Veterans' health and wellbeing: are we getting it right?

Introduction

It has been an enormous privilege to meet and represent the veterans community for the past three years as Scotland's Veterans Commissioner.

During this time I have been looking at aspects of transition, housing and employability that impact most on the younger generation of veterans and their families. The positive responses to all three of my reports on these issues have been heartening. So too, has the progress that has been made by the Scottish Government and others in implementing the recommendations set out. Perhaps most rewarding, though, is the way in which these reports have helped promote an increasingly progressive approach towards veterans across Scotland. This is reflected by the shifting attitudes of many politicians, employers, the media and large sections of the general public.

My attention has now turned to a set of issues that affect all veterans regardless of age, background or personal circumstances: health and wellbeing.

In Scotland, we are fortunate to have outstanding public and third sector organisations that help keep our veterans and their families in good health. One of my earlier reports concluded that "veterans, and those transitioning from the military in Scotland, typically have access to a high standard of health care." ^[1]

Since publishing that statement, I have heard many other positive comments about the quality of the treatment and care veterans receive from the National Health Service, Local Authorities and the numerous charities that work tirelessly in this sector. This is highly commendable and reassuring for those who decide to settle in Scotland after a career in the military.

That is not to say that veterans do not have specific medical and social care needs, nor to deny the fact that a small minority of them face considerable challenges when engaging with health and social care services.

Despite the overall positive picture, we cannot afford to be complacent. Nor should we ignore the opportunities that are emerging from changes within the NHS and an ever increasingly skilled charity sector. My primary aim, therefore, is to raise awareness of the need to protect the best of the current health and social care provision for veterans and to prepare for future needs.

I have tried to identify what the measure of 'getting it right' should be, and have come up with four key questions:

Are the health outcomes of our veterans population as good as they can be?

Do veterans face any disadvantages when accessing health and social care provision?

Does the health system properly fulfil our obligations to those veterans with the most severe and enduring illnesses and injuries acquired as a result of their military service?

Are the needs of our veterans population properly understood and considered by those who work in health and social care?

I have used these four questions as the starting point for my research and widespread engagement, which will continue in the coming months.

My second intent in publishing this 'thought-piece' is to initiate a debate in order to elicit responses and ideas from the many health professionals, officials, charities and veterans who are affected by, and understand, these issues.

Finally, I wish to start outlining some answers to these questions based on my work to date. These are not the conclusions of a health expert. They are my early impressions, formed with the help of the many individuals and organisations that have generously provided advice and information, without whom this work would not have been possible.

These impressions, along with continuing engagement and any responses to this paper, will be the basis of two subsequent reports with my detailed findings and a series of recommendations.

In the following chapters I explain the background and rationale before delving into the issues at hand and outlining my approach. Needless to say, I look forward to hearing from anyone with an interest in these issues.

Eric Fraser CBE
Scottish Veterans Commissioner