Adrian Blair: This Armed Forces Day we must commit to delivering adequate medical and psychiatric support for our veterans

Adrian Blair is Research Secretary of The Bow Group.

Today is Armed Forces Day.

Most people reading this would agree we have a moral obligation to help soldiers who have risked everything to lead a normal life afterwards. However, a new Bow Group paper by Ross Carroll, Stuart Carroll, and Julien Rey reveals how far the nation is from that ideal. Falklands hero Simon Weston told them Britain “is good at honouring its war dead, as this costs little… it’s not so great at honouring its war living.”  After reading their paper, it’s hard to disagree.

By conducting in-depth interviews with veterans of several conflicts, Carroll, Carroll and Rey reveal deeply inadequate medical and psychiatric support for veterans, inferior to systems in Australia and the USA.

Britain only has two dedicated treatment centres for service personnel (in Selly Oak and Surrey), to cover a veteran population of four to five million. So the main treatment burden falls on the NHS. Yet although the Government claims to have extended priority NHS access to all veterans (not just war pensioners), it’s not clear what that means in practice, and 71% of GPs and 76% of veterans are still not aware of it.

In addition to physical injury, psychiatric disorders among those who have served in combat are common.  Because disorders resulting from active service often don’t become clear for many years, and are unlikely to be self-diagnosed, the key to providing effective help is ongoing monitoring and support following active service.

That’s where the NHS really falls down: NHS psychiatry services are naturally geared towards the needs of civilian society. The NHS isn’t designed to provide the sustained support and follow-up that is essential for veterans.

Given these failings, it is not entirely surprising that around 2,500 ex service personnel sleep in homeless facilities in London on any given night (there are no adequate UK-wide figures), and 8,000 are currently in prison (close to 10% of the prison population).  Thousands of others are leading lives that are anything but normal, thanks to the lack of an adequate veteran support system. 

One Iraq veteran told the authors:

“Serving my country has been worse than a personal credit crunch for me. I have lost two houses, one career and one relationship from it, and sustained more health problems than I can count.”

The next Conservative government will face many dubious calls on an over-stretched public purse. The veteran support action plan in today’s Bow Group paper is emphatically not one of them. Indeed there are few better uses of public money.

Adrian Blair: New Labour's lost generation

Adrian Blair is Research Secretary to the Bow Group

"Tony Blair doesn’t care enough about climate change; cares way too much about Iraq; is dishonest; and has put me off politics." 

An extract from CCHQ propaganda, perhaps?  Or a tête-à-tête with the Chancellor?  In fact, this sentence summarises the political outlook of first-time-voters, many of whom were just 6 years old when the PM took office.  At least where views on his boss are concerned, Gordon Brown has more in common with this age group than you might think.

In what we believe is the largest poll of its kind undertaken to date, the Bow Group recently commissioned Populus to conduct a survey of 1,277 people who will vote for the first time at the 2008/09 general election (16-19 year olds in late 2006).  From the initial results we’ve analysed so far (previewed by Peter Riddell here), the extraordinary scale of Tony Blair’s failure to shape the values of this generation is becoming clear.  On climate change, Iraq, tax, and their attitude to politics in general, New Labour’s children have long since fled the Blair nest.

Adrian Blair: A fresh approach to drugs policy

Adrian Blair is research secretary to the Bow Group.

The way society treats hard drug addicts is expensive, ineffective, and ultimately indefensible.  As Research Secretary for the Bow Group, I’ve been on the lookout for some time for fresh, compelling ideas in this area.  The paper we published yesterday (Guardian story) by Humfrey Malins, CBE, MP - a respected Parliamentarian, but also a Deputy District Judge and Recorder of the Crown Court with long experience sentencing drug users - goes some way to providing them.

The PM’s own confidante, Lord Birt, estimates the total cost to the nation of “high harm” drug users as £24 billion annually.  Yet residential rehabilitation - probably the cheapest and most effective means to treat such people - is under-provided (just 1 bed for every 100 problematic drug users), and of the precious few beds available, up to half lie empty.

Essentially, a cured drug addict is far better for society than a “punished” one.  The current system fails all concerned, by neglecting the root causes of the problem.

> Cannabis is treated too leniently
Most problematic drug users start off on “softer” stuff.  By labelling cannabis as Class C, in addition to the harm done by the drug itself, the first step in the cycle of addiction is made far too easy.  Malins’ paper suggests a zero-tolerance approach to cannabis, together with compulsory testing of school pupils and re-classifying it as a Class B drug;

> Sentencing Methods Are Inadequate
Prison fails, as it doesn’t treat addiction, and drugs remain easily available.  The government’s Drug Treatment and Testing Orders (DTTOs) have a 2-year re-offending rate of 78.1% (according to a Parliamentary Answer to Mr. Malins).  The introduction of “Custody Plus” sentencing is continually delayed due to lack of probation officers - the number of probation officers in the Greater London area has fallen by 6% in the last year. 

> Residential Rehabilitation Works
Residential Rehabilitation - where addicts are isolated from the causes of their addiction and the problem is treated - is the most effective way to minimise reoffending.  Although the government still doesn’t measure re-offending rates from residential rehab, evidence from Sweden and trials in the USA suggest lower re-offending rates.  Residential rehab is also cheap: figures in the Bow Group paper suggest an average weekly cost of £674 relative to £800 for a prison place.

> There are Insufficient Residential Rehab Beds
The paper estimates there are around 250,000 “problematic drug users” in England - people dependent on Class A drugs.  Around 100,000 rely on persistent crime to fund their habit.  Yet the Government admitted in a Parliamentary Answer to Mr. Malins that there are just 2,530 residential rehabilitation beds in England - about one for every 100 problematic drug users.

> Too Many Residential Rehab Beds Are Empty
Every provider contacted in researching the paper had considerable spare capacity.  The paper estimates that up to 50% of beds are empty in most of England’s 119 residential rehabilitation units.  This is caused by lack of referrals from Drug Action Teams, due to persistent underfunding and neglect of residential rehab by Local Authorities, Health Authorities, and the criminal justice system.  The government claims that the National Treatment Agency is receiving £50m funding for new beds; but the Bow Group findings show that under-use of existing beds is the core problem.  A representative quote from one London provider we contacted:  "Lots of residential rehab centres are concerned whether they can stay viable or not because they are not getting referrals.  The Government say they are spending much more money, but what is happening to it I simply do not know."

In sum, the costly cycle of crime and addiction will continue, unbroken, without a much tougher approach to cannabis, widespread use of sentencing that aims to cure and not just punish hard drug addicts, and radical expansion and improvement of drug rehabilitation.  Labour’s inexcusable failure to do any of this presents Conservatives with a rare opportunity to save money in the long-run, while doing the right thing for some of the most desperate people in society, not to mention their would-be victims.

Download a PDF copy of Humfrey Malins' paper.