House of Commons - Defence - Minutes of Evidence

Select Committee on Defence Minutes of Evidence

Memorandum submitted by Professor Malcolm Hooper, Scientific Advisor to the Gulf Veterans' Association

ACTION—NOW AND IN THE FUTURE

IMMEDIATE ACTIONS

1. An International Conference

This would allow a full examination of all the science completed and planned. It would enable UK scientists to meet with those from the USA and elsewhere and debate all the issues.

I have already suggested such a Conference to the Gulf Support Group but so far no decision has been made.

2. A Public Enquiry

This would

(a) Allow a full examination of all the facts which are now available.

(b) Give the GWVs and their organisations a hearing.

(d) Provide a sound basis for a new relationship between the MOD, Government and the GWVs.

Such an Enquiry has been requested by the Royal British Legion and the Gulf Support Group as well as GWVs and their organisations.

It has been refused. "There are not sufficient grounds for an Enquiry".

What is provided here makes it clear that such grounds do exist and have been ignored, belittled, misunderstood, and misrepresented by the Government and MOD.

3. Immediate programmes of research must be commenced where the present evidence is strong

(a) Measurement of DU in GWVs and in important organs from autopsies.

(b) An investigation of the immunological status of Sick Veterans.

(d) SPECT and MRI scans.

(e) Use of new diagnostic procedures.

(f) Others identified from the International Conference of scientists.

4. The MOD must become pro-active in assessing and exploring new information that has been produced in the diagnosis and treatment of GWI/S

MOD, INDEPENDENT PANEL, MAP, AND RESEARCH PROGRAMMES

MOD CONFERENCE 10 DECEMBER 1998

This meeting was organised by Colonel John Graham of the Ministry of Defence, who is presently in Washington as the link person between the MoD, the Department of Defence, DOD, Veterans, Administration, VA, and other USA Government Agencies.

It was the first open meeting on Gulf Health organised in the UK. As far as I was able to judge those attending were drawn mainly from the Military Medical Establishments in the States and the UK. Other interested people were there including some Gulf Veterans and members of the Press and Media.

No speakers known to question and criticise the current views espoused by the MOD, DOD, VA were invited/agreed to participate in the Conference.

These include,

— USA Senators and Members of the House of Representatives who have convened Committees whose reports have been extremely critical and sometimes damning of the role of the DOD and VA; Shays, Reigle, and Burton Reports.

— Scientists who have produced many peer reviewed papers on Gulf War Illness(es), GWI, and proposed very different understandings of it; Robert Haley, Garth Nicholson, Katherine Murray Leisure, Howard Urnovitz, Bill Baumzweiger, Bill Rea, Jim Tuite and others from the USA, and Goran Jamal, 1998; Christine Gosden, 1999; Shattock, Waring, and others from the UK.

— The Conference was therefore very unbalanced in addressing all the issues of Gulf Health. The more so because the only UK presentations, the King's Study (Simon Wessley funded by the DOD), The Manchester Study (Nicola Cherry and Gary McFarlane, funded by the MRC) and Reproductive Outcomes Study (Patricia Doyle and Noreen Maconochie, funded by the MRC) had no results for public presentation.

— Dr Bernadette Guldager from Denmark was the exception. She presented data on 700 Danish Gulf Veterans. This recent data was the only new information derived from the meeting.

The Conference was largely a sham and in line with the behaviour of MOD towards GWS/I.

THE INDEPENDENT PANEL

This was convened in December 1997 and has met four times. It is solely concerned with providing independent assessments of MOD funded research programmes concerned with the possible interactions between vaccines and NAPS (pyridostigmine bromide).

All its work is involved with animal studies, mice, guinea pigs and marmosets.

The guinea pig work has now been abandoned and the mouse work still remains to be done and the marmoset work will not be completed until 2003.

Any work addressing

(a) The health of the current GWVs;

(b) diagnosis;

has been ruled outside the terms of reference of the Panel.

The panel provide an alibi for taking no effective action to help current GWVs. It is part of the official unwillingness to face the unpalatable truths of the Gulf War and to offer a proper justice to the GWVs. It is a smokescreen and cover-up!

MAP (Medical Assessment Programme)

This was established in October 1993.

A paper was published in the BMJ (Coker et al., 1999) on the first 1,000 cases. It is, by its own admission, deeply flawed.

(a) The programme was not designed as a research tool;

(b) Clinical diagnoses were made by 17 different consultants;

(c) Two different disease classifications were used, both differed from that used in the USA thereby making comparisons at best approximate;

(d) No denominator or comparison data was available;

(e) Psychiatric assessment was abandoned half way through the programme in 1995 after only 255/1,000 had seen a psychiatrist;

(f) Follow-up was inadequate in one in five psychiatric cases;

(g) "Nor do we have all the results of psychiatric assessments that we advised should take place."

There has been two changes of leadership and, as yet, no clinical audit.

The following are notes made at a MAP presentation to the Independent Panel by Professor Harry Lee on 29 March 1999.

It was emphasised that

(1) "GWVs came to MAP very worried and needed mainly reassurance in the face of their worries. When this was provided, by listening, the GWVs went away much happier." Only about half had any illness, which was described as PTSD. [In conversation, "paranoia was the most outstanding symptom"];

(2) MAP is not there to treat Gulf illness;

(3) Depleted uranium ammunition was described as "not dangerous". This is only part of the truth;

(4) History taking followed by examination and any investigations thought necessary on medical grounds revealed "nothing unusual";

(5) The spraying of organophosphate and other insecticides was stated to have been carried out with meticulous attention to the health and safety regulations and was not excessive;

(6) Vaccines were said to have been given according to the proper protocols and the regimen was not compressed;

(7) Oil fires were said to pose no pollutant problems;

(8) Any illness arising more than two years after the Gulf War was not attributable to service in the Gulf;

et al

The Lancet

(10) There is no sensible rationale for treatment. No consideration was given to possible treatments other than doxycycline study;

(11) The War Pensions Agency was described as generous in its treatment of GWVs;

(12) Small groups of disaffected activists who agitate and seek publicity driven research programmes were presented as unredeemable trouble makers!

Subsequently one GWV was completely misled about DU testing see section on DU above.

This is the evidence on which the GWVs lost faith in MAP.

MOD RESEARCH PROGRAMMES

1. The Wessley Study

This study commenced in 1997 and the paper was published in January 1999 (Unwin et al, 1999). It was funded by the DOD!

It was a questionnaire study in which no veterans were seen by a clinician.

2. The Manchester Study

This is led by Professor Nicola Cherry and funded by the MoD through the MRC. It involves yet another questionnaire, survey of mortality rates. It has not yet reported.

3. The London Study

This is led by Dr Patricia Doyle of the London School of Hygiene and Tropical Medicine and funded like the Manchester study. It is yet another questionnaire study which, very ambitiously, seeks to contact all GWVs in order to evaluate important questions about reproduction and birth defects.

4. Neurological Studies

These are an extension of the Wessley study and the first clinical assessment of GWVs. The study has just started almost 10 years after the end of the war.

We already have extensive studies from the USA, Fukuda, 1997, Iowa study, 1997 which answer the question of incidence of symptoms and mortality, Kang, 1996. All are increased in GWVs.

Haley, 1997, 1999, has carried out a number of neurological investigations. In this country Goran Jamal has reported important findings which have been ignored, Jamal 1998.

It is not unfair to conclude that the UK is running round the same track as the Americans but several laps behind. We appear to have learned nothing from their studies.

CONCLUSIONS

(1) MAP lost the trust of the GWVs by its uncaring and arrogant attidude. Some veterans have been misled by promises made which were not fulfilled.

(2) The MoD Panel is an alibi for inaction.

(3) Nothing has been learned from the extensive American studies and investigations.

(4) There appears to have been a deliberate conspiracy to avoid any open debate in the scientific community and the MOD about the issues of GWS/I.

(5) The UK research studies started very late, and only involved questionnaires or a literature review. Another alibi for inaction.

(6) Some important research in the UK has not been followed up.

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December 1999



© Parliamentary copyright 2000	Prepared 28 February 2000