Mental Health of Veterans

I beg to move,

That this House has considered the mental health of veterans.

It is a pleasure to serve under your chairmanship, Mr Stringer. I thank you and the Members who have turned up for the debate on what is probably rather a slow news day.

Since I introduced my Bill to ring-fence NHS spending for veteran mental health services, military personnel from across the UK have been in touch to confirm the worst: veterans are struggling to access mental health support and, sadly, we are all letting them down. We have only half an hour for this debate, so I cannot cover all the complex reasons why we are where we are today. I will focus on three areas: the importance of peer-led support, the funding problem and the need for a more holistic approach to ensure we look after veteran mental health in every aspect of life.

In addition to speaking to veterans up and down the country, my office has engaged with amazing charities such as the Forces in Mind Trust, the Ripple Pond, the Royal British Legion, PTSD Resolution—that organisation works with people who have post-traumatic stress disorder—and, of course, Combat Stress. Together with our NHS, these groups work hard with volunteering veterans to do what they can, but my fear is that without the Government’s help, they will struggle to continue the fight for improved mental health support.

I congratulate the hon. Gentleman on securing such an important debate. He is absolutely right to praise the work of a number of different charities in this area. Does he agree that we need a strategic approach to ensure that once veterans leave service, they are signposted in the right direction, and the support that they seek is properly funded?

The hon. Gentleman is absolutely correct, and I will come to that point later. I will deal first with the importance of peer-led support. One veteran, Mark Lister, who is a volunteer for Combat Stress in the highlands and who served as a forward observer in the Royal Artillery for 18 years, called me yesterday and relayed his personal experiences, which were most interesting. One thing he said that stood out was that there is a stark difference between the combat trauma experienced by a soldier or a service person, and the trauma experienced by a civilian.

In his classic, wonderfully frank highland manner, Mark said, “Jamie, only a veteran is going to know how to help another veteran. We don’t want to get bogged down in the trivia of military maps. We don’t want to go through explaining all that stuff. We just want to speak about our trauma with someone who knows and gets what it’s like”. He is absolutely right, because most of us will never understand what our veterans have been through. That is why some of the best care available comes in the form of peer-to-peer support. Alas, cuts to the NHS have made it harder for such services to exist, never mind to be set up in the first place.

I congratulate the hon. Gentleman on bringing this debate to Westminster Hall. We are all here for the same purpose. Does the hon. Gentleman agree that the recent witch hunt of our armed forces who served in Operation Banner has put additional strain on the mental health of those who served? We have a duty of care to those men and women to assure them that we will not allow them to be persecuted, when their only crime was to serve Queen and country. They need every assurance—not just mentally, but emotionally and physically—and the support of this place as they fight to overcome what they have seen and been subjected to in service.

The hon. Member for Strangford makes a point that I know is close to his heart. He has spoken about it with eloquence in the past, and he does so again today.

In constituencies such as mine, which is vast and remote, accessing healthcare is already difficult. That makes it particularly hard for veterans like Mark to reach out and share what they have been through with people who have also risked their lives for their country. The Government should be making it easier for veterans, service personnel and their families to connect with one another and access peer-led mental health support. Time and again, the evidence—both numerically, and in people’s personal experience—suggests that peer-to-peer treatment is the most effective form of mental health support for people who are affected by combat trauma. Accessing this kind of mental health support is a battle for those who have risked their lives for their country, and they should not be asked to fight that battle.

I turn to funding. It is the custom in this place to cite lots of statistics, so here are a few. The Care Quality Commission rated two out of four Ministry of Defence mental health centres as inadequate or needing improvement between April 2017 and January 2019, and there were shortfalls of at least 50% in uniformed and civilian psychiatric posts in 2017-18. Those are not good figures. Charities that provide support for veterans, service personnel and their families often receive no Government funding whatsoever. They rely solely on donations and pay no salaries. For example, in the last 11 years, PTSD Resolution treated more than 2,700 veterans, reservists and families.

I declare an interest: PTSD Resolution is run by my old commanding officer, Colonel Tony Gauvain. It is the most brilliant charity, and it takes very little money from Government. It has more than 200 counsellors and a 78% success rate. It is the sort of charity that we want to encourage and, indeed, give some more resources to, if we can.

The hon. and gallant Member speaks with great knowledge and authority, and I welcome his words.

PTSD Resolution prides itself on delivering a prompt, local, brief and effective treatment, at an average cost of £650 per case. If untreated, the social cost can amount to tens of thousands of pounds; it manifests itself in lost jobs, broken families or perhaps, most tragically of all, suicide. Since Combat Stress had to stop taking referrals from Wales and England because of a reduction in funding, PTSD Resolution has seen a 60% increase in referrals. It tells me that it needs the Government to co-operate in funding, according to demand and outcomes.

The chief executive of Combat Stress, Sue Freeth, said to me:

“82% of the veterans treated by Combat Stress have tried to engage with NHS services but their needs have not been met. The government needs to ring-fence funding for specialist services such as ours, that understand and can successfully treat those veterans with complex PTSD. There is a significant funding gap for veterans with complex mental health needs who need intensive clinical rehabilitation and struggle to access this support elsewhere.”

I congratulate the hon. Gentleman on securing this important debate. As the Member who represents part of Salisbury plain, I have a lot of interest in this, and I know the charities that he refers to well. I fully endorse everything he has said about those brilliant charities, and we need to support them directly, as well as providing more support through professional mental health services. Does he agree that beyond money and civil society, we have to consider the role of the statutory system and the literacy of some public servants, who are well-meaning but often let our veterans down? Veterans are sent from pillar to post, and they often have to repeat their terrible stories to frontline public servants in the Department for Work and Pensions or the Department of Health and Social Care, who do not really understand this matter. If we improved the literacy of those who work in our frontline public services, it would make a great difference.

The hon. Gentleman makes his point extremely well. The mention of Salisbury brings to my mind mixed memories as a private soldier in the Territorial Army, but we will gloss over that.

I believe that the Government must try to step up for veterans and bridge the funding gap, if they can. I do not have all the answers, but as a start we should ring-fence NHS funding for mental health support. As a Scottish MP, health is outside my remit, but, as my presentation Bill set out a few days ago, it is entirely possible for the Government to ring-fence NHS spending for veterans’ mental health support. As much as I think that ring-fencing NHS expenditure would be a good start, it is not, in all honesty, a catch-all answer. As many hon. Members know, mental health treatment can be complicated, and the circumstances surrounding veteran welfare can be challenging. We all need to bash heads together and see how we can collaborate more effectively to deliver a more holistic mental health strategy.

Does the hon. Gentleman agree with me, and with the Defence Committee, that there is a strong case for establishing a national mental health residential rehabilitation centre, with the emphasis on the public sector?

The hon. Gentleman makes an excellent and important point, which he and I discussed when we were on the armed forces parliamentary scheme last year.

As we know from recent publicity, last week Commonwealth veterans took legal action against the Home Office and the Ministry of Defence over a systematic failure to assist them properly with complex immigration rules. Many of those veterans, sadly, now fear deportation. The claimants allege that the Government failed to follow their own duties at discharge, meaning that little guidance was given about their immigration status. Under current Home Office rules, a Commonwealth veteran with a partner and two children would have to pay—can you believe this?—nearly £10,000 to continue living in the UK.

Why do I raise that point in a debate on mental health support? Imagine someone risking their life for a country only to find out that they will have to pay just to live there when they retire. I cannot begin to think how stressful it would be for someone on a military pension to try to pay the Home Office’s extortionate visa fees. When the Home Office makes such decisions, they tap into the general problem, which has already been alluded to. Mental health support for veterans is not just a matter for the Ministry of Defence or the Department of Health and Social Care: it is also a matter for the Home Office, the Ministry of Housing, Communities and Local Government, the Department for Work and Pensions and many others.

Just last week, Craig Bulman, who served in 2 Para, the Red Devils freefall team and the Household Cavalry, contacted my office and told me about his experience with the Child Support Agency. Again, it is not an issue that would immediately strike us as relating to mental health. However, Craig told me:

“I am currently helping with 13 cases, mostly veterans. Of those, I have four veterans who are suicidal due to their experiences with the CSA. In a couple of these cases, it triggered their PTSD.”

I have listened with great interest to the hon. Gentleman. As a veteran, I defer to no one in my admiration of our veterans, or my desire to ensure that their mental health is promoted. However, for credibility, it is only fair to point out that many other public servants are at least as badly affected by some of the traumas to which the hon. Gentleman referred. If he is trying to create a system in which we prioritise the management of particular groups, he needs also to consider the police service, for example, which today loses more frontline people than the armed forces. Otherwise, his case kind of falls apart. I wonder whether he agrees.

I absolutely accept the point and can think, off the top of my head, of a number of policemen in my part of the far north of Scotland, who, most unfortunately, are leaving the service. That is something we do not want to happen.

I spoke earlier about the highlands’ very own Mark Lister, and it is true that constituencies such as mine face an additional challenge with regard to access to public services. Transport is not good, health services are patchy and we have a housing shortage, as I am sure nearly all constituencies do. I stress again that improving mental health support for veterans requires Government Departments to work together, possibly with other services such as the police, and it requires the Treasury to find the money and put it where it is needed.

The big ask that I want to conclude with is my hope that the Minister and the Government will look closely at my Bill, the National Health Service Expenditure Bill, which has received support from across the House. I am grateful to Members of all parties for what I take as a great expression of support. Second Reading is scheduled for Friday 26 June, the day before Armed Forces Day. I hope that Members recognise that I do not intend to let the matter drop.

It is a pleasure to speak under your leadership this morning, Mr Stringer.

I pay tribute to the hon. Member for Caithness, Sutherland and Easter Ross (Jamie Stone) for his interest and for the way he continually drives the debate. Clearly, I have a script that talks about all the stuff we are doing, but I want to answer some of the specific points that he has raised this morning. I am delighted that he shows such an interest in the subject. He will know that support for veterans was a driving force for me in coming to Parliament; I wanted to drive through change. I can honestly say to him that a shift in strategy is under way in how we support armed forces veterans. For too long, colleagues in charities and in this House have asked the Government to step up and do more, and we are now starting to do that. I do not pretend for an instant that we have always got it right. That has led to some of the challenges that we face today, and I came into Government specifically to try to lead the change.

I want to challenge a couple of things that were said, and the first relates to the portrayal of veterans. There is no doubt that some of our people are extremely poorly because of what we have asked them to do over a number of years. I am acutely aware of that. The Prime Minister and I are acutely aware that the nation has a debt of gratitude to them that must be realised by more than words and ceremonies in Whitehall; it must be repaid by provision to look after them throughout life. It is important to me to challenge the portrayal of the problem as greater than it is. There is in the country undoubtedly a way of portraying veterans—exacerbated by the media and TV programmes—that suggests that military service or combat experience equals mental health problems. In reality, we all know that that is not so, and we cannot say that too much, because the problems that that view causes are significant. This week we are bringing in changes with respect to national insurance contributions, and that is important because although there are pretty good veterans programmes at big firms in cities, for people who can get access to those workplaces, sometimes when I have been to towns and cities someone from the CBI has stood up and said, “I can’t take the risk on a veteran.” They are worried about whether they will be off sick, and all the concomitant issues with service. We must be careful about the narrative that veterans are all broken. I would not advance this view if it were not true: the vast majority leave their service greatly enhanced by their time in the military. The reason I raise that is that is that if we do not get it right we will simply be unable to meet the challenge of those who are genuinely poorly and unwell because of what the nation asked them to do. I am committed to getting those people the help they deserve.

I support exactly what my good Friend the Minister is saying. I am backed up by other Members here, such as my hon. Friend the Member for Bracknell (James Sunderland). The vast majority of members of the armed forces go through their service and do not have a problem at the end of it—that is absolutely true; but please, Minister, give more resources to PTSD Resolution, because it deserves them.

I thank my hon. Friend, who knows the impression he left on me in my formative journey into this place. I think that I am speaking for him at a dinner tonight, where we can take the matter further. I shall come on to the question of funds for specific charities in a minute.