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Select committee inquiry

The Armed Forces Covenant in Action Part 5: Military Casualties

Closed

Defence Committee · Opened 17 December 2013 · Closed 30 March 2015

6 recommendations · 15 conclusions
Inquiry on parliament.uk ↗

What the inquiry looked at

“The Committee has followed the progress of work introduced by the MoD to address the recovery of personnel and has examined the approaches taken by the NHS and the Devolved Administrations to the support given to wounded, injured or sick Armed Forces personnel discharged from the Services. This inquiry will follow up the issues identified in the Committee Report’s into military casualties. Terms of Reference”

The committee's words, from the inquiry page on parliament.uk ↗.

What the government said

The government responded on 23 January 2015.

Summary written by Accountability Index from the government's response.

The government responds to each recommendation in turn, setting out existing work and some dated commitments, and states that the needs of those who have served and their families "will continue to be met".

  • On reservists' mental health, research into contributing factors and a tailored Post Operational Stress Management programme has "now been commissioned", and both will report by March 2016.
  • On alcohol, it states that "there is still more that can be achieved". By the end of 2015 it will introduce a screening tool, while a brief intervention programme is "being considered".
  • On recovery, 29 additional Personnel Recovery Officers are to be added in two phases, with phase 1 on 5 January 2015. Ofsted's assurance pilot will report by 31 March 2015, with full implementation decided on later.
  • On hearing loss, it states that the evidence was "insufficient" for the expert group to recommend changing the compensation threshold. It does not compensate tinnitus alone, citing the absence of a "robust method of assessment".

Read the government's response ↗ Read the report ↗ Report an error

How the inquiry ran

Each dot is a dated item listed on this page, from the inquiry's opening on 17 December 2013 to its close on 30 March 2015.

  1. Oral evidence 3 sessions
  2. Report 30 Oct 2014
  3. Government response 23 Jan 2015

What it recommended 6 recommendations · 15 conclusions

1We welcome the introduction of the Trauma Risk Management system and the MoD’s work in...
Concluded (the committee's words)
We welcome the introduction of the Trauma Risk Management system and the MoD’s work in reducing the stigma attached to seeking help for mental health problems. We also welcome the fact that personnel are seeking help for mental health problems earlier than in the past. The Armed Forces have seen a significant increase in the number of personnel requiring treatment by the Defence Community Mental Healthcare Teams without a proportional increase in the number of staff. Given evidence that Service personnel are coming for mental health support sooner than in the past and while they are still serving, pressure on existing resources will only increase. In response to this Report, the MoD should inform us of its plans to deal with the increased volume of work and tell us how quickly it can ramp up its support for personnel in the event of any further acceleration in the number of personnel coming forward for help.
2The higher incidence of mental health problems developing in reservists deployed to Iraq and Afghanistan...
Concluded (the committee's words)
The higher incidence of mental health problems developing in reservists deployed to Iraq and Afghanistan has been known for some considerable time. Given our earlier recommendation in 2011 that it investigate the factors contributing to that higher incidence, we are disappointed that the MoD is still in the process of commissioning this research. This has meant that the MoD has yet authoritatively to identify or to address these issues and provide support specifically tailored for reservists. This is of great concern to the Committee given that the importance of identifying and addressing the particular problems facing reservists is increased by the growing dependence on Reserve Forces in Future Force 2020.
3We welcome the MoD’s acceptance of our previous conclusion that it needed to recognise the...
Concluded (the committee's words)
We welcome the MoD’s acceptance of our previous conclusion that it needed to recognise the seriousness of the problem of alcohol consumption in the Armed Forces and that it has strengthened its response to the problem. However, we remain concerned that the MoD’s response has not had any noticeable impact on the level of excessive and binge drinking in the Armed Forces. We are not convinced that sufficient focus has been given to dealing with the problem at every level of the chain of command. We also question whether the MoD has examined whether excess alcohol consumption may, in some Service personnel, be masking other mental health problems.
4We are disappointed that the MoD took well over a year to commission research into...
Concluded (the committee's words)
We are disappointed that the MoD took well over a year to commission research into the drivers of excessive alcohol consumption. The conclusions of the study are very worrying. Clearly, urgent action is needed to tackle the harm caused by the abuse of alcohol to both Armed Forces personnel and their families. In its response to this Report, the MoD should tell us how it intends to implement the study’s recommendations and in what time frame.
5The MoD should determine a comprehensive strategy and plan to tackle alcohol misuse, identifying how...
Concluded (the committee's words)
The MoD should determine a comprehensive strategy and plan to tackle alcohol misuse, identifying how it intends to change the culture within the Armed Forces and identifying practical measures to reduce consumption including, if necessary, reviewing pricing policies and availability of alcohol on bases. The plan should 38 The Armed Forces Covenant in Action Part 5: Military Casualties, a review of progress incorporate the recommendations of the study on excessive alcohol consumption. It should also include performance measures which will indicate whether the plan is working in reducing excessive alcohol consumption.
6Increases in violent offending behaviour are linked to deployment in combat roles and subsequent misuse...
Concluded (the committee's words)
Increases in violent offending behaviour are linked to deployment in combat roles and subsequent misuse of alcohol and other risk taking behaviour. The MoD should identify those most at risk of such offending and put in place measures to assist these personnel to manage the aftermath of deployment in combat roles better.
7The MoD needs to understand better the links between deployment on combat operations, alcohol misuse...
Concluded (the committee's words)
The MoD needs to understand better the links between deployment on combat operations, alcohol misuse and domestic violence. The MoD must be more proactive at all levels and should re-examine its policies on domestic violence and develop plans to intervene to prevent domestic violence or, at least, reduce the incidence of domestic violence by Armed Forces personnel. These plans should deal with both regulars and reservists.
8We are disappointed that the MoD has taken so long to act on the recommendation...
Recommended (the committee's words)
We are disappointed that the MoD has taken so long to act on the recommendation in our December 2011 Report to review the support it offers families. Families need improved support, in particular, the families of reservists who find it harder to identify sources of support than regulars. The MoD should provide us with its study of the support to the families of wounded, injured and sick personnel as soon as it is available. It should also tell us how it intends to implement the recommendations of the SSAFA report on support to bereaved families and the above report. We call on the MoD to use the reports it has commissioned as the basis for a revision to its policy for the support of families.
9The shortfall in the capacity of the Defence Recovery Centres has meant that some wounded,...
Concluded (the committee's words)
The shortfall in the capacity of the Defence Recovery Centres has meant that some wounded, injured or sick serving personnel have not been able to benefit from them and reservists, in particular, have found it difficult to access them. We welcome the opening up of the Centres to veterans but recognise that this will also increase demand. Whilst we welcome the Army’s decision to increase the number of Personnel Recovery Officers, we doubt that this increase will be sufficient. In response to this Report, the MoD should outline both its estimates of expected demand on the Defence Recovery Capability from serving personnel, reservists and veterans and its estimates of the additional resources, in particular, numbers of staff, needed to meet those demands and also clarify whether staff will be provided by the MoD or the charitable sector.
10The MoD should inform us of the latest progress in implementing the recommendations of its...
Concluded (the committee's words)
The MoD should inform us of the latest progress in implementing the recommendations of its review of the Defence Recovery Centres. In particular, it should tell us how many additional Personnel Recovery Officers have been appointed, and when and how the new evaluation and assurance scheme for the Defence Recovery Centres will be implemented.
11The Defence Medical Rehabilitation Centre at Headley Court has been a valuable resource for those...
Concluded (the committee's words)
The Defence Medical Rehabilitation Centre at Headley Court has been a valuable resource for those injured in the Armed Forces. We welcome the announcement of a new Defence and National Rehabilitation Centre and commend the generosity of those charities and individuals who have committed to fund the Centre. In response to this Report, the MoD should tell us what its financial and other commitments to the establishment will be over the next ten years. The MoD should also inform us of the results of its negotiations with the trustees about the future of Headley Court.
12The Government should tell us how it intends to respond to the conclusions and recommendations...
Recommended (the committee's words)
The Government should tell us how it intends to respond to the conclusions and recommendations on the treatment of musculoskeletal conditions raised in the Chavasse Report for serving personnel, reservists and veterans.
13The Government should tell us how it intends to respond to the recommendations on the...
Recommended (the committee's words)
The Government should tell us how it intends to respond to the recommendations on the support of Service personnel and veterans with hearing loss and tinnitus and on the prevention of hearing damage in younger members of the Armed Forces as set out in the Royal British Legion Report on hearing problems in the Armed Forces.
14Despite the assurances provided by MoD that the processing times had improved and backlogs reduced,...
Recommended (the committee's words)
Despite the assurances provided by MoD that the processing times had improved and backlogs reduced, we understand that serving personnel and veterans are still experiencing long delays in having their claims processed. We recognise that the backlog of cases awaiting award by Veterans UK has fallen but we are concerned that the throughput is still too slow. In response to this Report, the MoD should set out how it intends to reduce the time taken to adjudicate on claims under the Armed Forces Compensation Scheme and the War Pension Scheme.
15We welcome the establishment of a longitudinal study looking at the long-term impact of injuries...
Concluded (the committee's words)
We welcome the establishment of a longitudinal study looking at the long-term impact of injuries sustained in operations in Afghanistan. We will continue to take an interest in the progress of this long term study, its conduct and its management.
16We remain very concerned about the long term impact of deployment in Iraq and Afghanistan...
Concluded (the committee's words)
We remain very concerned about the long term impact of deployment in Iraq and Afghanistan on those personnel who were injured physically or psychologically. Other aspects of Service life may also have a long term impact on the health of veterans. However, there are issues which need to be tackled now; these include provision for those requiring musculoskeletal treatment and wheelchairs and those suffering hearing loss.
17We are not aware whether the MoD has made concerted and comprehensive efforts to keep...
Concluded (the committee's words)
We are not aware whether the MoD has made concerted and comprehensive efforts to keep in touch with people discharged from the Armed Forces due to life-changing injuries. The MoD should tell us how it intends to remain in contact with such discharged personnel to ensure that it can monitor whether individuals are receiving the support they deserve.
18It is too soon to judge the long-term effectiveness of the measures to address the...
Concluded (the committee's words)
It is too soon to judge the long-term effectiveness of the measures to address the mental health needs of veterans. The MoD with the Department of Health should monitor the provision of mental health support to veterans and remedy any 40 The Armed Forces Covenant in Action Part 5: Military Casualties, a review of progress shortcomings identified. It should include the results of this monitoring in the annual report on the Armed Forces Covenant. The MoD should also monitor the implementation of the improved services for amputees, act on any shortcomings and again report the results in the annual report on the Covenant.
19Despite assurances from the MoD and the Department of Health, we are still worried that,...
Recommended (the committee's words)
Despite assurances from the MoD and the Department of Health, we are still worried that, as operations in Iraq and Afghanistan fade from the public eye, the necessary long term support for those injured will not be maintained. In response to this Report, the Government should make explicit its continued support for those damaged physically or psychologically in the service of the country.
20The system intended to improve the transfer of the medical records of Armed Forces personnel...
Concluded (the committee's words)
The system intended to improve the transfer of the medical records of Armed Forces personnel leaving the Services has been in operation for less than a year. The MoD told us it will be monitoring performance closely. The MoD should provide us with a progress report on the success or otherwise of the system and the timetable for making the improvements that it was planning.
21We have heard a great deal about the multiplicity of governance arrangements for healthcare and...
Recommended (the committee's words)
We have heard a great deal about the multiplicity of governance arrangements for healthcare and the processes for liaison between the MoD, the Department of Health, NHS England and the Devolved Administrations. We do not believe that these arrangements ensure that veterans get appropriate treatment for their needs and that this treatment is consistent across the whole of the UK. The Government should explain how the MoD’s recently created Partnership Board with the Department of Health, NHS England and the Devolved Administrations will ensure that serving personnel and veterans are receiving appropriate and consistent treatment wherever they live.

Evidence

Oral evidence sessions 3