowed to have a go, if that is what the veteran or the patient wants?

I do not see a particular difficulty at this moment, though, when someone transitions into civilian life. If they have an existing condition for the six months after they leave, they can be looked after. If it arises in the mental health arena then, of course, the Defence Medical Services will look after them. But the primary responsibility for the delivery of healthcare, in my understanding, is with the National Health Service.

Q143 Mr Williams: But it is a complicated picture. You alluded to the link, for instance, with housing conditions and how, sometimes, those issues have to be resolved before the mental health difficulties can be addressed. In that sense, there is obviously a responsibility for local authorities and for the Assembly Government as well. What concerns me is this. I will give you an example. A constituent had read somewhere, for instance, about the Community Covenant and the responsibilities of local authorities to address those issues. The constituent rang my office last week and said, "Who do I speak to on these issues?" I could point him in the direction of somebody in the local health trust. There is a champion for veterans’ issues there. It was less clear at a county council level who I could point him to. From a veteran’s perspective, it is a frustrating picture, in a way, and a confused picture.

Lieutenant Colonel Poole: It is very confusing as to what is out there. As we move forward, it is possibly going to be at least as confusing as it is at the moment. When we talk about the Covenant, about priority treatment and all these things, it is very difficult not to give veterans false expectations of what they are going to get. If a veteran approaches almost any of the exservice charities, they will be helped to meet whatever need it is that they are coming with. That is why we still keep welfare officers because we believe that we need to push people in all those directions, as you have already said. I think that local authorities will still be responsible for housing but debt and relationship difficulties may well will still be looked after by charities. But, by collaboration and partnership, we can provide them with a clear pathway to what will help them and make them better. For me, the real bottom line about this is partnership and collaboration between those that are offering and can provide the outcomes that veterans are seeking.

Q144 Mr Williams: That is very much the model that has been used in Wales, the collaboration of all those different agencies.

I have a negative question now and I am slightly reticent about asking it because there has been so much progress and I am mindful of the fact that each of the health boards in Wales has now appointed a champion to address these issues. To what extent, as a charity, do you feel you are picking up the pieces after the failures of the NHS to address the issues? I am sure all of my colleagues will have had people coming to their constituency surgeries feeling very aggrieved at the way in which they have been treated in the past by the NHS. To what extent are you picking up the pieces?

Lieutenant Colonel Poole: Inevitably, we do. I think it fair to say that if I were asked my ambition for Combat Stress I would probably say, "To close it", quite frankly. Why are we there in the first place? We are there to meet unmet needs. Hopefully, one day, all the needs will be met and we will no longer be required. It probably will not happen soon, but we do pick up sometimes where there is a lack of understanding, perhaps from GPs. If we go back a few years, nearly everybody had served in the forces at one stage or another. As we move forward in time, fewer people will have done so because the services are getting smaller. Consequently, there are times when veterans have some difficulty in explaining their individual and particular needs in a way that is understandable to the people who are listening to them. There is a difficulty in the way they explain things, as even I find. I was in the army for donkey’s years and here I am, some years out of it, and I cannot understand a word some of the young people say. So there are issues here with the way they speak and what they are talking about. One thing we try to do is provide somebody who understands sufficient to be able to explain it to a professional. Whether that professional is from the National Health Service or is one of ours does not matter. What we have to do is make it easier for people to be referred into services or to be moved from one service to another and that everybody understands, so the poor old veteran does not have to keep repeating himself and saying, "I can’t understand why you don’t understand me."

Mr Williams: Your wish list there has answered my next question. Thank you very much indeed.

Q145 Chair: Lieutenant Colonel, there was some evidence in some of the submissions we have had that people on waiting lists who transfer, particularly if they transfer from England to Wales or vice versa within the armed forces, find they are put to the back of the waiting list for any NHS treatment they might need, whether physical or mental health related. Is that something you have come across or are aware of?

Lieutenant Colonel Poole: No, it is not, and I cannot comment because I do not know, certainly it is not something that I have become aware of. From our point of view, when we see somebody who has referred-and it is nearly always-themselves, or indeed a family member who has referred them to us, we do get stories that it has taken a long time to get treatment from the NHS. But I cannot say where they were in the queue before.

Chair: That question might get asked again later on in the evidence session to other potential witnesses.

Q146 Jonathan Edwards: The last Welsh Government created the All Wales Veterans Health & Wellbeing Service and we have received evidence that matters have improved substantially since that service was introduced. Would you agree with that assessment?

Lieutenant Colonel Poole: Yes.

Q147 Jonathan Edwards: That was a good one. How do you interact with the service?

Lieutenant Colonel Poole: Not enough. We have, and certainly when the All Wales Service was being set up I did go and have meetings with Jonathan Bisson and Neil Kitchiner, the people who were setting it up. Certainly we did have input into what was being set up.

I will provide you with a little bit of background about what has happened in England recently because in some places it is working extremely well. After the Murrison report "Fighting Fit", each of the old NHS Strategic Health Authority areas, 10 of them in total, were asked to set up an armed forces NHS network. They duly did. Part of that was a mental health subgroup. When the Murrison money came-£150,000, which is not very much-to each of those 10 regions, it came with a ticket which said, "What we really want you to do is to put more feet on the ground to look after veterans with mental health problems, so please do not spend this on administration, or whatever. Please spend it on clinicians who are going to treat." In about six or seven cases that is what they have done.

They looked at the other providers out there and they said, "Actually, we can force multiply this £150,000 by using what is already there." Therefore, we have partnership arrangements and collaboration arrangements-MOUs and SLAs-with the trusts who provide those services so that veterans are able to move freely between them. Of course, the benefit for the National Health Service is that they are getting our input for nothing. The benefit for the veterans is that they are able to get quicker treatment and at a level which they require. If, for instance, the London one-which is run by Camden & Islington PCT-say, "We think you would be better treating this person", then we will treat them. If, on the other hand, it is something we are unable to deal with, we are able very quickly to push them into the National Health Service. It is a system which meets the needs of all. Does that help you?

Q148 Jonathan Edwards: Yes, but can I expand it in terms of Wales and the eight different health authorities? Is there any sort of postcode lottery there?

Lieutenant Colonel Poole: I do not know that there is a postcode lottery. What I do know is that we work with the All Wales, but I am not sure that there is this osmosis between that service and our service which might make it easier for veterans to get the treatment they need. Everybody is different and requires a different sort of treatment.

Q149 Jonathan Edwards: Can I turn quickly to PTSD? Do you think that healthcare professionals are sufficiently trained to identify those problems early on?

Lieutenant Colonel Poole: I am not a clinician. However, I think PTSD exists not only in the services but outside the services. From speaking to my clinical colleagues, there are a number of different things which might be contributors to an overall diagnosis of PTSD. That is how I understand it and, as I say, I am not a clinician. Picking it up in the service, I think they do the very best they can. What we do find is that, particularly from our point of view, it does not often kick in that early. For our average veteran, from incident to seeking help, it can take as long as 13 years. In fact, that is the average.

Q150 Jonathan Edwards: You will be aware of the Improving Access to Psychological Therapies programme which operates in England.

Lieutenant Colonel Poole: Yes.

Q151 Jonathan Edwards: Is there any reason why that should not be rolled out to Wales?

Lieutenant Colonel Poole: No. Going back to my statement at the beginning, I think it is a very good system because it does provide a sort of stepping point which is nearer the bottom than the community mental health teams. What people were finding-or certainly what our patients were finding-was that it was very difficult to attract the selector’s eye from the community mental health team because you have to be pretty sick to get there. There simply are not the services available. The advent of IAPT has provided a stepping stone nearer the bottom and, of course, once they are in the NHS system they are much more likely to be able to progress to the sort of treatment that they need. There is a fairly good suite of help there. At the bottom there are things like the Big White Wall, of which I am sure you are all aware, and we have a 24hour helpline. Those are, if you like, right at the bottom of the triangle of need. Then IAPT fits quite neatly above that. For veterans, there is perhaps a gap between IAPT and the community mental health teams and we fill that gap. Does that help?

Jonathan Edwards: I am grateful.

Q152 Chair: Very briefly, I am not personally aware of the Big White Wall.

Lieutenant Colonel Poole: The Big White Wall is a scheme where people can use their computers and their telephones to go in and seek help. It is run by the Portman NHS Trust. It has been going for about a year and it does require a subscription, unless you are a veteran where it is already paid for by the MOD and the Department of Health.

Q153 Chair: Thank you very much. Do you think there are too many service charities raising money at the moment?

Lieutenant Colonel Poole: The majority of the sustainable charities that have been there for quite a long time are pretty clear about exactly what niche they are looking to fill. In general terms, they do not duplicate. It is very clear that we do one thing, the British Limbless ExService Men’s Association does another, Blind Veterans UK does another and the Royal British Legion another. We all know and have worked out our relationships over the years. We know that we are not going to duplicate. There are a number of emergent new charities, and I have concerns about whether or not they are going to be sustainable over the longer period. When we depart from Afghanistan, unless the forces are deployed elsewhere, the amount of money they are able to attract as charities is going to reduce. Also, not only are some of them not sustainable but, similarly, some of them are attempting to duplicate that which is already there, which is waste.

Q154 Chair: Have you ever found yourself in conflict with other charitable organisations?

Lieutenant Colonel Poole: Not really. There are other organisations out there who purport to do similar things to that which we do, but we are the only exservice charity that is registered and regulated by the CQC and provides treatment in accordance with NICE guidelines and best practice. So there are others out there who are saying that they can cure PTSD and so on and so forth. My attitude towards any of them is that, provided they do no harm to veterans, I do not know that I am going to complain too much. But they will do harm if they are not sustainable and veterans become dependent on a particular source of help which may not be there in the future.

Q155 Chair: Presumably there is only a certain amount of money in the pot, as it were, from people’s generosity. So if a charitable organisation sets itself up purporting to do what you have done-excellently, in my understanding-for many years, that could mean less money for a charity like yours which works within NICE guidelines, could it not?

Lieutenant Colonel Poole: Absolutely.

Q156 Chair: Do you think there is a case for suggesting that charities set up-particularly if they are offering some form of medical treatment, whether that be physical or mental, for exveterans-ought to be regulated by some statutory body?

Lieutenant Colonel Poole: I think there is going to be a form of selfregulation here because, of course, many of them will be looking for funding from the National Health Service and from local authorities and the health and wellbeing boards-this is particularly in England, as I understand it-and they will be subject to any qualified provider. There will be some regulation behind the "any qualified provider".

Chair: Thank you very much.

Q157 Nia Griffith: Following on from that, obviously if statutory bodies look into it and say "No", there is a danger that perhaps, in raising money from the public, this does not happen. Can I confirm this with you? Are you saying that you are the only one that, for mental health, has the recognition of the regulating bodies CQC and NICE?

Lieutenant Colonel Poole: Among exservice charities delivering what we deliver, we are.

Q158 Nia Griffith: So there could be other charities out there that are not that (a) could be collecting money from the public but (b) could be "delivering" treatment or services which have not been passed by the regulator as being up to standard.

Lieutenant Colonel Poole: There may.

Q159 Chair: Lieutenant Colonel Poole, before we finish, are there any recommendations that you might have for us, or is there anything that you were hoping you might be asked but were not?

Lieutenant Colonel Poole: No, not at all. We would like to work much more closely with the NHS in Wales and we would like to work with Jonathan Bisson and his team more closely. The other thing that I would also say is that in Scotland there is sometimes the desire that Scottish money should pay for things that happen in Scotland, and it does not work. We provide an awful lot of people in Scotland with things from central charity. Were there ever to be in Wales the idea that Welsh money should pay solely for Welsh veterans, I think that probably would not work either. We are very much a national UK charity. We would love to have a treatment centre in Wales but we cannot afford to have a treatment centre in Wales. The dispersal of the veterans would not make that a costeffective venture in any case. What we do is provide for veterans in Wales exactly the same as we do for veterans elsewhere across the country.

Chair: Thank you very much indeed for coming along today.

Examination of Witnesses

Witnesses: Bryn Parry OBE, Co-founder and Chief Executive, Help for Heroes, and Major General Andrew Cumming CBE, Controller, Soldiers, Sailors, Airmen and Families Association (SSAFA), gave evidence.

Chair: Good morning. Thank you very much, Mr Parry and Major General Cumming, for coming along this morning. I will begin, once again, with Jessica Morden.

Q160 Jessica Morden: As an introduction, could you explain a bit more about what your organisations do and the support that you offer for veterans and their families?

Major General Cumming: The Soldiers, Sailors, Airmen and Families Association Forces Help is a terrible mouthful and we are working on our image and our branding as well. There is a major exercise going on there. It is a very old organisation and has evolved since 1885 when we first took an interest in families’ welfare. It has been going since then, and it has been a combination of work we have done on the health side and what may have passed for social work pre the second world war through to the current day. We are an entirely independent charity but we do have a number of contracts with the Ministry of Defence for health and social work matters. This is really for our forces abroad. It is mostly now the army as the RAF has almost totally withdrawn. It might amuse you to know that last year, at the request of the Ministry of Defence, we withdrew our last nine midwives from Gibraltar. You may ask why there were nine midwives in Gibraltar, but that is what they wanted and that is what we provided. Some of them have gone to Cyprus now. We have about 550 employees around the world. We have small teams in Kathmandu, in Brunei, in Canada, where there is a training area, in Naples, where there is a big NATO headquarters, and so on. So quite a lot of people are employed.

Also, within the "serving community" we do charitable things. For children who have special needs, typically about 80 to 100 children a year get a holiday from SSAFA from charitable money. That is a bit of relief for the parents. It gives them a week off and so on and gives the children something completely different.

Perhaps surprisingly, we are an adoption agency. Typically, we manage to place 25 to 30 children a year with service families. We are able to do that and, because it is a small operation, to do it very centrally with the single postcode being our central office here in London, so that as families do move around the world they are not constantly starting again. You can do that with adoption because it is not very many people. It may take two to three years, but that is the home address in so far as the authorities are concerned and it works very well.

Until September last year we ran a confidential support line for the armed forces which then graduated into something slightly broader, which we call Forcesline. The military pulled the funding on that in September last year, which was a shame. For the sake of £350,000, they lost a fairly valuable asset which was heavily used, not just by the serving element but the wider military community, for whom it was very valuable, and the knockon effect of that, which is happier soldiers, sailors and airmen if the family are also involved. So we have had to reduce that dramatically. We now pay for it ourselves. It is only a Monday to Friday job. It used to be 12 hours a day, 365 days a year and now it is five days a week, eight hours a day. But we are still getting lot of business through that.

We have two very specialist housing areas on the inservice side. There is, of course, the sad occurrence, from time to time, that families split up. That happens an awful lot. No arrangements are made. Generally speaking, it is the husband who is welcomed back into the bosom of the Sergeant Major-given a warm bed and three meals a day-and the wife is given twelve weeks to leave her married quarter. We run two what we call steppingstone homes where we can take the families in, one in north London and one up in Tyneside. Probably, at the moment, we are not providing enough spaces. There are about 21 family spaces at the moment and it is pretty full. It takes three or four months to enable those families to settle down, take a deep breath and go and find where they are going to live, and we can help them with housing, children’s education and so on.

Then there is the inevitability, as Peter Poole talked about, of becoming an exserviceman. We run a caseworking organisation, not a grantgiving organisation. We are a doing charity rather than a grantgiving one. We have 6,500 volunteers throughout the British Isles available to pick up on those people who need help-not who want help but who need help. Generally speaking, Mr Average would be a 70yearold exsoldier, but they fall into the bracket either side of that, particularly 60, 70 and 80yearolds, and there are still a few 90s and the odd 100yearold. Increasingly, there are more 20, 30 and 40yearolds. It is not significant, but there are increasingly more.

Also, we are working with our colleagues-with Bryn, for example, from Help for Heroes-and, at the request of the army, we have recently set up a mentoring service. We are running the pilot for that at the moment. We have been asked to set up 42 mentors, each of whom is now matched to somebody who needs help much more than anybody else. Inevitably, 42 are not enough. We anticipate that it will be attractive, that the army will wish it to expand and that we will expand it. It is paid for charitably, and that is fine. For your interest, there is one active mentor in Wales who is busy at the moment with somebody in Llandudno.

Q161 Jessica Morden: Thank you very much. Mr Parry.

Bryn Parry: Help for Heroes is a very young charity, formed on 1 October 2007, as a simple response to a desire to do something to help the wounded. Our first task was a swimming pool at Headley Court, which was suggested to us by a senior member of the armed forces. We rapidly realised that a swimming pool would be nice to have but that, if we could raise more money, the big problem we were going to be facing was how we help our young men and women-support them-during the rest of their service career following injury and also how they transit into civilian life.

In fact, the original idea was suggested to me by a sergeant in the 2 Royal Welsh who I was chatting to at the station at Salisbury when I missed my train. We see their life as a road to recovery, and I have a colourful graphic to show you. Basically it starts at the top left where we have the moment of impact. It is where the soldier, sailor or airman is either injured, wounded or becomes sick in the service of our country, and then we try and facilitate his or her recovery throughout life. Typically, it starts with the Aeromed Packs on the aircraft, enhancements to the facilities at the Queen Elizabeth Hospital-and before that Selly Oak-some support to the SSAFA initiative to do the Norton houses for the relatives and now another house at Birmingham working with the Fisher Foundation from America.

£8.5 million was put into Headley Court. There is a quickreaction fund which enables need to be sorted out within 72 hours, caseworked by SSAFA and the Royal British Legion, and there is £6 million in there. We have donated a considerable amount of money to various service charities-£6.5 million to Combat Stress, for example. We have helped with adaptive adventure training and sports for the military under the "Battle Back" programme. We have the individual recovery programme fund, which helps towards transition to enhance the learning and skills base that soldiers, sailors and airmen need to get into civilian life, and now we are involved in a £136 million project alongside the MOD and the Royal British Legion where we are creating recovery centres at Catterick, Colchester, Plymouth and Tidworth in Hampshire. The Legion are our principal partners. They have created a smaller centre in Germany at Sennelager and have taken on the running costs of the one we started up in Edinburgh.

The locations of these centres are designated by the military and are designed to be where the soldiers are, so they are at garrison towns. The idea is that they go there for a military course as part of their recovery and then we enhance that with some civilian support. Within the centres there is a support hub, including SSAFA, Combat Stress and all the other principal service delivery charities. The idea is that when someone transits into civilian life he or she can stay a member, or stay in touch, and then when things go wrong later in life, which inevitably they will, they can return and say, "Help, I have a problem"-or several problems more likely-"with my prosthetics, my mental health, my housing, my welfare, my marriage or my job." We would like to think that everything is in one place, either in reality or virtually on the end of the phone or online. We have been supporting the Big White Wall. We have been the backers for that.

To date we have raised £135 million. Every penny of that has been spent or allocated and we are racing as hard as we can to find a further £65 million to do all the things that we have on our wish list at the moment.

Q162 Jessica Morden: I have one more thing very quickly, because the Chair will tell me off for taking too much time. You have been very successful-and we have been to St Dunstan’s as part of this inquiry and seen some of the things you have done-in a short amount of time. Why do you think that is?

Bryn Parry: I think, to be honest, the British public was ready to do something. After or during every major conflict, going back to the day when SSAFA was founded or the Royal British Legion or the Army Benevolent Fund or Blind Veterans UK-St Dunstan’s, as it was, in Llandudno-it has always been a response to an emotional desire to help. Therefore, it is part of the British landscape and we were simply the latest variation of that.

Q163 Jessica Morden: Finally to both of you, have you any concerns about the MOD definition of a veteran, if you like, which is a question we asked earlier to Combat Stress?

Major General Cumming: I do not.

Bryn Parry: No. Soldiers themselves who become veterans may not feel they are-I am a veteran, we both are, but I do not feel that I am-the typical veteran that one perhaps was led to believe, that is, a second world war veteran. But if people who have served and are now no longer serving have to be called veterans, then that is what we are. I have no problem with that.

Q164 Jonathan Edwards: May I quickly talk to Mr Parry? Obviously Help for Heroes has been a huge success and you mentioned the sum of £135 million, did you?

Bryn Parry: £135 million, yes.

Q165 Jonathan Edwards: Do you have any idea how much of that you have actually raised from Wales and how much of that you have actually spent in Wales subsequently?

Bryn Parry: Yes. I do not know how much we have raised in Wales because we are not that sophisticated, to be honest. We have spent, in Wales specifically, £1 million up in Llandudno with Blind Veterans UK and a proportion of £6.5 million with Combat Stress because of the various work we are doing. There are two outreach teams we are funding there. We have various normal help and support. One of the things I want to point out is that the money we are spending supports Welsh soldiers, sailors and airmen but not necessarily in Wales. We have recently put £100,000, for example, into a young corporal’s house in Wales. But typically, if you look at where the Welsh regiments are based, they are in Aldershot, not far from Newcastle and at Tidworth. The 2 Royal Welsh are in Tidworth and half their wives appear to be employed by us. Where the soldier is serving, we are there to support. At the moment we do not have a centre in Wales, although, obviously, we are constantly happy to look at any suggestions that the MOD might make. But you can say that over £2.5 million to £3 million has been spent in Wales. The rest is there for Welsh people.

Q166 Mr Walker: I think you heard earlier the conversation we had about resettlement and I am wondering if, from the perspectives of either of your organisations, you have any particular concerns or views as to how the resettlement process could be improved.

Major General Cumming: Inevitably, nothing is perfect. My impression is that the services have pulled themselves together quite considerably in response to what has been going on in Afghanistan and Iraq for the last eight or so years. They are doing a much better job by all those who have served. There was a time when, if you had not served for more than three or four years, you got no resettlement whatsoever. You simply were not eligible. It only clicked in for people who had served longer. Now they are bringing in some form of resettlement for early service leavers. There is a recognition that everybody who has ever served, whatever their circumstances-and it may be they fell out of training after two weeks or something-needs some sort of advice, if nothing else, to get them back on their feet and going somewhere.

I like the idea-and we talk also about the idea-that Peter Poole produced, that resettlement is a process that ought to start at the first transition. Your first transition is from a civilian citizen into a serviceman and you then transition out of that at the end of it. I think it needs to begin at the front. Some sort of programme needs to be inculcated into the minds of people so that it does not become too much of a rush and a big wall to climb at the end of their service. That is something that is recognised and that they are probably working towards.

Q167 Mr Walker: What about the Help for Heroes perspective?

Bryn Parry: We deal with the wounded, injured and sick, and I think we have a particular problem there because a lot of these boys and girls are badly damaged. We are seeing, in the recovery centres-and we have only been up and running with Tidworth since July, Catterick started a couple of months ago and Colchester we opened last week, so this is pretty recent stuff-people who have to face life with, in some cases, lifechanging injuries. While there is a huge willingness out there among employers and the public generally to support them, at the moment we do not have those guys ready. We have a lot of work ahead of us to get that right: to prepare-and that means in partnership with the MOD, but it does not mean relying entirely on the MOD, in my opinion-the wounded, injured and sick personnel, to match them to the employer, to use systems like mentoring but also preferred employers, to educate the employer as to what they are going to get and how they can be supportive and then ensure that, when things go wrong, we have support in place for life. I am afraid things cannot happen fast enough or well enough and we are driven by a certain amount of impatience to get things going. It is better than it was and it is getting better, but it is still not there yet.

Major General Cumming: If I may, we need to put a whole lot of perspective on to this. It is not a huge wall that has to be climbed by the Government or the Ministry of Defence or anybody. It would be fair to say-and I am speaking fairly generally now-that if there are 22,000 service leavers every year, about 95% of those simply get on with life. They are looking forward, they are not looking back. They are fit, strong and are probably no more than 40 or 45 years old. Their key issues are a house, a job, family and education. They do not even think of sickness. Some of them-and you heard from Peter Poole-maybe 13 or 14 years later hit another wall, which is a mental health issue. Some of them will become alcoholics. Whether that is connected with their military service or not is a moot point. Some will go to prison. Whether that is connected with their military service or not is definitely a moot point. It probably has nothing to do with it. People will hit the racks. You open the newspaper and see "Soldier Murders Wife". You discover that he actually served for two years 50 years ago, but he is still stuck with the stigma of being that. But the vast majority will get by.

The 5%-and this is, I think, the people that Bryn has done so much excellent work with-are the people that really do need that focused concentration. This is where the Government-aka the Ministry of Defence-could make life much easier for us in the charities to help them by introducing them to us, if you like, very broadly speaking, instead of letting us stumble across them years down the line. It is all to do with this policy at the moment, a gatekeeper policy, whereby servicemen, as they leave, are invited to opt in to a scheme whereby they say, "Yes, I do need help". There is much discussion going on at the moment as to whether this should be changed to an optout system and that they will have to be introduced. It is all to do with data protection and that sort of thing. We could do better if we knew.

Mr Walker: That is very interesting.

Q168 Mr Williams: I was going to ask you about the issues that veterans face when they leave the services and adjust to civilian life, but you have answered that unless you want to enlarge on it a bit more.

I was also going to ask about the support currently offered by the MOD in the early months after discharge. Again, you have indicated a certain level of frustration with what is there now but a recognition that things are improving with the Armed Forces Bill, the Covenant and, not least, the work of your charities. Could you indicate to me the next step? You have talked about that particular issue of optout and the data protection issues. What is the next step to advance this? You have talked about impatience and it is an impatience this Committee shares as well.

Major General Cumming: I think it is a very difficult debate.

Bryn Parry: I am the impatient one. Do not forget that I am only talking about the wounded, injured and sick, whereas Andrew is talking about the wider veteran community. We are a very small organisation, focusing on a small group of people. His is a bigger organisation focusing on a much wider category, 20,000 a year. We are focusing on a cohort of about 5,000.

Q169 Mr Williams: Notwithstanding that, what would you like to see from Government now? Government has moved forward. Public opinion is certainly with you, not least because of the £135 million your charity has raised in such a short space of time. If you had a wish list at this point, what would it be?

Bryn Parry: It would be to work in complete partnership with the MOD. There has been a very understandable desire and a belief, within the MOD, that these are servicemen and therefore they need to be looked after by the MOD. I consider that they are citizens of this country and therefore they are the responsibility of all of us in this country. Therefore, they need to be looked after in partnership. When the time comes for them to transit back into civilian life, civilians have a role to play in that. It has not been easy, as a wellmeaning organisation that comes along simply designed to help, to work with an organisation like the MOD. It has become much better recently. But the issues we are seeing are about preparing a young man to become a civilian after a period of being a soldier and being traumatised.

One of the points that I wanted to pick up on from Peter Poole is where mental health within the armed forces is comparable to those people in civilian life. Within the group of people who have experienced battle conditions, it is much higher. It is also an issue of mental wellbeing, not the full-blown mental health PTSD that we all talk about. Everybody who has combat experiences and, worse, has been injured in those experiences has real issues. We need to come up with a way that we can heal, prepare and then support that cohort of people. In my opinion, they need a lot more help than your normal fit soldier who does his time and moves on. The system works, and the charities are there in support of the people where it falls down or where they have special needs. But we now have a particular cohort in the wounded, injured and sick that we need to work on. It is great that the public has focused on these people, and it is not just the amputees, do not forget. The fact we are seeing somebody without a leg is what gets the heart strings, but a lot of these people have other physical and mental illnesses and a lot of them are servicerelated illnesses rather than battle casualties.

The solution needs to be joined up. That is the key I am looking for and getting towards. We now have the Cabinet Committee for the armed forces to try and join up all the ministries to make sure that this becomes an absolute priority.

Chair: I am gently suggesting that maybe we will need to be a bit more concise, interesting though this is, because otherwise people could end up having to be-

Major General Cumming: Could I make a point on the question you asked? There is this underlying desire, quite rightly, by the Ministry of Defence to look after people who were its own. But when the soldier, sailor or airman leaves the armed forces he or she becomes a civilian citizen again. The Ministry of Defence is not funded to look after them. In America there is a massive programme for veterans of $17 billion dollars, and it is probably much more than that now. You are on the horns of a dilemma here, are you not? Either you say to a man or woman, "You are forever a serviceman and we, your country, will look after you", or we say, as we do in this country-and I think it suits the ethos of the British-"You serve and you do something else and you are part of the country." You are not marked forever as a soldier, sailor or an airman.

Q170 Mr Williams: I asked Mr Poole in the earlier session about, again, that unco-ordinated approach, whether it be between the NHS, the Assembly Government in Cardiff, the MOD here or the voluntary sector. That is a frustration you share, presumably.

Bryn Parry: We have not had many frustrations with the NHS. In fact, the relationship has been good. We have had an increasingly good relationship with the MOD. I think the frustration has been that wars have been going on for 10 years and only now are we putting something in place to sort out the casualties. That is why I get frustrated. Most of the guys who have been injured are still in the services at the moment, and only a very few of them have transited to civilian life. So the problem is still to come.

Q171 Mr Williams: Very quickly, Chairman, I have a factual question for Mr Parry. Can you explain the arrangements that currently exist for when physically injured veterans are discharged and their care is transferred to the NHS? What arrangements are there already?

Bryn Parry: The practical details are that, if they come through Headley Court, their OT-their occupational therapist-goes to see their house to make sure it is suitable. But there are a lot of issues like house adaptations. We are having to fund-quite considerable amounts, several million pounds so far-house adaptations because local councils are too slow. Also, there is the problem for the veteran who walks into his hospital and says, "My legs do not fit. My prosthetic limb does not fit." The prosthetist-this has been in the Murrison report-who sees that leg says, "This is more sophisticated than anything I have ever seen and, what is more, I do not have the budget to repair it." Again, we have to have a special solution. That was raised on 19 December 2010 and we still do not have it in place yet, but we are working on it.

There are guys in the services who have been well looked after by the Ministry of Defence. They are still, most of them, in and they are starting to come out. We do not yet have all the solutions in place and the prioritisation. At the moment, technically, you can walk into your GP and say, "I am a veteran" and you should be put on top of the list. That, in practice, is not happening. I think it is about awareness, everybody understanding that these guys are special and then putting in place a system that recognises that. It has to be done in partnership. It is not solely the Government’s responsibility. As I said before, the third sector has a part to play.

Q172 Chair: You have already made the point that GPs are unaware, often, of the ability to prioritise people who have developed illness as a result of service. What about this other suggestion which I raised earlier on, that service personnel who move or are transferred, particularly if they go from one part of the United Kingdom to an area with a devolved legislature, are often put to the back of waiting lists for treatment that they may have been waiting for? Is that something that either of you have come across?

Major General Cumming: If you are abroad, there is no issue. You are looked after by the military system. If you are back in this country and you, the soldier, sailor or airman, are serving you are looked after by the military and you will be taken care of wherever you are, wherever you move. For the most part, they will go into the Queen Elizabeth Hospital in Birmingham. If you are a member of a family, you are back on the national health system when you come back from abroad and you take your chances with everybody else. So, yes, these issues do arise.

Q173 Chair: So it is more of an issue for the families, probably.

Major General Cumming: It is the families, yes, who will suffer most from this. This is why I gave you the example that, if you operate on a small scale, like adoption, it is very easy to handle. On a wide issue like medical care, it would be almost impossible for any single charity to set itself up to manage that process better. We can certainly interdict and act where we know about these issues, but not necessarily with great success.

Q174 Chair: We have also heard evidence that there is a difficulty in transferring medical records from the MOD back to GPs when people leave. Is that also something you have come across?

Major General Cumming: This is one of those things. One of the first casualties, if you like, of a serviceman leaving is that that address may not be the address for very long at all. If it is a single soldier, it could be his parents’ address and, yes, it is his address, that is perhaps where the GP receives the documents, but actually he has gone to work in London or he has gone to work in Glasgow. He is working somewhere completely different and his home is somewhere else. He is not thinking about his health for the moment. This is the 95%. They are not interested. They do not go and see a doctor. They do not have to. They might go and see a dentist but you have to pay for that anyway wherever you are, mostly. So it is not, I think, the fault of the system so much as a fact of life. If we are talking about getting better coordination and so on you do need the education in the first place to tell people what is available to them, but you do need the individual to play a part in this whole game as well. Quite often they do not.

Bryn Parry: Again, specifically from our perspective, your normal GP is not as experienced in the injuries that we are seeing. The pathology of a battle casualty, especially an IED casualty, is completely different from anything you would normally expect to see in your surgery. Therefore, again, we need to look at-or I suggest we need to look at-how they can be referred to specialist centres. At the moment that tends to be the Queen Elizabeth Hospital in Birmingham but also, increasingly-for reconstructive surgery and specialist care like that, burns and spinal injury-Salisbury Hospital, which we are supporting. As I keep on referring to it, we have the cohort of the wounded who have particular needs as a subsection of the wider veteran community. If somebody joined the military because he did not enjoy or did not get a job in civilian life or did not enjoy schooling and education and then he goes and steps on an IED and he comes from a broken home, a tough background and everything else, his problems have now been compounded. If he then goes back to his home village and does not have a job and his family are still dysfunctional, we have a real problem. This needs to be underlined with a sense of urgency because most of these guys are still to leave and when they do they have to be cared for.

Q175 Nia Griffith: I want to turn now to the issue of alcohol and drug abuse. If somebody presents with very specialist injuries to a GP, it may be very obvious, but I would imagine that this group is a much hardertoreach group and maybe they do not even surface very much. Can you give us some idea of the proportion of your clients that are veterans who are suffering from alcohol or drug abuse problems, how willing they are to seek help and in what ways they come to you?

Major General Cumming: I do not think I can give you that figure at all. My inclination and experience would be to say that there was more alcoholism than drug abuse, but I would not be absolutely certain of that. I certainly cannot give you numbers. As I said, alcoholism can presumably be taken up at any age and manifest itself at any age. They might be the very people who do not seek help at all but rely on GPs. I could not put my hand on my heart and say, "We see X number of alcoholics every year". If we did, we would refer them to a GP, but I think we would be very careful about how we would recommend their needs should be met if we thought that perhaps money would then be spent on drugs and alcohol.

Q176 Nia Griffith: So you do deal with some veterans who have these problems.

Major General Cumming: Inevitably, but I cannot give you a number.

Bryn Parry: It has not been a problem for us but I gather that 13% of the armed forces have alcohol problems, so it is much higher than in civilian life. That is me reading a statistic. We are not experiencing any significant problems.

Q177 Nia Griffith: Are you saying serving or veterans?

Bryn Parry: Most of the people we are working with at the moment are serving and with most of them it is their injuries and mental state that we are concerned about more than their alcohol. Obviously, if somebody does go home and, on the first night, he has bought beer and he stays in every night afterwards and he has bought pints of beer, it will not be long before he is an alcoholic if he does not have an alternative to that. Again, it is a concern, as an illness, on the edges of what we are concerned about. But right at the moment it is more to do with employment, housing, proper medical support and all the other issues.

Q178 Nia Griffith: You are saying that perhaps there is more alcohol consumption among the military than in civilian life.

Bryn Parry: Apparently.

Q179 Nia Griffith: Is this something that you have raised at all with the MOD or do you think it is something that we should be raising, the whole issue of an alcohol culture?

Bryn Parry: I am afraid that is outside my area.

Major General Cumming: That is the job of the Ministry of Defence. It is not for us charities to say "Stop drinking". It is up it them. This is Government business and they are Government employees.

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Q180 Nia Griffith: It has not been something that has been raised at all.

Bryn Parry: To be honest, when you are dealing with people some of whom are missing several limbs and have got a terrible mental state, it is not the biggest priority at the moment.

Q181 Jonathan Edwards: In written evidence we have received some criticism about how the Disabled Facilities Grant is administered in England and in Wales. Do you have any comments on that and do you think they have sufficient funding to help veterans?

Bryn Parry: Again, that is an issue that I am not qualified to talk about. The Armed Forces Compensation Scheme and the way that the disability allowances are administered is being done at a level way beyond me. I am not the right man to ask.

Major General Cumming: It is not a satisfactory area. It takes a very long time to get out of local authorities the equipment that perhaps is recommended, to put that together with the occupational therapist’s report and so on. It is an area where fairly quickly-and why not?-the exserviceman turns to charity for help to try and fill that gap. If you are talking about an 18month or twoyear wait for your stair lift, certainly a charity would look favourably on reducing the impact of that on an exserviceman by giving them the facility or by paying for it. I suspect it is also an area where local authorities know that the charities will step in rather than make the person suffer.

Q182 Jonathan Edwards: I have a final question to Mr Parry. We already had a discussion about the five personnel recovery centres that you are setting up. Considering that Wales produces a high percentage of its population for the armed services, and really when they retire they are more likely to relocate home, why would I be wrong in coming to the conclusion that there should be a centre in Wales so that veterans are able to be treated closer to their families?

Bryn Parry: This is a misunderstanding of the intention of a recovery centre. The recovery centre is somewhere where most of the people who go through it are serving. It is preparation to move into civilian life. The MOD, not me, decided that they would like them colocated on to the garrison towns. They are literally blistered on to the edge of the wire, so they are accessible from the outside but also from inside. Therefore, they are close to the medical centre, typically, if the families are still living in the quarters and so on. They are staffed by both us and military staff. They have a secondary role, which we want to see, which is returning young veterans coming back to use the sports facilities and the welfare facilities. If the MOD identified a place in Wales where they wanted a recovery centre, we would be so keen to do it because, as you can probably tell from my name, I am slightly biased in favour of the Welsh and I want to make sure that we get the best service. It has been a frustration, but we are only 96 miles away from Tidworth and we are in Birmingham now. Wherever there is a Welsh soldier, they are very close, when they are serving, to a recovery centre.

Q183 Mr Williams: I have a question for Major General Cumming. We touched on local authorities a moment or two ago in your last answer. Are you concerned at the speed with which local authorities across the country are not yet proceeding with their Community Covenants? There are some good stories, but there is a mixed picture. Are you clear in your mind what the Community Covenant will be saying to exservicemen?

Major General Cumming: No. I am really quite surprised at how well it is going. You hear every day of new Covenants being opened up between the military and local authorities and so on, and I think it is a very "good news" story. It is a very positive outcome from the work done by the Covenant Reference Group and I think that is good news. I do hear of different interpretations of how it should benefit the two parties, if you like, because it is not a oneway thing but a twoway thing. I am quite happy to hear that as well because, if nothing else, we, in this country, are very tribal. If you try and do exactly the same in Caithness as you do in Cornwall, one of them will be a huge flop. They might both be a flop because it works better in Birmingham. So I am all for what I would call a "liberal"-in the small "l" sense-

Q184 Mr Williams: You can use the big "L" if you want to.

Major General Cumming: -interpretation of how best it should be done. I did hear of one instance where the money provided was going to be split in equal chunks to primary schools-that seemed to me to be a pity-or some was going to be given to parents. That seemed to me to be a lazy approach. But it is the only time I have heard of it and I cannot remember where it was-it was not Wales-where it seems not to be being interpreted in the true spirit of how it should be. I think it is a "good news" story.

Q185 Chair: Do either of you have any idea about the percentage of rough sleepers who are exveterans?

Major General Cumming: No, I do not. It is rather like the prison population, is it not? There was an inquiry into that which gave the rather shattering news that actually it was not such a big proportion of the prison population as people had first thought. The homeless is a very wide issue. We have a very good feel for it here in London. We have a very good feel for it in Glasgow. We are trying to set up similar organisations in the principal urban areas like Manchester, Liverpool, Birmingham, Newcastle and so on. But, no, I could not give you a figure.

Q186 Susan Elan Jones: Relating to the issue of adjusting to civilian life, could I ask you, Mr Parry, if you could tell us something about the Families’ Activity Breaks project that is due to start shortly?

Bryn Parry: Yes. That was something we funded. We were asked by the last Government if we would put some money towards it. Originally it was taking bereaved families on short holiday breaks and also-I think the original idea was-some of the wounded <?oasys [pc10p0] ?>as well. But it has not had a great takeup. It has not been run by us. It has been run by FAB, and we certainly put some money in to start off with. It is a great idea and there are other similar projects going on.

Q187 Susan Elan Jones: In terms of social housing policy in England and Wales it is fair to say that a lot of the military veterans’ organisations have been fairly critical about this. Could you give us some ideas of any changes you would like to see made to social housing policy, perhaps starting with you, Major General?

Major General Cumming: Let us focus on Wales because that is the indicator clue you gave us on the door. Our experience is that the Welsh Government has got this buttoned up and is saying that there should be a system whereby exservicemen can come in and not at the bottom of a list. But whether that has got down to every local authority, we are not certain. Certainly it is our experience in Anglesey and in Pembrokeshire that the local authorities are not aware of this. There is still a demand, I think in Pembrokeshire, that you should have been resident in Pembrokeshire for three years and in Anglesey five-although it might be the other way round-for perfectly good reasons, that they do not want people buying second homes and things like that. But servicemen have been excluded from housing in Anglesey and Pembrokeshire on those grounds, that they have not been resident for long enough. Even though in one case-and we have a letter here written to the Welsh Assembly about the very issue-the wife of this family had lived in Anglesey all her life and her parents were still living there, she was not considered to be a resident on Anglesey. So I think the idea is good, but whether it manifests itself properly across the whole organisation, I do not know.

Q188 Susan Elan Jones: In terms of the issue of discretion, I believe that at the moment councils have a discretion whether to disregard income from war pensions and the Armed Forces Compensation Scheme when they are calculating entitlement to council tax benefit and housing benefit. Would you like to see this discretion become a statutory obligation; that is, not a discretion?

Major General Cumming: If I understand you right, I think it should be taken out of the equation. I cannot give you a quote from Wales, but I can tell you that we did have a case in Hereford a couple of years ago where a single mother received the compensation for her son who was killed and then, when it came to calculating all this for her, it was considered to be her income and that she had more money than most. It should not, in our opinion, have been taken into account, and indeed, in the event, it was not. It was eventually excluded, but it required quite a lot of hard work.

Q189 Susan Elan Jones: Mr Parry, do you have anything on that?

Bryn Parry: I am afraid, again, it is not my area, but I echo that.

Q190 Chair: You may have heard me ask this question earlier, but do either of you think that there are too many service charities and do you have your doubts about the effectiveness of some of the ones that have been set up?

Major General Cumming: It must be very confusing for a serviceman out there. There are an awful lot of service charities and I will not put a figure on it because the last one is bound to be out of date. An awful lot of charities have sprung up as a consequence of what is going on or has gone on in the last decade. Some of them have done an astonishing job. Without being in the slightest bit patronising, Bryn has done a fantastic job of alerting the public to what is going on and getting them to contribute and play a part. Equally, and for good reasons or bad, too many little charities spring up all the time. There will be the mother who has lost a son who wants to do something, and who is going to stop her doing that? The fact of the matter is that probably whatever it is she wants to set up is being done already by somebody. But it adds to the blur and the noise in an already quite noisy arena. It is very difficult to stop them. Again, we have done a little bit of research and, in so far as Wales is concerned, there are one or two on the mental health side that one would seriously raise one’s eyebrows about. It is very difficult for me to say, "No, they do not do a proper job", but I do note that they appear to be unqualified and unregulated, and actually there are people who do the job, like Combat Stress or indeed the National Health Service. There are people there who do it properly and who can be held accountable for it and I wonder if some of these smaller charities can or cannot.

Q191 Chair: Obviously, these questions are not in any way loaded at any of the witnesses who have come forward today. Mr Parry, do you think there might be grounds for some sort of benchmarking or tighter regulation of service charities? What concerns me is that if one single, offthewall charity is found to have done something improper, it could have an impact right the way across the board, including on respectable charities like yours.

Bryn Parry: In order to form a charity you have to go to the Charity Commission. As Andrew says, it is a natural desire to want to do something, especially when you have had a bereavement, and obviously we were moved to do something. We did not want to form a charity. We wanted to raise money and give it to an appeal but for a specific purpose. We did not find a charity that was able to accept and use that money for that purpose, so we had to form a charity. But there are restricted funds. If somebody is moved to raise money in somebody’s memory or to focus on a particular area, it is perfectly possible to find a charity, such as ours, with wide charitable objects and create a restricted fund. It can even be branded with their own name and in memory of, or whatever.

Q192 Chair: You are raising money for Help for Heroes but under different auspices.

Bryn Parry: Yes, and then set up a restricted fund so that the funding can be targeted to a particular cause and guidance can be given. That saves an awful lot and means that more money gets to the beneficiaries. We have a few of those going on and they are very effective. We have not been, up until now with the recovery centres, in any sort of delivery. We have found the right expert, whether Combat Stress or SSAFA or whatever, who does the delivery and we have simply funded them. That is the key as well, rather than setting up another delivery charity without very much money, with all the incumbent overheads and not getting much money to the beneficiary. That is always the concern.

Q193 Mr Walker: We now have, in London and Cardiff, Veterans Ministers. Do they make a difference to the work that you do and does the fact of having Veterans Ministers make a difference?

Major General Cumming: One of the questions being asked all the time, and again this is a very difficult one, is why is the Minister of Veterans-and veterans are, by definition, no longer servicemen-part of the Ministry of Defence when he has no particular funding to take on veterans programmes? Should he not be part of the Home Office, perhaps part of the Cabinet Office or whatever? He is probably in exactly the wrong place because, to be fair to the Ministry of Defence, given that they are focused on current operations, training and the day’s activities, with the best will in the world they have very little idea of what it is like to be a veteran because none of them are. They are all serving. But the Minister of Veterans is, I think, in the wrong place.

Q194 Mr Walker: That is an interesting point. I do not know if you have anything to add to that, Mr Parry.

Bryn Parry: I agree. The thing we have seen recently is the establishment of the Cabinet Committee for the Armed Forces and Veterans. We have always been asking for a champion of the wounded but, in simple terms, the problems are not within the MOD. They tend to be once people leave the MOD and, therefore, it makes perfect sense that the Minister for Veterans’ Affairs should not be inside the MOD. He should be talking to all the ministries where veterans have interests or concerns. Hopefully, this Cabinet Committee will help in that way.

Q195 Mr Walker: I have one final quick point. You have both made it very clear that this is not just a job for Government and there is much more to do. What do you think the priority should be for the UK and the Welsh Government to improve the support for veterans?

Major General Cumming: A tremendous lead has been created by the Covenant Reference Group. It has done good work. Although it seemed stodgy to begin with, it has loosened up and got going. It has generated a great spirit of enthusiasm among other Government departments. Since this is Welsh Affairs, I would say-and I sit on the CRG-I do not think the Welsh Assembly should knock itself. It is talking to business very seriously and it is involving the charities. We have a representative who comes and sits in all the meetings there and I think they are doing a very good job. It is a very difficult job and it goes back to the nub, which you finish your report off with, that it is all to do with education, information and so on. A key player in all this-and I go back to what I said earlier-is the individual, him or herself, who needs to be playing a part in what you are trying to put together for them. They are not doing it through idleness or lack of care. They are doing it because they do not need to do anything at the moment. They might later.

Chair: Thank you all very much indeed for that evidence. We are very grateful to you for coming along here today. That ends the session.

Prepared 8th February 2013