We failed Jack, admits Army as coroner rules death by misadventure of cavalry trooper
The Army has made a number of changes – including making it easier for soldiers to maintain ceremonial kit – following the death of Household Cavalry Mounted Regiment Trooper Jack Burnell-Williams.
The 18-year-old was found hanged in his barracks days after escorting Queen Elizabeth II's coffin on 28 September 2022, which assistant coroner Bernard Richmond ruled death by misadventure.
He said Tpr Burnell-Williams had been under stress because of the "frankly ridiculous hours that members of his troop were expected to work".
A cry for help
Mr Richmond said Tpr Burnell-Williams's death was out of character and his actions on that day were "of an impetuous nature".
He added: "I reject the proposition that he formed a settled intention to kill himself – it was at worst a cry for help and more likely, in my view, an expression of frustration and despair."
The hearing heard Tpr Burnell-Williams had joined a particularly stressful branch of the Army and "everyone must have been exhausted" while preparing for their ceremonial duties.
The assistant coroner said there was a culture in the regiment of people having to pull their weight and Tpr Burnell-Williams had been undertaking more duties.
Deepest condolences
Brigadier Rupert Evetts, Commanding Officer Household Cavalry, issued an apology for failing the young trooper and said new practices had been introduced in the wake of Tpr Burnell-Williams's death.
He said: "To Jack's family and friends, we offer our deepest and most heartfelt condolences.
"Jack was just 18 years old – a soldier with tremendous potential and enthusiasm, who showed a real passion for serving his country. There are no words that can adequately express how truly sorry we are for your loss.
"The Army fully accepts the coroner's conclusion and the failures identified in the Service Inquiry report.
"We failed Jack, and we failed you. For that, we are profoundly sorry.
"Since receiving the Service Inquiry findings, we have worked to address every issue identified – across culture, behaviours and working practices – with the sole aim of improving the safety and welfare of all who serve.
"We have so far delivered 26 of the 36 recommendations and are making significant progress to complete the remainder as quickly and thoroughly as possible to ensure irreversible change."
What the Cavalry has changed
Brig Evetts said the following changes had been made:
:: Reduced soldier workload – civilian staff help maintain equipment and only horses needed for ceremonial duties are now kept in London.
:: Simplified kit preparation, with turnout standards clearly defined and duty rosters fairly shared.
:: Continuing to strengthen leadership by appointing additional commanders and investing in training – creating a culture where personnel feel safe to raise concerns.
:: Living and working conditions at Hyde Park Barracks have been improved.
:: Changes have also been made at training establishments.
He added: "We owe it to Jack's memory, and to his family, to ensure that lessons are not only learned but acted upon.
"No family should have to endure what you have been through. We remain resolute in our commitment to this work."
Pride turned into exhaustion
Tpr Burnell-Williams's mother Laura said in a statement read in court: "Jack achieved more in his short lifetime than many do in a full one.
"One of our proudest moments was seeing him take part in ceremonial duties at the late Queen's funeral. We were all incredibly proud that he was part of such an important moment in history.
"When Jack first joined the Army, he was so happy. He was proud, excited and loved coming home to show us everything he had achieved.
"But as time went on, something changed. The light inside him slowly dimmed and his cheeky smile faded. We barely spoke because he was constantly exhausted and had no time.
"When the police knocked my door, my immediate thought was that Jack had been injured and was in hospital.
"When they told me what had happened, I couldn't believe it and I was in shock. I still don't feel like I have accepted Jack has gone."
His father Daniel added: "We watched him on TV with tears of joy running down my face.
"I will never forget the day Laura rang me and said 'you need to get here now, it's Jack, the police are here, it's bad'.
"When she told me, my whole world fell apart, my heart ripped from my chest. That is not a feeling any parent should ever go through."
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