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Ivor Caplin MP, Minister For Veterans speech to Combat Stress - 22 September 2004
Thank you for inviting me here today to speak to you and many thanks to Toby Elliot, or should I say the new High Sheriff of Gwent, for his kind opening words. Since becoming Minister for Veterans I have enjoyed working in collaboration with your organisation. I am determined that this fruitful relationship will last long into the future.
I am particularly delighted to be here on board HQS Wellington Now in its seventieth year, this vessel is itself a veteran and provides a fitting forum for this conference today. Whether it has any form of combat stress we will only know later today!
It seems longer, but in fact I have been Minister for Veterans for a little over a year now and am finding the role most rewarding. I have very much enjoyed meeting and getting to know many of you. This conference today is a further valuable opportunity to continue the process of collaboration and to strengthen the ties between the Veterans' Community and the Ministry of Defence.
As I am sure you are aware, I am keen to promote and support the valuable role of veterans in our society. This can best be achieved by full, frank and regular consultation with veterans' organisations such as Combat Stress. I am a very strong believer in open Government and I will always be very happy to hear from you to discuss with you and yes, sometimes we will not always agree. That is the nature of good, strong constructive relationships.
I do not however just sit in the MOD Main Building - I have made it my business to get out and about. I have been to Tyrwhitt House in Leatherhead and also to Hollybush House in Ayrshire. I was impressed by the standard of care provided by many of the cheerful and selfless staff, as well as the facilities for occupational therapy and art therapy. But most of all I was inspired by the sense of understanding and comradeship that prevails. This must be of enormous comfort to those struggling with mental problems. I congratulate you on what you have achieved so far.
There has been a strong bond between the Government and Combat Stress ever since it was created in 1919; originally this was with the Pensions department in its various guises, but most recently with the MOD. Combat Stress has maintained a unique reputation for the sympathetic ear it lends those Service leavers who find civilian life difficult because of mental health problems. From the terrible advent of shell shock, right through to today's ex-Service issues, Combat Stress has worked with the Government to provide an important, indeed necessary, addition to the support supplied to Veterans.
I expect that the relationship between Combat Stress and MOD will continue and grow. However, we in the MoD are committed to modernisation and as we adapt to changing needs, circumstances and research, and as understanding of mental illness and its management expands, I also want to ensure that Combat Stress enables itself to remain a key provider in the ex-Service mental health support field of which it has so much expertise.
I am sure you will agree that these are both momentous and emotive times for Veterans. This year saw the 60th anniversary commemorations of D-Day, one of the largest events in the world this year! Next year will see the 60th anniversary of the end of the Second World War. While we celebrate with those veterans who took part in those extraordinary events sixty years ago, we must not forget those who sacrificed their lives - or their physical or mental health - to guarantee the freedoms we enjoy today.
And we must also remember those who have made similar sacrifices in the service of freedom since then, and continue to do so. Unfortunately, freedom, from the Nazis 60 years ago or from the Taliban in Afghanistan or from Saddam Hussain, does not come without the cost of young lives of which we are all aware.
I want to develop and consolidate the important relationships that are being forged with Ex-Service Organisations, and to encourage a forward looking approach while continuing to commemorate the past bravery of our veterans.
I have had several memorable visits to do just this. I have visited Leopardstown Hospital in Dublin; Korea for the 50th Anniversary of the end of hostilities; Norway for the unveiling of the memorial in the Fjords as well as Normandy for the D-Day Commemorative events. I am committed to the Government's comprehensive agenda for veterans and to raising awareness of its aims and objectives in all Government Departments and at every level of government in the UK. The events of 2004 and those planned for 2005 underline a key theme of passing on the baton of remembrance to future generations. This is of course crucial.
But today I would like to say something about three other key strands of our work at the MoD: tailored support for in-service personnel, the easing of transition from military to civilian life and welfare support provision for veterans. All have a bearing on the issues you will consider today.
There are various common misconceptions about the ex-Service community and the problems they face. It is important to emphasise, for example, that it has long been the case, and continues to be so today, that the majority of personnel leaving the Services settle successfully in the civilian community.
The high level of ex-Service employment within only a few months of returning to civvy-street is itself a good indication of how well most ex-Service personnel adapt to civilian life. This underlines the transferable skills a career in the military provides for people and the high esteem with which most employers hold those with a military background.
But clearly we need to provide appropriate help to those who do face difficulties. Previously, problems have been addressed as they have arisen, but we have begun to take a more structured approach and to base policy, and ultimately resources and action, on evidence of real and measured needs.
One of the most important objectives for me is to ensure the proper standards of support, not only for in-Service Personnel, but also for those now in civilian life.
Sadly not all Service personnel adjust to life in the Services and in extreme cases this can lead to self harm and suicide. Recent statistics show, however, that the number of suicide and undetermined deaths within the three services are lower than in the UK population as a whole. Unfortunately, the one exception is among young men under 20 in the Army where the statistics show that there have been 1.7 times more deaths than expected. In overall numbers the instances of suicide remain small but one case is one too many. I am absolutely committed to reducing the incidences of suicide and self-harm in the Armed Forces.
The Army have created a comprehensive approach to in-Service personnel support. They have updated the guidance and procedures on the prevention and management of suicide and deliberate self harm. This has been shared between the other services. When instituting a through life approach to Service personnel support, I strongly believe the emphasis must be on prevention of problems, through screening, reporting, data collection, training and education.
Commanders at all levels play an important role in this process. It is crucial that they get to know their people sufficiently well to identify any danger signs that may be on the horizon.
Improvements in training have been instituted. A better defined approach to instructor training combined with improving supervisory ratios have helped to prevent problems. The opportunities for recreational facility use and welfare projects have also been increased to allow personnel a forum for relieving the stress of military life.
In addition to these measures, I am particularly pleased with the growing culture of providing every trainee access to an empowered officer. This guaranteed access combined with efforts to ensure a better balance between male and female instructors and supervisors is designed to provide a balanced and tailored system of support, particularly for those most at risk to mental stress.
All these measures have been brought in to improve the lives of personnel and identify and prevent problems before they arise. However, in the rare cases where acute problems do occur there must be effective systems in place. That is why I welcome the more robust methods of tracking incidents of bullying and harassment, within the Army in particular.
Combat Stress offers admirable support for some of the small section of veterans for whom transition into civilian life is hard.
The MOD has long been committed to ensuring that Service personnel make a smooth transition back into civilian life. Longer service is rewarded with eligibility for increased resettlement time, but personnel who are medically discharged are entitled to the full resettlement programme, regardless of their length of service.
Our current policy also ensures that those personnel medically discharged who are unable to undertake resettlement due to ill health can defer resettlement for a period of up to 2 years after discharge. For those personnel who cannot undertake resettlement through long-term ill health, there is also the potential to transfer the resettlement entitlement to a spouse (or other family member), or, in case of death, widows or widowers.
The employment consultancy advice available through the Resettlement programme, is considered to be among the best available. Our statistics show that 95% of service leavers who undertake resettlement training find employment within 6 months of leaving the Armed Forces.
However, there has been a gap in provision of support and advice to Service leavers. Until recently there were some 9000 Service personnel that left the Armed Forces without entitlement to resettlement. This figure includes those who were compulsorily discharged, either from the trained or untrained strength, those who were unsuitable for military life, or those who chose to leave before they served the mandatory length of service required for entitlement to resettlement. This policy has now changed.
Although procedures existed within the Armed Forces to help Early Service Leavers when they return to civilian life, these were often locally determined and there was no consistent tri-Service policy in place. I introduced the tri-Service “Early Service Leavers Policy”. The policy, which became effective on 1 April this year, ensures that all Early Service Leavers receive a mandatory brief and interview. In short, for the first time, we know that we are giving everyone leaving the services structured help in resettling in civilian life. This, I am sure you will agree, is an important step forward.
While finding employment and housing is not a panacea, the positive transition between service and civilian life must surely induce self worth and instil the all-important self-confidence needed to make the successful transition to civilian life. With these measures and processes I hope we can continue to provide a good grounding for transition to civilian life. I am sure in future we can continue to improve the lot of Service personnel moving from military life. As I mentioned before, civilian employers clearly appreciate the disciplined approach to work and the organisational and management skills which ex-service personnel bring to their work environments, and I include the Gurkhas in that.
Now, I would like to say a little about our structured provision of support for the ex-Service community. I say community because right from the start of my appointment I have made plain my broader definition of the term 'veteran'. This includes dependants of service personnel - who are as affected by military life as those who serve and I am sure those of you here today fully support this view.
Indeed the support and care you provide for families whose husbands, wives and children are affected by Service-related mental problems is one of the most important roles Combat Stress performs. I saw this for myself when I spoke to some residents at Leatherhead.
At the Ministry of Defence, we have brought in a new approach to ex-Service personnel support. Previously, veterans concerns were dealt with on a “single issue” basis by the responsible department within Central or Local Government.
Now we have a more integrated approach to veterans' service provision. This is illustrated by the Veterans Agency free phone helpline and website, which provides a one-stop-shop for advice and information catering for veterans both young and old on issues as varied as advice on compensation and war pensions, civilian housing, employment and commemorative events.
I have had the opportunity to meet the staff in Blackpool who provide the one- to-one advice. I was very impressed by their helpful attitude and commitment to aiding veterans and their families with a wide variety of issues affecting them. I am planning to visit the Agency again before the end of the year.
So, with the continued co-operation of organisations like Combat Stress, our service delivery can become even more integrated and efficient in future.
Part of our recognition and support for veterans is displayed
in our new compensation and pension scheme. Both new schemes are due to come
into effect from April 2005 but in the case of the new pension scheme this
will only apply to new entrants, with those currently serving being given
the option not later than April 2007.
The new schemes have been designed with the objective of focusing resources
better on need and this includes a number of groups in which Combat Stress
also recognises the case for greater support, including the more seriously
disabled and the dependants of those who die in service. So the new pension
scheme includes measures designed to provide fairer terms for Armed Forces
personnel, such as benefits based on final pensionable salary (instead of
representative pay rates) and common terms for officers and other ranks.
But it will also provide major increases in dependants' benefits. Widows'
and widowers' pensions at full career will be increased to 62.5% of the member's
pension, from 50% at present. And we will also increase the death-in-service
lump sum to 4 times pensionable pay. As I am sure you will agree, it is crucial
that we support the families of our personnel, and in particular dependants
of those who make the ultimate sacrifice.
In addition to this, all benefits will be extended to unmarried partners, including same sex partners. This forms part of our commitment to a comprehensive and inclusive package for veterans, responding to the lifestyles that increasing numbers of our personnel are choosing.
Overall, the pension scheme will offer those now in-Service terms that are competitive with the best outside as well as confidence that their dependants will be well provided for in the event of their death.
I have also made every effort to ensure the new compensation scheme will provide a fairer deal too. The outcomes are expected to be more consistent for all those entitled to compensation, with particular improvements for the more seriously disabled who are not well served by the current arrangements. The new scheme will better reflect modern medical understanding, as well as current practice and thinking on disability. Decisions should be fairer, quicker, more transparent and simpler to understand.
As part of our design to meet the needs of more serious injury, there will, for the first time, be a tariff-based lump sum payable for pain and suffering, these will be very substantial sums in the case of serious disablement and will help people make the adjustments required to the way they live their lives. Where appropriate, a Guaranteed Income Stream will also be paid for life, to compensate Service personnel whose earnings capacity can be expected to have been affected.
There have been changes to a more modern burden and standard of proof about which I know some in the ex-Service community have expressed concerns. However, our work shows that no claim should fail where death or injury is likely to have been due to service. This has not been a cost cutting exercise - the new arrangements will cost broadly the same as the old - but there will be a much better focus on need, with the more seriously injured, including those with serious mental conditions, receiving a proper level of support for the first time. I am confident that with systems of support such as these, veterans will realise they are recognised, valued and supported.
The scheme will be introduced for all members of the Armed Forces for all injuries and conditions the cause of which arises after 6 April 2005. At the moment the House of Lords has rejected the burden and standard of proof that we have proposed for the new compensation scheme; this puts in jeopardy both the compensation and pension schemes given that the two are designed as a single overall package of benefits. I have considered their Lordships' views but I have decided that these must be overturned by the House of Commons. This will ensure that the scheme as a whole is consistent with new, modern and fair values.
The links between Service establishments and veterans continue to develop. We are reviewing ways for veterans to make use of the social and mess facilities at the base of their previous Regiment or Unit on appropriate occasions. Officials are now exploring how these measures can be adopted by the Services so that this can work and so that we can really improve links with our veterans at local level. Measures such as this will surely aid the lives of all veterans, including those who are finding civilian life difficult. The RAF already have related schemes.
Before I leave this subject I should also mention plans for the first ever “Veterans Awareness Week” in July next year, to conclude with the 60th Anniversary Commemorations of the Second World War on Sunday July 16th. I would like to develop this into a regular event which celebrates the achievements of veterans and promotes the work of the ex-Service organisations. I hope that Combat Stress will be closely involved in this exciting and challenging initiative.
I would like to say a few words on how I see the relationship between MoD and Combat Stress developing in the future. It is an important and valued relationship. By tailoring our approach to modern thinking and changing needs we can deliver the best possible support package to veterans. Medical opinion agrees that most mental illness can be treated (some cases more successfully than others), and whilst care and support are vital, promoting return into society, through work and other measures is equally important.
The MoD provides considerable funds for Combat Stress under Article 26 of the War Pension Scheme which makes provision for remedial treatment. Against a claim for an increase in fees of over 10% for each of its houses, we have already implemented a 5% increase in fees which is above the rate of inflation but I am pleased to announce today that, having considered the details of the claim, we can now agree the full increase. This will be implemented as soon as possible, backdated to the start of this year. Overall, we are satisfied that the level of charges represents good value, even though the increase is higher than the normal rate of inflation. I have no doubt that this will be good news for the Society.
This is a period of great interest and investment in mental health in the UK. The increase in Combat Stress's fees underlines my personal commitment to maintaining a key role for Combat Stress. But change brings challenges for Combat Stress as well as others involved. To endorse MoD's commitment to Combat Stress, we are working with the Society to conduct a review into the future of its treatment regime. I hope that this will enable the organisation to continue to work as an extension of government in the treatment of mentally ill veterans.
The complex issue of mental illness treatment must be grasped and tackled. The undoubted commitment to the care of those with mental health problems must be matched by the commitment to developing new strategies for the effective rehabilitation of clients which takes full account of the latest available medical evidence.
The National Institute of Clinical Excellence (NICE) will be publishing the UK Post Traumatic Stress Disorder treatment guidelines early next year. Combat Stress will, I am sure, also be taking these into consideration as it looks to evolve its approach to veterans with psychological problems. It is in a good position to make sure its approach fully reflects modern best practice, and I am convinced you can and will do that.
I firmly believe that with this forward looking, integrated approach we can provide a comprehensive, tailored package of care for in and ex Service personnel. With Combat Stress's record of care and our joint commitment to evidence-based approaches, I am sure our effective partnership will continue long into the future.
By working together in good collaboration and partnership, we put at the centre of what we all do - the Veterans themselves, young and old alike
We should always remember and that is why we are so passionate and determined about what we do. Thank you to Combat Stress - a partner and a friend to the Veterans of the United Kingdom.
