Additional Areas of Scrutiny
Diversity in the Armed Forces
66.The make-up of the Armed Forces has changed dramatically over recent decades, and it is now more diverse than it has ever been. For example, in April 2000 only around 1% identified as being from a non-white ethnic group, and by October 2020 this had increased to 9.1%.124 Likewise the percentage of female Service personnel has been increasing almost every year, from 8% in April 2000 to 11% by October 2020.125
Service complaints
67.During our evidence sessions, we heard testimony from witnesses that the experience of those with protected characteristics is not always a positive one. As highlighted already in our discussion of the Service complaints system, female and BAME personnel make up a disproportionate number of complaints, and the Wigston review into inappropriate behaviours was clear about the need for cultural change. The latest Armed Forces Continuous Attitude Survey found that “over one in ten (12%) personnel report that they have been subject to bullying, discrimination or harassment in the last 12 months, unchanged since this question was first asked in 2015”—but 90% did not make a complaint.126 The House of Commons Defence Sub-Committee inquiry into Women in the Armed Forces is gathering evidence on the experience of female Service personnel, including their interactions with the SJS and complaints system.127 Some of the evidence we and the Sub-Committee have received shows that there is a lack of confidence in both systems, with Tony Wright of Forward Assist mentioning a great degree of underreporting of sexual assault by female Service personnel.128 Asked whether enough is being done to support these groups in the complaints system, Nicola Williams told us that:
I don’t think enough is being done generally. I can understand why, although I do not agree with the approach. There has been less attention paid to the specific needs and experiences of those particular cohorts, and more a one-size-fits-all approach. That has not worked and never has worked for both ethnic minority and female personnel within the service complaints system. That is because equality, which is one size fits all, is not the same as equity, which should bear in mind the unique experiences of those cohorts.129
68.While it is clear that female and BAME personnel are overrepresented in the complaints system, it is not possible to directly compare for LGBT+ personnel, as sexual orientation is not mandatory to declare, and less than 22% of all personnel declared a sexual orientation as of 1 October 2020.130 Caroline Paige and Craig Jones MBE, Joint Chief Executives of Fighting with Pride, also told us they expected there would be a degree of underreporting from this group “not least because in that process there might be the perception of outing yourself.”131 In the Wigston review however, it is noted that Stonewall’s research indicated that “26–36% of Lesbian, Gay, Bisexual and Transgender Service people have experienced negative comments or conduct from colleagues at work because of their sexual orientation.”132
Experience of veterans
69.Fighting with Pride also told us that the Armed Forces have become much more inclusive in recent years, but this is juxtaposed with the experience of LGBT+ veterans who left under the ban on homosexuality, lifted in 2000. While we were told that initiatives such as the return of medals and posthumous pardons are welcome, supporting these veterans who may have suffered hardship for many years as a result of this policy is a key challenge for Government, and one it says it is working to address.133 On this matter the Minister for Defence People and Veterans said:
I am absolutely determined that we will find a mechanism of restorative justice for that cohort. […] I cannot rewrite history, and I cannot promise that every last penny that was lost out on because people did not achieve their long service and good conduct. There is not a mechanism possible to make that happen. What I will do, and what we are doing at the moment as part of cross-Government activity involving the Cabinet Office, the Ministry of Defence, the Office of Veteran’s Affairs and the Home Office is find a mechanism, working with Fighting with Pride, Stonewall and others, to address the appalling injustice for this cohort of veterans.
I give a commitment today to write to the Prime Minister to ask him to reflect on my apology to the LGBT community last year, and to ask him to consider doing so on a national level. […] I hope that the hon. Member for Liverpool, Walton will […] work with me to get to a place where this cohort is properly looked after and some sort of restorative justice takes place134
70.We also heard evidence that those with protected characteristics should be given specific consideration when it comes to applying the Covenant. We heard that some of the groups discussed feel invisible or unwelcome in the veterans’ sector. Caroline Paige told us:
Fighting with Pride was delighted to work with SSAFA earlier this year and late last year, and with Cobseo—the Confederation of Service Charities—to make an observation in the annual report to the covenant that diversity and inclusion was not included and there was no mention whatsoever of protected characteristics. That is all very well and great—the covenant is a promise to all in the military family, that they deserve our respect and support and fair treatment, and demonstrates the value of their contribution—but people can sign up to the Armed Forces Covenant and have that logo on their website, saying that they support the Armed Forces Covenant, but actually they may have values that differ from the modern military, in terms of how they regard veterans who have protected characteristics.135
71.David McMullen of Citizenship 4 Soldiers also told us that Commonwealth soldiers were facing hardship due to their immigration status and could not use the Covenant to access services in the same way.136 Commenting on the visa fees his organisation is campaigning against, he said:
It is not in the essence of the Armed Forces Covenant, which specifically says that it will understand that those “who have served in the Armed Forces, and their families, should be treated with fairness and respect in the communities, economy and society they serve”. That definitely has not happened.137
72.As noted earlier, we wrote to the Minister early in our inquiry to request any Diversity and Equality Impact Assessments available for this Bill, but none have been forthcoming.138 Since they are overrepresented in the system, measures on Service complaints appeals are likely to disproportionately impact female and BAME Service personnel. It is also not clear whether the Statutory Guidance will include any reference to protected characteristics when applying the duty for due regard.
73.We are in no doubt that the majority of Service people benefit enormously from their time in the Services and heard encouraging evidence that the experience of those with protected characteristics has improved. However specific concerns remain, and we recognise there is more to be done. Diversity is a source of strength for the Armed Forces and all should welcome and encourage a more diverse Armed Forces. We recommend that a metric be added to the Annual Report on the Armed Forces Covenant to report on the experience of those with protected characteristics.
74.The Minister for Defence People and Veterans committed to “find a mechanism of restorative justice” for veterans dismissed due to their perceived sexuality during the years of the ban on homosexuality and the Minister should report back to the House on progress within three months.
75.We fully support the important work of the Defence Committee’s Sub-Committee on Women in the Armed Forces. Once it has reported, the Ministry of Defence should carefully consider its conclusions and recommendations.
Healthcare
76.We considered that the healthcare of Service personnel and veterans was of the highest importance and we therefore inquired specifically into these matters during our oral evidence sessions. On health, the Bill will introduce a new duty on some public bodies to have due regard to the Armed Forces Covenant (see Chapter 2). We wanted, in particular, to build on the work of the Defence Committee by inquiring into the mental health treatment of veterans.139 We therefore heard from representatives of Combat Stress, Forces in Mind Trust, the Department of Health and Social Care, NHS England, the Scottish Government, and Cardiff and Vale University Health Board.140
77.On the status of veterans’ healthcare Air Vice-Marshal (retired) Ray Lock CBE, Chief Executive of Forces in Mind Trust, told us that the provision of healthcare to former serving personnel and their families, particularly in the mental health area was “improving remarkably”. The retired Air Vice-Marshal spoke positively about the veterans’ mental health pathway as well as veteran aware general practices and hospitals.141 Professor Catherine Kinane, Medical Director at Combat Stress, told us that “great progress is being made” in veterans’ mental health with the NHS “very keen to learn” having made “great strides forward to understand veterans”.142 Dr Jonathan Leach, Armed Forces Clinical Lead at NHS England, told us that the NHS has done “a huge amount of work” to understand veterans’ particular needs.143 Nadine Dorries MP, Minister for Patient Safety, Suicide Prevention and Mental Health at the Department of Health and Social Care, explained the investments and programmes introduced in order to support veterans mental health services, highlighting the Transition, Intervention and Liaison Service (TILS) and the Complex Treatment Service (CTS).144
78.Despite the above evidence the 2020 Armed Forces Covenant Annual Report illustrated that some wait times for veteran specific treatments have not met targets with a wait of 37 days for face-to-face appointments to be offered through TILS, against a target of 14 days.145 There was an increase in wait time for appointments through CTS, at 33 days, up from 18 in 2018–19.146 The number of veterans who complete treatments after referrals through Improving Access to Psychological Therapy (IAPT) is 42.4%, down from 47.6% in 2014–15.147 During our evidence collection the Minister for Patient Safety, Suicide Prevention and Mental Health was asked about the waiting times for TILS, with the Minister explaining the systems for GPs and referrals, and stating that Op Courage has helped to keep waiting times to a minimum and that she believed that the position was “successful and improving”. The Minister told us that specific and bespoke schemes such as TILs, CTS, and other services can meet the needs of veterans and can deal with veterans’ problems incredibly quickly.148
79.Additionally, whilst Air Vice-Marshal (retired) Lock felt that improvements had been made he told us that there are areas where the provision could improve even further with Professor Kinane also commenting that there is “an awful lot to learn”.149 One of these areas for improvement was around the level of understanding of “priority treatment”. The Minister for Patient Safety, Suicide Prevention and Mental Health told us that “priority treatment” forms part of the Armed Forces Covenant and means that veterans should receive priority treatment where it relates to a condition that results from their time in the Armed Forces, subject to clinical need.150 Dr Felix Davies, Operations Director at Combat Stress, told us, however, that there is a lack of awareness and some confusion about “priority treatment” for veterans, with work still needed to promote its principles as part of the covenant and to clarify what this means in practice.151 Professor Kinane told us that priority treatment is not yet embedded or broadly understood within healthcare.152
80.When asked about the risks of a “postcode lottery” for veterans healthcare, Professor Kinane told us that the whole NHS does not progress at the same pace uniformly, with some areas of excellence and some areas “dragging behind”.153 Dr Davies told us that the variation across the healthcare system was a challenge, and that he would welcome moves to consolidate and collaborate across the sector and across the UK.154 Professor Kinane made a specific point about improving services in Northern Ireland, arguing for funding for Combat Stress to carry on treating veterans with complex mental health problems.155 Dr Davies explained further that:
Northern Ireland is the only nation of the four UK nations that does not have any NHS-provided or commissioned services specifically for veterans. We are conscious that there is a lack of statutory funding for veteran mental health provision in Northern Ireland, and that has an impact on the capacity of provision for veterans there, a number of whom are veterans of Op Banner and are living in the environment where they once served, so there are multiple complications there.156
81.The evidence also touched on veterans suffering with alcohol and substance addiction, with levels of alcohol abuse much higher among veterans than in the general population, according to Professor Kinane. Professor Kinane told us that this was a barrier to accessing effective psychological treatment for other mental health conditions, as the individual has to have substance misuse treatment and be “dry” for a period of time in order to be able to then access psychological help.157 Dr Davies emphasised the importance of integrating the treatment of substance misuse with the treatment of the underlying mental health condition.158 Tom Harrison House, a centre providing a specialist addiction recovery programme for UK Armed Forces veterans and emergency services personnel, told us about the lack of provision for veterans when it comes to addiction treatment and the difficulty that the centre has encountered when trying to work alongside the Armed Forces and MoD.159
82.We welcome the fact that the provision of healthcare to veterans, particularly in mental health, is improving. More however, should be done. We recommend that:
a.The Government urgently set out how it plans to meet targets for the Transition, Intervention and Liaison Service, Complex Treatment Services and Improving Access to Psychologica Therapy;
b.Further work be done to ensure that the principle of “priority treatment” is better understood by both veterans and service providers;
c.Work be undertaken to minimise variation in the level of services across the UK, with specific funding required in Northern Ireland to deal with the challenges faced by veterans attempting to access mental health services there; and
d.Work be undertaken to improve data collection with regard to the numbers of serving personnel and veterans requiring treatment for addiction and other mental health illnesses. The Minister gave a commitment that there should be “a single front door and clear pathway people can navigate” for treatment for addiction and other mental health issues and we encourage the Department to do further work on this, alongside the NHS and partners such as Tom Harrison House.
Housing
83.Subsidised accommodation is considered a key part of the ‘offer’ given to serving personnel. It reflects the unique nature of Service life–the need to be mobile, the lack of choice in location and accommodation and the remoteness of some bases.160 However the National Audit Office reported on single living accommodation and found that the MoD is not meeting its commitment to provide high-quality subsidised accommodation to all Service personnel.161 An earlier National Audit Office report highlighted that only 50% of those living in Service Family Accommodation were satisfied with the standard of their accommodation in 2016.162 For these reasons we inquired specifically into the state of Service accommodation. Whilst the Bill will introduce a new duty on some public bodies in housing to have due regard to the Armed Forces Covenant (see Chapter 2), it does not apply to Service accommodation providers. We heard from a representative of the Defence Infrastructure Organisation, which directly manages Service family accommodation and provides the support and maintenance to single living accommodation, and Amey Defence Service, which maintains some defence infrastructure and housing.
84.David Brewer, Chief Operating Officer at the Defence Infrastructure Organisation, characterised the state of Service accommodation by telling us that:
There are some common characteristics across both those groups of accommodation [single living accommodation and Service family accommodation], the principal one being variability. There is some very good accommodation; there is quite a lot of adequate accommodation, and there is a small amount that is poor. Looking across the single living accommodation first, approximately half of that is in good condition, close to half is in a fair condition, and we rate about 7% as poor. That poor accommodation is not always fully occupied. It is often not used, or it is used for very short durations. The picture is probably a little better in family accommodation, which has really shown improvement over the last three or four years, with investment increasing, but it still has quite a long way to go.163
Tim Redfern, Managing Director of Amey Defence Service, agreed that the estate was mixed in its quality but added that the levels of investment in the estate over the last three years have increased, and he thought that the estate was getting better.164 David Brewer acknowledged that there were some areas where accommodation is not at the right standard, in particular regarding heating and hot water failures.165
85.Tim Redfern told us that the nature of the “fix on fail” contract that Amey Defence Service provides does not meet the expectation of the personnel but said that there is insufficient money in the contract to meet people’s expectations.166 David Brewer explained that whilst they are introducing a much stronger element of planned preventative maintenance there is still a “backlog of an old and tired estate that needs to be brought up to standard”.167
86.The level of satisfaction for personnel and families living in Service housing is still too low. Whilst work has been undertaken to improve this, accommodation is an area that needs to be prioritised by the Ministry of Defence. The Committee notes that by excluding central government as a responsible public body, Service accommodation is not covered by the duty of due regard. The Government may wish to consider adding this as an area where the duty applies in the future.
Published: 22 April 2021 Site information Accessibility statement