Between 1 January 2014 and 31 December 2018, 23 UK Armed Forces personnel have died on training or exercise. There were a further 17,403 UK Armed Forces personnel injured in 21,822 incidents.

Between 1 January 2014 and 31 December 2018, 15 UK Armed Forces personnel have died whilst on combat duty, of which one was due to hostile action. 506 UK Armed Forces personnel were injured on combat duty, of which 28 were battle injuries.

The attached table shows the data broken down by the last five calendar years:

The United Kingdom has not conducted airstrikes from any platform, either manned or unmanned, in counter-terrorism operations in Yemen, Pakistan or North Africa. We do not comment on the operations of other countries.

Inquests in England, Wales and Northern Ireland are carried out under the Coroners and Justice Act 2009 and the Coroners Act (Northern Ireland) 1959 respectively.

Inquests are carried out where a death was sudden, and the cause is unknown, where someone has died an unnatural or violent death, or where someone has died in a place or circumstance where there is legal requirement to hold an inquest, for example in prison custody or whilst sectioned under the Mental Health Act.

In Scotland fatal accident inquiries are carried out under the Fatal Accidents and Sudden Deaths etc. (Scotland) Act 2016. A Fatal Accident Inquiry (FAI) is mandated by the 2016 Act in certain circumstances, including in respect of military deaths in Scotland. Under the previous legislation -the Fatal Accidents and Sudden Deaths Inquiry (Scotland) Act 1976- an FAI was not mandatory for such deaths.

The Ministry of Defence has not assessed the potential impact of different legislative regimes in place historically

The protocol for liaison on Fatal Accident Inquiries (FAIs) relates to fatalities of Armed Forces personnel outside the United Kingdom (the protocol) and is shared between the Ministry of Justice (for the Chief Coroner's Office), the Ministry of Defence (Armed Forces Personnel), and the Crown Office and Procurator Fiscal Service (COPFS).

The protocol was originally drafted and agreed on 31 August 2012; it was subsequently revised on 25 May 2017 following consultations between the parties. The Ministry of Defence put forward further revisions. Further work on the protocol was delayed due to the Ministry of Justice not being able to provide feedback due to being overwhelmed with the terrorist events in London and they have not been in a position to consider the protocol further. Further consultations on the protocol have not been able to be held due to time commitments by the other parties. COPFS have advised that as part of a modernisation project, they plan to revitalise the discussions on the protocol in the near future. These discussions will now include the Foreign and Commonwealth Office.

The protocol must be owned by all parties as it is a tripartite agreement. The protocol is a draft document until full agreement is achieved by all the parties, and cannot be published at this time.

The investigation of deaths, whether they are military or civilian lies with the Scottish Government and the Crown Office of the Procurator Fiscal/Scottish Fatalities Investigation Unit.

The Ministry of Defence (MOD) complies with the appropriate legislation; Inquiries into Fatal Accidents and Sudden Deaths etc. (Scotland) Act 2016 for investigations into deaths of Service personnel in Scotland.

The decision to conduct Fatal Accident Investigations is for the Crown Office of the Procurator Fiscal in conjunction with the Scottish Fatalities Investigation Unit.

The MOD will always support the Scottish Fatalities Investigation Unit in its deliberations/investigations in an open and honest manner.

An initial investigation is carried out following any death, very serious injury or serious injury of a Service person, including natural causes whether they are on or off duty.

The initial investigation includes an overview of the event, what happened, to whom, when and why. These accounts are conducted expeditiously after the event (within five days if possible), and are designed to be a swift capture of the events and aimed to identify any immediate lessons that may have been found.

The internal investigations also present recommendations to prevent any recurrence of a similar incident where possible. These investigations are always shared with the Crown Office/Scottish Fatalities Investigation Unit.

All Service personnel killed in Iraq and Afghanistan were repatriated to the United Kingdom and each death was subject to an investigation carried out by a Coroner (or Procurator Fiscal in Scotland). It is for the Coroner to determine the scope of an inquest including the application of Article 2 of the European Convention on Human Rights. The Ministry of Defence fully supports all Coroners inquests.

The Ministry of Defence no longer directly employs local staff in high risk operational areas.

The Government will not provide any additional information on the circumstances surrounding the death of Sergeant Tonroe at this time.

Sergeant Tonroe, who was killed on 29 March 2018, was embedded with US forces on a counter-Daesh operation.

The UK is not providing support to the Free Syrian Army. The Government will not provide any additional information on the circumstances surrounding the death of Sgt Tonroe.

The Government will not provide any additional information on the circumstances surrounding the death of Sgt Tonroe.

In 2013 the High Court ordered the Ministry of Defence (MOD) to establish a non-criminal process of "quasi-inquests" (which we have designated Iraq Fatality Investigations (IFI)) in appropriate cases to comply fully with the investigative obligations under the European Convention on Human Rights, which include procedural requirements (to involve the victim's family, to ensure public accountability, and to identify systemic issues) that cannot always be achieved by a criminal investigation alone. The MOD understands the strain any investigation places upon its personnel, the vast majority of whom conducted themselves professionally in the most difficult circumstances, and is committed to providing them with proper pastoral and legal support. IFI are essentially inquests, they are not criminal investigations and can only take place when a decision has been taken not to prosecute. They take place to provide the families of deceased Iraqi civilians with answers about the circumstances of their deaths.

It is important that allegations of wrongdoing are investigated to allay public concerns, if unjustified, or to expose discreditable conduct. This process remains appropriate and legally necessary.

UK airstrikes always follow the principles of international humanitarian law: necessity, proportionality, distinction between combatants and non-combatant civilians, and the prevention of unnecessary suffering. The complex and congested urban environment of Mosul presented particular challenges for those undertaking airstrikes as part of the Coalition support to forces on the ground against Daesh. Our rigorous targeting processes take into account the conditions on the ground, including the potential presence of a civilian population. We undertake a battle damage assessment after every airstrike. This assessment examines all the available records including video, and one of its roles is the identification of any collateral damage, including civilian casualties. If any such assessment indicated anything that should be scrutinised further, a full investigation would be undertaken, with appropriate resources allocated to it. Thus there is no requirement for a further evaluation of the deployment of UK airpower in the campaign against Daesh.

UK airstrikes always follow the principles of international humanitarian law: necessity, proportionality, distinction between combatants and non-combatant civilians, and the prevention of unnecessary suffering. The complex and congested urban environment of Mosul presented particular challenges for those undertaking airstrikes as part of the Coalition support to forces on the ground against Daesh. Our rigorous targeting processes take into account the conditions on the ground, including the potential presence of a civilian population. We undertake a battle damage assessment after every airstrike. This assessment examines all the available records including video, and one of its roles is the identification of any collateral damage, including civilian casualties. If any such assessment indicated anything that should be scrutinised further, a full investigation would be undertaken, with appropriate resources allocated to it. Thus there is no requirement for a further evaluation of the deployment of UK airpower in the campaign against Daesh.

Between 1 April 2003 (the earliest date for which the Department holds electronic information) and 30 September 2016, 761 ex-Service personnel registered a claim for mesothelioma through the War Pensions Scheme (WPS) which was subsequently awarded.

Of the 761 awarded claimants 721 had since deceased. For those 721 claimants who are deceased, information on their cause of death is not held centrally and could be provided only at disproportionate cost.

No calculations have been made by the Ministry of Defence on the percentage of the total number of deaths from this disease amongst former Service personnel. However, the Health and Safety Executive's most recent publication on Mesothelioma Mortality in Great Britain from 1968 to 2014 (including by broad types of occupation) is enclosed and can be found at: http://www.hse.gov.uk/STATISTICS/causdis/mesothelioma/mesothelioma.pdf

Whilst no conclusions can be drawn from one year’s data, Public Health England is analysing the drug misuse and treatment datasets to identify possible reasons for the change in drug misuse deaths reported in 2013. This analysis is due to be published in a statistical bulletin in 2015 and will help inform any possible future actions.

Exposure to secondhand smoke is a serious health hazard. More than 50 carcinogens have been identified in secondhand smoke.

The report of the United States Surgeon General titled “The health consequences of involuntary exposure to tobacco smoke” concluded that secondhand smoke causes premature death and disease in children and adults who do not smoke. The scientific evidence indicates that there is no risk-free level of exposure to secondhand smoke. Children exposed to secondhand smoke are at an increased risk for sudden infant death syndrome, acute respiratory infections, ear problems and more severe asthma. Smoking by parents causes respiratory symptoms and slows lung growth in children. Exposure of adults to secondhand smoke has immediate adverse effects on the cardiovascular system and causes coronary heart disease and lung cancer. Legislation to stop smoking in vehicles carrying children will come into force in England on 1 October 2015.

The report of the Royal College of Surgeons titled “Going smoke-free: The medical case for clean air in the home, at work and in public places” included estimates that secondhand smoke exposure caused approximately 122,200 deaths in the United Kingdom in 2003, and that the majority of these deaths occurred as a result of exposure to secondhand smoke in the home. These estimates were made prior to the introduction of smokefree legislation in England in 2007. Over the past decade, the proportion of smokers who say that they do not smoke in the home has increased.

The evidence is clear that smokefree legislation in England has had beneficial effects on health, as set out in the report “The Impact of smokefree legislation in England: evidence review” which was published alongside the Government’s “Tobacco Control Plan for England” in March 2011.

The reports referred to have been placed in the Library.

At this stage it is not possible to draw any definitive conclusions about a longer-term trend in deaths from one year’s data. Public Health England is currently analysing the data to better understand the reasons for the increase.

No assessment has been made of the impact of family bereavement on the mental health and well-being of children and young people. However, we are investing £54 million over the four year period 2011 – 2015 in the Children and Young People’s Improving Access to Psychological Therapies (CYP IAPT) programme.

CYP IAPT interventions can help children and young people who have been impacted by family bereavement.

The CYP IAPT approved interventions include:

- Cognitive behavioural therapy for emotional disorders such as anxiety and depressive disorders, obsessive compulsive disorder (OCD) and Post Traumatic Stress Disorder;

- parenting training for conduct disorders (3-10 year olds);

- systemic Family Practice; and

- Interpersonal Psychotherapy for Adolescents.

On 25 March, we launched MindEd, an interactive e-learning programme on children and young people’s mental health that seeks to help any adult working with children and young people. The MindEd e-portal provides a ‘Loss and Grief’ module, aimed at helping children and young people who face loss, such as loss of a parent by death or divorce. MindEd is available at:

www.minded.org.uk

NHS England is currently reviewing the National Health Service Serious Incident Framework. This describes the principles and procedures that all organisations providing, commissioning or overseeing NHS-funded care should follow when responding to Serious Incidents. Serious Incidents by definition include all unexpected or avoidable deaths in NHS-funded care. The revised Framework will provide up to date guidance on the appropriate response to such deaths, including how investigations should be carried out and quality assured to deliver learning and improvement of services.

The current Framework is available at:

www.england.nhs.uk/wp-content/uploads/2013/03/sif-guide.pdf

NHS England is also working on plans for a Root Cause Analysis (RCA) Investigation academy to drive good practice in the use of RCA investigation, ensuring its full potential is harnessed in order to inform learning and measurable patient safety improvement.

In addition reforms to the process of death certification and the coroner service, including the appointment of a Chief Coroner, will help identify appropriate cases for referral to the coroner for further investigation as well as benefiting bereaved families across England and Wales by creating more effective coroners services.