House of Commons - Defence

Select Committee on Defence Seventh Report

MoD'S RESPONSE TO GULF VETERANS' ILLNESSES

5. In their October 1995 Report on Gulf War Syndrome, our predecessors said—

In responding to allegations of a Gulf War Syndrome MoD has been quick to deny but slow to investigate ... MoD's response has been reactive rather than proactive and characterised throughout by scepticism, defensiveness and general torpor.[

In response, the government said that the Committee's criticisms of the MoD were 'unjustified and unsupported by the facts' and that the tone of the Report was 'unhelpful'[15] although, as was pointed out in the second report on the subject produced by our predecessors in March 1997, almost all of the recommendations contained in the 1995 Report were eventually accepted by the government.[16]

6. The 1997 Report discussed at some length the circumstances which contributed to incorrect information being given to Parliament about the use of organophosphate pesticides during the Gulf War, the measures which were subsequently necessary to correct this, and the internal inquiries carried out by the MoD to establish how this sequence of events had arisen. Our predecessors commented that—

They believed that the MoD's potential liability to compensation claims from veterans 'colours its attitude to certain developments' and that—

Developments since 1997

7. After the present government took office, it responded to our predecessors' Report and stated—

The new Government believes we have a debt of honour to those who have served their country in the Armed Forces and has been determined that a fresh start will be made in dealing with this difficult and complex issue.[

That response also announced the publication of the government's document Gulf Veterans' Illnesses: A New Beginning which gave details of the new approach and stated—

It undertook to adhere to three principles: that Gulf veterans would have prompt access to medical advice from the MoD Medical Assessment Programme (MAP); that there would be appropriate research into veterans' illnesses; and that the MoD would make relevant information public.[21] Details of how these principles would be fulfilled were set out in twenty key points and these are set out as an Appendix to this Report.[22]

8. In oral evidence to us shortly after the government's document was published, the then Minister for the Armed Forces, Dr Reid, explained that the government's new approach—

... contrasts with some of the circumstances which gave rise to a great deal of distrust between the veterans and the Ministry of Defence.

and he added—

It is against this promise from the MoD of a fresh start in its approach to Gulf War illnesses that we have assessed its performance.

PROGRESS IN IMPLEMENTING THE TWENTY KEY POINTS

9. In April 1999, almost two years after Gulf War Illnesses: A New Beginning was published by the government, the then Minister for the Armed Forces told us—

I think there is a worry among the Gulf veterans that not very much is happening.[

In oral evidence, in December 1999, veterans' representatives themselves told us that they were not satisfied with the MoD's progress in implementing the twenty key undertakings made in July 1997.[25] The National Gulf Veterans and Families Association (NGVFA), in fact, took the drastic step of breaking off relations with the MoD last November in a dispute over testing for depleted uranium[26] (see paras 36-40). Much of the veterans' dissatisfaction arises from the response they have received from the MoD's Medical Assessment Programme on which four new undertakings were given. We discuss this further below (paras 16-29).

10. Eight of the key points related to research. On epidemiology, the MoD undertook to continue funding two large-scale epidemiological studies, which the previous government had agreed to fund in December 1996, following recommendations by our predecessor Committee in its Report in October 1995.[27] These studies are currently being undertaken at the University of Manchester, led by Professor Nicola Cherry, and at the London School of Hygiene and Tropical Medicine, led by Dr Patricia Doyle. Results of these studies should be available later this year[28] and we discuss their possible contribution to research below (paras 66-70).

11. Three of the key points referred to the government's commitment to set up a research programme into the possible health effects of medical countermeasures, the vaccines and tablets given to troops to protect them against the threat of chemical and biological warfare. The programme is overseen by an independent panel of scientific experts including a member nominated by Gulf veterans. Initial results of a dose ranging study (a study on guinea pigs to identify a vaccine dose combination which produces an immunological response whilst being tolerated without severe clinical effects) have been presented at a conference in Washington and are intended to be published. The full study is expected to take three years to complete.[29] Professor Malcolm Hooper, Emeritus Professor of Medical Chemistry at the University of Sunderland, who acts as chief scientific adviser to the Gulf Veterans' Association and who appeared before us as a witness, is a member of the panel but was not impressed by its achievements. He told us that it had met four times since it was set up in December 1997; that all its work was involved with animal studies; and that any work addressing the health, diagnosis and treatment of veterans is outside the panel's terms of reference. He said—

The MoD believed that Professor Hooper had misunderstood the purpose of the independent panel: its function is to provide independent oversight of the research commissioned into vaccines and pyridostigmine bromide. Overall guidance on MoD research into Gulf illnesses is being provided by the Medical Research Council.[31]

12. Specific commitments were given in the twenty key points to conduct research into the effects on Gulf veterans of possible exposure to organophosphate pesticides (OPs). The Report of our predecessors in March 1997 focused on the issue of OPs following the MoD's admission that it had misled Parliament, including in evidence to the Committee, on the extent of the use of OPs by UK Armed Forces in the Gulf. A memorandum was published in October 1997 explaining how parliamentary questions on OPs had come to be answered incorrectly between 1994 and 1996.[32] A report on the possible OP contamination of tents used in the Gulf and subsequently sold to the Scout Association was published in April 1998.[33] Further reports looking more widely at the possible health risks associated with OPs were published by the Institute of Occupational Medicine in July 1999 and the Committee on Toxicity in November 1999. The MoD is currently studying these to see if they have a bearing on Gulf War illnesses[34] (see paras 31-32).

13. Four of the key points related to provision of information to Gulf veterans which might be relevant to their illnesses. Since October 1997, in addition to the studies already mentioned, reports have been published on a number of specific issues of concern to veterans as possible causes of illness. These cover: medical countermeasures; the possible presence of a chemical warfare agent at the Sabahiyah Girls School in Kuwait; possible connection between the presence of dead animals in the Gulf and the use of chemical and biological agents; testing for presence of depleted uranium in Gulf veterans; chemical warfare; and the release of nerve agent at the Khamisiyah Depot.[35] We discuss many of these in detail below (paras 41-63). MoD has also commissioned, through the Medical Research Council, a systematic review of worldwide published research relating to Gulf veterans' illnesses.[36]

MOD WEBSITE ON GULF VETERANS' ILLNESSES

14. An important step in the provision of information to veterans was the introduction by the MoD in early 1998 of a website on Gulf veterans' illnesses.[37] This makes available published research documents, provides information on obtaining medical and other assistance, and offers links to other relevant government agencies and to other websites, such as the United States Department of Defense Gulflink site. The veterans' associations believed the website could be improved on similar lines to the Gulflink site, which offers facilities for subscribing to a mailing list and for commenting on the site by e-mail. Gulflink also provides an extensive list of veterans' organisations.[38] Professor Hooper, expert adviser to the Gulf Veterans' Association, told us that there was 'some partiality' in what was included on the MoD website and that he was concerned about 'the spin being put on some of the data that is there'.[39] He would also like to have seen more of the research work carried out in the United States included on the site.[40]

15. We regard the website as a very useful facility for those wishing to find out about Gulf War illnesses. It provides ready access to research documents which individuals might otherwise have difficulty obtaining, as well as providing key information to concerned individuals wishing to seek advice and assistance. We recommend that the MoD look at ways in which it could further enhance the information provided on its Gulf illnesses website, including facilitating contact between veterans.

14 Eleventh Report, Session 1994-95, op cit, para 60 Back

15 First Special Report, Session 1995-96, Government Reply to the Eleventh Report from the Defence Committee, Session 1994-95, on Gulf War Syndrome, HC 187, Annex 1, para 4 Back

16 Sixth Report, Session 1996-97, op cit, para 4 Back

17 Sixth Report, Session 1996-97, op cit, para 67 Back

18 Sixth Report, Session 1996-97, op cit, para 75 Back

19 First Special Report, Session 1997-98, op cit, Annex 6, para 2. Back

20 Gulf Veterans' Illnesses: A New Beginning, op cit, para 5 Back

21 ibid Back

22 See p xxxviii Back

23 Minutes of Evidence, 29 July 1997, HC 222-i, Q 190 Back

24 Q 3 Back

25 QQ 120-127 Back