North East England joins together to help health of ex-service community

Last updated:27 July 2010

At the end of June, 22 scrutiny Councillors from 12 different local authorities and 34 guests from around North East England gathered in Durham to discuss the health needs of the ex-service community – armed forces veterans and their families.

They listened to and questioned speakers from government departments, the armed forces, the Royal British Legion, the regional Strategic Health Authority, one of the Directors of Adult Services in the North East, and the Career Transition Partnership, which is charged with helping service personnel leaving the forces; and they took part in round-table discussion with public health specialists, commissioners and clinicians.

This “overview day” was a key stage in the North East’s work as a Scrutiny Development Area.  The review of the health of the ex-service community aims to improve understanding about the health needs of this large and little understood group, to make recommendations about how better to address those needs – and also to help the Centre for Public Scrutiny develop a toolkit which can help future health inequality reviews throughout the country.

Councillors are now splitting into working groups, looking at physical health, mental health, and socio-economic wellbeing.  The working groups will be well placed to engage directly with veterans and their families, with the help of groups such as the Royal British Legion and the Soldiers, Sailors, Airmen and Families Association (SSAFA).  Each working group is supported by scrutiny officers from four local authorities.  They will report back in the autumn to a board made up of the twelve health scrutiny chairs or their deputies, which will produce a final report.

This is the first time that the twelve local authorities in North East England have come together to undertake a major joint scrutiny review this way.  Throughout, the scrutineers are keeping track of the lessons they learn about how to manage a scrutiny review across such a large area, and involving so many different bodies.

One thing that is already clear is that thorough preparation, regular contact between members and a fair and equitable division of the work are crucial.  It has resulted in a high degree of enthusiasm and commitment, not just from members and officers, but from everyone we have approached as part of the review.  Joint working can be laborious, but none of the local authorities alone could have set up as thorough and wide-ranging an event as the overview day, and speakers who might hesitate to travel across the country to speak to one scrutiny committee were delighted to travel to speak to twelve at once.

There are around 5 million people in this country who have served in the armed forces.  Most of them are not the young men and women returning from Afghanistan who we read about in the newspapers every day, but the veterans of older conflicts – the Second World War, Korea, Malaya, Northern Ireland, the Falklands, the Balkans – or just those who did their National Service when called up.

Taking into account families and other dependants, well over 10 million people – a sixth of the population – may have had their health and wellbeing affected by military service.  But our knowledge of their needs is patchy.  The NHS took steps earlier this year to improve their recording of whether or not patients are veterans, but for the most part this data is still unavailable to public health departments and commissioners.  Veterans – or their families – approaching social services, housing providers or voluntary agencies are not normally identified as having served.  There are some flashes of light from surveys and academic studies, but the illumination they provide is patchy. 

Health and wellbeing in the ex-service community compared with the general population

• 52% report long-term illness or disability (general population: 35 %)

• Suicide rate among ex-service men aged 24 or under is 2-3 times higher than general

• Among 25-65 year-olds poor general health two or three times more likely to be reported than among general population; particularly
- Musculo-skeletal conditions
- Cardio-vascular or respiratory conditions

• Unemployment among ex-service community twice the general rate among most age groups

Both the outgoing Labour government and the incoming Coalition government have stressed that improving provision for those who have put their lives on the line for their country is a high priority: for example, it was highlighted in the new NHS operating framework.  The Ministry of Defence and Department of Health have welcomed the regional scrutiny.

The North East has a particular interest in the health of the ex-service community because it has been a major recruiting area for the post-War professional armed services.  Over 10 % of the recipients of war pensions are from this region, which holds less than 5 % of the population as a whole.  But most regions will have substantial ex-service populations, not least from the ageing National Service generation, so the review team hopes that its findings, as well as its methods, will be useful to health scrutiny throughout the country.