Annex 2
Letter to Dr A Ming, Hull Royal Infirmary
from the War Pensions Agency, February 1998
Re: Mr S F Rusling,
The above-named, who is understood to be a patient
of yours, has made claims for War Disablement Pension for a variety
of symptoms, and we have reports on file written by you following
consultations with Mr Rusling.
We would be most grateful if you could clarify
some points pertaining to your assessment of the conditions suffered
by Mr Rusling. This is most important as any condition for which
a War Disablement Pension is given must be shown, by law, to be
a disablement attributable to service factors. The evidence for
awarding a War Disablement Pension for any such condition must
therefore be based on sound and reliable medical evidence.
In your letter dated 10 June 1997 you stated
that Mr Rusling had features compatible with a peripheral neuropathy.
We are nor clear if this diagnosis was confirmed by objective
and formal laboratory investigations. In your subsequent letter
to Dr Koul dated 29 September 1997 you stated the Mr Rusling had
undergone a full battery of neurophysiological tests which were
all reported as being normal. Photocopies of your letters are
enclosed herewith.[7]
You also noted that the features of peripheral
neuropathy and the positive ANF may be related to the vaccinations
he received whilst serving in the Gulf War. The extensive literature
and scientific evidence of which we are aware has not, to date,
confirmed or made any link between the vaccinations given to Gulf
veterans and peripheral neuropathy. We also know that a great
deal of research is currently ongoing to study the effects of
multiple vaccinations but to date no conclusions have been reached
which would be accepted as being scientifically reliable.
For background information, I would like to
inform you that, whilst it is accepted that organophosphates were
used in the Gulf War, an investigation by the Ministry of Defence
has found that in the main, these were used properly by appropriately
qualified personnel. Mr Rusling was not employed in this capacity.
Could you please advise us of the significance
in Mr Rusling's case of a positive ANF, and what injurious process
it represents. We are particularly anxious to know if, in your
expert opinion, the positive ANF is related to service factors.
Mr Rusling has also claimed for ocular pains—referred
to him as "pains in both eyes". What, in your expert
opinion, is the cause of his ocular pains. May I refer you to
your letter of 27 June 1997 to D Clarke (copy enclosed) in which
you stated that a whole series of electrophysiological tests were
conducted which showed normal results.[8]
We note that in your letter dated 3 December
1997 you have diagnosed Mr Rusling as suffering from "Gulf
War Syndrome". Such a syndrome has not as yet been recognised
as a distinct clinical entity by the relevant Governing Medical
Bodies in the UK. We are aware that, to date, a great deal of
research is still ongoing on this subject and that it may take
some considerable time before any conclusions can be definitely
drawn regarding the existence, or otherwise, of any such syndrome.
Could you therefore, clarify the use of this diagnostic label.
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