Examination of Witnesses (Questions 200
- 219)
WEDNESDAY 15 DECEMBER 1999
MR SHAUN
RUSLING, DR
DOUG ROKKE,
MR TONY
DUFF, PROFESSOR
MALCOLM HOOPER,
MR JOHN
DENNIS AND
DR HARI
SHARMA
Mr Colvin
200. This is a question for you, Mr Rusling,
and Mr Duff. Have any members of your associations been involved
in the epidemiological study, either Cherry or the other one?
(Mr Rusling) With regards to the Wessley study, Mr
Colvin, none of our veterans took part in that, none.
Chairman
201. Were you invited to?
(Mr Rusling) We never got the forms through the post,
sir. We never got any information. We believe it may well have
been selected personnel who were not showing signs and symptoms
of illness, but obviously we would not possibly be able to prove
that, but what I can confirm is that none of our members took
part in that study.
(Mr Duff) As far as our association is concerned,
the Wessley study first of all, we had his paper looked at by
two dozen clinical researchers in this field and received a negative
report and we actually put that to the MoD and to Professor Wessley
directly. We have had individuals actually complete the questionnaire,
but I would agree with Shaun that most of our members have not
come across it.
Mr Colvin
202. Did they conduct a pilot survey before
actually doing the full survey?
(Mr Duff) Yes. If I can move on to the other two studies,
Nicola Cherry's study, as Professor Hooper has remarked, we were
deeply unhappy with that. We received her questionnaire through
the post and she had provided a little map that was supposed to
represent the area of contamination that we had been alluding
to and, frankly, my son could draw better.
203. Would you not have seen this during the
pilot? Would this map have appeared, for instance, during the
pilot study?
(Mr Duff) Yes.
204. Presumably you commented on it?
(Mr Duff) Yes, we commented, but we did not receive
a reply about it.
205. What about the other survey?
(Mr Duff) As far as the Pat Doyle study is concerned,
we supported that 110 per cent. She is never going to report though,
that is the problem, because her study needs everybody to get
involved and unfortunately that is not going to happen with the
best intention in the world, and I just hope that when she settles
on a percentage that she can report on, I hope it is in the higher
end of the scale and not the lower because she really will have
some fundamental things to say, but she is just not getting the
level of support that she needs in order to complete the work.
206. You are talking about Professor Cherry?
(Mr Duff) No, Doyle.
207. The other report?
(Mr Duff) Yes.
208. Do you think there is any other research
of this nature that ought to be carried out?
(Mr Rusling) There is one sort of information that
has not been drawn upon and that is the War Pensions Agency because
they have records of every single veteran from the Gulf War who
has come forward with health problems and all their signs and
symptoms. They have got the information. I would imagine that
at least 90 per cent are shown to have a form of PTSD—chronic
fatigue, irritable bowel, fibromyalgia—which would actually
show a serious health problem and the information is there and
there has been no will, possibly political will, to get that information.
(Mr Duff) I can probably shed a bit more light on
that. In a meeting that we had with the WPA in October, we put
the same points to them in a slightly different way and we have
got a commitment from them to look at this with us and actually
identify certain areas where we can look forward so that we can
produce this information so that people can see exactly the type
of things we are bringing to the WPA. This is to help them as
well as help us because they recognise that although they are
not part of the MoD, they really need as much information going
into their department as the MoD does and they are not getting
that either and clearly we want to see continuity because we have
a team of general practitioners at Norcross deciding every day
on somebody's disability and if they have not got the evidence
and the information to hand, then some of those awards are not
being correctly made and, therefore, they suffer from that and
we do not want to see anybody suffering through a lack of information.
209. I think that it has now been generally
accepted that there is no sort of single Gulf War syndrome and
even the heading we all operate under now is "Gulf War illnesses"
in the plural, but, Professor Hooper, when you were asked questions
earlier on, you said that veterans are suffering from a variety
of symptoms, and we all know that too, but there was no single
cause which has yet been identified for any one of those symptoms
and you have confirmed that and that is the general view.
(Professor Hooper) I think that is a red herring,
Chairman.
Chairman
210. It was something that we all pursued quite
ruthlessly for five or six years and it was not a red herring
then; we were desperate to find out if there was any cause, desperately
anxious.
(Professor Hooper) But you can have syndromes that
do not have single causes. Chronic fatigue syndrome is one and
fibromyalgia syndrome is another. I think the semantics are not
something I want to get bogged down in or that I want this report
to get bogged down in. I am quite happy with the word "syndrome".
It does not worry me at all. It is a multi-organ, multi-symptom,
multi-insult injury which can be accommodated within the framework
of current medical thinking and scientific thinking in the paradigm
of what is called the "neuroendocrine immune paradigm"
which I referred to in the paper I have given you, and all that
is saying is that all these systems interact and interrelate and
that the interrelationships can be provoked from one side or the
other; they can be provoked by stress, they can be provoked by
vision, they can be provoked by perception, they can be provoked
by injury, they can be provoked by vaccines, but the systems are
all communicating, they are all talking to each other, so what
comes out of that is a conglomerate which distils down in different
directions for different people and we will have the flavour sometimes
of the insult. For example, PTSD can come out of organophosphate
poisoning.
Mr Colvin
211. So the answer to my proposition is yes?
(Professor Hooper) There is no single cause.
212. Exactly.
(Professor Hooper) But I think to look for a single
cause is to be asking the wrong question.
Chairman
213. Do you all share that analysis? Is that
the current attitude of all the organisations?
(Mr Duff) If you are looking for a single cause, it
was the war.
(Dr Rokke) It is impossible to have a single cause
because of the total complex symptoms we are talking about.
Mr Colvin
214. Do you think the money we are spending
at the moment on trying to find the causes would actually be better
spent on treating those who are suffering?
(Dr Rokke) Absolutely, loud and clear. If you can
come up with ways to restore my quality of life, to restore Shaun's
quality of life, to restore Kevin's quality of life, if you can
come up with some actual physiological treatment that can restore
our quality of life, I think we would all be grateful. One of
the things that has come out loud and clear since I started this
stuff so many years ago is that the veteran, the warrior, the
civilian, and we have to make sure that this is loud and clear,
the civilian, who is still not receiving care, because of deliberate
exposures, because of the work that he did for our governments,
is suffering, but if we can restore the quality of life, we are
probably going to see a whole turnaround of things. When we talked
about stress, the stress that is occurring today, and I could
go on with stories where we are handling suicides in the middle
of the night or attempted suicides, it happens all the time, and
because the individual has been placed under such stress because
he cannot get adequate medical care, he goes in and they say,
"It's in your head". Families are being destroyed. We
are literally talking about families which are under destruction
because of the fact that adequate medical care has not been provided.
We are talking about families that are under destruction because
they do not have incomes, they cannot work. Remember it is those
who cannot work right now that have limited incomes and I know
for a fact that they would love to if they could be restored,
so if we could come up with adequate medical treatment, if we
could come up with adequate medical treatment to restore some
of our respiratory capabilities, if we could come up with medical
treatment, and Garth Nicholson is doing tremendous work out there,
Bill Baumzweiger—these are physicians—Bob Haley, these
guys are doing some phenomenal work, but they are not being supported,
so if we put support in to providing the money necessary for actual
treatment, we are going to go a long way. If I could go back in
my life and change the decisions we made in theatre medical command,
I would, and maybe I would not because it was war, but overall
the name of the game is today, whether it is in the United States,
France, Germany, Great Britain, Canada, the warrior, the civilian,
the military warrior have been abandoned, they have been seriously
abandoned, and their medical care has been turned away, the problems
we know about have been turned away and all that is happening
is that families are literally under destruction because of this
aftermath of the Gulf War.
Mr Cohen
215. I have a couple of questions about the
war pension situation. Firstly, on the seven-year rule, you know
that obviously under the current system, for a veteran who applies
for a war pension within seven years of leaving the services,
there is a presumption in favour of the claimant. We have had
what to my mind has been a bit of an unsatisfactory situation
whereby my colleague, David Clark, raised it on the floor of the
House and got what we thought was a very good answer from the
then Minister, Doug Henderson, that the rule would be extended,
that the presumption in favour of the servicemen or ex-servicemen
would continue. He then came to this Committee and he said that
that was not exactly what he meant and the matter then was the
subject of a review. Well, if you look at the point of what he
said, that is so, but the impression was different on the floor
of the House. I want to ask you about that seven-year rule because
we still have not seen the results of the review. Have you had
any information or advice from the MoD on how it is going to operate?
Have you had any explanation of the delay and, most importantly,
what are the implications of that rule if it is not changed?
(Mr Duff) First of all, no, we have not had any evidence
from the MoD. The working reality of the situation at the moment
is that thanks to the close working relationship that we have
with the WPA, they have said to us in all honesty that they do
not see this as an initial problem other than for an act of policy
because they believe that on the Gulf War issue, from what they
have seen over the last few years they know that it is sufficiently
serious enough and the people that come to them are sufficiently
serious with debilitating illnesses and other disabilities that
they would do everything in their power to make sure that an adequate
award is made. Failing that, and we have proved this in recent
months, where someone has had an award that they do not think
is fair on medical grounds or on others, we then have the ability
to go back to them as an association and actually go through the
process with them and try and reach an adequate assessment because
clearly what was said in April came as a bit of a bombshell because
that was not the first time it had been discussed. John Reid had
discussed this with us and of course his attitude was that he
thought it was perfectly right and if he did not have any answers
to give us, then why should we suffer at the hands of a ruling
that was created many decades ago? He thought it was perfectly
right, so long as the veterans came up for this award and that
the evidence of disability was there and there were no other grounds
to consider whether they should be awarded pensions, and we think
that is absolutely right. Thank God, the executive of the WPA
think like us, otherwise there would be a lot more people in strife
than there are.
216. So you are saying that the outcome of the
review from your position is really that the overwhelming case
that the extension of this presumption on behalf of the claimant
should continue?
(Mr Duff) Absolutely.
217. How many people would be affected if it
was not?
(Mr Duff) Well, it is a bit of an unfair question,
but at the end of the day I would say that the majority of the
force that went out there would be affected. It is that serious.
The problem with service life these days is that we could all
allude to an injury or a disability of some form that we could
claim for and 90 per cent of us do not bother because we work
it through and it is not in ourselves to go for these kinds of
things, but, having said that, we need to encourage people to
come forward for these things now, not in the sense to get a pension
from it, but just to have it on record. Not having the facility
to actually do something about this is just unacceptable to us.
I will tell you that the other area of concern for us, as far
as the WPA is concerned, is that when they make an award, and
often, as you know, the awards can be quite substantial, that
award does not relate to any other aspect of DSS policy or MoD
pensions. Where we get an invalidity pension from the MoD, we
have to go through the medical board system and if we did not
go through that, we would not get a pension. Now, we are talking
to them with respect to medical boards because clearly somebody
who comes out and is judged to come out, in technical terms, with
a P7 where they are debilitated and not able to work within their
own trade structure, but are still able to work in other areas,
they do not get a pension for that, but of course that may stop
them from working, in which case they go into other streams of
benefit which technically they should not be getting because they
should be provided for under the existing legislation for servicemen,
and clearly the MoD needs to look at this. Individual pension
rights for regulars, TA, reservists, that is not satisfactory
either. We have been looking at this kind of pension reform for
three or four years now and we have still not got fundamental
answers to the questions we have asked, and I am sure that will
be requested through this Committee.
Chairman: Would you drop us a note on
reservists and the TA and the benefits they receive please as
that would be really helpful.
Mr Cohen
218. You referred to the War Pensions Agency
and that was the second question I really wanted to ask. That
of course is part of the Department of Social Security, but maybe
the Ministry of Defence could be helping a lot more in dealing
with it. You said you have a good relationship generally with
it and we have heard some reports of problems at the Agency, although
I note from a letter from the Chief Executive, Gordon Hextall
to Ashworth Tetlow—
(Mr Rusling) That is our charity solicitor, Mr Cohen.
219. Or rather in a letter to you, Mr Rusling,
he said, "The Agency places a priority on providing a high
standard of service to war pensioners and I am satisfied from
my own oversight and feedback as well as from customer satisfaction
surveys and comments from ex-service organisations that we generally
succeed in this respect". Are you reasonably happy in this
respect?
(Mr Duff) I am grateful that I can pick up the phone
and speak to him because if I have got a case serious enough to
warrant his attention, I can pick the phone up and put it to him
directly. In fact I know that the majority of the work that is
done by the Association is in that format. I do not believe in
back-and-forth arguments or wishes or a wish-list or whatever.
He is a chief executive and he is like everybody else and he is
there to do a job, so if you put the evidence in front of him,
he is going to do the job. If he does not do the job, we will
kick him out.
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