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UNCORRECTED TRANSCRIPT OF ORAL EVIDENCE To be published as HC 762-vi
HOUSE OF COMMONS
TAKEN BEFORE THE
THE MILITARY COVENANT IN ACTION? PART 1: MILITARY CASUALTIES
WEDNESDAY 7 SEPTEMBER 2011
SUE FREETH, KEVIN SHINKWIN, BRYN PARRY and JEROME CHURCH
Evidence heard in Public
Questions 407 - 473
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Taken before the Defence Committee
on Wednesday 7 September 2011
Mr James Arbuthnot (Chair)
Mr Julian Brazier
Mr Jeffrey M. Donaldson
Mr Dai Havard
Mrs Madeleine Moon
Ms Gisela Stuart
Examination of Witnesses
Witnesses: Sue Freeth, Director of Health and Welfare, Royal British Legion, Kevin Shinkwin, Head of Public Affairs, Royal British Legion, Bryn Parry, Chief Executive and co-founder, Help for Heroes, and Jerome Church, General Secretary, British Limbless Ex-Service Men’s Association, gave evidence.
Q407 Chair: Welcome to the Committee. As you know, our inquiry is called "The Military Covenant in action? Part 1: military casualties". We apologise for keeping you waiting; I am afraid that we were disrupted by a Division, but these demands of democracy happen from time to time. They may even happen during the course of the evidence session, but we hope not. May I invite you all to introduce yourselves and to say what you do?
Sue Freeth: My name is Sue Freeth, and I am the director of health and welfare at the Royal British Legion.
Kevin Shinkwin: I am Kevin Shinkwin, and I am head of public affairs at the Royal British Legion.
Bryn Parry: I am Bryn Parry, and I am the co-founder and chief executive of Help for Heroes.
Jerome Church: I am Jerome Church, and I am a member and general secretary of BLESMA, the British Limbless Ex-Service Men’s Association.
Q408 Chair: Could you set out very briefly, in a couple of sentences or so, what each of your organisations does, perhaps contrasting it with what other organisations do?
Sue Freeth: The Royal British Legion is well known in a number of areas. It represents and campaigns on behalf of the Armed Forces community. It is the custodian of remembrance and is the organisation responsible for the Cenotaph and remembrance services around the country and, more recently, even virtually. We also have very large health and welfare programmes, so we run a large number of welfare services. We support serving personnel, their families and, of course, veterans and their dependants. We are the largest organisation and provide a wide range of services, but those are also complemented by a number of organisations that we fund in the ex-Service sector. We provide grants, homes, and breaks, and case management for liaising between individuals and the services that we and other charities have. We now work quite closely with a number of other large charitable organisations to tap into their services, so we have a strategic partnership with the benefits and money advice service to enable people to have their money, benefits and debt sorted out. A very wide range of services are provided by the Legion.
Q409 Chair: What proportion would you say goes to serving personnel, as opposed to no-longer-serving personnel or to families?
Sue Freeth: It has increased over the last five years. I would say approximately 20% of our casework is around supporting either serving personnel or, particularly, their families. Surprisingly, over 50% of our work is actually now supporting people who are of working age. That is a significant shift that has really occurred over the last 10 years, and particularly the last five years.
Q4010 Chair: Is there anything that you wish to add to that, Kevin Shinkwin?
Kevin Shinkwin: I would only add that, regarding the covenant, we are just incredibly grateful to members of the Committee and, indeed, Members of Parliament and Members of the House of Lords for their support for getting the principles of the covenant enshrined in law. I would really like to take this opportunity to put on record our sincere gratitude for that.
Q411 Chair: Thank you. Bryn Parry, you appeared before the Armed Forces Bill Committee, but I do not think that you have appeared before this Committee.
Bryn Parry: No, I have not.
Chair: Welcome to this one.
Bryn Parry: Thank you.
Q412 Chair: Tell us about Help for Heroes.
Bryn Parry: It was founded in 2007 as a direct response to hearing about the casualties in both Afghanistan and Iraq. We have wide objectives, but we currently choose to focus on what we call the current wounded, injured and sick, so there is no difference there-the people who are affected by their Service. Typically, that is post-9/11. The vast majority of what we do is for the serving, but, obviously, as people are now transiting into civilian life, we are starting to pick up more cases of young veterans.
Q413 Chair: So you do not actually have a dividing line that says that you do not deal with one or the other.
Bryn Parry: No. We promote and protect the health of those who have been wounded or injured while serving in the Armed Forces by the provision of facilities, equipment and services. Then we can also look after people and their families, and anyone, actually, who is under the command of the Armed Forces, so it would work for people who have been injured while being a journalist, for example.
So far, we have raised about £108 million, and we have given out in grants-either spent or allocated-about £100 million, all for direct and practical support. The first task was to provide a rehabilitation complex at Headley Court-the swimming pool complex. That was £8.5 million. We have then gone on and given grants to various different charities, including SSAFA, BLESMA and St Dunstan’s, and we have a number of capital projects with them. We are now working with our partners in the Royal British Legion on the recovery process; we are creating recovery centres around the country.
Chair: We will come on to that later.
Bryn Parry: We also have a fund called the Quick Reaction Fund, and another called the Individual Recovery Fund, where we are looking after individuals and working in partnership with the benevolent funds of the respective services. We are doing both capital projects and individual support.
Q414 Chair: Thank you. Jerome Church.
Jerome Church: We are one of the specialist charities formed after the first world war, and we are very focused on prosthetic issues, among other things. We are a membership organisation, a sort of fellowship of shared experience-I have to say, a group of individuals with a certain perverse pride as well. Despite our name, we are men and women, in Service and ex-Service, and always have been, but we cannot tell our membership to change the name, because they like it. We provide, through, I suppose, a social network and a more professional approach, a well-being service for our people-a very good welfare service that focuses on every aspect of welfare.
Rehabilitation has become increasingly important-rehabilitation through life. We work with other charities and with Help for Heroes on that area. We have always focused on prosthetics issues. I think the country’s prosthetic service has basically grown up with BLESMA after two world wars, and I hope we are in the business of helping it to grow substantially again, in technique and expertise, over the next year or so. We also respond to issues as and when they arise. For example, we have been very closely involved-pretty effectively, I think-with the review of the Armed Forces Compensation Scheme. I sat on Lord Boyce’s committee. We are still very involved with that on an individual basis, which leads me to the last point, which is that we represent our members individually, whatever their needs are, dealing with authorities in whichever area-national or local. We represent them collectively wearing our campaigning hat, as we did on the Armed Forces Compensation Scheme and as we are presently doing, with the help of Help for Heroes and my COBSEO colleagues, on Dr Murrison’s report into prosthetics, which we are awaiting.
Chair: We will come on to that as well. We have a group of questions about the relationship between the Ministry of Defence and charities. We will start with Jeffrey Donaldson.
Q415 Mr Donaldson: Thank you. In its memorandum to the Committee, the MoD recognised that there has been a step change in the charitable funding offered to the Armed Forces. It had initially not co-ordinated the facilitation of such offers well. How would you assess the performance of the MoD in working with each of your charities?
Sue Freeth: Would you like me to start? Collaboration between the charitable sector and the MoD has a long history. Headley Court and the organisations here have a long-standing relationship with the MoD. Over the past five years, and particularly in the past couple of years, there has been much greater encouragement and involvement. I think it is only just beginning to bear some fruit; we need to give it some time to see how well that develops. At times, there is a reluctance to engage with the charities in a co-ordinated way, as you say, and perhaps to engage with them early enough in identifying problems and looking at potential solutions. I definitely think that at the moment we are certainly willing-and I know colleagues in the ex-Service sector are willing-to look at how we can complement some areas of operation that are really outside the core business of the MoD, and use the skills, experience and expertise of the charitable sector better-better than we are doing now. I feel positive about it.
We would want the MoD to be encouraged to see us as professionals, and as able to provide some of the things that perhaps traditionally it saw itself as needing to provide, while not diminishing the responsibility for it to be there. I feel positive about it. I think the Legion is making a contribution to making that happen. We would like more openness, more transparency and more engagement earlier.
Bryn Parry: I came to this from a small business background; I didn’t have a charitable background at all. When my wife and I started the charity, we found it extremely difficult to work with the MoD, and to understand it and with whom we had to deal. The first three years were complicated, and I felt that we were treated with a certain amount of suspicion, perhaps. Perhaps we were almost looked upon as an irritant, or as outsiders trying to interfere, when in fact our motivation was simply to help. However, it was very difficult to find a simple conduit-a way of helping-for our desire to help. Initially, we met the Chief of the General Staff, General Sir Richard Dannatt, and I understood that we were given a task, which was to fund the swimming pool and rehab centre at Headley Court. We then went through a long process to try to get that in place.
I found the first couple of years quite complicated and difficult. This year, we finally have a single point of contact up at defence level, and we sit on the defence recovery steering group every two months. I can talk directly to a two-star at defence level, who is nominated to be my point of contact, which is extremely helpful. Whenever I have an issue or I hear something, I can ring him up, and it is working very well. I would ask for that role to be expanded within the MoD to make my life even simpler, but certainly, since Christmas 2010, things have improved dramatically by having that point of contact.
Q416 Mr Donaldson: Do you think that the MoD is sufficiently well equipped to manage the additional funding that has been generated by charities’ activities? You referred to expanding the interface with the MoD; have you any particular thoughts on that?
Bryn Parry: I think it is not the MoD’s fault that it is used to looking after its own, and likewise, regimentally, everyone looks after their own. An awful lot of people believe that they are doing the right thing, and that it is their responsibility to do it. I can completely see where it comes from. When you have an extraordinary amount of public support, which, in turn, provides an extraordinary amount of extra funding, it is very important that that is properly targeted and directed. That targeting should not be decided by people like me, who are ill informed. It should be the decision of experts, whom I would take to be the MoD. In an ideal world, I would be working on a series of targets or projects. That is what I always wanted. I ended up finding that I was second-guessing, because there appeared to be a vacuum of ideas, so instead of working down a list, I was creating one.
Now, we have the beginnings of the three Services, and their principal personnel officers, looking at lists of what they want to do, then bringing that up to the defence recovery steering group. They sift through and decide what they think could, or should, take third-sector support. Ideally, that is then passed out to the third sector. I do not believe that we should be working in parallel; we should be working in partnership and support. I would be very interested to see that area developed.
Q417 John Glen: Bryn, can I focus on your evolving relationship with the MoD? You said that, initially, it was complicated and difficult, but that the single point of contact has made it much easier. Over three or four years, no doubt you have had considerable interaction with many aspects of the MoD. Can you identify for us, in a bit more depth and with a bit more colour, perhaps, what you think some of the barriers were? There is the cultural barrier, in terms of its inherent capacity to do what it does, and there is a shift in mindset, but what are some of the practical issues that existed and have been overcome? Secondly, what remains that still grates? You may now have a point of contact, but, no doubt, the whole of the MoD has to respond to whatever you push in through your point of contact. There must still be some barriers remaining.
Bryn Parry: Yes. The point of contact gives me one entry point, as opposed to trying to work out who to talk to. So, if I-or we-have an issue to do with housing or prosthetics, instead of having to try to find out who to talk to, you simply go to that one, and they put you in contact, or they chair the right person. That is a great step forward.
Our difficulties were that, possibly, we were seen as highlighting that there were gaps in what the MoD was providing, or was seen to be providing. There is a sensitivity that we were doing Government work, or were being seen to do Government work-or that Government could be held up to be accused of us doing Government work. Rather than us being seen as an emotional response to a feeling of helplessness-to meeting the young men and women who had been grievously injured, wanting to do something to help, and raising money and expecting to work in partnership-our offer of help was seen as criticism, or prospective criticism. It took an awful lot of time for me to explain to people that we were not criticising: we simply wanted to help. We wanted to help to best effect. It is very wearing to spend your time arguing that what you are doing is simply trying to help, as opposed to being seen as an irritant. Being called the grit in the oyster was one of the more polite things, but I have heard less polite things as well, if you wanted some colour.
John Glen: It always helps.
Bryn Parry: Inevitably, it was upsetting the status quo to some extent. There has been a realisation that first, we are here to stay and secondly, we need to work in partnership. Genuinely, I do not think the provision of support to members of the Armed Forces for life should be the total preserve of the MoD. Members of the Armed Forces, or people who choose to serve our Armed Forces, are the responsibility of all the citizens and all the taxpayers of this country. As a taxpayer, I am happy to do my bit towards supporting those people in the MoD. It makes me feel better, when my son or his friends are fighting, that I feel I can do something. I cannot prevent these young men from being hurt, but I can help them get better. That makes me feel better, and therefore I think we must allow that to be able to be there.
If we raise funds and raise support, that must be properly channelled to something worth while. We should not be given little tasks. Likewise, we should not be providing body armour or ammunition or medical support. We should be doing what they call the extras, the nice-to-haves. I feel very strongly, and I have not changed my tune in four years, that men and women who are prepared to serve our country deserve the very best, and I am prepared to do my bit to ensure that that happens.
Q418 Chair: Now, Jerome Church, do you want to add anything to what has already been answered on this question?
Jerome Church: No great detail, Chairman; I agree with everything that has been said. I have watched this change over 11 years; before then, most of the care for veterans belonged to different Government Ministries, and then I saw it come into the Ministry of Defence-the transfer of the War Pensions Agency and all that aspect. At the same time, we have always been closely involved with the medical services, for obvious reasons. I have to say, I have had terrific co-operation over these last few years with all those particular areas-the SPVA, the medical services and, of course, Headley Court. We had quite a lot to do with the provision of advice about prosthetics, which never used to be done by the Ministry of Defence. In my day, we just went along to the local limb centre and hoped for the best. Most of the time that worked quite well. All I am trying to say is that there has been terrific evolutionary change. The co-operation with officials-not just with senior officers, but also at official level-has been an extremely positive experience of late.
Bob Stewart: Doesn’t grit become a pearl sometimes?
Jerome Church: That’s the hope.
Q419 Bob Stewart: When the Ministry of Defence frees up all this space, in your collective opinion, would it be a good idea to put some of the charities into the space in the Ministry of Defence-COBSEO, possibly, and other people like that, such as your charity, BLESMA?
Chair: In the main building.
Jerome Church: We step into a slightly difficult and dangerous area when you start suggesting that charities should take a certain course. There might be a logic in it, but there are some compelling reasons, I suspect, why we would like to keep our independence, even among ourselves, all for the good. Don’t think we do not co-operate, but to have a sort of forcing house might be detrimental in the end.
Q420 Bob Stewart: Bryn mentioned a point of contact. You could have a COBSEO room.
Bryn Parry: Are you thinking that they would all have offices in there?
Q421 Bob Stewart: A sort of liaison office, at least.
Bryn Parry: There is value in liaison. We all value it, and there is great good in being independent and fleet of foot, and being able to manoeuvre quickly without having to go through process. That is one of the reasons why we have been successful in being able to deliver a lot of things very quickly: we are not hidebound by process. That, in many ways, has been one of the things that we have found difficult, because the MoD has not been able to react as fast as we can. Liaison is good, but to imagine floors and floors of charity workers all wearing grey suits and ties-I am very happy wearing my hoodie, sitting in my industrial unit in Downton.
Q422 Bob Stewart: I am thinking of the Royal British Legion as well. What is your view, as you have moved from Pall Mall?
Sue Freeth: On the ground, at base level, the idea of us being present to support and being close to people is very important. I would support my colleague’s response; there is a benefit in our separateness in one sense, but I think we would welcome making more routine our involvement and our engagement at a number of senior levels, so that we can look forward and plan together. At times, we have felt like the afterthought. When we have been able to identify issues, the Ministry of Defence has not felt ready yet to admit that those were issues; nor has it been able to specify what the requirement from us was. That is one of the challenges that Bryn and the British Legion particularly have had, in terms of shaping and developing the defence recovery process.
Bryn Parry: If we can all-in the MoD as well-understand what the MoD needs from us, and if we, the charities, can work very closely to ensure that the right people do the right bit of that, there can be proper co-ordination so that we do not get overlap. In many ways, if you can funnel it up through the MoD and have the DRSG or whatever you have at the top, and talk across to the third sector-and we can all put our hands up and say, "That is the bit I think I am good at"-that is great. We have collectively found it very frustrating being picked off by various people within the MoD. If we think we are doing something and, say, the Legion thinks it is doing another, but in fact we are both doing the same, there has been conflict. We are now hand in hand together, and we are now sitting down in partnership with those people in the MoD. That is working well.
Jerome Church: In the end, we need to achieve a balance between the need to co-operate to make it good for the beneficiary, and the need also to represent and campaign for that beneficiary. That is a neat balance for charities in this sort of business.
Q423 Bob Stewart: So the collective wisdom and answer is: thumbs down.
Chair: It sounds more lukewarm than thumbs down.
Jerome Church: Yes, lukewarm.
Q424 Mr Brazier: Mr Parry, what did you say this new co-ordinating body was called that acts as your point of contact?
Bryn Parry: It is the defence recovery steering group. Primarily, it is the three principal personnel officers, or their representatives; it is the Surgeon-General’s representatives; and it is the communications side of the MoD. At the moment, it works with a representative from COBSEO, who represents the various different charities, such as BLESMA. Because we are largely focused at the moment on the development of the defence recovery capability, the Legion and Help for Heroes are the two principals, so I sit there with its director general.
Q425 Mr Brazier: Right. Just a small follow-through on that: I think we have something like 200 regimental associations in this country, some of which have really quite significant assets. I think they are all nominally members of COBSEO. Do you feel that they are in any way being brought into the picture, or do you think that more could be done to make use of them?
Bryn Parry: I understand that there are over 450 Service charities.
Mr Brazier: Four hundred and fifty?
Bryn Parry: That is what I understand, if you count all the regimental associations and all the charities set up to provide flags for every ship in the British empire and so on. I believe that collectively they are worth £1.9 billion. When I was trying to raise my first million, I found that staggering, so we have all been trying to work out how that is well co-ordinated. Regimental associations are extremely important, certainly as part of the recovery process, where the association between the regiment and the individual does not cut across his membership of BLESMA or his membership of the Legion, or whatever it is. It is his family, but then he has to go to various different places. There is also a community of the wounded. Where it is falling down is that in the old days you had regimental depots, and your serving wounded went back to the depot when they had a few months in which they were not able to serve in the battalion. That does not happen anymore, so we are no longer able to send our injured, probably with their families, for a period of recuperation. We have to find some alternative to that.
Certainly, there are the links with the regiment. Organisations such as the Rifles and the Grenadiers have their own regimental casualties officers, who back up the regimental association and deal with their serving wounded. Some regiments, such as the Rifles, have several hundred-250 or 270-wounded on their books, and have their own regimental casualties officer.
Mr Brazier: I have met him.
Bryn Parry: Mike and I work hand in glove-we have to-and he will be working with Jerome, too.
Mr Brazier: If I may, I will send you a paper from someone from the Life Guards Association who has some ideas for putting it all together.
Sue Freeth: The Legion and the ABF work closely together, and we have close working relations with the regimental associations. Can we do more to bring us together? Yes, we can. We need to, not only to make best use of the available funds over the coming years, but to streamline the administrative costs, so that we have as much money as possible to support individuals. We would all welcome a greater focus on encouraging people to do that. There is a great sense of family in the Service community, but there is also a great sense of individual organisations and their own identities. It is how you strike that balance while achieving efficiencies, so that, as Bryn says, individuals can benefit from the very large amount of money that resides in those different smaller organisations, which can feel as if it is difficult to get out. There is a lot of willingness, but encouragement is needed.
Bryn Parry: We have a lot of overlap and a lack of co-ordination. There is an awful lot of money, but at the moment there is an awful lot of need. I heard one wonderful comment: somebody said that a regimental association was asked how much money the regiment had. When he was told, he asked, "What is it there for?" and he was told, "It is there for a rainy day." His comment, which came from the back of the hall, was, "As far as I can see, it is raining very hard"-except he did not use that expression-"so who is putting up the umbrellas?" The umbrellas need to go up. This is when the money should be spent-at the moment. The idea of sitting on vast sums, with a reducing community who will ultimately need it, should be looked at.
Chair: We will come on to that.
Q426 Mrs Moon: One of the pieces of evidence we received suggested that, because of the plethora of organisations and the financial power of the main charities, people have become silo-orientated and the opportunities for innovation have been reduced. People are almost saying, "Oh, that’s my field, and I’m not going to share anything, because I do that." Would you concur with that? Has there been a building of walls around people’s identified areas of expertise, rather than there being opportunities for innovation? What about the smaller charities that are trying to establish themselves? Are they finding it harder to break through with their new ideas and concepts?
Sue Freeth: COBSEO, particularly under the leadership of Tony Stables, has tried to lead the way forward on that. There have been a number of initiatives over the past couple of years. One of them, which is now being implemented, means that all of the organisations are able to use one internet system so they can pass cases to each other very quickly. That has started to break down the ownership, "I do this bit, and you do that bit." The British Legion has been very conscious of that, and we have been looking closely at our own services. What are the things that we can do, should do and are equipped to do well and better in the future? What things that we have done in the past should we leave to other organisations that are also capable of doing them? We have started to take responsibility between us for providing a completely joined-up service.
One challenge that individuals definitely face is that there is a lot of help out there, but finding it is extremely difficult. We are starting to engage a number of the other charities around us, small and large, as well as some of the agencies-the Service Personnel and Veterans Agency and others in the MoD-and we propose to actually say that if we were to focus our expertise on providing very good, joined-up information online and on the ground and helping people through that pathway, we can leave the other specialist areas to those charities that already have a great deal of expertise and perhaps develop and provide some of our own funding to enable them to do that. We are trying and will be leading the way on that, and it feels as though there is an appetite around us to think much more innovatively. I feel very hopeful about that.
We have certainly been working with smaller local organisations in the last three or four years and providing more funding for them, and we are actually getting much better results for people when we invest in the community. That is a model that we are starting to share with other charities. The time has come to break down some of the walls between us. It is not always easy to do, and it is very difficult sometimes to step away from something that either your trustee board or your members-in our case-or beneficiaries really like you doing, but the reality is that you have to stand back and allow organisations to do it that are closer to individuals and better at doing it. We are definitely up for leading the way and genuinely demonstrating that we are willing to do it. I believe that there are organisations around us that are starting to think like that. It is only very early days, but the potential is there.
Bryn Parry: I would agree with that. Following on from Julian Brazier’s comments, I think that, from my point of view-that of the wounded-a man may be a rifleman, a commando or a Para, but he has still lost his leg or still has a spinal injury. The regiments have to let go, because they cannot look after a person. They have to go to specialists. Likewise, charities such as BLESMA, while 99% of all the wounded at the moment are BLESMA members, would not want to think that they can solve all their problems.
Jerome Church: Most of them.
Bryn Parry: Certainly, part of the job of Help for Heroes is making sure that we fund the right people who do the right bits. We see life, from the moment of impact to the rest of their lives, as a road to recovery, and we want to ensure that there are both capital projects and facilities and individual funding along that road. Paving stones-if you like-are put in place and some, which are to do with prosthetics, will be provided by organisations such as BLESMA, some to do with welfare and other things will be through the Legion, and there is also St Dunstan’s, the charities for the blind and so on. Likewise, we need to find people for employment and housing and so on.
COBSEO has been working towards that by selecting charities to lead in what are called clusters, so you have a cluster of charities that all specialise in one area with one driving it forward. That is a very useful beginning, but I do not think that we have got there yet. In the last three, four, five or six years, there has been a tremendous change under COBSEO’s leadership, but it is the beginning. The right thing is certainly not in place at the moment, but we are on the way.
Q427 Mr Havard: Following that, the MoD talked to us about the embryonic contracting process that is developing in this area. You almost described a sort of contracting process yourself there with what COBSEO is undertaking, which leads to collaboration rather than competition. Could you say something about what your discussion about that contracting process will be and whether it is going to lead to more collaboration? Is there a danger that it will actually just cement competition between the organisations over securing some of those contracts?
Bryn Parry: The word "contract" sounds like procurement.
Q428 Mr Havard: Exactly, it is also like primes and subs and the sort of language that comes out of the MoD.
Bryn Parry: Don’t get me started on that, otherwise we will have to go out to European tender for toilet rolls.
Mr Havard: Exactly.
Bryn Parry: No. This is sitting down and saying, "What is the need? What should be funded by Government? What is available to be funded by others? Where do we need your help?" Then a team of like-minded people sit in a room and see who is best equipped to do it. It is not for the MoD to sit there and tell us who they wish to do it or for us to tender for it. In my opinion, that would not be a good idea. There are charities with skills; the trick is to ensure that we all know what our skills are and in what we want to specialise. We can’t all be multi-skilled, so we specialise in our area.
We all know what we are doing, so if somebody walks into the room and says, "My legs don’t fit, my wife doesn’t like me, I’ve lost my job and I’m having nightmares", I would like to see BLESMA stick its hand up and say, "Prosthetics-we’ll take that"; Combat Stress stick its hand up and say, "We’ll take the nightmares"; Remploy take the job issues; and Haig Housing Trust or whoever take the housing issues. We have specialist teams who take the problems.
All these boys carry what I call a "portfolio" of problems. The fact that you’ve lost your leg is not the only problem, because all sorts of things cascade out of that, not only to do with the individual but to do with his family. All those things need be addressed. Some of them need to be addressed by the right Ministry-it doesn’t have to be the MoD, but could be the DWP. I am very keen to see some organisation or person adjusting and ensuring that that person is championed to the right people who can provide him with the right support.
Jerome Church: Charities like ours that have been around for a long time intuitively do that. That’s what we do. If one of my members has a housing problem, we have a terrific relationship with Haig homes, so it’s no problem. It’s sorted and the boy or young girl is sorted out. We do it.
Sue Freeth: None of us, round this table at least, has a contract for service as such, other than the current relationship with the defence recovery unit. To a degree, we probably enjoy the freedom. We do not have a contractual relationship with the MoD. From the Legion’s point of view, I do not think we necessarily would not want to have one, but that does not mean that we do not believe that there are services that we could provide well for which we would not be prepared to have an agreement. However, if there is no money-if there is not a contractual or funding reason-a formal contract is not really necessary. I think it is more about agreements to operate and work together that could focus stronger working relationships in certain areas. However, moving into contracting is not necessarily the solution, by any means. Unless it was on the right terms, some of us would probably rather not have them than be tied into having them.
Q429 Ms Stuart: You have implicitly answered quite a lot of the questions we wanted to ask, so can I just pin down a few things for clarity? Bryn Parry, we were wondering when you decided to work with the MoD rather than work on your own. From your answers, I gather that in Christmas 2010 you got a co-ordinating person. You were quite happy to work off a list and I note that you said, "We were asked to raise money for the swimming pool in Headley Court". Can you take me through that? You were asked to raise money for Headley Court. Who decided that they wanted a swimming pool?
Bryn Parry: Would it be helpful if I went through a brief history?
Q430 Ms Stuart: I am keen on knowing about that moment when you decided to work with the MoD rather than on your own. What was that link?
Bryn Parry: My motivation was to help. I thought that I could raise a reasonable amount of money. Originally, I thought I could raise £500,000 in the summer of 2007. I then met a general and I said, "I think I can raise £500,000". Five days later, he introduced me to the Chief of the General Staff, General Sir Richard Dannatt, and I said, "I want to help and I think I can raise £500,000, so what would you suggest I raise it for?" I did not want to raise it just to put into a big pot. He had been to visit Headley Court and said, "I think we need a swimming pool at Headley Court". I thought that I was getting my task from the Chief of the General Staff, which, as a failed captain, was good enough for me. I then realised that it was not that easy.
It was not that I chose not to work with the MoD, but in order to fulfil my task, as I saw it, I had to work with the MoD. We had to go through all the procurement, the other testing things and challenges to deliver a building-a facility-at a reasonable price, within a reasonable time. That put lots of grey hair on my head. I have always worked with the MoD but I have never had any direction from the MoD. As a result of a continued amount of frustration, I went to see the Chief of the Defence Staff on 15 March this year and that is when I said I think there needs to be a single point of contact at a senior defence level, rather than single Service level, who can be my point of contact. They are not tasking me. They are sitting down with me and saying, "This is what we would like to do. Would you like to help?" There is no contract, as we have already discovered, this has been a partnership. Again we are very sensitive that what we are providing is the extras and not the core. We are not providing the medical treatment. We are providing the slightly softer things to do with transition and so on. In my mind there has never been any difference. I wanted to help. I wanted someone to tell me how to help.
Q431 Ms Stuart: Before I open up to wider questions, there is one other thing. You started something new, as I understand it; it is a trading company that works with Help for Heroes. Has there been a change in the way you report to the Charity Commission?
Bryn Parry: Every major charity can have a trading company in order to do trading activities. If you want to sell tea towels you have to have a trading company. Charities are not allowed to make profits, so you have a trading company. That is how all charities work. This is not to do with how we work with the MoD; this is simply how we choose to offset our operating costs. We have a trading company which sells about 450 different product lines, some of which I am displaying here, if anyone would like to buy some. The income from that is then granted across to the charity and that is used to offset our costs.
Q432 Ms Stuart: But in terms of the charity’s running costs and the way you reported to the Charity Commission last year, will it be the same next year? There have not been any changes or things you spell out more clearly?
Bryn Parry: I am not sure I understand. We have audited accounts, exactly the same as everybody else. So what we do is have a trading company. Most people’s trading companies do not make much money. We have a trading company. It is within our group. It is an individual thing. It makes money. It then donates a grant or donation and that helps us cover our operating costs. It is as simple as that. The Royal British Legion does the same thing. When you sell your wristbands, buttons or whatever, the profits from that are gifted across to the charities. It is the same thing. Ours has just become a core, if you like, of how we operate.
Q433 Ms Stuart: All of you have started to address this question of the things we have a right to expect Governments to do and the MoD needs to do and the things where we think it appropriate that people make individual donations and the voluntary sector comes in. Do you think we have got that balance right or is there a danger that you become subcontractors of the MoD and provide services which the MoD should be providing?
Bryn Parry: This is the question. This is why we must retain our independence. We will always decide whether we want to get involved.
Q434 Ms Stuart: With respect, there is a difference between who the "we" is who decides. If you are a membership organisation then the we is the membership organisation. If it is a fundraising charity, the "we" is quite different.
Bryn Parry: It is my trustees, but taking good advice.
Q435 Ms Stuart: And you think that is sufficient?
Bryn Parry: My board of trustees-
Jerome Church: And your donors-
Bryn Parry: And the donors. I say, "This is our wish list". We are currently trying to raise a lot of money for recovery centres. We have put photographs up of them. We explained to the public what we are doing and when they are going to be ready. Frankly, if the public do not agree they would not have given us money. We have a board of trustees and we have good governance and we have everything properly audited so that you know exactly how much money we have got in and what we are proposing to spend and how we are spending it. So there is complete transparency.
Q436 Ms Stuart: What is the British Legion’s view on that?
Sue Freeth: For the British Legion’s trustees, that is, as you say, a thorny issue: how do you make sure that you protect the entitlements that you believe the state should and can provide for individuals and how far do the voluntary organisations use their resources to fill those gaps as they emerge? I think the Legion has done that so far. The partnership, for example, on defence recovery is a very conscious decision and a wish to make sure that people who are being injured now in much larger numbers really get the quality of support they need, given that they are so young and some people have been particularly seriously injured. To do that at the right point and quickly is absolutely critical.
Our trustees take every step when they look at whether we are doing something that was previously done by the state. They take those steps very carefully and on an evidence base. We have started working over the past five years or so very much on research. We do our research on what the greatest needs are from a very large constituency of people, and we take decisions about what services we provide on that basis. Our trustees will continue to think very carefully about things that they want to do and that they believe the charity should be doing, and about the things that we should be asking Government to find the resources to do.
Q437 Ms Stuart: Jerome Church, can you add whether, in your experience, the MoD is actually using the money you give it properly?
Jerome Church: I do not actually give the MoD any money.
Q438 Ms Stuart: Or the resources or the goodwill-
Jerome Church: I have always been interested in that boundary between the statutory requirement and working with charities or charitable funds-the balance between what should happen and what needs to happen. My motto is-I am afraid that we all know this, going back to dealing with local government and with all sorts of areas-that sometimes we just need to meet need with speed, and we cannot wait for the bath lift or whatever to come from the official sources; we just have to get on and do it. Otherwise, my older members would be dead before it arrives, and we won’t have that. There is always that sort of conflict that a charity has to reconcile and justify.
Bryn Parry: Can I go back to our first example, which was the swimming pool at Headley Court? There was no swimming pool at Headley Court, but the argument was that patients at Headley Court had access to swimming. They were taken to a swimming pool at Leatherhead, where they were able to swim in one lane of a public swimming pool. Government, or the MoD, were able to say that the need had been provided-if there is a requirement for the guy to swim a couple of hours a week, he is getting that-but we came along and said, "We would prefer that individual to be able to swim in his own swimming pool within the confines of his own building, surrounded by people who will not object to his being in that pool." The need was being fulfilled. Was it being provided to the very best level? I did not think so, therefore I said to the public, "Please could you help me to raise some money if you feel the same as I do?" And they did. That is how it is.
Jerome Church: We are moving into the same area. Bryn and I have talked a lot about this, and we went to Simon Burns in December last year about prosthetics, because we are very worried. BLESMA has always been very concerned about funding prosthetics, because it is a bottomless pit, if you are not careful. It is a very expensive business.
Q439 Ms Stuart: Just to finish the block of questions, the past few years have seen a considerable increase in donations from the public, not least because of new concepts and new approaches. In 10 or 15 years’ time, however, a man in a wheelchair who probably did not control his weight quite as well as he should have done will no longer strike a chord as being a hero who requires help, and there will be a whole generation of children who say, "Where is Afghanistan? I don’t know where it is." I wonder what thought you have given to this, and this may be something that Kevin wants to think about a bit more. How do we continue that involvement of raising money? What is the thinking, post-Afghanistan, to raise the money that we need?
Kevin Shinkwin: I think one of the main ways of encouraging people to give their support is by showing that we are delivering and that we are making a difference to people’s lives. Each of our organisations is doing that very visibly. The current visibility of Afghanistan and the conflict there is important as an incentive, but there will continue to be issues such as the ongoing support for people who will have long-term conditions even though they are very young now. So, it is important to show people by providing services, by ensuring that we give voice to people’s concerns, and by campaigning, because campaigning is a very cost-effective way of raising and maintaining profile. We should ensure that we continue to do that to make sure that we are relevant, so, regardless of whether there is a current conflict, people understand that a lifelong duty of care remains-not just a lifelong duty of care to those who are injured, but to bereaved Armed Forces families, whose debt, as a society, we can never repay.
Q440 Chair: My concern echoes what Gisela Stuart has said. While what you suggested should happen clearly should-that we should maintain this level of interest, even when Afghanistan has become an item of history-the worry that such interest might not be maintained is real. I wonder whether anything might be said, for example, for setting up a ring-fenced fund to come into effect, say, 20 years from now, in order to deal with the perhaps significantly greater problems of our Armed Service veterans. This is, in a sense, the rainy-day issue. It is a defined issue, however, to cope with a problem that may well arise, which needs to be addressed now.
Bryn Parry: There is £1.9 billion stuck away in bank accounts. The way most Service charities work is that they have invested the money, they do some fundraising, and they then spend the income on that money. The capital money is not being used. A percentage of that could be used at the moment, because, frankly, I think it is raining outside. If you could use some money now to put in place a significant project that would provide support, all you have to do in the long term is keep that going. We have an opportunity with the public support at the moment. It is a once-in-a-lifetime chance to get this right. I have seen the last four years as a race to try and put in place recovery centres and get the recovery capability in place, as the thousands of young men and women who will now go through their lives as a collective cohort will need special help.
I do not get the argument that when a Serviceman moves into civilian life he should not be disadvantaged. I am afraid that I am an advocate of saying that a Serviceman who joins, risks his life, and then sustains a life-changing injury must be positively advantaged. They need to be treated specially, and that means it needs to be made easy for him or her, so that when they have a problem in later life which is related to their Service, they immediately get the very best.
At the moment, we have money available. It is coming in, and this is what we have been trying to do, but we need an awful lot of it to be released, where possible. We need help to see where that can be done, and we need co-ordination. It is all very well having a bunch of good people trying to do their best, but right at the moment, it is not as focused as perhaps it could be.
This is our opportunity to get it right. If we do not-I was with a boy last night who lost his legs very high, and he has got all sorts of other problems. That chap is 22 years old now and he is living an undignified life, because he trod on an IED at Christmas time. I do not want to see that boy living an undignified life when he is an old man.
Sue Freeth: The creation of a fund has been a reaction, over time, on a repeated basis. The Legion now administers a number of those funds. One was set up for Northern Ireland and one for the Falklands. There have been a whole series of them. In a way, I agree with Bryn, who is saying that actually, it is much easier to show the public that you are spending the money as close to the time that it is actually being raised. Clearly, the large number of people whom we are still supporting are veterans from previous campaigns, right back to Korea, the Falkland Islands, and all the campaigns between then and now. The creation of a fund is tempting, but I am sure that if the coffers now available to us were emptied and we were able to show and tell the stories that we heard people telling earlier, people in the future would still feel an affinity with this group of people, particularly if we still manage to evolve remembrance. Remembrance is not only about those who have given their lives, but about those who have been injured and are casualties of previous conflicts. We have our moment’s silence-the first half is for those who have lost their lives and the other half is for those who are still with us. I think it is that combination of things.
We already know that we are probably coming very close to the end of the public’s willingness to contribute as generously as they have to this campaign group. I think that in five years’ time, it will be much more difficult for us to engage the public. The challenge will be with organisations, such as ourselves and the new ones that spring up, to keep that spirit alive. It will be difficult, and it has been difficult. In history, there have been moments when it has been easier and moments when it is very difficult. We do not know what the needs of the current cohort, who have been injured very young, will be or what their lives will be like. We need to be ready to support them through a very long life-which they would like to have.
Jerome Church: I echo what has been said. My organisation tries to fundraise by always telling the donors that we are a long-term business. Many Service charities are. That is easy to illustrate in BLESMA’s case, because every year between ’19 and ’99 is represented. It is indicative that we still have more second world war members than current conflict members. It shows how long they live. I know what they have had to go through. I know their stories and I hope that the new generation will not have to go through quite what some of our older members went through.
Bryn Parry: The sad thing now is that people are surviving injuries that they never would have.
Jerome Church: That is the added component to the issue. We are all very concerned about care right through life, not just in old age when the old injuries come back to haunt them, which tends to be the case with today’s old veterans. It is right the way through with these youngsters.
Q441 John Glen: I want to get to the bottom of the assessment made of the costs that will accrue. I think that Help for Heroes spends 92% or 93% of its money on capital projects, which, in essence, set up liabilities for the future-the running costs. If every charity or more charities put a higher proportion of their capital into projects today, which sets up running costs for the future, and we see a reduction in the income flow to charities due to less public awareness or whatever, you will create increased liability for ongoing running costs and reduced income. There is a difficulty there. When you go to the MoD and agree a project, which you are given discretion to deliver, what is your impression of the assessment made to take account of the ongoing costs for those better facilities, which in the past have not been provided for by the MoD?
Bryn Parry: At the moment, there are four major centres for recovery. There are five-the Legion and Erskine are working together. We did the initial funding on conversion and the Legion took the running costs over for Erskine. However, if we take the four that we are on at the moment, they have big capital costs to provide the buildings. The best of those will take 60-the one for the Royal Marines in Plymouth. It is 50 in Catterick and Tidworth, and 30 in Colchester. The building cost for Catterick is, say, £13, million and the running costs look like they will be somewhere between £1 million and £1.3 million. That is all worked out by people who are rather cleverer than I am. We are meeting the capital cost and working with the Legion, which will contribute towards the running costs. We will be going to the private sector, looking for sponsorship and everything else. With the bits that it does not manage to do, we will do our very best to top up to whatever it costs.
Sue Freeth: Our trustees have given a commitment to £50 million over 10 years for those running costs. That is the contribution to the defence recovery capability that we have made.
Bryn Parry: If you take a building, the expensive bit for the big fundraising effort is the capital, because you have to raise £13 million in a lump to build it. Then, if you have to do £1.3 million a year for a long time, that is a very large amount of money, but it is easier to raise £1.5 million a year than it is to raise £13 million. So I would argue that if we can release that much money and focus on the putting together of a very well co-ordinated plan that is future-proofed, it is then rather like, back in King Charles II’s time, the Chelsea Hospital being built. I do not know whether that was created with a foundation-ideally it is. Wellington college, to which Julian Brazier and I went, was set up in 1859 and endowed with a foundation for people like me, who were foundationers. The cost of the building must have been huge, but funding 10 people like me every year to go through a free education is probably not huge. We will have less to raise every year if we can get it right now.
Q442 Sandra Osborne: We want to explore the issue of the recovery of injured personnel and their families. Sue, could you tell me to what extent the Royal British Legion works with people who have been injured?
Sue Freeth: We work in complement with both BLESMA and the Army recovery process that Bryn has now connected us with. Our focus is particularly on helping people to find their way to the things that they are entitled to from the different organisations around us, and on filling in, with the other organisations that provide grants, the gaps where there is not funding available to help them. One of the biggest challenges that we see for people is housing during their recovery period. There are still problems, particularly while people are recovering and still inside the Ministry of Defence and its responsibility. It is difficult for people to get their temporary adaptation sorted out, because some of them will be living on base, some will be living at home and some of them living in social housing. That is a problem area that we see on a regular basis. I think colleagues here will probably support that.
We are seeing people who, in particular, are looking for ways into further training and work. A lot of people who have been injured have not completed their full training-they are not work ready. They are going to need an awful lot of support. While people who are medically discharged and seriously injured are entitled to the full career transition partnership package, that actually needs to be much more of a comprehensive package for someone who is leaving the Armed Forces well before they expected to. They are incredibly young, and need not just help in training but help with finding further training, accessing benefits that they may well have to depend on to complement the package of support that they left with, and finding a home to live in that is not just going home to mum and dad. They have a whole of plethora of things, and I think the role that we are playing in particular, because we know the statutory and charitable organisations so well, is helping to accompany that individual through that pathway. That is certainly a role that we can do more of-making the best use of all the other Service charities’ services.
Q443 Sandra Osborne: What do you feel about the quality of the input from the Ministry of Defence? Do you think it is adequate? What else could be done?
Sue Freeth: Certainly, the new policy-the new AGAI 99-is in place now. It is very early days. I think all the ingredients are there to get it right. There are some tension areas that we have some concerns about. On the manning levels of defence medical capability, we are slightly concerned that there may not be enough people really to support that process. I think that we are not the only ones who would raise that as a concern. I think that the BMA has also raised this as being a worry area. That is something that we have shared with the Ministry of Defence, and I am sure that it will be keen to make sure that it addresses that.
The potential changes in the national health service could rock some of the protocols that are being put in place to support people who have continuing care needs, who are going to be living, and who are seriously injured. Again, we share those concerns. There is quite a bit of piloting going on at the moment, in terms of trying to make this a seamless journey. It is very early, and we need to work very hard to try to make sure that this journey gets joined up. We need to pre-empt as the environment changes around us. We need to watch out, so that once people leave, both at local government level and in the NHS, the good will and good intentions do not get unravelled. Those would be our primary areas of concern.
Q444 Sandra Osborne: Is there any difference in the support that is going to reservists?
Sue Freeth: I do not think that the initiatives, of which there are now a large number, are finding-this was what happened with the reservists in the cases we have come across-the reservist community easily enough. We know that the Ministry of Defence has got reservists at the top of its priority list, but finding ways of capturing reservists is something I do not think the initiatives we have at the moment are doing well enough. More work is needed, frankly. I haven’t got solutions, but we are all tasked with thinking about how to make that better and promoting it to reservists and employers who have reservists on their staff.
Chair: Bob Stewart, you do not have to say yes to this question, but were you catching my eye?
Bob Stewart: I was trying to.
Chair: Then you have done so.
Q445 Bob Stewart: We have a Veterans Minister. I think that the Service Personnel and Veterans Agency is a pretty useless organisation; I have said that for a long time. I really think that, as Bryn and all of you have said, we have a direct and urgent responsibility to look after people who have been hurt in the Service of our country until the grave. I personally think it is rather sad that a bit of the SDSR did not look at how we deal with the long-term wounded, particularly as the ratio has gone up from one in three in our day, Jerome, to one in 10. You know, one dead, 10-
Bryn Parry: One in five.
Bob Stewart: One in five, you think; okay. But it has gone up substantially, hasn’t it? The responsibility that is very much on your shoulders at the moment should be taken in by Government in a much more serious way, because every time I have challenged the Service Personnel and Veterans Agency in one way or another, I have been told, "Go to Blackpool", or wherever it is and so on.
We require the Ministry of Defence to be very much more serious and professional in looking after those people once they have taken their uniforms off and are cast on to the NHS and social services. I just do not believe it when it says, "We have a tag on everyone who is wounded, and we’ll keep a tag on them for the rest of their lives." I just have not seen that. I ask for your comments on that.
Jerome Church: Of course, it comes from the old War Pensions Agency, which did not belong to the Ministry of Defence. There is quite a history there, and it was a good history. It was a good organisation. A lot of the people were the same people. I am a big of a supporter of the Service Personnel and Veterans Agency. It has worked very hard to sort out its understanding of the way the Armed Forces compensation scheme worked. We have helped it along. That is just one aspect of the Government. Yes, we have a Veterans Minister and quite a small veterans department, which seems to be getting smaller all the time, because the MoD is getting smaller. Clearly, there is not going to be the capacity in the MoD to look after them in the way that one might wish. The capacity actually belongs to the country. We have got to work very hard. For instance, if we go back to the prosthetics business, we have been working very hard on NHS responsibilities there. We will see if that works-and it had jolly well better. There will be other, parallel, concerns about the care of the wounded that relate to the NHS and to all those agencies that do care. We have people now who are going to leave very soon who will need care all the time for the rest of their lives. It is not the MoD that has identified that, but somebody has.
Bob Stewart: It could be under MoD auspices though.
Jerome Church: I don’t think it has the capacity.
Q446 Bob Stewart: No, no. It’s got to have the capacity. I think the feeling of the Committee is that we are extremely concerned about the long-term looking after of our wounded. It is better now than it has been in the past, but, my goodness-
Jerome Church: The in-service is very good.
Q447 Bob Stewart: In-service is fantastic. It is not the in-service that I am concerned about.
Sue Freeth: We have seen from the current covenant initiatives and the creation of the covenant executive group, which is bringing all the Government Departments together, a new commitment from Government Departments to share that responsibility with the Ministry of Defence. Again, it is very early days, but there certainly are signs, for instance in what we are doing with the Department of Health, that they are committing resources. They are seeing, in thinking about this community, how doing so is benefiting other people whom they have responsibility for, whom they could approach slightly differently. Coming from those Government Departments are very small amounts of money that are available to dedicate to this community. The Ministry of Defence at the moment has very little more, and most of the initiatives are being funded and resourced by other Government Departments, charities and, in one or two areas, commercial organisations and donors. Whether that is going to be sufficient-
Bob Stewart: The answer is no. It is not going to be sufficient. The suggestion is-
Bob Stewart: I must shut up. All right.
Chair: Order. We need to pick up a bit of speed, so I would like crisp questions and crisp answers.
Bryn Parry: I consider that the long-term care of the wounded, the injured and the sick cannot be within the boundaries of purely the MoD. We need, therefore, to have some other way of picking up those individuals while they are serving, ensuring that they transition successfully into civilian life, and overseeing and linking in to all the various different Departments-whether housing, welfare or pensions-that they need. Somebody needs to be championing that particular, unique and very special group through their lives. That should not, and cannot, be left to a junior Minister in the MoD, and nor should we be kicking him, because it is way beyond the area that he should be covering.
The point is that while people are in Service, they are getting superb treatment. If you go to Headley Court and look at, say, the prosthetics provision there, it is wonderful. The problem is that the guy comes out with his C-Leg and takes it home to Bournemouth, and in two years’ time he goes to his NHS prosthetist, who says, "I haven’t got the experience or the funding to give you a new one." That is the problem.
Q448 Bob Stewart: Of course, the boys and girls are talking about that; they are worried about that when they leave the Services.
Jerome Church: We are all waiting, to be fair-
Chair: We are just about to come on to the Murrison report.
Bryn Parry: But the point is that young men and women are staying in the Army at the moment, or wanting to stay in the Army, because they are worried that care in civilian life is not going to be as good as they are getting. We want to congratulate the Services and the MoD for what those people get while they are in, but we need to be concerned about what they are going to get if they leave. That is holding people back from thinking about having fulfilling futures. We now need to inspire, enable and support them as they go through the rest of their lives. Until we have got that right, the thought of losing your legs will seem like a death sentence, because you will prefer to be the biff in the stores rather than make a success as a chief executive of some multinational with no legs later on.
Chair: I have no doubt that this will feature heavily in the report that comes out of this inquiry.
Q449 Mr Brazier: In America, from the moment you cease to be in uniform, you are under the auspices of an organisation that is wholly at arm’s length from the Pentagon. Having had a strong disagreement with the British Legion many years ago on this, could I ask you whether you think it right that the Veterans Agency is in the MoD?
Bryn Parry: No, I don’t.
Sue Freeth: I agree.
Q450 Ms Stuart: This is a very specific question aimed at Jerome Church, and I declare an interest because the Queen Elizabeth Hospital is in my constituency. Could you tell us a little more about how Headley Court, the QE and you worked together on the provision? Also, to make the question brief, tell us a bit more how you contributed towards the Murrison report.
Chair: The Murrison report, for the interests of the record, being into the provision of prosthetics.
Jerome Church: Murrison mark 2, as it were. Very briefly, as an organisation we have always been allowed by the MoD into Selly Oak and now the QE. That was originally because we were the guys who could talk about the life ahead a bit, particularly to the families who might be by the bedside. We still try to do that as much as possible. We then follow very closely our people at Headley Court and we have a surgery there every couple of weeks, mainly to do with making sure their compensation scheme thing is working all right, and we have had some great successes there, and alerting them to the other things we can do. That is building a relationship with people whom I hope we can help for the rest of their lives. That is our job.
On Headley Court we were delightfully surprised five years ago when we saw the quality of what was being provided. We campaigned to have it put there and we did not expect it to be quite so good. I then had to scratch my head and say, "Crikey, this is going to be a problem in a few years’ time". We knew what would happen out there in the real world of the NHS with its very limited budgets and very local decision-making. As was always said, they don’t lose their legs for Anywhereshire; they lose them for the whole country, as it were. It is the country’s responsibility, not local decision-making, postcode lottery and all that sort of stuff.
We campaigned for a long time to get that right. Help for Heroes also gave us some support, particularly as it got more and more urgent. We were given the promise, "Oh yes, it will be done." But we know how the system works and we knew that there was no method of doing that. There was no funding chain, and that is the key thing. So we then have been very involved with Dr Murrison. We were delighted he was appointed to do it and he was extremely interested and receptive and consultative with us and others. I know a good deal about what his thinking is and I think and let us hope-I know it has gone to No. 10 and I know it is now back at the Department of Health-it is being improved even more. I am sure they are doing a very good job.
Q451 Mr Havard: This sustainability argument, particularly in this narrow area, but the general question of the sustainability of services over time is clearly crucial to the whole of the thing we are discussing. Yes, there are fears among individuals about whether they will be able to have these state of the art things in future. I want to come back later and ask you a question about how this applies across the whole of the UK, but how do you think this will play within the English health authorities who are going to have a very varied commissioning process? What are the potentials for a consistency of application across the areas of England, rather than a uniformity of allocation in terms of providing these services over time?
Jerome Church: My contacts within that community-the prosthetic world, as it were-are very hopeful that they will be given structures that they can prove their worth with. That is my reading. There are skills there. They can be a bit dissipated. The prosthetic community itself-the number of prosthetists-is fragile. We have to be very careful. We have to look after it for the good of the whole country.
Q452 Mr Havard: It is not just populated by doctors?
Jerome Church: No, no. Doctors don’t know anything about prosthetics. It is the prosthetists and the technicians who really know their business and, may I say, those of us who use it. That is the really important part. If they can be focused in the right place, and I think there is every desire to do that, in the right centres with the right resources-the funding chain is absolutely crucial to this-so the prosthetist does not have to look over his shoulder and say, "Oh, that’s beyond my budget." He can go to the veterans budget-or whatever they are going to call it; the commissioning process-and that money will be guaranteed.
Q453 Mr Havard: So, you think there should be something specific in that commissioning process-no matter how it might be differentiated for other arrangements-particularly dealing with somebody being able to tap the right money at the right time.
Jerome Church: Absolutely. Who said it? Follow the money.
Bryn Parry: Money and expertise.
Chair: We will not press you about what is in the Murrison report. I want to move on from these very physical injuries to the linked, but wholly different, psychological injuries.
Q454 Mrs Moon: I wonder if you can tell us how effective the MoD is in identifying personnel who are experiencing mental health problems, whether as a result of combat or not? Is the MoD effective, and what could it do to improve the service it provides?
Sue Freeth: I think Dr Murrison’s mental health report and the recommendations from it are to be launched next week. We have certainly been involved in the development of those, and we are very satisfied with the involvement we have had-I know that Combat Stress is, too. We need to see how well they reach out to people and encourage people to come forward. They will, and should, make a significant difference. They have been trialled and tested, if only with small numbers at the moment. Again, there is a chance for that to be more effective than it has been and address concerns that a large number of us have had.
There will always be a challenge for people who have served in the Armed Forces to come forward with mental health problems. It is almost an added barrier, on top of those faced by the general population, who also do not find it easy to come forward. One area where we have had, and still have, concerns, which we have shared, is that at the moment, people have a vulnerability test when they return from tours, at that stage in the decompression period. We wonder, as others do, whether that is too early to capture people’s vulnerability and that actually, it should be done later, when people have settled, gone home, and had more time for reflection. That is when things tend to occur, rather than immediately after a tour of operations, when you are on your way home and your mind may be distracted or on other things. We would certainly like to see that addressed, and for it to be properly evaluated, to ensure that as many people as possible are being captured.
However, we have every confidence that the initiatives that are now being launched have a real opportunity to reach out to people. Particularly, there is the big white wall initiative, which will allow people to come forward anonymously. We have great hopes for it, but we will only know when we actually see it go live. Like the prosthetics side, in our experience, we are seeing and finding people who are looking for help and have depression and anxiety just as much, if not more, than PTSD, who are coming from the Falklands and subsequent campaigns. It takes people varying amounts of time before they are willing to come forward, and I do not think that that will necessarily change in future.
Q455 Mrs Moon: Mr Parry, did you want to come in? You looked as though you wanted to say something.
Bryn Parry: I always want to come in on this subject, but I am not crossing-have you finished?
If I am allowed to say, I think that one has to assume that anyone who has had their life changed by injury in the Service has associated mental issues. The way that the Armed Forces look at mental issues is that there is a screening process during decompression and the idea of TRiM. Again, that happens very early, and it tends to be that you march into a room, the sergeant-major asks how you are feeling, and you say that you are feeling fine. He then asks whether you are sleeping all right, and you say fine. He asks whether you are troubled by the tour, and you say no, not at all, and march out. That is it. Actually, if anyone has been injured, they have problems and it ought to be assumed that they have, unless proved otherwise.
Therefore, I think that psychological support should be integral to the recovery process and not a door that you can knock on if you are having a bad time. That is what I have been pushing within the Surgeon-General’s department, to see the psychological support in Service to be absolutely integrated. Down at Plymouth, with the Royal Marines, they have two psychiatric nurses who work with the guys all the time, so when they are on the treadmill in the morning, they can have a chat to the guy on the next treadmill who is a CPN. It shouldn’t be the stigma of knocking on a door. That’s the problem. You get Servicemen who have spent an awful lot of time trying to be Servicemen, especially people in the infantry, special forces or anything like that. They are certainly not going to say, "I think I am a nutter" to anybody. Someone said to me, "When I am in a battalion, I am a mong, but when I am together with my mates, we are all mongs together." That is the point-there is no stigma. Once you have been injured, you know that you have some sort of issues that you need to chat to people about. It is not a big thing. Psychological support should be part of it, without stigma, in the same way as bandages, prosthetics or anything else.
Jerome Church: We don’t really understand psychological in BLESMA. I have often been asked this question, "Do you have big problems?" We are not entirely sure, but we think what happens is the fellowship business-I mentioned one company earlier that had shared experience. That has helped.
We were very much branch-orientated in the old days; we have very few now. Once loneliness comes in, coupled with physical injury, and once you are past the adrenaline of recovery in three or four years’ time, there is a danger. That’s why we are keeping people entwined in some way. Bryn is doing the same with Band of Brothers, and we do it in BLESMA all the time. I believe that it has a huge effect on the psychological injury abatement.
Q456 Mrs Moon: Is there a difference in the effectiveness of treatments available to those who have a general mental health problem from the effectiveness of treatments available to those who suffer trauma as a result of Service and their experience in combat? Is there a difference in the treatments offered? How effective are they?
Sue Freeth: The King’s College Centre for Military Health has been following a cohort that it started back in 2003. It is teasing out those differences so that we can get the Department of Health and the Ministry of Defence to respond. As we have said, one of the areas that has already been identified is an unwillingness or a reluctance to look for help, and the way that people find help accessible is through comradeship experience.
There are a number of initiatives that I think will help. Now, people are encouraged to get their GP before they leave the Armed Forces, so that their general practitioner’s name and details will go to on their medical records and go out with them. That is only just starting. That provides a potential, gradually, as people are willing to start to recognise that asking for help and asking for a particular type of help that you need and that you don’t see other people around you in your local general practice needing is okay. The Armed Forces network that the Department of Health has set up will bring together people to look at health issues and resource them, now, with community mental health practitioners, who are being recruited, where possible, from people who have a Service background. That will start to bring together a lot more communities to support people and lots more support groups. That should start to address the problem.
But we are at an early stage. We are less than a year into the creation of that Armed Forces network set up by the Department of Health, and the resources that were identified in the Murrison report are literally only just now being turned into community mental health nurses. There are only a few on the ground at the moment. In a year’s time, we hope to see many more. It is very early days.
Jerome Church: But very encouraging.
Sue Freeth: But very encouraging. It is something that we have wanted for a long time, and which we hope we will be able to retain with the changing nature of the NHS ahead. The biggest anxiety is that those resources will be dissipated and that the structures, such as the strategic health authority which is being tasked to oversee them, will not be there to protect and to foster that relationship-and to foster it with the Service charities and the comradeship groups.
Q457 Mrs Moon: There is a huge hill to climb in getting GPs to understand mental health generally. But to get them to understand combat stress-related mental health problems is going to be even bigger.
Bryn Parry: To take that one point, it is very encouraging, but we have been at war for 10 years-and I do not find that very encouraging; I find it enormously disappointing. We have been at war for 10 years and these issues have been going along for a long time. We had experience in Northern Ireland and in the Falklands before that, yet we seem to be waking up to something for the first time. It has been going on for a very long time and now we need to solve it.
Q458 Mrs Moon: Mental health is an area that we have long needed to sort out, and GPs play a critical role in that. Do you see yourselves playing a role in opening up GPs’ awareness of mental health and combat-related mental health strategy? I notice that Combat Stress said that only 5% of those who are referred to it, as a charity, have come through GPs. That demonstrates a general lack of awareness among GPs of combat stress-related illness, and a lack of checking, even, to see whether patients in front of them have a Service background. How do we get them to appreciate the services that they could direct people to? Do you see yourselves playing a role in that?
Sue Freeth: Last year, we started developing a relationship with the Royal College of General Practitioners. We did a survey last year to benchmark how much understanding and knowledge there was across the GP community of veterans’ needs and the services available to them. You will not be surprised to hear that the level of understanding and knowledge was very low. What little they were aware of had apparently been learned from the press, not from their own colleges and the Department of Health, so we are starting from a very low base.
More online training is being designed this year, but we see ourselves-and the networks see themselves-having a role to play in getting GPs to understand what is available locally to connect the people whom they are seeing to services and to ask them whether they have served their country, which is important. We would very much like GPs to have that on the list of things that they are obliged to ask their patients. We have not been successful in managing to do that, but we will not stop continuing to ask, because we think that it is a very important factor in connecting people to the right kind of health services.
There is a big job to do and we see ourselves having a role in it. It must be done through national organisations as well as at a local level. We must connect people to charities that can provide people with not only awareness, but the ability to do something and the resource to plug into, because I do not think that they will ask the question otherwise.
Q459 Mrs Moon: Is the alcohol culture in the Armed Forces exacerbating the mental health problem? Is it masking it? Is it increasing it? What role is alcohol playing?
Jerome Church: It depends what you mean by culture. Responsible behaviour is something that the Armed Forces try to inculcate, as far as I remember. But it is not something that you are likely to prevent completely.
Bryn Parry: If someone is not getting the proper psychological support, they are facing demons and they need to drink to sleep-
Mrs Moon: To self-medicate.
Bryn Parry: -the chain of command will often pick that up. That is a typical combat stress matter that you see with someone later on in their life-a person has become an alcoholic and is then getting help for post-traumatic stress disorder, or whatever it is.
I do not know whether that is part of the problem; the problem is that the guy is going to fight a war and is coming back with all sorts of problems because you have asked a civilian to become a soldier and go and kill people, or take incoming fire, and so on. Then you ask him to come back and readjust to society. One of the ways in which he will do that is by using alcohol, but you cannot blame the alcohol culture for the problem. It is much wider than that, as we are asking people to go to war. We train them to go to war and then we have to train them to become civilians.
Q460 Mr Havard: Along with alcohol, there is a series of other risk behaviours that often are indicators of a problem rather than the cause of the problem.
Bryn Parry: Your happy person has a drink when he is with his mates and enjoys it. Your unhappy person drinks alone to try to mask a problem.
Mr Havard: Or engages in other risky behaviour.
Q461 Chair: Can I put to you some evidence that has been given to us by Resolution? There has been considerable mention of Combat Stress today on the mental health issues. However, it is not the only organisation that deals with mental health issues. Two points come out from what Resolution says. The first that, "At present funding is channelled to certain well-established third sector organisations (Combat Stress, RBL, SSAFA, etc)…From experience, they are disinclined even to consider…new operational approaches which they might be able to adopt in order to increase efficiency and effectiveness within themselves." Therefore, Resolution is saying, essentially, "All the money is going to people other than us", which may be true and something that needs to be addressed.
However, Resolution also says, "the arrival of personalised medicine is an opportunity for the government to accept that individuals vary widely in their response to different treatments and that what works for one person may well not work for another. Rather than see this variance as an irritant, we suggest that the DoH and MoD should respond by inviting all providers with an interest in this area, to collaborate in a new, open practice and research network…where evidence from outcomes in individual practice and cases, is used to guide treatment." Do you think there is something to be said for that approach, basing funding perhaps on the evidence achieved from outcomes?
Sue Freeth: I would certainly identify that Resolution and other small organisations that have alternative treatment practices do face difficulties when they come to organisations, and indeed when they come to the Ministry of Defence, in terms of looking for funding. That is partly the stance of the Legion. We talk widely to those organisations that we believe are the experts. We are not experts in mental health, so we do take a lead and look for guidance from the Department of Health particularly on which treatments are safe for us to fund and support.
Where someone is looking for funding for a developmental area we feel much more nervous and reluctant to support because we cannot determine whether a treatment is safe or otherwise. We use NICE guidelines, practitioners who follow NICE guidelines, and treatments we are willing to fund, if they are not already being funded and are not already a statutory funded service.
I think it would be very helpful if the development of this practice and variety was led. At the moment it is very difficult for those on the periphery: I recognise that. I think the Department of Health and the Ministry of Defence and some of the charities are trying to bring together some policy statements to enable us better to develop relationships with those organisations.
Jerome Church: We all instinctively go towards evidence-based treatment. That is the way we tend to think. If the evidence is there, I suspect that support would follow in most instances. It is a very difficult area.
Q462 Chair: It is a different area from what BLESMA deals with?
Jerome Church: It is not something we have much experience in, I have to say. But in COBSEO-I am a member of the executive there-I do see these arguments from time to time.
Q463 Mrs Moon: I wonder how you are seeing different mental health provision being generated, operated, and whether there is innovation, perhaps, in some of the devolved Administrations. You talked a great deal about the Department of Health, but that does not operate in three areas of the UK. The Ministry of Defence does not necessarily have an easy communication system with the devolved Administrations in the rest of the UK. Is there work being undertaken outside England that is innovative or is there actually less flexibility and innovation? How do you see the availability elsewhere?
Sue Freeth: Wales and Scotland are contributing to the discussions and planning of the variety of different treatments that are working effectively there, so they are beginning to share some work that they have led. Wales, in particular, invested slightly earlier than England in developing better mental health services-or started to think about that-for the veteran community. It has developed some ways of working and it is beginning to share those practices.
From what I can glean, the area which there is most conversation about and which there is most investment going into, at a local level, is talking therapies. Talking therapies sound as though they will be particularly beneficial to the veteran community, particularly those who have depression and anxiety problems. I was in Devon and Cornwall last week and I met the two Department of Health-funded-but local-community mental health staff, and those types of treatments are what they were doing most of. They were meeting individuals and linking them together into talking therapy programmes. They reported good engagement and real progress for those people who were doing it. They are really at the forefront: they were the first ones that were piloted. That is as much information that is coming through at the moment.
A mixture of alternative therapies are being tried out and are being reported to be successful, but they have not been thoroughly examined. If you bring a group of people together who have had no support and give them support, almost anything is better than nothing. The extent to which it actually has a long-term benefit for the individual is something you are going to find out over time.
We are not qualified organisations to be able to comment much further.
Chair: Not too many more questions now. We will move on to support for families.
Q464 Mr Donaldson: Sue, may I ask you how well the MoD supports the families of injured or killed personnel from the Armed Forces? What is your experience of that?
Sue Freeth: I will talk about the injured, and Kevin will comment on the work we have been doing around the families of those who have lost their lives. On the injured side, families are now becoming more involved and more engaged. Bryn was telling a short story just outside, before we came in, about how families can often very much affect whether or not someone engages with what is available.
Interestingly, the Ministry of Defence had a welfare conference last week and it is the first time in the seven years that I have been in this sector that families have been present at a welfare conference. In fact, the first half of the conference was a presentation by a variety of different family members about their experiences. That was a demonstration that the Ministry of Defence is trying to recognise that engaging early with the families of people who are injured is very important in their pathway. That does not mean that it isn’t without its challenges. The families who were present had some good news stories and each of them also had some areas where they did not feel that they got as good a support as they should have done. More effort will be needed, but the MoD has started to take that seriously. Family members are now incorporated in the protocol for engaging people, both once people have lost their life and their family is informed, and particularly for those who are injured. It is not perfect, but we are there.
Q465 Mr Donaldson: It is improving, you think?
Sue Freeth: It is improving.
Kevin Shinkwin: For bereaved families, the main point I would make is that Parliament did a wonderful thing in 2009 in passing the Coroners and Justice Act with very broad cross-party support. The reason why it was such a wonderful thing was because the chief coroner that the Act created was identified as a position that would spearhead essential reform of the coroner service. Sadly, we know first hand that many families have mixed experience of, for example, military inquest and the inquest system itself. Briefly, the point that I would make is that Parliament has a fantastic opportunity right now, in the passage of the Public Bodies Bill, to reinforce the good that it did in 2009 by ensuring that the chief coroner is taken out completely from the Public Bodies Bill.
Just one additional point that I would make is that I am amused, dismayed, to see that figures that I do not recognise in terms of the cost of the chief coroner are being bandied about when honestly we as charities-a number of charities-are rooting for the chief coroner as cost-effective and far less expensive than the figures that seem to be emanating from various parts of Government. We have made a very pragmatic, principled and constructive offer to Government, to say that we would like a chief coroner-we want it taken out of the Public Bodies Bill-but we recognise that because costs are such an important issue that there should be an elongated timetable for the implementation of the Coroners and Justice Act 2009, which governs how the chief coroner is set up and the activities that that post holder will undertake.
Q466 Mr Havard: Individuals will have different views about this. In my personal experience, from 2003 on this Committee, we were dealing with Deepcut and suicides and so on-right the way through the whole process-and then the involvement of the coroner service in repatriations and all sorts of different things. That reform of the coroner services, and their ability to provide appropriately, at the right time, throughout all of these things with the Armed Services, has been a problem right the way through, and it is starting to resolve itself. If, however, that is not done and they do not take it out of the Public Bodies Bill, you said that the establishment of the chief coroner was helping to consolidate and develop the very reform that was required, which I agree with, so how do you see it going forward, if it remains in the Bill?
Kevin Shinkwin: The option that the Government seem to be in favour of at the moment is effectively to put the post on ice. They are calling it schedule 5-that is the part of the Bill that they are saying they will reinsert the chief coroner into.
The point that I would make very quickly is that, in December, the Government suffered their biggest defeat since the election, when the Lords took the chief coroner out of the Bill. So the status quo at the moment is that the chief coroner is safe. It will only not be safe if the Government proceed with their plan to reinsert it.
Now, in terms of schedule 5 and putting the chief coroner on ice, the consensus from, for example the BMA, Inquest and others is that actually the need for a chief coroner would continue. I mentioned that I was dismayed by how the arguments have been presented by Government. My dismay is rooted in the fact that the Government seem to be focusing not on the human cost of Deepcut and other issues that you raised but on the financial cost. I made the point earlier about how we can never repay our debt to bereaved Armed Forces families. If the Government, by putting the chief coroner in schedule 5-on ice, rather than abolishing it outright-tacitly accept that there might well be a need for a chief coroner, why not proceed with a chief coroner who is actually significantly cheaper than what they are suggesting would be the case? Surely, bereaved Armed Forces families have suffered enough and deserve the chief coroner as a mark of respect.
In answer to your question, I would rather not entertain the possibility of there not being a chief coroner because I think that the Government are tacitly accepting, by presenting the schedule 5 option, that they may need to revisit the situation in the future. My argument would be, "Let’s not actually go there. Let’s merely consider how we are to make it work now within existing financial constraints and within the context of an elongated implementation timetable for the Coroners and Justice Act 2009."
Q467 Mr Havard: I agree that the costs of not doing it go far greater than the obvious, and they are not just simply financial. What is the difference between putting it on ice-as you described it-in schedule 5, and an elongated process of implementation? Are they not the same thing in a sense?
Kevin Shinkwin: They are not for one particular reason. Fundamental and integral-Bryn made the point about the importance of something being integral-to the Coroners and Justice Act was the concept and application of independent leadership by an independent judicial figure. I am not aware of any proposal being made by the Government now that would replicate that concept to any extent, yet it is an absolutely essential and integral part of the reform equation. For example, with the ministerial board that has been proposed by the Government, and which would be chaired by a Minister, if you had coroners-as we have now-who are resistant to reform, why would they not say, in obstructing reform, "Ah, I am simply standing up for the judicial integrity of the coroner’s service," and actually reveal that the Minister does not have sufficient authority to push through reform in a way that the chief coroner could? In addition, the chief coroner could do so more cost-effectively than now because there would not need to be a reliance on judicial review, which is incredibly expensive and very upsetting for families.
Q468 Mr Havard: Well, you have got my vote.
I wanted to finish off the questioning about devolved authority and the different architecture. We have a little difficulty here because we tried to break up our discussion about the covenant into manageable chunks. At the moment we are doing the injuries part of it, but we are clearly aware that when people transition out of the Service with difficulties, it is not only the health service that is involved.
It seems you suggest that in order to square the circle of a different architecture of provision and commissioning arrangements in the four countries that make up the United Kingdom and the differentiated process in England, on limbs for example, and so on, there may be the need for a specialist fund that is centrally deployed. We are struggling with the question of how a declaration of intention that is meant to cover the whole of the United Kingdom, and citizens in the United Kingdom who may later move around within it over the long period of life that they will have, will get a consistent application of a central declaration in that differentiated architecture of commissioning provision. Understanding that is our difficulty and, particularly in relation to the health service delivery, I wanted to ask what observations you may have about delivery as it now is. The situation is already radically different in Wales, Northern Ireland, Scotland and England, and any observations you might have would help us-just a small question.
Jerome Church: The words "pious hope" come to mind.
Mr Havard: Not me.
Jerome Church: Certainly, looking at the limb service, we know where it works well. In all our administrations there are good and working artificial limb centres. We believe that they intend to follow the spirit of what comes out of the Murrison report and the structures that it suggests, which should be, in my view, reasonably easily implemented, if that was the way that the devolved Administrations felt they could follow it. They should do that. I go back to what I said before: time will tell on this one. It is a nagging worry.
Sue Freeth: Certainly the evidence that we gave to the prosthesis review was that we felt that shared agreements between the Administrations and a pooling of funding, not only from the Department of Health but perhaps from the MoD as well, particularly during the recovery period when the person is still officially serving, are necessary to ensure that there is a real commitment to co-ordinate this pathway. It can take quite a long time. An individual might be in the recovery phase for six or seven years, or three or four years. If there is a pooled funding structure and a joint funding structure, people have to talk to each other. If there is not, they do not have to work together.
It is not just about the money itself; it is the leverage the money gives you which we want to see being applied. We want joint commitments and agreements between Government Departments and pooled funds to support this group. That could be applied to not only prosthetics, but to other areas, perhaps to on-the-ground continuing care, where individuals, who might have their entitlement dismantled or disjointed or similarly not enacted in one part of the country, might get that entitlement in full if they lived somewhere else.
Q469 Chair: Final question. You have the opportunity to make one recommendation to the Ministry of Defence. No cheating: not two. What is your recommendation?
Jerome Church: Can I think about that? I have a rather long list.
Bryn Parry: To create a particular department at defence level to champion the wounded, injured and sick. I would ask that we create an extra, outside of the MoD, role for an independent commissioner or a tsar-whatever you want to call it-who heads up a team that talks to all the various different Ministries, agencies and charities, so that we have one co-ordinated approach. If the recommendation is for just the MoD, it has to be at defence level, but if I am allowed to widen it, then that is what I would like. We need to treat these men and women as they become older as a special group who need special support. That needs to be co-ordinated.
Q470 Mr Havard: A bit like the veterans agencies in America.
Bryn Parry: Yes. Going back to the architecture, in long-term life, when you get ill and get flu or whatever, you go to your GP. If you have a medical, psychological or housing need that is pertinent or special because of your service, you need to be able to tap into special support. I would therefore suggest that we have regional centres so that you know that if you have a problem with your prosthetic or problems psychologically, you can talk to someone who understands the nature of warfare. You do not want to go to a mental health group where you are asked not to talk about your military experience, which has happened on several occasions, because it might upset others in the group, and you do not want to end up talking to some so-called psychologist who does not understand what you have been through. When you feel that your needs are to do with your military Service, you need to go to someone who understands. I would centre them around the country, obviously in Wales, obviously in Scotland and elsewhere as well so that there are special centres within an hour and a half or two hours of anywhere in this country.
Kevin Shinkwin: I would very respectfully urge the MoD to urge the Ministry of Justice to reflect on the debt that we as a nation owe to those who have fallen and those whom they leave behind, the Armed Forces families, and not to reinsert the chief coroner into the Public Bodies Bill.
Q471 Chair: Sue? It’s unfair for the Royal British Legion to have two goes at this, but there we are.
Sue Freeth: You very generously allowed us to have two voices, so thank you for that. The issue that I want to mention is early engagement. I’m talking about engaging the organisations that are already able to contribute in order to fill some of the gaps that we’ve been talking about today. In that way, we make the best use of what we have already.
Q472 Chair: Jerome, you have your second bite at this.
Jerome Church: And I agree very much with what Bryn said, but I would like a guarantee from the Ministry of Defence, down at the level where things really happen, that in a recovery process, the handover of the injured person will be properly effective, not just in relation to prosthetics-although I really hope that is effective-but in relation to all aspects of their health. At the moment, there is a lot of, "Yes, that’s what we’re going to do," but I would like to see it properly formulated. As we said in relation to prosthetics, we need it done properly. We have had lots of promises. We want to see how you are going to do it.
Q473 Mr Havard: Do you mean that it would be right for the individual in some way to be represented in a process of compliance? Is that what you are saying?
Jerome Church: At some stage, he ceases to be a soldier. At that stage, all the right avenues and all the right contacts need to have been made in terms of his health and his condition then, and in terms of alerting people to the future deterioration that may well come. Every aspect of his health and social care should be properly handed over. That is the MoD’s job. If I am allowed to go wider, going back to the word "cross-cutting" and everything else, the various Government bodies that take on that responsibility should be somehow held to account.
Chair: Thank you all very much. This has been a very rich evidence session, with a lot of interesting ideas and threads coming out of it. We are most grateful.