AFC0041

Written evidence submitted anonymously.

I [Redacted] am the partner and full-time carer for [Redacted] and he has asked for my assistance to support his wish to provide evidence to the Defence Committee as it examines the Armed Forces Covenant.  Due to his extremely fragile mental health, he respectfully requests the committee to keep his details anonymous at this stage of the proceedings.

[Redacted], joined the Royal Engineers as a Sapper at the age of sixteen and half in 1975.  He served for almost 38 years, promoting through to the rank of Major.  He inexplicably and abruptly left the service at the end of March 2013 with less than two years to serve to full pension.  His service included operating as a special forces group bomb disposal officer and deployments to Northern Ireland, Bosnia, Belize, Iraq (Gulf Wars I & II), Afghanistan, Kenya and Sierra Leone.  On leaving the armed forces in 2013 at the age of 54, [Redacted] was unable to maintain substantive employment. He has not worked at all since 2016 and relies on 24/7 support from me to cope with daily life.

[Redacted] suffers with service-related physical injuries and mental ill health. It has taken over ten years for the full extent of his service-related injuries to be accepted by the Ministry of Defence and he is now, finally in 2024, in receipt of a War Pension that recognise his disability at 100%.

He wishes to submit evidence to the committee as it is his opinion that if the intent of the Armed Forces Covenant had been fully observed by Government ministries, then the challenges he has faced since leaving service could have been avoided and his transition into civilian life much better delivered. He hopes that by sharing his experiences with the Defence Committee then the scope of the Covenant could be expanded to ensure much fairer treatment for other service veterans facing similar challenges and so enable them to contribute more effectively to our civil society.

Where is the Armed Forces Covenant failing the Armed Forces Community?

From [Redacted]’s direct experience he believes that he has been failed in two critical areas: his healthcare and his treatment by what is now known as Veterans UK (VUK), previously the Service Personnel and Veterans Agency (SPVA).

HEALTHCARE – SUMMARY

[Redacted] has complex health care needs as a direct result of his service and the Armed Forces Covenant states that those who have sacrificed the most should be eligible for services that are not available to others.  Despite contact with VUK from August 2013 and having had to battle until present day for recognition of his 100% disablement under the War Pension Scheme, interaction with Op Courage and more recently Op Restore, he is not in receipt of a personalised care approach nor bespoke support.  

[Redacted] is dependent on my 24/7 support to both ensure that he does not succumb to his constant suicide ideation and that he is assisted with the challenges of daily life in the civilian environment.

Mental Health

In his final month of service [Redacted] attempted to take his own life whilst at Wimbish Barracks.  Despite this he was never seen by a psychiatrist prior to his final day of service on 31 March 2013.  He was inexpertly found to be suffering with adjustment disorder by a mental health nurse who took no account of his service history which included traumatic exposure from the age of eighteen in Northern Ireland and many further traumatic incidents.  His assessment also took no account of his recent two and a half year deployment to Sierra Leone where he was given Lariam (mefloquine) as malaria prophylaxis for almost 1000 days (having previously taken it on several earlier deployments to Belize, Kenya, Iraq and Afghanistan with no medical consultation).  He received no appropriate or substantive mental health support and on the day he left the army he had no life plans in place and no home to go to.

[Redacted] was advised by a fellow veteran to submit a claim for a War Pension for his physical injuries and did so in August 2013.  In November 2013 he was given an examination by an SPVA appointed medical practitioner.  Despite [Redacted] suffering a complete breakdown during the examination, the practitioner took no further action to ensure his wellbeing.  On receiving the practitioner’s report, the SPVA paid no attention to comments made regarding [Redacted]’s mental state and contrary to procedure failed to acknowledge his mental ill health.  Between 2015 and 2018, [Redacted] was seen a further three times by medical practitioners on behalf of SPVA/VUK who noted the severity of his mental ill health. Neither the practitioners nor the agency acted on these observations to provide a referral pathway for psychiatric assessment or treatment.  [Redacted] was finally advised to seek support from Op Courage in mid-2021 by the then Minister for Defence People and Veterans (during a teams meeting arranged by his MP with Johnny Mercer) only to be told that he was too complex for their care.  On then being referred back to his GP and then to the local NHS mental health service he was again assessed as too complex and his GP advised that the NHS were unable to support his needs.

In late 2021 VUK eventually made a wellbeing intervention and following consultation with NHS England he was re-referred to Op Courage. On this occasion he was assessed by an appropriate practitioner who sought to determine the extent of his mental ill health and recognised the neuropsychiatric impact of Lariam.

[Redacted] was finally assessed in 2022 by a consultant psychiatrist and a public health specialist and diagnosed with Complex Post Traumatic Stress Disorder (CPTSD) and likely brain stem damage due to Lariam toxicity.  Although potential therapeutic pathways have been explored, none have been identified that address the neuropsychiatric impact of Lariam toxicity.  [Redacted] has been unable to achieve any form of stabilisation and progress.  His ability to benefit from any stabilisation therapy has been severely impacted by the stress of having to continue to challenge VUK to attain a full and fair War Pension settlement.  (At the time of writing this submission the effective date of his claim remains under consideration by the Upper Tribunal.)  He continues to be assessed as too complex for the generally available PTSD treatment pathways offered by the third sector in liaison with Op Courage.

Physical Health

[Redacted] suffers with service related musculo-skeletal injuries that restrict his ability to mitigate his mental ill health through exercise and pastimes.  During service he was an outstanding sportsman, representing at service and combined service level and in the highest percentile for physical fitness.  Exercise was core to the management of his mental health.  He is now unable to exercise at a constantly beneficial level or to undertake alternative pastimes due to lack of mental capacity and manual dexterity. 

Having learned about Op Restore in 2024, [Redacted] approached his GP for referral. We understand directly from the GP that the process is disjointed and frustrating from the practice perspective and [Redacted] has certainly not received the joined-up response promised by the Op Restore brochure that refers to case worker support, coordination with Op Courage and development of care plans. None of this has materialised in his case.

VETERANS UK

On making his initial claim for a War Pension, [Redacted] had no understanding of the complex, destructive, de-humanising and legal process he would have to contend with over the coming twelve years to try and achieve the care that he needed and deserved. Having entered the armed forces at the age of 16 and built a career over almost 38 years, he operated in a culture where mutual care, respect and trust was vital.  He was invested in by others and returned that investment as an officer in command who placed the wellbeing of his soldiers at the forefront of his work.

[Redacted] reasonably expected that when he needed care at the end of his service, VUK was there to support him.  The reality of his experience is that [Redacted] has had to endure repeated service failures, recognised by the Parliamentary and Healthcare Ombudsman, and finally – since 2022 – by the last two military heads of the organisation.  He has had to take his case to the War Pension and Armed Forced Compensation Chamber Tribunal on three separate occasions, each time resulting in decisions in his favour.  From an initial assessment in 2014 of 6-14% mental health disablement, in 2024 the Tribunal judge determined that VUK had significantly under-assessed this.  The judge determined that [Redacted]’s mental disablement was at least 60%, the maximum that he could award given that an assessment of 40% for physical disability was also in place.

Had VUK assessed [Redacted]’s initial claim honestly and with his best interest at its core then his case could have been managed much faster with potentially much better outcomes for his mental health.  He was never looking for financial redress but for acknowledgement and care. The constant delays, deflections and denials by VUK have rendered [Redacted]’s claim to become legally complex and have stolen what should have been the prime of his post service years.

The battle for justice with VUK has exhausted [Redacted], caused him extreme distress and anxiety and endangered his life.  It has prevented him from successfully engaging with Op Courage.  The lack of early recognition of, and intervention in, his mental ill health by the organisation has certainly disadvantaged [Redacted] in his transition from service to civilian life.  He has been unable to work, remained distant from his family, particularly missing out on playing an active role with his grandchildren, and is unable to live independently.

The actions of VUK have directly disadvantaged someone who gave the most due to his service life and deprived him of the opportunity to fully integrate into a post-service environment and thereby access goods and services in a normal manner.

Are there areas which the Armed Forces Covenant ought to be extended to and why?

It remains unclear to us as to whether VUK / Defence Business Services / Ministry of Defence fall under the umbrella of the current covenant.  They are not normally required to be accessed by the general population so comparable disadvantage cannot be easily demonstrated.  However, the actions of the MoD and its subsidiary departments in failing to support the armed forces community in transition creates disadvantage for those who have served.  Our lived experience with VUK clearly demonstrates this disadvantage.

We believe that the Covenant and the Covenant Legal Duty should apply to Government and its ministries to ensure that there is no longer the opportunity for them to fail to support the armed forces community.  The MoD in particular has a key role to play in delivering successful transition of those who have served to enable them to reintegrate into civil society without facing disadvantage through service-related disablement.

What legislative changes should be made and why?

Whilst we are not legislative experts the biggest failing that we have experienced is the lack of candour from organisations and individuals by those who in principle exist to support those who have served.  Perhaps the muted changes to civil service obligation to candour should be implemented as a matter of urgency to enable justice for those disadvantaged by their service who are seeking only the duty of care they deserve in return for their service.

What impact would the extension of the Armed Forces Covenant legal duty to central government and devolved administrations have?

We would hope that the extension of the Covenant legal duty to central government could finally result in the end of institutional denial of its duty of care to those who have served and sacrificed in defence of the realm.

For [Redacted] this is of extreme importance as the MoD continue to deny the causal link between Lariam toxicity and the onset of long-term and even persistent neuropsychiatric harm despite significant clinical evidence to the contrary.  This denial is directly impacting the development of care pathways for those, like him, seriously impacted by the drug.

In Conclusion

It is clear that in [Redacted]’s case, the existence of the Armed Forces Covenant has had no impact on reducing or removing the disadvantage he has endured as a result of his service. He has been completely let down in his transition from service and no longer has any trust in the institutions that should have taken care of him; the implementation of the Armed Forces Covenant has fundamentally failed [Redacted].

We would be happy to provide any additional information and insight, both in person and in further correspondence, to the Defence Committee as its inquiry into the Armed Forces Covenant progresses. 

23rd January 2025