CORRECTED TRANSCRIPT OF ORAL EVIDENCE To be published as HC 762 -i

HOUSE OF COMMONS

ORAL EVIDENCE

TAKEN BEFORE THE

DEFENCE COMMITTEE

THE MILITARY COVENANT IN ACTION? PART 1: MILITARY CASUALTIES

WEDNESDAY 30 MARCH 2011

DAWN McCAFFERTY, JULIE McCARTHY and KIM RICHARDSON

Oral Evidence

Taken before the Defence Committee

on Wednesday 30 March 2011

Members present:

Mr James Arbuthnot (Chair)

Mr Julian Brazier

Mr Jeffrey Donaldson

John Glen

Mr Mike Hancock

Mr Dai Havard

Mrs Madeleine Moon

Penny Mordaunt

Sandra Osborne

Bob Stewart

Ms Gisela Stuart

Examination of Witnesses

Witnesses: Dawn McCafferty, Chairman, RAF Families Federation, Julie McCarthy, Chief Executive, Army Families Federation, and Kim Richardson, Chair of the Naval Families Federation, gave evidence.

Q1 Chair: Welcome to the Defence Committee. You are the first evidence session of the inquiry that we are doing into the Military Covenant and military casualties. Welcome back. I know that you are frequent visitors to Select Committees, so thank you for coming to give us evidence. Despite the fact that you are frequent visitors, I wonder if you could possibly introduce yourselves, and say very briefly something about your organisations.

Julie McCarthy: My name is Julie McCarthy and I am Chief Executive of the Army Families Federation. We are a group that represents the voice of Army families. We collect issues, and we talk to and help families to solve individual issues and to also lobby the MoD, the Army and other Departments to ensure that the needs of Army families are taken into account, particularly in policy making.

Kim Richardson: I’m Kim Richardson and I chair the Naval Families Federation. We do much the same as Julie’s organisation, except that we represent the whole Naval Service family, so we speak to serving personnel as well. We are the smallest of the three federations-there are only six of us, based in Portsmouth-and we offer a voice to Naval Service families. On a personal note, I’m an old state registered nurse and my husband and I met just before the Falklands when he was on board HMS Coventry, which was sunk, so we go back a long way. I represented the three Federations on the Armed Forces Compensation Scheme Review, led by Lord Boyce.

Dawn McCafferty: I am Dawn McCafferty and I chair the RAF Families Federation. I could say, "Ditto, ditto." Obviously we do the same role, but on behalf of RAF families. Our organisation is quite small, and we’re the youngest of the three. There are only eight people in my team, and we’ve been established for nearly four years. We are parented by the RAF Association. Similarly to my colleagues, we represent RAF families in terms of solving individual issues they may bring to us, but also in terms of getting generic evidence on themes and issues of concern to them, and bringing those to people who can perhaps make a difference.

Q2 Chair: Okay. Thanks very much. So, clearly you work with the Ministry of Defence and with different units within the Armed Forces. How do you work with Reservists?

Julie McCarthy: We have a TA and Reserve Forces specialist, and one of her main roles is to get out there and connect with the TA and with Reservist families, and we also make sure that any policies apply equally to the TA and Reserves. It is very difficult, because a lot of TA and Reserve families won’t be interested in the fact that their partner may put green on until they get those call-up papers and know that they are going away. So engaging with them is an ongoing process, and trying to keep them engaged after deployment is very difficult.

Kim Richardson: We would offer our services to Reservists and to the RFA. The challenge we have is that our families are very dispersed. They don’t tend to live in Service family accommodation; they tend to live in their own homes, which fits in with what Reservists do. But we do get contact from Reservists, and we would speak to them in the same way as we would any Naval Service family.

Dawn McCafferty: From an RAF perspective, the Families Federation represents Reservist issues. We run what we call interactive evidence workshops around the Air Force to gather evidence, and we include the Reservist squadrons in those evidence sessions. Certainly the serving members of the auxiliary squadrons can give us their views. As the others have said, it is quite difficult to reach the family members because they live beyond the wire. The other way we connect with the Reservists is that we go to their annual Squadron Commanders’ Conference and take evidence from the Reservists there as well. So we have a good link with them, and also we get updates on reservist policy matters when we go on visits to Air Command.

Q3 Mr Brazier: Sorry, could you repeat the part about the conference? I didn’t get that.

Dawn McCafferty: The Reservist Auxiliary Squadron Commanders have an annual conference, when they gather together to share best practice and presumably get policy updates. We’ve been invited to the last two, and will be going this year as well.

Q4 Bob Stewart: You are not an executive arm of the Ministry of Defence, but who pays for you?

Dawn McCafferty: We are paid for by the Air Member for Personnel’s budget, but it is essentially a contract through the RAF Association. It’s currently a five-year contract, and is paid for through the MoD budget.

Q5 Bob Stewart: So, the MoD budget pays for all three of you, one way or another.

Dawn McCafferty: It’s different for the others.

Kim Richardson: We have a contract. We are contracted through a naval charity under grant-in-aid, but the money originates with the Second Sea Lord’s office.

Julie McCarthy: We don’t have a contract; we’re an independent charity. We get 57% of our budget from grant-in-aid, so it comes from the HQ Land Forces budget but it is ring-bound by the Treasury. The other 43% of our funding is the Army Central Fund, the Duke of Westminster’s fund-which supports RTA work-or the Army Benevolent Fund. Various other charities support particular projects that we run.

Q6 Bob Stewart: So you are pretty independent. You would class yourselves as utterly independent-batting for the Service families.

All witnesses: Yes.

Dawn McCafferty: Certainly, when I set up our Federation three and a half years ago, I went to see the Air Member for Personnel at the time, and said, "What do you mean by ‘independent’, as you’re paying for this service?" He looked me in the eye and said, "Independent with a capital I. I need to know what the families’ views are, raw and unfiltered." That is what he sees the Federation as delivering.

Julie McCarthy: For all of us, all of our services very much support that and value the fact that we are independent.

Q7 Bob Stewart: And you are fearless.

All witnesses: Absolutely.

Q8 Chair: Why is there a difference in the funding between the three of you?

Kim Richardson: It’s just the way we’ve been set up. The Army Families Federation are the old guys on the block.

Julie McCarthy: Over 30 years old.

Q9 Chair: So you have built up fundraising events and organisations and things?

Julie McCarthy: Absolutely. The grant-in-aid was put in place about 10 years ago to secure our future, but it’s set up as a charity from many years ago. We are much bigger; we are 65 staff, so we need that as well. That is why we are set up as an independent charity governed by the Charity Commission.

Q10 Chair: Does it matter that you don’t have a contract?

Julie McCarthy: No, because we are a charity; and because it is grant-in-aid in terms of the way that we apply for funding. Because the MoD sees our value, funding has pretty much been guaranteed. Because we rely on other charities for our funding, our future is not dependent, either, on grant-in-aid.

Q11 Mr Havard: Does the way you’re set up mean that you can attract other funds from other places, whereas the other organisations might not be able to?

Julie McCarthy: Quite possibly, yes.

Dawn McCafferty: I think we can seek some sponsorship, but if I want sponsorship for an event, for example, or to support the marketing of my magazine, I would need to go to the MoD-the RAF contracts branch-and seek its consent to do that. I cannot just go out and seek funding, because I am funded through my contract. We have had limited funding from some other organisations.

Q12 Chair: So does that mean that you can’t raise charitable money as you wish?

Dawn McCafferty: Well, I don’t, because we are part of the RAF Association, which is a charity in its own right. It is a fundraising charity in support of the whole of the RAF family. Our role is purely to meet our contract. The contract is quite specific about what we are supposed to do, and that is what the RAF is paying for.

Mr Havard: So you couldn’t get, for example, funds from something like the Joseph Rowntree Foundation or European funding initiatives, or something else that you might be able to.

Julie McCarthy: Yes, we have made various things with that. We wouldn’t get money from Help for Heroes because we don’t specifically do something to support, but we apply to various other grant-making charities.

Q13 Sandra Osborne: How do you fit in with the other organisations such as the British Legion, Support Our Soldiers, and all these organisations that are on the go? How do you co-ordinate with them? Also, do you operate throughout the whole of the UK? Do you have staff in Scotland, for example?

Julie McCarthy: We do. We have a network of co-ordinators based in most of the major units around the UK. We have a branch in Cyprus, Northern Ireland and Germany, and we rely on volunteers in BATUS, in Naples and various other places. We try to work as collaboratively as possible with other charities wherever we can, particularly with SSAFA and with the Army Benevolent Fund.

We feel that we are unique-I think all three of us would agree-in solely representing the views of serving personnel and their families. That is unique among all of the organisations, which tend to cross over between serving and veterans. I am the wife of a serving officer, so I am doing it from the point of view of, "This is my life as a serving person and these are the things that impact on me." I think that can sometimes get lost in the noise of charities that rightly support a whole spectrum of the military community. The veteran and serving community is estimated at some 10 million people, and it is very difficult to get a consistent voice if you are trying to address all those people. We focus on serving families, and we do that very well.

Dawn McCafferty: All three of us work together very closely, and we are invited to gatherings and meetings where we are asked to represent the family perspective. For example, if you take the External Reference Group on the Covenant, we are representing the family perspective, but you will also have members of RBL, SSAFA and COBSEO, who are representing not only the family perspective where they are involved in that, but the veteran perspective, with which we tend not to get involved.

Q14 Chair: Are you part of COBSEO?
Dawn McCafferty: My parent charity is a member of COBSEO.

Q15 Mr Hancock: When we carried out a report on Duty of Care in this Committee, one of the problems we experienced was the fact that your organisations-not the RAF, because at that time it was not in existence as it is today-had great difficulty, from the Army’s perspective, in getting heard within the MoD. Has there been a significant change for all three of you over the last few years to reward this Committee for the work it did in getting that issue raised with the MoD in a positive way? I would be interested to know from all three of you about how you have seen the climate and the receptiveness of the MoD to your points of view, particularly as the issues affecting families have grown so significantly.
Kim Richardson: I have been in post for seven years. I was there at the start of the Naval Families Federation, and I can honestly say that the Government paid lip service to the voice of the families seven years ago. We did not have the connections and the direct access that we have now. What I have is the luxury of being able to see that we have evolved into something that has become quite well respected. Our views are sought and I am very comfortable that there is nowhere that we can’t go. When I say "where we can’t go", where our families can’t go. So in the seven years, huge change, absolutely.
Dawn McCafferty: There are some examples we can give-the Armed Forces Pay Review Body. When we started giving evidence to that a few years ago, it was very much on an informal basis, and now we are part of the formal evidence team, which is another step in the direction that says, "This is a respected and credible team that gives evidence". Also, in terms of our access to the Ministry of Defence, we have just left a meeting where we have been briefed on ongoing projects with a family perspective, and we have been briefed on the review of the Children’s Education Allowance. We have been brought into the MoD to be brought up to date. I don’t think that would have happened seven years ago.
Kim Richardson: It didn’t happen seven years ago. To be fair, it probably didn’t happen even five years ago-I think that it is probably the last four years that things have gone like this, and they are staying that way. Week on week we are being asked to contribute to things like today, that we wouldn’t have been five years ago.
Chair: If you’re wondering if you are respected, you are. I’ll come back in a moment.

Q16 Mrs Moon: I wonder how much families have been placed in a position of not only being the source of information about the impact of Service life on families, but also becoming the mouthpiece for the serving Forces, in the sense of the nervousness that if you say something and it is negative, it might affect your career chances. How much are you the safety valve?
Dawn McCafferty: I think I can almost counter that, in that 65% of the people who come to us for support, advice and signposting are in uniform. I think that that is an encouraging sign that people are prepared to engage. When I first came into this organisation, our predecessor organisation did not represent the serving family member. I found that quite difficult to get my head around, and I challenged the RAF and said, "The family is the whole family, and the person in uniform as well." The RAF quickly agreed to that, and said, "Yes". But there is an issue there, about chain of command and responsibility for welfare and I have to be very sensitive to that. But having served myself for quite a period, I understand that sensitivity, and therefore I am very comfortable engaging with serving personnel.
But you are right. There are those who perhaps don’t want to come to us because there is fear of any repercussion or concern, and perhaps it is then the partners who are bringing evidence to us.

Q17 Bob Stewart: I want to ask about your mandate. All Services have squadrons, companies, whatever. How far down do you go? Who are the representatives, and what is the structure-so that when you speak, you actually have a mandate from your people that you are representing?
Kim Richardson: We are all structured slightly differently-

Q18 Bob Stewart: In principle?
Kim Richardson: We have a team of six-five full-time equivalent jobs-and we have a worldwide commitment to Naval Service families. I would see it that we offer a voice. There will be some families out there who do not require someone to stand up and speak for them. I was probably one of them a few years ago, because I have a voice myself.

Q19 Bob Stewart: Forgive me, that is the wrong track. What I mean is, do you have a representative at unit level? Do you go down? You have your staff in a headquarters somewhere and my question is: where do you get your authority to speak, beyond the fact that people ring you? Do you actually have representatives in, say, a battalion, a squadron or a ship?

Julie McCarthy: We don’t go down that far. Of our 65 staff, we have 63 Army wives, one Army husband and a male Army civil partner. Most of them are based within large garrisons, apart from probably 25 who are in offices. But they are all Army spouses as well, so they will be living on a patch and you can guarantee that wherever we go, if the person you are meeting knows you work for the Army Families Federation, you come and get spoken to.

Q20 Bob Stewart: So presumably all three of you go to wives clubs. Representatives go to a wives club meeting and then you hold the meeting.

Kim Richardson: We go into mess decks. I will go and sit and talk to submariners in mess decks, and go to families days at sea. Wherever the Service or the families ask us to come, we will come.

Q21 Bob Stewart: That will work, too-that means that you are actually down at unit level talking and your staff go down and talk to units there.

Kim Richardson: We can’t do it otherwise.

Q22 Bob Stewart: I know. I suspect I understand the reason why you wouldn’t have a unit representative, because they just wouldn’t get round to it. But actually doing that is a very good way.

Dawn McCafferty: What I think we do have at unit level is a very good linkage in with the HIVE organisation. I am sure you are familiar with what HIVE does at unit level. We will link in with those, but also when we go out and do our evidence gathering-what we call our workshops-then we are gathering evidence from LAC right the way through to Air Chief Marshal. Our evidence last year covered every rank and partners of most of those ranks. So I am comfortable that, when we sit in front of you and give evidence, we are giving as best a representative voice as we can, bearing in mind Kim’s point that not all families want to come to us and give evidence.

Chair: So that’s what you do and what you are. We had now better get on to our inquiry.

Q23 Ms Stuart: On physical injuries-separating physical and mental for the moment-if I look at the figures, in Operation Telic we had, between 2003 and 2009, more than 1,900 aero-medical evacuations-quite significant numbers. Can you give us a sense of how the families feel about the medical treatment following injury, and whether they are being looked after as well as the individual? I am also trying to understand whether you think there is a difference between the three Services, because I find it quite difficult to get my head around why there are three of you.

Dawn McCafferty: Certainly, the feedback that I get from family members and from those who are serving is that the medical support that they get, if they are injured on operations, is second to none. Indeed, many people are probably surviving on the battlefield who might not have survived years ago. They are brought home to the United Kingdom and they are given first-class treatment right the way through to, hopefully, recovery and rehabilitation. If they can’t be rehabilitated back into full-time Service, then there is so much work going on now to help them transition into life beyond the Armed Forces. I think my only concern-probably shared by families-is whether that is enduring. Does that carry on not just for two years or five years after Service, but the rest of the life of that injured person? There is also the wider support for that family. I am not sure if we have evidence to suggest-we’ve not had long enough-that that is enduring and will be there for the rest of their lives.

Chair: We will come on to that particular issue in the next hour or two.

Kim Richardson: I would say that families feel that their serving personnel are being cared for very well; I would not dispute that at all. Where I think we have a part to play, and certainly the role that I feel we have, is where people fall through the cracks. We will only start seeing that as time progresses. I have certainly spoken to families of serving personnel where there have been things that we can do better. One of the things I don’t think we’re doing is going back to the families to say, "Where could we have done better?" I think it is early days at the moment. I think everybody is learning. I would not sit here smugly and say that we are getting it absolutely right for everybody. There are areas where we could do better.

Julie McCarthy: I absolutely agree. Nobody doubts the quality of medical care that soldiers are receiving. In terms of support for families, the staff at Queen Elizabeth hospital-and Selly Oak before it-and the patient support services work as hard as they possibly can to ensure that families are supported. Those soldiers who are less severely injured can inform their kin themselves. I think the unknown version of what is happening is that those who were telephoned by the soldiers themselves and told about an injury were then filled with fear about what had happened, and there wasn’t necessarily the same follow up-that is what we picked up in a recent deployment survey. I know that issue is being addressed by the Army to ensure that doctors are able to phone families back at home and explain about injuries.

Q24 Ms Stuart: How easy is it to define what the family is? I know that Selly Oak has had some problems.

Kim Richardson: It is broad. In my view, who the family are comes down to the serving person. For some young Royal Marines, their mates are their family. They don’t necessarily have normal parent arrangements, and it is not our place to determine who somebody’s family are. That is the place of the serving person. It must be done on an individual basis.

Q25 Mr Hancock: This is really to you, Kim. It was interesting to hear what you said about your husband being on the Coventry when it was lost. My brother-in-law was on a ship that was lost in the Falklands. He was in the Royal Navy and he suffered dramatically from that. He was rescued from one sunken ship and put on another that was then bombed, and he has never recovered from that. The Navy looked after him remarkably well and kept him in the Service for as long as it could, but the trauma was so great that it finally had to let him go. When it let him go, he got no support and was desperately looking for help. He went to SSAFA and all sorts of organisations. My question is about the length and endurance of support given.

Chair: We are coming to that point in due course.

Mr Hancock: I was just following up on what the lady said.

Chair: I know. That is why I said then that we will come on to it.

Mr Hancock: I would be interested if we could get an answer about the endurance of that support. The Falklands war was not that long ago, and these people have been forgotten.

Chair: We will get an answer to that; we have no doubt.

Q26 Mrs Moon: You said that you work closely together. I was interested in your comment about not going back and asking the families whether they think that the support that they received was the right support. How much do you compare and contrast the different schemes in each service? Have you identified gaps in your own schemes, and support services that make you think, "I wish we had what the Navy has", or, "I wish we had a bit of what the RAF has"?

Kim Richardson: We all compare notes. On the question of why there are three of us here, we would each answer that in our own way. We all feel very strongly about our own Service, and we need that at the moment. We compare notes, and we probably work together better now than we have ever done before. I see that as a real positive. I also see that we do some cherry-picking. If somebody does something particularly well, I’m very happy to sit outside the Second Sea Lord’s office and say, "Why is it that the Army are doing that and we’re not?" In the same vein, if the Navy is not delivering what our families would like us to deliver, I am equally comfortable telling him that we ought to be looking at that as well. It can be any aspect of doing what is best for our families.

Dawn McCafferty: One of the challenges for us is that because we represent the views of families on a massive range of issues, it is actually a challenge just to keep up with the processes of one Service. I have been out of the Service for four years, having served for 23. Things have moved on dramatically, particularly in this arena. I have spent the past couple of weeks trying to get my head around exactly what is provided now and what the policy is. I have an awareness of the Army and the Navy’s processes and procedures. As Kim has said, we will point out where we think there is best practice in another Service, and ideas that perhaps we could follow.

To be honest, with a small team, trying to keep up to date with what the RAF is doing is enough of a challenge. I am grateful to the RAF because it allows us to go to Air Command on a regular basis to get updates on what is happening. There is a lot to take in because it is not just this issue, but housing, child care, education and employment. There are so many things to get our heads around. You could ask, "Could we understand each other’s business in-depth?" That is probably one reason why it is good that you have one from each Service. We are specialists on our own Service and our own families’ experience.

Q27 Chair: That reminds me of something that I should have said right at the beginning of the evidence session. At the end, we will ask you to suggest issues that we should consider in other inquiries-not just medical issues. I am giving you the chance to think about that. We want brief pointers as to why we should look at x, y or z.

Q28 Sandra Osborne: Could I ask you a practical question about support for families whose loved ones, having been injured, are in hospital in Birmingham? This has been brought up with me in my constituency. People have difficulty travelling down to Birmingham from Scotland to visit their family, and paying for accommodation and travel. Are you aware of any problem with that? Are there any issues that need to be dealt with on a practical basis?

Kim Richardson: There are structures in place to help families with those sorts of practical costs. The way I would say that families struggle is that their whole life goes on hold when they are supporting someone in hospital. I have certainly spoken to more than one family member whose job has taken a back seat and their business has closed down because they have dedicated their time to supporting their son in hospital. The impact, which is not just on the immediate family but, like a ripple effect, on the wider family, can be enormous. The Service recognises that it needs to put in place support, such as practical financial support. We do have a good support structure at QE in Birmingham. Could we be doing more? I am sure that we could. This is where we need to come back and ask families, "What would you have liked to see that you didn’t have before?" That is absolutely key to us improving what we are doing. It is not just the financial side of things; it is bigger than that.

Dawn McCafferty: I’d like to highlight the role of the Visiting Officer. If someone is hospitalised, long term, a Visiting Officer will be appointed and they are the family and the patient’s point of contact for any issues like that. They should then be able to take back an issue to the parent unit and say, "There is a problem here." It could be as simple as arranging transport, booking accommodation or liaising with SSAFA to go into Norton House at Selly Oak.

Q29 Chair: Sorry, liaising with SSAFA? SSAFA provides some of this?

Dawn McCafferty: Absolutely. It should not be for the family to search around all those agencies. There is a dedicated person trained to do that liaison role on behalf of the family, and they are appointed in all such cases. They are trained up to do this, so the family should be guided. The Visiting Officer should go out and find the support that is required.

Julie McCarthy: It is important to remember that in the immediate aftermath of somebody coming back to QE, the issue is not with resources then. People are escorted to the hospital and accommodation is provided. It is the issue of the long term. As somebody is downgraded in their illness, that support is stepped down. It is quite difficult for families to understand when they know that they still need to be there, but there is not necessarily the resource for them, because other people are coming in who are very seriously injured and who need to use up that accommodation. The issue is with the long term. Families still have to come down to QE, but the patient is rehabilitating.

Q30 Chair: Now that you have mentioned SSAFA, will you say what the difference is between what you do and what SSAFA does?

Dawn McCafferty: There is a contract between the RAF and SSAFA to provide professional qualified social workers, which is not what we in the Families Federation provide. We are a group that represents the views of the families. SSAFA is there to provide professional welfare social services support to families who are going through any sort of welfare crisis, so it is part of the welfare support team within the chain of command at unit level; it is part of that welfare connection. The Visiting Officer would tap into the SSAFA support to help any family or casualty who is in need of support. There is quite a distinction between what we do and what SSAFA does.

Q31 John Glen: Can I turn to mental health issues? It is probably fair to say that in the last few years public awareness of mental health issues has risen, and so, too, probably has awareness on the part of politicians and Government. We have had the Murrison report, which has made some recommendations. I have two questions. What is your assessment of the effectiveness of the MoD, in terms of identifying mental health issues? If you think it is deficient, what more do you think it could do? Secondly, in terms of the families, there is a direct impact on them when someone has mental health issues. What is your assessment of the preparation and education that the MoD or different forces provide in guiding families to understand what might happen if a mental health issue is presented?

Kim Richardson: When somebody goes away, if I am being honest, I don’t think the family is planning for them to come back with mental health issues. A lot of planning takes place before they go. I have to admit that it’s an area I have some concern about-about where families are going to seek guidance and help. I can probably focus on the Royal Marines as a good group to focus on. They are roughy-toughy guys and their families don’t ask for very much. They ask for less than the Navy blue side does. Will they go and seek help through the chain of command if they realise that there is a problem at home? Possibly not. So I am very grateful to be here today and to have an opportunity to say that I think this is where we need to engage more with GPs and the civilian side, who perhaps don’t actually get us. I am not convinced they understand who we are.

Sometimes a wife realises that there is a problem, or she has a problem herself. I have spoken to some mums of serving Royal Marines who have seen their young men come back and they are not the same people they were when they went out. They are likely to go through the civilian GP, or to speak to somebody on that side. While I am comfortable with what we offer within the Service, with Naval Personal and Family Service and Royal Marines Welfare doing a fantastic job, do they necessarily see everything? No, I don’t believe they do. We must make sure that that area is resourced properly, but that we start transitioning across into civvy street as well. We can’t just do it all within the Service.

Q32 John Glen: Just to be clear, is there any proactive attempt by the MoD-

Kim Richardson: Yes.

John Glen-to evaluate families’ needs?

Kim Richardson: Families’ needs, no. For the serving person, we have something called TRiM-trauma risk management. We again come back to the Royal Marines. All their welfare experts are Royal Marines, so they understand the person that they are dealing with. The family, on the other hand, tend to get on with it on a day-to-day basis. They are probably seeking support from their wider family or their friends and the people around them. They are not necessarily as likely to approach the chain of command to ask for help.

Julie McCarthy: Can I give you a quote to illustrate the sort of things that families come up against? I have a quote from a wife in North Yorkshire: "My doctor told me to have a hot chocolate and not watch TV late at night when I told him I was struggling to cope and not sleeping well." Her husband was deployed, and it is not just about bereavement or somebody coming back with injuries. It is about coping sometimes with multiple deployments and seeing your friends getting knocks on the door telling them about their husbands. I spoke to a young wife the other day whose husband’s best friend had been killed, and she just did not know how to cope. She said, "What do I say to him?" She needed support in knowing how to deal with it. How do they tell their children that their daddy’s friend is dead, or that their friend’s daddy has lost their legs? It is about that whole wider family. Too often I get told, "That’s an NHS issue." Actually, no, it is because of military Service that that is being impacted, and we should be addressing that.

Q33 John Glen: So you are making the distinction, I think, between an ongoing need, regardless of what’s happening operationally, versus a response to recent events in Afghanistan, which is perhaps what prompted the greater awareness. You’re arguing for it to be embedded in, regardless.

Julie McCarthy: It should be. The pressures of Service life are not just about operational service. The guys are away a lot anyway, never mind when they’re in Iraq or Afghanistan. I think something should be built in to support families much better.

Dawn McCafferty: There is also an issue around the transition protocols between the MoD and the NHS. Transferring support out for the Service person is pretty well understood, and it is being tested and trialled at this time. No doubt lessons will be learned, and it will be enhanced. It is the transition of the family members who, as Kim says, are registered with GPs.

I have certainly had evidence from one family where the individual in uniform was getting medical and mental health support through the MoD as required, and it was spot on, and just what he needed. She and the children were suffering in their own way. She was finding it very hard to adjust, went through to the NHS support, and found very little empathy or support available for her, because the perception was that it was an MoD responsibility. She couldn’t get across to them that she doesn’t come under the MoD for medical or mental health care. Someone must help them, and particularly the children. She was really looking for counselling support for the children, and all she could find was charitable support. There’s an identified gap. I am not saying that it’s a massive issue. It’s probably a minority, but where it exists, there’s a need to address it.

Chair: It’s a very important issue to get right.

Q34 John Glen: I am conscious that on this Committee we have representation from Northern Ireland, Wales and Scotland. Given your national role, do you see any different interpretations of this need and response to it among different parts of the United Kingdom?

Dawn McCafferty: I think the exposure we’ve had through the External Reference Group, the Covenant issues and, before that, the Service Personnel Command Paper, probably drew the differences to my attention for the first time, and to the fact that although England might make legislation, we would be looking to the Devolved Administrations to support us on that. I think our representation is absolutely spot on, because where best practice is being recognised, it is then being followed through. [Interruption.]

Q35 John Glen: I think you were saying that you had become aware of the differences.

Dawn McCafferty: Absolutely. Let’s say we wanted something done in one part of the Administration; we’d be following through whether Scotland, Northern Ireland and Wales were able to replicate that service. We’ve spoken before in this Committee about seeing really good support from the Devolved Administrations. We’ve been to the Expert Group on the Armed Forces in Wales, where they’ve really taken some of the issues forward. There are differences because, rightly, we must allow those Devolved Administrations to make their own decisions, but when they see that it’s the right thing to do, they all get behind it.

Julie McCarthy: It’s important to consider that there are also differences across England because of the individual PCTs. I’d always assumed that in places like Catterick and Colchester, where there are big populations, things would be okay, but sometimes that’s where there is the most ingrained belief that "That’s all right; the Army deals with that" or "the MoD deals with that." The issue is down at ground level among individual practices and PCTs themselves.

Q36 Chair: It is very good to get this evidence. If you are hoping that a report by politicians will resolve some of the misunderstandings in this issue, you may be a little optimistic.

Kim Richardson: We can hope.

Chair: It’s a long-term process, I suspect.

Kim Richardson: We are cup half full.

Q37 Ms Stuart: In a sense, it is the oldest problem-Penelope and Odysseus. Someone goes away and you don’t know what will happen with the family when they come back. There is uncertainty. Have you looked at how other countries deal with what is essentially a problem you can’t resolve-it just is?

Julie McCarthy: I stupidly look at MilitaryHOMEFRONT and a lot of other American sites. We look at the amount of things that the Americans are given and at the American model.

For example, with counselling in mental health, there is automatically a pre-paid scheme that families can use to get access to professional counselling; there is not a limited budget that they have to seek out if they have problems. The approach is a lot more joined-up in some areas. I know that they have much bigger budgets, and much bigger problems, than we do, but taking one of Kim’s themes, if a parent has to give up time to care for their son, there is an obligation by law in America to keep that job open and to allow the parent to take a break from employment, which we just do not seem to take account of in this country.

Q38 Chair: I think that the Committee has heard in previous years that the American outcomes on mental health issues are not as good as the British outcomes. I do not know whether that is true, or whether we are simply not looking at them.

Julie McCarthy: I think a comparison is possible between serving personnel, but of course we have never compared what the Americans do for families with what we do, because you couldn’t do anything for families. We can’t compare what perhaps should be provided in support for families, although we could compare what they do for serving personnel.

Dawn McCafferty: I think what’s encouraging is that research is beginning to be done. From our perspective, we have been banging on the table for 3 years saying to the researchers, "Could you please have a look at what impact there is on families of the stress of deployment?" I think that King’s College has already started some work on Army fathers, or possibly a tri-Service study of fathers who are deploying and the impact on the children and the family. It will be interesting to see what that throws up in terms of potential mental health issues for families.

Q39 Penny Mordaunt: I have a quick question following on from that. Are there particular challenges within individual Services? I am thinking about people who are currently in Service and the dispersal around the UK of families. You pointed out that there are hotspots where you could focus on sorting out the GP stuff. Are there different issues that you have as individual Services about how you might tackle that?

Kim Richardson: I would like to say, and perhaps it is something that you could do something about, that data protection makes it very difficult to contact our families. We had an aspiration that we would be able to amend the system that pays all three Armed Forces to allow us to have a sort of opt-out box, so that we could contact families directly. I am completely comfortable with saying that many families out there will not know that we exist because they set up home in their own communities and live their own lives. The time that they need us, or somebody else, is when they have a problem and an issue. It is challenge to reach those families.

Q40 Penny Mordaunt: And your families would be fairly dispersed?

Kim Richardson: They are across the country. We have hotspots in Liverpool, Birmingham-not around the traditional naval ports. For us in particular, it is a huge challenge because I am convinced that there are people out there who are not particularly sympathetic with Afghanistan-with Afghanistan, we are not back to where we were with the Falklands. Some people would like to seek some help and they are not sure where to go. That is a challenge for all of us, but more so for us because our families are more dispersed.

Dawn McCafferty: We’ve got similar challenges in that our families can be very dispersed. A large proportion of the RAF families now decide to live in their own communities and not necessarily on the base. So we have families in Birmingham, Scotland and Wales, as Kim has.

The challenge if that family is in need is to identify a trained Visiting Officer who is close enough to make a real difference to that family. If, for example, the casualty is a regiment gunner from Honington, but the family are in Scotland, there’s no point appointing a Visiting Officer from Honington because it will be really difficult for them to provide the necessary support, so staff will then look to the nearest RAF unit to provide support locally. They try to match that support, recognising that our footprint is small and getting ever smaller.

Q41 Chair: Would it be fair to say that these mental health issues are still more difficult to deal with in relation to Reservists?

Julie McCarthy: Absolutely, because they may be going back to a GP who has no idea how to deal with that, and the soldier may be away from a unit where TRiM can be conducted. We have had families come to us saying, "I know there’s something wrong. I don’t expect it’s PTSD but there is perhaps a transition issue going on with my soldier having come back and I don’t know how to deal with it. What do I do?" Unless that soldier seeks help himself or herself, the family find it difficult to know what to do.

We rely on the charitable sector to point people towards PTSD Resolution, Combat Stress, that sort of organisation, to get help. Where it is not PTSD, what do you do? Providing information to families before soldiers come home would be useful, so that they know that some things are perfectly normal and a soldier will get out of. They can be told what to look for so that they know there is a problem and that it is not just a transitional condition.

Q42 Chair: And it is more likely, isn’t it, to be alcohol than PTSD?

Julie McCarthy: Absolutely.

Dawn McCafferty: Reservists when they are mobilised have the same access to the same level of support as the Regulars. It is just that a physical injury is quite apparent and they will not be demobilised until everything has been done to get them as fit as possible. The challenge is that mental health issues might not become apparent. They will try to assess that, but if it is not apparent and they are demobilised and it comes out three or four years downstream, there is then an issue of how to get back into the system for support.

Kim Richardson: I think we need to differentiate between those who are injured and perhaps have mental health issues, and those who have come back and have potential issues that have not been recognised. Dawn touched on Visiting Officers. If someone has been injured, the Visiting Officer network springs into action. I am comfortable that they do a fantastic job. They also do it on top of their own jobs. The Navy sticks with that family until the family determines that they are ready for it to leave.

I come back to your question about dispersed families. That is a family where someone comes home who is not injured. They are going back into the home environment, perhaps with issues. I heard from a young mum with a Royal Marine son who is quite concerned about his behaviour. She came to us to talk about where to go for help for that. He is not seeking any help. We need to recognise that these are young men going back out again and again and again. It is not going to get any easier. We need to separate the two things: between those who have a care pathway that is defined and they are being looked after, and those who perhaps have not yet, because it has not raised its head.

Q43 Mr Hancock: After the first Gulf war, when troops were coming back, one of the big problems-and this Committee found it-was that GPs could not get the right information back from the MoD. There was a big, big problem ensuring that medical notes-and even unit notes about someone’s behaviour not being properly helpful-were being put towards GPs. I would like to know whether there has been a change. Are medical records of serving personnel who have been on operation-maybe not physically ill, but have suffered a mental setback while they were away-being transported to the GPs, so that the GP can support the family?

My second point is about the chain of command. Kim, you rightly said that for a lot of these young Marines their real family is the unit they serve in. That is apparent when you meet them on a regular basis. They don’t have significant ties at home.

Do you think the chain of command is properly equipped to spot the sort of issues that these young men are facing when they come back, having served on two or maybe three tours in Afghanistan and one in Iraq? They are coming back and the chain of command isn’t prepared to give them the benefit of the doubt. They just think, "You’re a tough Marine, get on with it." Is there a sense that more work needs to be done, that unit officers and NCOs need to be trained to recognise the problems that these young men are facing?

Kim Richardson: Starting with your first question about GP notes, I am not in a position to compare how things were with where they are now. I actually don’t know how that works, when they move to a civilian practice. I am conscious, with my work that I did with the Armed Forces Compensation Scheme, that we have different methods of recording medical notes in the Services. Can I sit here and say that I am confident that absolutely everything gets recorded? I am not sure that I can say that, because they have different methods of doing it.

Dawn McCafferty: I agree with you, but I think the transfer of records was one of the key parts of the Transition Protocol. The transfer recognised that people were potentially leaving the Armed Forces with medical conditions still outstanding and needing support, but who were lost off the radar because GPs weren’t picking up those conditions as the notes weren’t being transferred.

A big part of the Protocol is to ensure that such information gets passed across-whether it is then understood, because it is written in a different language or a different way, I don’t know. But I am sure that one of the key themes of the Transition Protocol was to ensure that all available records were passed across so that there was no break in the support that was needed.

Q44 Chair: The chain of command?

Kim Richardson: If somebody doesn’t want to be identified, they have ways and means of hiding their problems. I am confident that, particularly where there is the core ethos that perhaps the Royal Marines or a ship’s company have, they look after one another. If they see somebody who is struggling, I am comfortable that they would do something about it.

The problem is that we are seeing young men who are struggling, but who are perhaps not presenting in the way you would expect. So a young Royal Marine who I spoke to had come back from Afghanistan and taken up 10 mobile phone contracts. He then had money worries and was getting himself into a real old hole. He couldn’t explain why he had taken up 10 mobile phone contracts, but some of it was the buzz. They are still looking for that buzz and that thrill. So who decides that that is not normal behaviour? If they want to hide it, they will.

Dawn McCafferty: Again, the introduction of TRiM and having TRiM practitioners at unit level has been a big step forward in ensuring that flight commanders and senior NCOs are at least aware of how to watch out for any symptoms that might be a cause for concern.

Julie McCarthy: I think that TRiM works very well. My concern for the chain of command is: who is TRiMing them? Actually it is our senior NCOs and our officers. The families that feed back to us when there are issues are those where the guy says, "Well, no, I’m looking after my guys, my squadron, my regiment." They are not seeking help, but they are seeing their men injured and lost, and they feel responsible for that. They’re under a lot, but there is an assumption that as a senior NCO, a warrant officer or an officer, "You won’t suffer from that because you’re in command. So crack on."

Q45 Chair: And the Chaplains?

Dawn McCafferty: The RAF has certainly addressed that issue quite recently and said that there is a need to "train the trainers" to ensure that they watch out for themselves and recognise any symptoms of being overwhelmed. I must say that the Visiting Officer role must be one of the most difficult in the Military. Absolutely, it is a real challenge to take that through and do it professionally. And there is a danger of being overwhelmed by the responsibility of it, and, therefore, as you say, we need to support those people so that they can deliver to best effect.

Q46 Mr Hancock: You have probably answered part of this, but how are those trained practitioners selected? Who are they in units? Who is it who gets that job?

Dawn McCafferty: Some years ago-this is since I served, so I am not as familiar with it as I should be-the RAF decided to create a trained Visiting Officer cadre. There is a pool of individuals who are selected on the grounds of their maturity and their ability to take on what is, as I have just said, a very challenging role. They are then put through comprehensive training. Some of that training is tri-Service, and I know that they share best practice in how to deliver that training.

If there is an injury or a casualty in a unit, the Personnel Management Squadron will look at the pool of available people and determine who is best suited to that particular family. For example, it wouldn’t necessarily choose somebody who is well known to the family-a friend on the squadron-because that might not be a very clever thing to do. So they might choose someone who is a little bit more distant, but who perhaps served on the squadron and knew the individual but wasn’t close. What the RAF is trying to do is provide capacity on a unit to cope with any casualties or injuries that come along.

Mr Hancock: I will get in trouble if I ask you another question.

Chair: You will.

Q47 Mr Brazier: I want to take you back to the question on Reservists, to which you gave very full answer in so far as we can go on that. It seems to me that it is worth turning it the other way round. In our constituency postbags the common problem with mental health cases is that, on the whole, they don’t present. We hear about them indirectly because neighbours are complaining about being harassed, because parents or siblings are worried, or whatever. In that respect, there is a parallel with civilian life.

The fact that more than half of our medical output at the moment in Afghanistan and elsewhere is through the Reserve Forces offers an opportunity for mental health for the Armed Forces as a whole-regular and reserve-that is currently untapped. In a way, I should be putting this point to Ministers rather than to you, but you may well have views on it.

It seems to me that, through the use of large numbers of NHS personnel in the reserve forces in Afghanistan, we now have quite a large ceiling across all regions of the NHS, of people in civilian jobs who are primarily civilian doctors and nurses, who have a pretty good idea of what it is all about because they have been out there and served. Would you support a greater role for trying to find a way of picking up and identifying these people, who may not present till several years later, whether they are ex-regulars or Reservists?

Chair: I wonder if that is more of a policy question, although you may have a view on it.
Julie McCarthy: I suggest that those medics that were taken from TA aren’t necessarily in primary health care-they are taken from secondary health care, from hospitals-so they wouldn’t necessarily see the initial presenting symptoms. I think it is a good idea, but I am not sure it would still address the issue.

Q48 Mr Hancock: We are still talking about people suffering from traumatic stress and other mental health issues. So when the problems are identified, how effective is the treatment that they themselves receive? Secondly, are the families given enough support once these difficulties have been identified? In other words, is it explained to the families how this will transmit itself over a fairly lengthy period of time?
Julie McCarthy: As far as I can see, from the feedback I have had from the few families I know that have experienced treatment for mental health, it is very good. Certainly, in terms of the chain of command, they have tried to reduce the stigma of mental health as much as possible. But I think soldiers and families still feel that there is a stigma. It is not a visible injury, and they may compare themselves to someone else and say, "Well, they lost an arm or a leg." They have these traumas where you can’t see an injury. I think they feel that it is not a real injury, and there is some guilt associated with that, but I don’t think the support is any less.

Q49 Mr Hancock: Where would they get the support, then? There isn’t a Headley Court, is there?
Julie McCarthy: No, but there are mental health units regionally. Actually, in some terms, the provision is slightly better, in that they go regionally to be treated rather than to a single-

Q50 Mr Hancock: To a military unit?
Julie McCarthy: It is a military NHS partnership, as far as I understand. I think that’s right.
Dawn McCafferty: I think that there are military practitioners in mental health who will follow through those who need that support.
Julie McCarthy: Yes. The help is definitely there, and it is not my area of expertise, but there is help and I think that it is very good help. I know that it has recently changed from being treatment at the Priory to these regional centres.

Q51 Chair: And you also mentioned Combat Stress and Resolution.
Julie McCarthy: I think that there are many charities doing a lot. Veterans Aid picks up a lot when people transition into civilian life. The difficulty is in getting people to seek help for mental illness. I don’t think the issue is about the treatment-it is getting people to own up that they have an issue. Families have raised the point that they can’t get somebody treated until the person admits to having an issue. That is still very much where the problems are.

Q52 Mr Hancock: What happens for soldiers who return to units in Germany, for example, who are suffering in this way, who are in Germany because their families are still there? Is there a facility in Germany?
Julie McCarthy: There are mental health clinicians in Germany, yes.
Dawn McCafferty: SSAFA will be there as well.
Kim Richardson: I don’t know how big the problem is, because it is not something people are necessarily comfortable talking about. I have had very little contact from families who have had an issue with mental health. It would be interesting to know from the Service-I think it is only the Service that can answer-how big a problem it actually is.
Chair: I am afraid that apparently there is going to be a vote in the House shortly. If there is, there is; we will just have to vote as quickly as we can and come back, because we’ve got a lot of ground we still wish to cover. Sorry about that.

Q53 Mr Havard: On the question of rehabilitation, in its broader sense-there is physical rehabilitation, but concentrating on rehabilitation in the sense that we’ve just been discussing it-how does a family recover as well as an individual, in terms of their whole presentation and their mental health? You are describing ways and services that support individuals. You seem to be saying, as somebody said earlier, that family needs are not catered for in that sense. Can you say something about how you see the way in which the family and the extended family-however it defines itself-is supported? The family is part of the rehabilitation, but it needs support to rehabilitate itself at the same time.

Dawn McCafferty: One thing that I find very interesting in working with Air Command and getting to understand what is now in place is learning how they now track our individuals who are seriously injured or ill through what they call the Clinical Pathway or recovery process. While that covers the Service person in uniform through rehabilitation and recovery, there is also a parallel pathway of welfare support that looks at the broader welfare needs of the wider family as well. That certainly wasn’t in place when I was serving 10 or 15 years ago and doing this sort of work as my bread and butter. It’s really helpful that there is a post in Air Command dedicated to tracking all those individuals through their recovery and then using that as a trigger to the unit welfare staff to ensure that those questions are being asked. Is SSAFA involved? Does the unit welfare team know about this family’s needs? Is anything further required? There’s now a system in place to track them through.

On whether that support is then delivered, like the others, I don’t have that much contact from families of seriously injured or ill personnel, but I can only assume that some of that lack of contact is actually because it might be working quite well and they are getting very good support. At unit level, there’s a whole team of welfare support staff ready to help. The key thing is connecting them to family members to make sure they understand what the need is.

So there is this parallel pathway where the individual who has been injured is transiting through all his or her treatments, rehabilitation and recovery. Obviously, a decision is made at some stage about whether he or she can stay in the Service or has to transition to civilian life. Along that parallel path, the family are being looked after. I am reassured that that is being looked at. We’re probably not all the way there yet-there’s probably more to be done on that side-but at least they’re asking the questions of whether there’s a wider need than just clinical recovery.

Julie McCarthy: I think there’s a lot of hope, particularly in the Army environment, that the Army Recovery Capability will pick a lot of that up and ensure that rehabilitation of the family provides them with the information they need. That’s the most common complaint that I’ve heard. It’s just information. It’s knowing what’s going to happen; it’s the "what if?".

There’s one organisation-the Defence Career Partnership. We may have spouses who suddenly have to become the main breadwinner. It’s about equipping them after years in the Service. They may have to go out and work or, at a very young age, become a full-time carer. It ensures that they understand what future implications for them will be available and what is there for them. If the spouses of our Foreign and Commonwealth personnel don’t have indefinite leave to remain at the moment, they have no recourse to public funds, so they can’t get a carer’s allowance. That’s the question for them: what will happen to them? There are implications depending on each family’s circumstances. It’s not that there is no desire to support families; it is just knowing exactly what families need. If any of the Services know what families need, they will do their best to meet that.

Kim Richardson: All I would add to that is that to get really good, firm evidence, you need to be talking to the experts. They are organisations such as Combat Stress, who would be able to give you that feedback. I don’t believe it is something that families would necessarily see us for. We are not experts in anything. I would not necessarily expect them to come to us with concerns unless the system was not delivering, and I am certainly not seeing evidence that the system is not delivering.

Q54 Mr Havard: You have partly anticipated one of the questions that I was going to ask about the relevant support organisations, whatever they might be, and whether families have got sufficient information to understand what those are. You are speaking about navigators, mentors or guides who can help through the process. How well is that applied generally across the piece?

Julie McCarthy: There are so many organisations out there that sometimes it is very difficult for people to identify who that is. We were saying earlier that by the time a family has got up the courage to make a phone call, if they are told, "It’s not us; you need to phone so-and-so," and then the next organisation says, "No, no. It is not us," at that point the family says, "Do you know what? I’ll sort myself out. Don’t worry." It is about knowing from the off. In some respects, COBSEO, or an organisation such as that, has a role to play in identifying the right people to direct families to in the first instance. There is a role for that.

Kim Richardson: I also think that one size does not fit all. People choose their support by what works for them. Some people find that their friends and family are enough. We could sit here and say that if you have a mental health issue, Combat Stress is where you need to start, but that might not necessarily be the case. So an element of what we do is signposting and offering choice. There is a lot out there-there is a lot available-but I counter that by saying that I am not convinced that our families know the extent of what is available to them.

Q55 John Glen: You have seen a massive increase in the amount of charity activity in this space over the past five or 10 years. How do you feel about the distribution of what is offered by the MoD and the charitable side? Linked to that question, you have said that there is a wide array of organisations, but there must be a lot of overlap, too. How do you feel about that?

Dawn McCafferty: It is a very confusing area for all concerned, be they the charities, the MoD or the Service person and their family. The boundaries are not at all clear-there is a grey area. All credit to the charities, which step in straight away if they see suffering and deliver what is needed. They will perhaps ask afterwards whether they should be doing so. They will then go back and negotiate, perhaps with the MoD or the Government, saying, "Perhaps you should have delivered that capability."

People step forward to help because of the inherent wish not to let people suffer. If families are in need or a Service person is suffering, those charities will step in and help. But the boundary between where responsibility lies-from the MoD, the Government and charity-is a blurry line, not just for the individuals who are offering support, but for all the families in the middle, who are looking out and seeing a plethora of provision and not knowing to whom they should turn. We cannot guide easily either, because I am not sure that I understand the boundaries between those areas.

Perhaps this Inquiry might shed a useful light on the boundary issue. Perhaps it will try to provide some clarity-working with the charities, the MoD and the Government-and say, "Let’s try and draw some boundaries here." Everyone could still contribute, but it would make a little clearer who had a lead and who was responsible for certain areas.

Q56 Chair: Am I right in thinking that Combat Stress does not provide support to serving personnel?

Julie McCarthy: It does not. It is for veterans who are suffering from PTSD, so it could not help people who have other mental health issues.

Q57 Sandra Osborne: When a partner is suffering from PTSD or some other mental health issue, there is a possibility that domestic violence will occur. In that case, the spouse, whoever they may be, may need to seek support or protection for themselves and sometimes their children. Is there a mechanism within the Armed Forces for that on a confidential basis?

Julie McCarthy: The MoD has just published a joint-Service publication on its policy on domestic and sexual violence. I am sure that it would provide a copy to you if you needed it. The lead in the RAF, for any domestic violence issues, concerns or allegations, is SSAFA, the professional social workers. They would get involved on a formal basis and support the family if needed. We have been approached by family members who feel at risk of domestic violence and we signpost towards the professionals, because that is not something that we are qualified to support.

Chair: I am sorry to conclude there, but you will understand that we have a lot to cover before we go off to the Chamber.

Q58 Mr Havard: I want to address the matter of time and late presentation of certain issues. For example, Barnardo’s has worked with fathers in the community and discovered that some of their problems are due to their being ex-serving men. However, those problems might arise and cause feedback into the family 10 years on, so late presentation is an issue. As some of these things move away from being acute problems and perhaps become chronic ones that need treatment over a long term, could you say something about what you think is happening in terms of how we could address this business of late presentation for families who might not now be part of the immediate military community but have the same root problem?

Kim Richardson: I took a phone call from a man around the time of the Falklands 25th anniversary. There were a lot of celebrations and there was a lot of talk in the press about it, and it took me two and a half hours on the phone to work out that this chap had served on a ship that had sunk. He’d spent 25 years coping and managing, and he went to pieces when it was being revisited and highlighted. So I do have concerns that there are going to be people like that out there, and we have to take into account that this could be a very long-term issue for them. Combat Stress probably would say that it is already seeing that anyway. Where are those people going to be picked up? There’s a very good chance that by that stage they won’t be in the Services.

It is about our using all the resources that we have to inform those people out in civvy street that this is potentially what’s going to happen. This is where I think it is about engaging with PCTs, GPs and the health experts who are likely to come across people in that situation later on. Perhaps their families approach people for help. When families need help they will find someone, but it would be nice if they knew beforehand where to go.

Dawn McCafferty: There is also a role for the Service charities here-[Interruption.]

Chair: I think that we had better stop and go and vote.

Sitting suspended for a Division in the House.

On resuming-

Chair: Again, I am afraid, we were interrupted mid flow. Was there anything that you wanted to say in response to that last question, if you can remember what it was?

Kim Richardson: Yes. Where can we get that bell? My husband would welcome it.

Q59 Mr Havard: I was asking about how you do things over time.

Julie McCarthy: Picking up on what John Glen said about the charity, one thing that concerns me is that, over time, we may see a number of charities disappear. We might see Afghanistan go out of the headlines, and what concerns me is that, if it is charitable provision, that charitable provision might fall away. Many of the people whom we speak to do not understand why, not necessarily the MoD, but the Government are failing to provide something. Taking the American model again, it is provided by the State, full stop. I don’t think that people understand that, and they fall through the cracks because of it. Because it is not statutory provision, they are dependent on those charities and on catching them at the right time in order to get provision.

Q60 Mr Havard: That was partly what I was driving at-sustainability. We seem to have two cohorts. We have people who are currently serving, for whom we might be putting in place a lot of support. We also have people who have served who may come back and present, but they are a much more problematic group to even identify. But sustainability of provision over time is clearly something. These are not acute problems that will be solved in two or three years, so that is why I wonder whether you will be able, the way you are structured, to actually support what is likely to be a growing community of need.

Julie McCarthy: For us, it is about the people whom we deal with, so the answer would be no, because it is not in our charity objectives.

Q61 Mr Havard: So once they stop being military families proper and they move into a veteran community, how do you hand them over?

Dawn McCafferty: We would signpost them to the key charities with which we are linked. Before the bell went, I was saying that there is a role for Service charities in terms of picking up, further downstream, people who perhaps come out of the Service and did not feel that they needed support or to ask for help at that stage, but who, maybe 10, 15 or 20 years later, might present. I think that the big charities, like the Benevolent Funds, the Royal British Legion and SSAFA, which have caseworkers out in the community, may well be able to identify those. I know that the RAF has put in a lot of effort, through the Benevolent Fund and the RAF Association, to find what it calls "the lost generation"-those who have not become members of that organisation but who are out there, are veterans and who may well be in need, if not now, in the future. It wants to make them aware that there is support there for them. So I think there is a role for the charity sector to be the "eyes and ears" on the ground, out in the community, to find those veterans. As somebody said earlier, GPs need to be trained to ask, when somebody presents, "Do you by any chance have a military background?" It might have been 15 or 20 years ago, but it may still be relevant to why that person is now presenting.

Mr Havard: I am having that discussion with my local health trust to try to deal with that very problem as to whether they are aware, continue to be aware, and how that will be refreshed. We will be taking evidence from the charities, obviously, so you can think about things we could do later. You have given us some ideas about what we need to gain from them. Thank you very much.

Q62 Chair: If it is difficult now to ensure that GPs are aware of and are empathetic towards former Service personnel, how much more difficult will it be in 15 years’ time if there isn’t a conflict going on and there is nothing in the headlines?

Kim Richardson: That is why we have to start now.

Dawn McCafferty: I think that’s where the Covenant will have to play its part. The test of the Covenant itself, as to whether or not it delivers that awareness and mutual regard between those who are not serving, those who have served and those who now serve, will be connecting them together and saying, "We recognise the fact that you have served." I know that the covenant is still only in draft, but we will not be measuring its success in five years’ time. It will be in 10, 15, or 20 years’ time when we measure whether those enduring obligations that we are trying to set in concrete now will endure right the way through, so that people serving now who transition out will be supported right the way through to the end of their lives if necessary.

Mr Havard: And they may have a new, different family by that point.

Chair: There are a couple of questions we would like to ask about bereaved families, and about what happens when people remain in Service. While we are waiting for people to come back from the vote, could Penny Mordaunt ask about leaving the Service?

Q63 Penny Mordaunt: Do you think that personnel and their families are getting the level of support that they actually need, considering everything from ongoing medical treatment to help finding employment and accommodation-a very broad range of issues-and looking at all agencies that might be involved in that? Not only the MoD and the Armed Forces, but also the NHS and local authorities. The question to all of you is, are people getting what they need? If so, what is it, and if not, what is it?

Kim Richardson: It is still early days. I think that there is a structure in place and that the Service recognises that it has a job to do. For some of our personnel there is still that sense of uncertainty about whether they will go or not, and when they do go what package they will leave with. I think there is some sense of uncertainty there. The people who worry me the most are those who have injuries that are not so obvious. I have spoken to a number of Royal Marines who have hearing loss. They are actually fit young blokes and you would not know that there was a problem, but there is. We are at the beginning of this and need to be careful how it is handled, but I also think we need to get feedback where it is not working, because some people will undoubtedly fall through the cracks.

We also have a group of people who do not want to leave; they do not want to transition out. The challenge to families-and it might not be a wife or partner; it could be a mum or dad-of someone then returning home could be quite significant. So for me it is early days.

Dawn McCafferty: One organisation that we haven’t mentioned is the Service Personnel and Veterans Agency, which has a welfare role as well, in terms of that critical two years of transitioning out from the Service into civilian life. There is a remit upon those welfare staffs to make regular contact with those personnel and families and make sure that they are making that transition, and if they’re not, why not? What problems do they have? Again, it is early days for that. I cannot say that I’ve had any feedback one way or the other on whether it is working. I have had occasional contact from guys and girls who have transitioned out and fallen through the net, and we have connected them to the SPVA Welfare Service. I have heard nothing afterwards, so I hope that that has put them back on the right track. So there is another level of support there; they don’t just drop off the radar. The SPVA are there to support their transition for two years.

Julie McCarthy: I agree with everything my colleagues said. In terms of ongoing work and looking at what will be done in the future, encouraging all Service families to think about things like home ownership earlier in their careers may mean that if something does happen then they are better prepared to move on. I think some of it is about getting people to think about transitioning before anything happens, and that will perhaps make them better prepared if something does.

People like the Defence Career Partnership are looking at putting people into worthwhile jobs. That’s a key thing, because I think that is one of the scariest things. Families have asked us what they will do; they can actually still do a huge amount, perhaps once medical care is finished. Organisations like that have a huge role to play, as do local authorities. Big organisations throughout the country could help by employing and providing employment prospects, for both veterans and their spouses.

Q64 Penny Mordaunt: One issue that we discussed when we were thinking about how to gather evidence for this inquiry was potentially doing survey work at a local level across the UK. For example, with existing and emerging local NHS structures, with local authorities, potentially with some big agencies that might be looking at employment services and the new things that are happening on that front. Sorry to put you on the spot and please feel free to come back to us on this. If we were going to do that, would there be some questions that you would particularly want us to ask of the NHS or a local authority or another body?

Dawn McCafferty: I am sure that we would come up with some questions if you gave us a little bit of time.

Kim Richardson: I live and work in the Portsmouth area and I met with some representatives from Portsmouth City Council. It was a really interesting conversation because about 20 minutes in I realised that although we have a naval base on their doorstep, they do not actually understand us. It is behind a wire. So my plea would be, "What more can we do to get you to understand us? Do you get us or is it just the odd programme that is on the telly, the bit of news? Is it another death in Afghanistan and the families being informed and you move on?" I feel we have a role to play here in engaging with people like that to tell them what we are all about. I can only see that benefiting our families in the long term.

Julie McCarthy: There are some very good examples, particularly in Wiltshire and North Yorkshire. Wiltshire has a military-civil partnership. They even have part of their website dedicated to the Military and talking about what the local government will do for the Military. It is about looking at examples like that and how it works and encouraging those councils with relatively low numbers of Service personnel to adopt that model as well, because the issues occur where there is not that understanding and perhaps where there are lower numbers as well, although that flies in the face of Portsmouth, possibly.

Kim Richardson: Wales has done that. We engage with Wales and one of the things we did was paint a picture for the Welsh Assembly of what a Service family is. We are all different. They followed through in a really positive way. I am sure we have an open door at the moment. We have to be knocking on it because it’s not going to last forever.

Penny Mordaunt: Could you follow up with us? It could be about what is in place or even whether someone is a point of contact, not just with the NHS and local authorities, but with other big agencies and services that you would like us to look at.

Q65 Mrs Moon: We have asked a lot of questions about mental health recovery and rehabilitation. How much frustration with the pace of action are you picking up from families at the moment? How great are their concerns that family members are not getting adequate rest, leave and space? That may not necessarily be before deployment back out to theatre; it could be deployment to the next job. Do they get the time to recover from a deployment, or to unwind with the family in a different rhythm, before they have to move on? Is that an issue?

Kim Richardson: I think so. Our families can’t understand how the Navy is downsizing when they see less of their serving person than they ever did before. Even periods of time at home that used to be traditional jobs, where somebody would perhaps be able to take an early day to collect a child from school, are not happening so much now. Although we focus on Afghanistan, Iraq and now Libya and the bigger things, the jobs at home were the downtime. I certainly would say that our families are not seeing that anymore. We cannot ignore that.

Dawn McCafferty: I support Kim: it is the downsizing that is causing the real ripple of concern. We are only just coping now, from a family perspective. It is, "I am not seeing much of my husband or Dad, or whoever, and now we are going to get smaller, yet we cannot see the commitments lessening". Yes, there is predicted withdrawal from Afghanistan, but who predicted that Libya would come up? What’s next? The families feel that if they are stretched now, what is life in the RAF or the Armed Forces going to be in 2015 onwards? Do they want to be around to be part of that? If they’re feeling the stress now, what will it be like then? I think it will be the families who put the pressure on the guys and girls to say, "Enough is enough." We’ve said that before. It is one of the biggest factors in exit surveys. The reason why people leave the Armed Forces is not to do with job satisfaction, pay or anything like that. It is to do with the family. People say they need to give their family better support; they want to spend more time with their family.

It was only a small sample, but last year we asked our family audiences a question about work-life balance in the RAF. Last year, 60% said, "Yes, broadly, we think we have a reasonably good work-life balance." This year it was 60% the other way-60% saying, "No, we haven’t got a good work/life balance." That was a really marked change in just two years of asking the same question. That’s a really strong indicator that, again, people are feeling very stretched.

I think the stats that are provided will indicate that Service personnel haven’t lost a great deal of leave, and perhaps working hours are down. I’ve just read the Armed Forces Pay Review Body report. The stats are there, and you can’t deny them if they’ve been produced. The question is what they really mean, maybe not in terms of losing leave, but in terms of getting leave when you wanted it. In terms of stretch, how do the families actually feel? There is stress there, and I am concerned about what it will be like once we have gone through the phases of redundancy that we are about to go through. How much harder will it be?

Q66 Bob Stewart: What happens when bereavement occurs? What’s the current procedure? Let’s just take the Army, because that’s probably most-

Julie McCarthy: In terms of notification, a notifying officer will be appointed. They will be a warrant officer or above, not a subaltern or a young captain.

Q67 Bob Stewart: There’s no release of names whatever until the family have heard?

Julie McCarthy: No. There’s Op Minimise in theatre, so that the name can’t get out, although we have had experience of the name leaking out for various reasons.

Q68 Bob Stewart: In theatre, you normally have a news black-out. You tell everyone they’re not to use their phones, right?

Julie McCarthy: Yes. There are no phones. The internet will go down. That’s Op Minimise.

Q69 Bob Stewart: I want to get through this quickly because we don’t have much time. The notifying officer approaches the house, where there will normally be a wife, whether she’s on base or not.

Julie McCarthy: Or a parent. It’s whoever is the emergency contact that the soldier has left.

Q70 Bob Stewart: The next of kin on the next-of-kin form. Who goes to the house?

Kim Richardson: It’s not necessarily the next of kin.

Julie McCarthy: No, it may not be the next of kin; it’s the emergency contact.

Q71 Bob Stewart: I understand: it’s whoever the soldier, sailor or airman designates. Who goes to the house?

Julie McCarthy: The notifying officer.

Q72 Bob Stewart: On his or her own?

Julie McCarthy: No, there are two, I believe. They may be male or female, but they will have been trained to visit people. They will go to notify the person and will stay for a short period and then the Visiting Officer takes over. So they’ll see that person only once and it should not be a person who is very close to them.

Q73 Chair: It should not be.

Julie McCarthy: It should not be.

Q74 Bob Stewart: The notifying officer is normally a stranger. Are they normally with a Padre?

Julie McCarthy: It can be a Padre.

Q75 Bob Stewart: Or a families officer.

Julie McCarthy: No, it wouldn’t be the unit welfare officer, because they will then have contact. When the husband of a previous staff member of ours was killed, her emergency contact was taken-her notifying officer contacted her friend and took her to make sure that she had support.

Q76 Bob Stewart: And that person is then responsible for notifying the family? Who goes on to notify the family, if the emergency contact is not the family?

Julie McCarthy: I believe that’s the notifying officer, the Visiting Officer-it will be the unit. I think that’s a question for the MoD.

Q77 Bob Stewart: So the first person is there, and that happens. I’ve done it, so I understand. Normally it’s quick; someone goes in, says, "I’m very sorry, Mrs Smith. Brian has been killed." She collapses. Who comes and looks after her?

Dawn McCafferty: The Visiting Officer and the Padre.

Q78 Bob Stewart: The Visiting Officer is right behind, immediately?

Julie McCarthy: They should be, yes.

Q79 Bob Stewart: And the other person clears out.

Julie McCarthy: Yes.

Q80 Bob Stewart: The real question is this: for how long are bereaved families looked after from then onwards?

Kim Richardson: I have to pick you up on this. You said, "Go to Julie because it’s an Army issue." It’s not an Army issue.

Q81 Bob Stewart: I know. I said that because it’s more-I’m sorry-

Kim Richardson: No, it’s not more. The other two Services feel very sensitive, and this is something that I would like you all to pick up. It is not just the Army in Afghanistan losing people; it is the other two Services as well. It is one of the things that our families feel very strongly about, so I hope you don’t mind, but I need to say that.

Q82 Chair: You need to say that. And the Royal Marines-there were more Royal Marines in Afghanistan at one stage than there were people from the Army.

Dawn McCafferty: Can I just make this point, as well? I know this is focused on operational deaths, but actually a death is a death. If your guy has just been wiped out in a motorbike accident, it is exactly the same process, in terms of notifying and support.

Q83 Bob Stewart: I entirely agree. We are just talking about procedures here, and I am going shortly.

Kim Richardson: Each of the three Services has a slightly different way of doing it, and I think it would be helpful for the Services to explain it to you. For our Visiting Officers, they stick with families all the way through until the families determine that they want that to finish. Each of them does it slightly differently. It is not because that is wrong, but because they are tailoring it to what is right for our individual Service.

Dawn McCafferty: The guidance from the RAF is that the Visiting Officer will be that key link for a good six to eight months, and then might try slowly but surely to withdraw the support. If the family need him or her, however, they will be back there, particularly if there are things such as Inquiries and Inquests to take them through, which might be two years downstream.

Q84 Bob Stewart: Forgive me, but the Army was not very good at it. Maybe the RAF and the Navy are better at it. I am not trying to point-score; I am just trying to ascertain the system. The question really is: how long do people get proper support?

Kim Richardson: For the Navy, as long as they want it.

Dawn McCafferty: I would say the same for the RAF.

Julie McCarthy: That is notwithstanding the fact that specialist support may be required, which is not immediately forthcoming, such as if young children were involved. Sometimes specialist counselling and advice are needed, and again, we are relying on families going out to look at the charitable sector. Winston’s Wish is doing a lot of work with the military at the moment particularly to address children who are bereaved. There is very practical support, but emotional support such as counselling is an area that we need to look at.

Dawn McCafferty: We have examples as well of the RAF Benevolent Fund, for example, helping bereaved families to purchase a house and funding education for the children, either ordinary schooling or university. The support can still be in place years after the actual bereavement, so it is an enduring support, but it is very much guided by what the widow or the widower and the family want.

Bob Stewart: That is good, isn’t it?

Dawn McCafferty: Gone are the days when you would say to a family that you were withdrawing support at too early a stage.

Q85 Bob Stewart: What about money? I am so sorry to ask embarrassing questions, but one of the key things that people always panic about is money. I will be brief; for example, who pays for the funeral?

Julie McCarthy: The MoD.

Q86 Bob Stewart: What happens if the family say that they don’t want the MoD to pay?

Dawn McCafferty: A grant is made towards a private funeral.

Q87 Bob Stewart: What happens if the family say, "We don’t want you to identify that my son has been killed, by an MoD spokesman saying so"?

Julie McCarthy: If the family ask that the name is not released, it will not be released.

Q88 Bob Stewart: No; if the family say, "We don’t want the MoD to release the name. He’s ours; we will say."

Kim Richardson: I think if the family ask for something, everyone will bend over backwards to accommodate it.

Q89 Bob Stewart: I have not seen that happen; it has always been an MoD spokesman. I would think that if it were my boy, or my girl, I would say, "Why the heck?"

Kim Richardson: I don’t think our families are very comfortable challenging systems, often. You have an independent serving person, who goes away and may not contact the family from one month to the next, and all of a sudden you are making decisions for someone who has lived an independent lifestyle. You do what you think is best. A lot of families gain a lot of succour from having that support from the Service. I can’t speak on behalf of the Service, but I would be very surprised if a family said to the Service, "We want to do it in this particular way," and the Service said, "You can’t, because we want to do it our way."

Q90 Bob Stewart: The biggest problem is who to identify, because of the system, isn’t it? I mean, how far do you go out telling people, and what is the responsibility of the Service to tell extended family?

Julie McCarthy: Having spoken to the aftercare cell for the Army yesterday, their responsibility is the emergency contacts, and that is it. They will, however, make every effort. They have instances where they have appointed three Visiting Officers, because they have visited a spouse, and she doesn’t speak to the in-laws, who are divorced and don’t speak to each other.

Q91 Bob Stewart: Or a common-law wife.

Julie McCarthy: Absolutely.

Q92 Bob Stewart: This is a serious problem, which, of course, is impossible to solve, isn’t it?

Julie McCarthy: You never get any policy that addresses every make-up of family and allows that flexibility.

Bob Stewart: I don’t want to run this all the way down, because the Chairman has told me that I have to shut up.

Q93 Chair: I have not told you to shut up, but I do know that you have another engagement that you have to move on to. We haven’t been rushing through this because it is, in any sense, an unimportant issue. It is probably one of the most important issues that we face.

Dawn McCafferty: One support area that hasn’t been mentioned yet in terms of the bereaved is the Widows Associations. They have an important role to play in terms of a neutral support group. Each of the Services has one. They are there because they have lived and breathed it themselves. They offer a unique support network to those who wish to use it. It may be that newly bereaved are not comfortable joining in the first few months after the bereavement, but further downstream, they might welcome that support. That is a really good thing to have for the people who are bereaved and, indeed, the children. Again, SSAFA is doing some great work with some support groups for bereaved families and siblings, and, again, we are leaning towards the charity sector, but there is some great stuff happening there, and that support will be enduring.

Q94 Bob Stewart: Can I just put one thing on the record that I want your reaction to? I think that the Elizabeth Cross has been an outstanding success. What is your reaction?

Julie McCarthy: You are absolutely right.

Bob Stewart: It is the most wonderful thing that the previous Government brought in, because widows and families wear it with real pride.

Q95 Chair: By the way, while Bob Stewart is still here, he said that he didn’t think the Army did this very well, and I think he was speaking as an Army man. What is your view?

Julie McCarthy: I think that the Army have improved massively.

Bob Stewart: I am old hat.

Julie McCarthy: The Army are absolutely desperate to learn from their mistakes, and they review policy regularly. I am happy that they will do their best. If something falls down, it is because of the family situation, not because of policy.

Q96 Bob Stewart: One of the problems is that you must identify the people who will actually do the visits, and in a very small Service it is difficult for them to do it.

Julie McCarthy: What we find is that, if you look at somebody, perhaps the Rifles, who have lost a huge number of men, they would very much like to provide somebody from within the Regiment, who understood the Regiment. One of the bones of having a family Regiment is that if you want your Visiting Officer to be of that Regiment, that has a huge impact, and they are now looking to go out again.

You mentioned money. The Army Dependants’ Trust is a membership organisation that, within 24 to 48 hours of a death, whether operational or non-operational, will pay a grant of up to £10,000 to families to alleviate immediate financial concerns.

Q97 Bob Stewart: That is non-returnable.

Kim Richardson: Absolutely.

Julie McCarthy: It doesn’t have to be spent on anything in particular. The money is given to the family to alleviate financial concerns.

Q98 Bob Stewart: That was one of the biggest worries in my time. I was panicked about how much money these people would get.

Dawn McCafferty: The other concern that the immediately bereaved will have if they are living in quarters is, "Am I going to be kicked out very quickly?" Again, things have moved on to give them the reassurance that, pretty much, that quarter is there certainly for the foreseeable future through to a good two years out. By that time, they will hopefully have made that transition themselves, and many of them move out of quarters before that point. Even at the two-year point, if that family still feel the need, they will review that with the Service.

Q99 Bob Stewart: They want to be in a community that they know.

Dawn McCafferty: I think so. For those who have lived within that community, moving out is almost another bereavement, because they have to leave that other family behind. Again, there is a real sensitivity from Defence Estates and the chain of command about making the family feel that they are not being rushed. This isn’t something that is going to happen overnight. They are saying, "Take your time, make your plans, and we will support you as you transition out." That has changed dramatically since my early days in the Air Force.

Chair: This is all extremely good to hear.

Q100 John Glen: I have two observations about what you’ve said so far. You seem to be very loyal to each other, in that you are all doing similar things. You also observed, Julie, the experience that our troops have, in terms of being aware of a different offer from what American troops might achieve. I was wondering if you could explain what the drivers are of different expectations between the Forces. You seem to be saying that, broadly speaking, you all deliver about the same. But are there any tensions? Are you aware of specific best practices that the others have that you can’t have because of any constraints? Also, do you not think it would be better for there to be one offer that is the same? When somebody is bereaved, why would there be a different expectation from different Services, given that bereavement is bereavement?

Dawn McCafferty: I wouldn’t like to try to explain the different culture and ethos of the Services, but the reason they have evolved differently is that the light blue look after the light blue, the khaki look after the khaki and the same for the dark blue. The terminology that we use is different. For example, if we were asking an Army unit welfare officer to look after a bereaved RAF family, they potentially would not know what a unit welfare officer was because they don’t use that language. They are very comfortable being supported by their own Service. People have the feeling that that is the Service they belong to, and that is the Service that will look after them.

We could have a tri-Service casualty informing process and a tri-Service pool of Visiting Officers and say that anybody in any uniform could go and visit any family, but I’m not sure that would work. People have a very strong bond not just to their Service, but right down to squadrons and units. That is why local support where possible from a Visiting Officer from that unit is important. The chain of command and the parent unit of that family are critical to that ongoing care for the next couple of years-from organising the funeral to support networks and engaging with the charities. If that were in some way centralised and harmonised, we would lose out somewhere along the line.

Chair: Yes; particularly at a time of bereavement, you’ve got to get it right.

Kim Richardson: Each of the Services has a slightly different structure. Our welfare set-up is different from Dawn’s and Julie’s. It is about each of the Services using the resources that they have in a way that they think works best for their people. It is good for a Royal Marine to have a Royal Marine Visiting Officer, and it is even better for a Royal Marine’s family. It is about using your own resources.

Julie McCarthy: There should be minimum standards across the board. Everybody should expect the same.

Q101 John Glen: Do they exist?

Julie McCarthy: I think they do. In terms of treatment for injuries and bereavement, we don’t hear that that is one of the areas about which people say, "But the Navy or the RAF get it." As far as they can, people give a top-class service.

Q102 Mr Havard: We are trying to cover all the categories. We’ve done bereavement, rehabilitation and leaving the Service. Can I ask you some questions about people who have a problem-an accident or whatever-and return to Service? Could you say something about the adaptations or things necessary to rehabilitate someone back into Service life? How does that process work with families?

Kim Richardson: I have not seen any evidence that the Service hasn’t made it work. Sometimes the serving person needs some time to determine what is going to be right for them. That is a good thing. Some serving personnel feel that they are going to return to the Service and then perhaps realise that it is not necessarily right for them. I go down to Hasler Company in Devonport.

Mr Havard: The Chair has told me not to ask you about that.

Kim Richardson: We would be here for another hour because I think they’re fab. I go down about every six weeks to talk to the lads in Hasler Company about everything and anything.

Q103 Chair: They are the Marine trauma unit, are they?

Kim Richardson: They are not just Marines; the Navy can use it and it is being opened up to the other Services as well. It’s a recovery pathway and is where they get together. It is predominantly Royal Marines at the moment.

Q104 Mr Havard: It’s sort of self-sustaining and self-supporting.

Kim Richardson: Yes. So they come out of their unit and it becomes their unit. I have contact with Royal Marines who are in a position where they are not-

Q105 Mr Havard: Are these largely people who are making this very transition of getting back into Service activity?

Kim Richardson: Yes.

Dawn McCafferty: There is a process that certainly the RAF will go through. The medics will take the lead on assessing to what extent the injured individual can return to work and determine what fields of employment they are still able to do. That information will be passed to the manning staff who will determine whether there are opportunities for the individual to be still employed. As Kim said, we do not have evidence that that is not working well. If, en route, adaptations are needed to Service families’ accommodation, a process is now in place to work with Defence Estates. It might not be the quickest way of getting things done, but at least a process is in place to make it as smooth as possible.

Q106 Mr Havard: How does that work if they are not in Defence Estates accommodation?

Dawn McCafferty: There is even a protocol in place now to do adaptations to private homes, such as a parental home to which a single guy is returning after he has been injured and has to be discharged from the RAF. He can have his family home adapted so that he can return with whatever disability he might have.

Kim Richardson: The biggest challenge is for those who would like to stay but cannot-for whatever reason. For the serving person and the family, that might be something that they had not considered. They probably have the biggest challenge.

Q107 Mr Havard: Is the Army experience different?

Julie McCarthy: I am similar, in that we do not get a lot of that. As far as I know, that is what the Army Recovery Capability will pick up

Q108 Chair: What have you heard about that?

Julie McCarthy: The units will assess the care pathway as they go along, and whether that person will return to Service. They will establish at what stage they would do that, or whether they were transitioning out, and ensure that they and their family are equipped to do it. My concerns are about adapting houses with perhaps a reducing estate and pressure on budgets. I would like to make sure that we maintain a quick turnaround in the adaptation so that people can get back home and start living as normal a life as possible.

Q109 Mr Havard: Have you had any, "Well, he is pretending that he is getting on with it when he is not really getting on with it," from the families?

Julie McCarthy: We have not, but that is not to say that it is not happening.

Q110 Mr Havard: The family might be affected differently from the individual.

Julie McCarthy: Absolutely.

Q111 John Glen: I have a couple more questions. Let us consider one year after discharge from the Forces and mental health issues. One of the concerns that has arisen is that there is no attempt then to understand where people are at. Do they receive more assistance? Do you have any understanding of what happens post-discharge and whether there is assistance to the person’s mental health and for the families?

Dawn McCafferty: As far as I understand it, the SPVA has a requirement to make contact with the Service person-if not at the year point, then a two-year point after they have left-to check how they are doing and if they have particular needs in any area. Whether or not that is happening on a regular basis, I do not know. You would have to ask the SPVA.

Q112 John Glen: Do the families get in touch with you and say that they have mental health issues that they did not know about a year previously?

Dawn McCafferty: Not on mental health issues. Families, and indeed ex-Service personnel, come back to the Families Federation once they are out if they have been in touch with us during their Service. We do not tend to deal with the veterans’ issue so much. We signpost veterans on to SPVA, SSAFA, the RAF Benevolent Fund or the RAF Association, whichever we feel is appropriate. We just then monitor and make sure that they have linked up with the right people, but it is not really our area. It is not what we are here to do. We are here to represent the serving and families of the serving. It sounds callous to say that we draw a line and say, "No," but so many other organisations look after veterans that we have to draw a line somewhere.

Q113 Chair: Are you aware of any problems with the Armed Forces Compensation Scheme or with its administration? I am not asking you to tell me if there are lots. I am just asking whether there are any.

Kim Richardson: The whole process under Lord Boyce was very good. I welcomed the opportunity to be there representing all three of us because that was quite a step forward. I welcome the findings. There is still some ongoing work. Professor Sir Anthony Newman Taylor’s work is very welcome because he is focusing with his independent medical experts group on things such as hearing loss and genital injuries, which need extra work. I would like to see that continue, and I’d like to see him and his medical experts stay in place until well after we’re out of Afghanistan. I think it would be appropriate for that to happen.

So, the Armed Forces Compensation Scheme, as a concept, is doing a good job, but the process takes too long. After going to Hasler Company, I know that the position of some of the lads down there is that they are reaching a point where they will possibly be transitioning out of the Service, and they do not know whether they will get money, and if so, how much that will be. That adds extra pressure when they are trying to plan for leaving the Service or deciding whether they will stay. There is an aspiration or a request from serving personnel that they would like a dedicated point of contact in the SPVA so that they have some continuity. Once they have filled that paperwork in, they know a name, and the SPVA will keep in touch with them.

People also have some concern-and we are back to medical records again-that everything that they have experienced and the injuries that they have are completely recorded on their medical records. I have been asked on several occasions why personnel have to complete paperwork, and why they can’t physically sit in front of somebody and start their claims process with them. I realise that there is a huge resource implication for that, but I wonder whether some sort of sample testing should take place. One in 10 people could actually sit in front of somebody independently, who says, "Right, you tell me what happened to you, and let’s make sure that it correlates with what we’re seeing in the medical records and what you’re claiming for." So, among personnel who are claiming, there is a sense of nervousness about the process and how it takes place. That comes back to how many different methods there are of recording medical information.

Another aspect of the Armed Forces Compensation Scheme, which is a side issue, is that some of these young lads are being given huge wodges of money, and they are going out and spending it on fast cars, for example. Should we be considering financial advice and offering it to them when they are in receipt of what are big sums of money?

People talk about the scheme. It is a subject they discuss, and I’m sure that if you are even considering a visit to Hasler Company, they would tell you exactly what they think about it. They compare notes and they compare injuries. It is a topic for discussion. The principle is good, but I think we could be doing better. That would be my feedback, direct from the people I’ve been speaking to.

Q114 Chair: One quick question. I mentioned alcohol before, and the fact that there is more of a problem with alcohol than there is with PTSD. Is that something that the Armed Forces Compensation Scheme should be looking at? It doesn’t at the moment, because alcohol is considered to be a matter of personal choice, but is it something that should be an issue for the Armed Forces?

Kim Richardson: I don’t know how you determine whether somebody comes back from operation and drinks more. How is it decided whether they were doing that to the same extent before they went? I’m not sure how you would manage that.

Chair: It is difficult.

Kim Richardson: Hearing loss is something that is close to my heart, and I am not even convinced that our personnel have a benchmark or a standard for hearing before they go to Afghanistan. Are we benchmarking their hearing properly before they even go? How do you determine whether somebody comes back and has a drink problem?

Q115 Chair: I think we are, aren’t we? You have to pass a medical before you go.

Kim Richardson: You do, but I would ask whether it is doing what it says on the tin. That is the question I would ask, because I have been led to believe that that is not necessarily the case.

Q116 Mr Havard: So you are saying that there should be a proper audiometric test that is recorded, with a graph, rather than somebody banging the old tuning fork and asking questions.

Kim Richardson: I do, because it is acknowledged as being a problem. It is difficult to determine how you will make an award for hearing loss-tinnitus is a problem. That is why this extra work by Professor Sir Anthony Newman Taylor is so important, but if you haven’t got something to start with, it makes it even more difficult to come out with a firm diagnosis and put people into the right categories.

Chair: I warned you that it was going to be a catch-all question.

Q117 Penny Mordaunt: As the Chair said, we will do further inquiries, so this is your opportunity to flag up any specific issues that you are concerned about or that you want to make us aware of-the cumulative effect of things, for example, or how morale is.

Julie McCarthy: I shall mention two. On the bereavement side, I would like to see greater advice for our Service personnel on putting their wills together. Too many of our Service personnel are going out on ops without a will. There was the case of Lucy Aldridge whose rifleman son was killed and she was given his death-in-Service payment. She was on invalidity benefits, which she has now lost, and she feels that she is wasting the money that her son left and isn’t able to give it to his two half-brothers to help them in the future. She has lost her benefits when a very simple provision in his will of a discretionary trust could have solved that. I would like to see the MoD forms revised, which I know they are looking at, and solicitors being made much more available to our young personnel, who think they’re invincible and are not going to be killed. It should be much higher up their list of priorities to look at their family situation and write a proper will before they go on ops.

The other thing I would like to see relates to the Military Covenant. A very strong arm in the diagrams I have seen of the Military Covenant is the terms and conditions of Service for our Service personnel. I feel that these are being eroded, with no union representation, and that very much affects us as families, not least because of mobility. We are largely single-income. I have not been able to start a pension. I spent seven years in Germany when I couldn’t, and have never caught up. I feel that, in terms of the Military Covenant, we should be looking much harder at what people are given. Is it fair? Do we label Service personnel and families under a misconception that we are badly done to, or are we actually very well done to? I would like more light shed on that.

Kim Richardson: I have a couple of points. I know that some of the lads I have spoken to have taken out insurance with PAX or Service Life Insurance-those sorts of things-and when they have got down to the nitty-gritty and had the conversation about what they think they’re going to get, it is actually nothing like what they thought they had taken out. I would welcome some questions being asked about how those processes work, because they are being taken out with the best intentions. I spoke to a young chap who said, "I thought if anything serious happened to me, my family would get £250,000 and I would be able to buy a house and sort them out," but when it comes down to the bottom line, it is nothing like he thought.

The other thing is that you have engaged with us and asked us, but if there are any ways and means to engage with the families and people who are ready to talk to you, I would welcome your finding some way of doing that. They are not always asked for a view; you would find they would give you very good feedback if they were asked, but it is very much down to them when they choose to tell you.

Q118 Chair: How would we do that?

Dawn McCafferty: You could, for example, seek, if not oral evidence, then written evidence from the Widows’ Associations and ask widows for their views on how they were supported. They will have some stories to tell; hopefully, many of them good stories, because this is an area that the Armed Forces are really focusing on and getting better at, but there is always something they can learn. That would be a good area, as would be using SSAFA and the support groups that they have as a connection to families who have either been bereaved or have members who are seriously injured-through Hasler Company, for example; through Personnel Holding Flight with the RAF and the Army Recovery Centres-to see whether there is a linkage, through the chain of command links, to anybody who would like to contribute to your Inquiry.

As Kim says, we try to represent what the families bring to us. Hand on heart, I have to say that we do not have a great deal of evidence on our issues database from these particular groups. I have done my best to understand what the RAF is doing today because it is different from what it was when I was serving. The best people to talk about it are those in the chain of command who deliver the process, and those who are in receipt of it. Through the various support groups, you might get some really good evidence.

Kim Richardson: Could I make a plea? Could we differentiate between the bereaved and the families of the seriously injured? The families of the seriously injured find it quite difficult sometimes. We have a good website, RNcom, where bereaved families seek support and help from other people. Often, the families of the seriously injured feel that they have got their person and they are not in the same place as the bereaved family. Their experiences will be quite different and, in some ways, more illuminating for you than those of the bereaved families. We need to keep them as very clearly defined groups with their own needs.

Dawn McCafferty: You might also-I don’t know whether the chain of command could help facilitate this-get feedback from the Visiting Officers who have carried out the role because they are living and breathing this with the families of those who are seriously injured or the bereaved. Their experience of trying to deliver this might be a useful indicator back to you of where it is going really well and where things might be enhanced from their perspective. The Visiting Officers do regular reports back to the chain of command on any issues that they have come across with their families. Perhaps you could ask the chain of command to pull this together to identify any key themes. I am sure that the chain of command would be giving that sort of evidence anyway.

I see the Visiting Officer as such a key player in the delivery of this. Their experience of what they are being asked to deliver will provide some really good evidence. For example, is their training good enough? Did they come across any problems? Are the families feeding back to them?

Kim Richardson: Are you going to talk to SPVA? It might be interesting to hear its perspective and how it feels that it is delivering.

Q119 Penny Mordaunt: Just a comment following on from that. Mrs Richardson had previously mentioned to me about Members of Parliament visiting family days. Would that be a welcome thing for a body such as this Select Committee to do?

Kim Richardson: We said that we would take you out on board a ship with a group of families. It is not quite warm enough to be doing that yet, but it is on our radar. I am sure that that will be a welcome way of getting a very different perspective. We don’t have many ships now to take you out on, but we will do our best.

Q120 John Glen: Slightly linked to that, the SDSR threw up some issues around basing and the bases review. As a member of the Family Federation, how are you preparing for potential significant moves of troops back from Germany or just generally? Have you been consulted on such things?

Julie McCarthy: Not as yet. The Services themselves are still trying to work it out, given the big picture. Hearing that half will be out of Germany within five years is a shock, particularly to Germany. We have a conference in Germany in June and that is when the families will be hoping that the chain of command, including the General, will be there. There are a lot of questions. Families are just really uncertain about the future. They want some answers. They want to know-it does not matter whether it’s good or bad news-what is going to happen five or 10 years down the line.

Dawn McCafferty: From an RAF perspective, we are waiting for, hopefully, an announcement in June of when the next base closures will be confirmed. There is a media feeding frenzy going on out there in terms of campaigns-for this unit not to be closed or that unit not to be closed. That has a huge impact on the families living on that base, because they will be hoping that their unit will be spared the axe. It will be good to have, as soon as possible, certainty over which RAF bases will close as part of the Strategic Defence Review. Then we will help the families cope with that transition.

The redundancy package is something that we must keep an eye on-exactly how many people are applying and how many people will be made compulsorily redundant. There is so much going on at the moment with the families. We are just trying to keep a weather eye on what is happening and keep in touch with the MoD or the RAF. We are saying to them, "As soon as you have some confirmed information, pass it on. Use us as part of your communications strategy back to the families because we owe them clarity. We do not want them reading about it first in the newspapers or hearing it on the news."

Q121 Mr Havard: On several occasions, Kim, you have said that you felt that the experience of the families might be collected better than it is being collected-we have gone through different aspects. The MoD runs surveys and does a lot to try to capture information from serving personnel. Do you have any particular comments you would like to make, or are there things that you think should be happening in that area that are not happening?

Kim Richardson: I have recently become aware that we are perhaps not so good at asking people what they think, although it is early days. I am talking probably about the bereaved family, who can be taken up by the-

Q122 Mr Havard: Yes. You said that there may be different categories whose experience you want to capture.

Kim Richardson: There are. The bereaved families will be able to connect with widows associations, if they choose to do that. Some of the injured and their families are still going through a process years on, and I think we need to learn from that. I have met young people who are some considerable way down their line of treatment, but they still have a long way to go. There will still be an impact on that family. They are probably at a point where they may still have a connection with the Service but they think that perhaps their views are not views that would be as welcome now as they would have been at the initial injury. Actually, I think that they are more valuable, because what we are seeing is the pathway and where it could have been made better.

Q123 Mr Havard: Who should do that, and how should it be done?

Kim Richardson: There are ways and means. I think Dawn covered quite a few of them: engaging through Headley Court and Hasler Company, and telling people that if they have a view, we will welcome it.

Q124 Mr Havard: So there needs to be a continuous survey process.

Kim Richardson: I think so, and not even necessarily a survey.

Julie McCarthy: Just giving people the means, even if it’s a website.

Kim Richardson: They can come to us, but they might prefer to sit and type something at 11 o’clock at night. It’s about asking what would work best for them. Would they prefer to sit down and talk to somebody, or would they prefer to know that there is somewhere they can go where they can say, "You know what? We’ve had a really rubbish few weeks. This could have been better"? We could learn from that. I’ve learned a lot since I started doing this particular area of work from some really good people. It tells you that you don’t know everything, and we actually don’t.

Q125 Chair: I am conscious of the fact that we may have cut you off, Dawn, without asking you to give us your thoughts.

Dawn McCafferty: I think we have covered a massive amount of ground this afternoon. The focus of this inquiry is obviously on support to those who have been injured and bereaved. I think we’ve covered just about all the areas I would have wished to raise. My enduring message is that the RAF would agree that one size does not fit all. It is working really hard in this area at the moment, and has improved significantly since I was serving in the Air Force. I am actually very impressed with what I’ve been briefed on recently. I would like to think that it is a work in progress that will be taken forward. The staff are taking it very seriously, and I would commit to anything that we can do as a Federation to support the chain of command in delivering it.

As well, my message is that this is not just about the here and now-it is about the long term. That is where it cuts across from the MoD into the transition protocols and Government authorities. It goes into the Department of Health and also into the charity sector. That is the area in which I have less confidence in the long term. At the moment, there is some fantastic work going on, but, as Julie pointed out, some of those charities may not survive in the longer term. If they are the main support to a family or an injured Service person, when they fall over, what is there for them? There has to be a safety net.

I think it’s about long-term support. It’s about the transition, and I think as well a focus on where the boundaries are between all the different players, and trying to get a little more clarity there so that everybody understands what they can bring to the party. Hopefully, everybody is working to the same agenda, which is to give Armed Forces personnel and their families the best support that we can.

I was asked in a radio interview just yesterday why we should be putting in all this effort. If somebody is injured and they are in an ordinary civilian organisation, why would we not want to give them the best support? I think this comes back fundamentally to the Covenant. It’s about the unique nature of Service life and the sacrifices that we ask our people and their families to make. That is where we can stand up and say, "There is a real need here. We need to live up to that and deliver as best we can." There is a difference.

I would like to emphasise that all of us would back up how very special the families are who we represent. We are very pleased and privileged to be allowed to come to this sort of gathering and represent some of the views that they bring to us.

Chair: What a wonderful closing statement. I won’t add to it, except to say thank you very much indeed. It was fantastic.