How process and broken promises have stalled progress towards veterans' wellbeing
With the appointment of a new veterans minister and change of government, CEO of Veterans Aid Dr Hugh Milroy reflects on how mistakes can be rectified, and effective ex-service support measures integrated into wider social care.
When David Lloyd George made his visionary speech about a 'land fit for heroes' he talked about what was due to soldiers returning from combat but, like all true orators who lay down a thread, he went on to tug it and lead his audience along a different path. He invited them to consider how the nation's soldiers and sailors (sic) were part of a wider society - he spoke of common sacrifice, a common patriotism, and a common brotherhood.
Of Britain's recent wartime victory, he said: "To this triumph all classes of the people have contributed. There has been no distinction of rank, no difference of creed or faith, of state or condition of life. All opinions, all ranks, all creeds, all faiths have contributed to this memorable sacrifice to save the world. It is with this knowledge, that we must approach the next problem."
That problem was poverty, and he spared no punches in describing its impact: "Those in charge of the recruiting offices came to the conclusion that if the people of this country had lived under proper conditions – that is properly fed, properly housed, lived in healthy conditions that sustained life in its full vigour, then there would have been a million more men available who were fit to put in the army."
I make no apology for quoting at length because it saddens me that a problem identified more than 100 years ago has still not been resolved. Not all Lloyd George's suggestions for post war regeneration have relevance today, but his grasp of how impossible social progress would be, until issues like poor housing, insufficient income, food poverty, unemployment and meaningful support for the needy had been addressed, was truly prescient.
Fast forward to today and we see a landscape that I believe would horrify him. The clients we see at Veterans Aid are generally not heroes, but they are all former service personnel. Some sleep in cars, some in parks or on the streets; some are destitute, addicted to drugs or alcohol; some have struggled to get help with physical and/or mental health problems. This may come as a surprise to those who believe that a ‘working system’ is in place to help veterans in crisis, but I can say with the authority of one who sees evidence to the contrary, on a daily basis, that this is not the case. Indeed, in my opinion, the veterans’ care system has moved backwards. 'Operation' this and that - from the perspective of the many who come to our door - have been entirely irrelevant.
This is a crazy situation given that the veteran population is shrinking. These 'Operations' were ineffective because they were, to a great degree, based on political ambition and agendas rather than actual need. It's time to stop imagining that all is well and that effective mechanisms are in place. We see regular evidence that they have not only failed to deliver, but sometimes further alienated those in crisis. If ever there was a case of the 'Emperor’s New Clothes' this, was it. For example, political claims that there were no veterans on the streets over Christmas went unchallenged. Numbers were small, but it simply wasn’t true to say there were none because we were busy throughout the period. In fact, some of our clients were victims of the political gerrymandering that had taken place to support the 'no veterans on the streets' claim - people who had been placed in hotels for four days over Christmas with no access to food, and no plan in place to prevent them returning to the streets. Political box-ticking?
A recent BBC File on 4 investigation highlighted the plight of veterans with PTSD symptoms being denied compensation on the grounds that they were 'genetic', or offered piecemeal help, long after the point where it could have stopped them spiralling into divorce, despair and suicidal depression. This at a time when the sector includes around 1,700 veterans' charities and a variety of government initiatives designed to offer wraparound care and support. According to Pro Bono Economics, usage data of the Veterans’ Gateway suggests that in 2021, 24% of all searches were about employment, followed by finance and mental health.
This shouldn't be happening - and the advent of a new government offers an opportunity to stop it. Not by giving ad hoc handouts, introducing identity badges that are of little or no use, commissioning incestuously self-confirming studies or funding putative 'fast-track' services that frustrate, fail to deliver and are never objectively evaluated - but by a paradigm shift in thinking that challenges everything people believe they know about veterans. Two areas, in particular, are worthy of scrutiny:
Stereotyping:
There are now 35 MPs with a military background of some kind, drawn from across the political spectrum. This means that 5% of Parliament is drawn from the Armed Forces community – more than in the general UK population. Their political diversity, in itself, speaks to the lack of homogeneity in the world of ex-service personnel. We must stop branding veterans as damaged goods, over politicising and over medicalising their problems, just to be seen to be doing something.
If poverty is the big player, then that is what should be addressed.
Despite the huge diversity of the veteran community, it has become homogenised into a cohort perceived as having a susceptibility to mental health problems (primarily PTSD) and an inability to thrive in 'civvy street' - in other words a 'special needs' group, uniquely privileged yet also uniquely damaged. The strength of this perception has driven legislation, fuelled myths, wasted money, created a labyrinth of ponderous, bureaucratic processes that are not given the tools to deliver, and deflected attention from the monolithic elephant in the room. Poverty.
Overpromising:
There is no way of singling out a discrete sector of society for preferential treatment that doesn't negatively impact on others or raise unrealistic expectations; yet this is what has been done with veterans! They seem to have been built up to enjoy universal hero status; GP practices and the NHS have been urged to identify them as 'special' and an Armed Forces Covenant has been created that promises (but doesn't guarantee) fair play. Increasing numbers have signed up to this, but once again from the perspective of those we see in crisis, it can be virtually meaningless. ‘One Stop Shop’ emergency aid initiatives have been launched that simply connect people to call centres or fail to address either dire need or non-standard inquiries. Peoples’ lives are complex! The upshot among our clients has been cynicism, resentment, failure to engage and a cavernous separation between service users and providers.
Repeatedly we hear that committees have been assembled, the 'usual suspects' invited, and research commissioned to find out what veterans need. I've come to the conclusion that they inhabit a parallel universe because they, too, have so little impact on the lives of those veterans in crisis whom we see every day.
The fact is that if all sectors of society were treated fairly, there would be no need for veterans' charities or over politicisation of veterans' issues. The current replication of effort, expenditure, process and administration in the veterans' sector is mind-numbing. I hear the word 'collaboration' bandied about as though it's a universal panacea, but from my perspective what it really describes is a series of organisations competing for the same grants, funding the same research, passing clients around like hot potatoes and sitting on 'rainy day' investment portfolios. Like Jacob Marley's ghost, each new 'major initiative' rattles the chains of attendant bureaucracy - staffing costs, branding, publicity - so that it can become veteran-specific rather than community integrated.
My plea to our new Government is this: take a step back, and instead of seeing veterans as apart from society, make them a more integrated part of it. Don’t just repaint the sails. Listen to those on the ground who actually deliver – and track the money! Millions of pounds have been wasted on high profile veterans’ projects that replicate existing services, are not based on need and are rarely evaluated. For example, I have not spoken to anyone who could describe what the long-term impact was of the of the hundreds of millions given to the sector from the Chancellor as a result of the LIBOR fines.
Charities for veterans should be the icing on the cake, not the mainstay of their social wellbeing. After all, they operate against the background of a welfare state and a national health service. Investment in these will lift everyone – including the many veterans whose problems stem from poverty-related issues. There will always be a place for charities, but it should be in a supporting role. Effective delivery agencies with proven track records should be empowered, especially those uniquely equipped to deal with complexity and specialised issues, but replication and re-invention is not the answer.
Rebranding old services that promise much and offer little must stop. The focus should be on outcomes not brand, and an understanding that 'benevolence' is generally only valuable if it is bureaucracy-minimal. If real help is to be delivered, those in the fight must be empowered. It is naive in the extreme to think that giving to large bodies, who have millions in reserves, will ensure the timely trickling down of support.
Radical rethinks aside, it's worth noting that the Veterans Aid perspective is a frontline one: we are the A&E of the ex-service charity community. Clients only seek us out when they are in crisis, so they are not typical.
Most veterans transition seamlessly back into civilian life; most do not suffer from combat related problems. For those who do, there should be access to rapid and high quality care at point of need - as indeed there should be for non-veterans. But Lloyd George's observations about the whole nation prospering are as valid today as they were in 1918. In helping the many, we will help the few.
What's paramount is the need to address the alienation of those veterans who are in acute distress. The veterans who are excluded and feel themselves victims of those who, in their eyes, talk about helping but simply don’t deliver when their need is raw and real. The feeling of hopelessness and despair that is evident among those who meet us is palpable. Those at the sharp end need to have their say, unfiltered by big brands who frequently talk about putative needs among the veteran community. We must banish the de-humanising approach towards their alleged 'problems' and begin to listen. We must stop pretending that all is well and stop fantasising that calling an initiative an 'operation' will imbue it with military precision and effectiveness. Very few of the veterans who seek our aid have issues relating to military service - they have life problems!
PoliticsHome Newsletters
Get the inside track on what MPs and Peers are talking about. Sign up to The House's morning email for the latest insight and reaction from Parliamentarians, policy-makers and organisations.
