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Medical Treatment

Mr. Keetch: To ask the Secretary of State for Defence which private sector providers were selected in (a) 2000, (b) 2001 and (c) 2002 to date for the treatment of armed

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forces personnel, stating in each case (i) the number of personnel treated in that year and (ii) the cost to his Department; and if he will make a statement. [54133]

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Dr. Moonie [holding answer 7 May 2002]: The information requested, covering the Financial Years 2000–01, 2001–02 and 2002–03 to date, is shown below.

Financial Year	Number of Referrals	Private Healthcare Providers	Cost (£M)
2000–01	1,634	BUPA, Nuffield Hospitals Group, BMI, Priory, Cygnet, Foxleigh Grove, The Retreat, Caprio, Independent, NHS	0.769
2001–02	2,419	BUPA, Nuffield Hospitals Group, BMI, Priory, Cygnet, Trees Park, Caprio, Independent, NHS	4.095
2002–03 to date	467	BUPA, Nuffield Hospitals Group, BMI, Caprio, Independent, NHS	0.837

Notes:

1. The details provided cover central initiatives managed by the Defence Secondary Care Agency (DSCA), the use of private psychiatric facilities by the DSCA, initiatives run by the Royal Navy and the Army Training and Recruiting Agency (ATRA), plus local RAF referrals. The ATRA arrangements for the referral of potential recruits to private healthcare providers for pre-entry screening are not included, as they are not members of the Armed Forces.

2. Figures are shown for the numbers of referrals. Patients may have had more than one referral. Numbers of patients could only be identified at disproportionate effort.

3. Cost figures represent invoices paid in each financial year. The number of referrals does not correlate precisely with the cost figure for each financial year since some invoices may not be presented/paid until a subsequent financial year.

4. Referrals in 2000–01 include 41 in 2000 for which no associated costs are available and 12, at a cost of £2500, covering 2000–01 and 2001–02 which cannot be apportioned separately to each financial year.

5. Cost figure for 2001–02 is estimated as the final figure is not yet available.

6. Cost figure for 2002–03 represents expenditure to date.

Mr. Keetch: To ask the Secretary of State for Defence (1) pursuant to the answer of 21 June 2002, Official Report, column 597W, on medical treatment, on what date the Rapid Treatment Initiative commenced and with what budget; by what criteria personnel are treated under the scheme; how many personnel in (a) the Army, (b) the Navy and (c) the RAF have been treated under the initiative and at what cost to his Department in each month since commencement; which health care providers have been used under the scheme; and if he will make a statement; [65237]

(2) pursuant to his answer of 21 June 2002, Official Report, column 597W, on medical treatment, on what date the Waiting List Initiative commenced and with what budget; by what criteria personnel are treated under the scheme; how many personnel in (a) the Army, (b) the Navy and (c) the RAF have been treated under the initiative and at what cost to his Department in each month since commencement; which health care providers have been used under the scheme; and if he will make a statement. [65236]

Dr. Moonie [holding answer 3 July 2002]: Following competition, contracts were placed in 2000 with the Nuffield Hospitals Group and BUPA to provide treatment for a Ministry of Defence Waiting List Initiative (WLI). The WLI accepted referrals from 17 November 2000 to 31 March 2001. Treatments were undertaken up to 30 June 2001 and only exceptionally beyond that date. The budget for the initiative was £2.5 million.

Service patients were referred from shortage occupations on the basis that they were expected to be fit for military operational deployment within six to nine months of treatment. The total number of referrals into the scheme by Service was:

Service	Referrals
Royal Navy	168
Army	805
Royal Air Force	435
Total	1,408

Because of the number of hospitals participating in the scheme nation-wide and the number of patients treated, invoices submitted covered variable time periods with some information being provided months after treatments. Consequently, neither the invoice values nor payments made relate directly to individual months and it is not possible to provide a breakdown of the number of patients treated and the associated costs on such a basis. The total amount paid to the contractors for the WLI was some £2.2 million.

Further contracts were placed with the same independent sector healthcare providers for the MOD Rapid Treatment Initiative (RTI). Referrals were accepted during a four-week period in January 2002. Most treatments were completed by 31 March 2002 with a number remaining to be undertaken in June and July. The budget for the Initiative was £1.1 million.

The Initiative was open to Service patients requiring simple acute procedures, who were expected to be fit for normal duties within six months of treatment and who had at least 18 months left to serve in the Armed Forces. The total number of referrals into the scheme by Service was:

Service	Referrals
Royal Navy	51
Army	327
Royal Air Force	201
Total	579

As with the WLI, records held do not allow for the information on patients treated or costs to be readily supplied by month. As at 3 July this year, the amount paid for treatment under the RTI, for patients treated up to 31 March 2002, was some £664,000.

Gulf War Syndrome

Mr. Hancock: To ask the Secretary of State for Defence how many Gulf War veterans in the Portsmouth South constituency have been diagnosed with symptoms connected to Gulf War Syndrome; and if he will make a statement. [64481]

Dr. Moonie: The Ministry of Defence does not recognise "Gulf War Syndrome" as a medical condition. It accepts that some veterans of the 1990–91 Gulf conflict

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have become ill and that many believe this ill health is unusual and related to their Gulf experience. A large number of multi-system, multi-organ, non-specific, medically unexplained symptoms have been reported by some Gulf veterans as well as recognised medical conditions. The overwhelming consensus of the scientific and medical community is that there is insufficient evidence to enable this ill-health to be characterised as a unique illness, condition or "syndrome". With the exception of certain infectious diseases that are notifiable by statute, primary care doctors in England and Wales do not report centrally illnesses experienced by their patients. Therefore, the MOD is not able to assess the number of Gulf veterans in the Portsmouth, South constituency who have reported illnesses to their doctors. MOD is advised of cancer registrations in England, Wales and Scotland. We have published data on the incidence of cancer-related deaths in Gulf veterans as compared to a comparable group of Service personnel who did not deploy to the Gulf. Gulf veterans who wish to be examined by a physician expert in Gulf veterans' illnesses can be referred by their doctors to the Gulf Veterans' Medical Assessment Programme (GVMAP) which is funded by the MOD. As of 18 July 2002, 16 Gulf veterans had been seen at the GVMAP who were recorded as living in the Portsmouth, South constituency. Of these 12 were assessed as well at the time of their consultation.

Nuclear Safety

Alan Simpson: To ask the Secretary of State for Defence what steps have been taken to test the level of

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UK compliance with the new REPPIR nuclear safety regulations; what requirements are set down by the Health and Safety Executive in respect of the new nuclear safety regulations; and whether his Department has provided the HSE with information to calculate safety zone distances in respect of a nuclear accident. [73187]

Mr. Ingram: The Radiation (Emergency Preparedness and Public Information) Regulations 2001 sets down the requirements and responsibilities of operators, carriers and local authorities in responding to a reasonably foreseeable radiation emergency.

The Ministry of Defence has undertaken assessments to identify the hazards and evaluate the risks from the Defence Nuclear Programme and has provided to the Health and Safety Executive reports of these assessments including, where appropriate, the area which is likely to be affected by the dispersal of any radioactive substance.

The MOD maintains contingency plans to deal with accidents involving defence nuclear materials and conducts regular nuclear accident response exercises designed to test these plans.

Alan Simpson: To ask the Secretary of State for Defence what nuclear weapons accident exercises his Department plans to hold in the next 12 months. [73186]

Mr. Ingram: The following table gives the current date, name and location of the nuclear weapon accident response exercises that are scheduled to take place during the remainder of 2002. The nuclear weapon exercise programme for 2003 is not yet finalised.

Month	Name	Location
August	Convoy NAR team Standardisation	Leicestershire
September	RAF Station NAR team Standardisation*	Northamptonshire
October	UK/US Table Top Exercise	Norfolk
October	RAF Station NAR team Standardisation*	Suffolk

*RAF Station Nuclear Accident Response (NAR) teams provide immediate response forces for the air transportation of nuclear weapons.

Alan Simpson: To ask the Secretary of State for Defence what lessons were learnt from the nuclear weapons accident exercises in East Anglia conducted on 24 May. [73185]

Mr. Ingram: There were no formal nuclear weapon accident response exercises held in East Anglia on 24 May 2002.

The Nuclear Weapon Convoy Group were however conducting training in East Anglia at this time as part of an ongoing training programme to ensure that the highest standards of safety and security are maintained. The details of this operational training are classified and I am therefore withholding the information requested under Exemption 1 of the Code of Practice on Access to Government Information.

Alan Simpson: To ask the Secretary of State for Defence whether the transfer of activities at Rolls Royce Nuclear, Derby, qualifies for its appraisal under REPPIR. [73188]

Mr. Ingram: It would not be appropriate for me to comment on the commercial activities of Rolls Royce at Derby and the application of Radiation (Emergency Preparedness and Public Information) Regulations (REPPIR). They are a matter for the company and the Health and Safety Executive as the regulatory authority for REPPIR.

Alan Simpson: To ask the Secretary of State for Defence what plans he has for bringing the non-legislative LAESI guidelines into line with the new REPPIR requirements in respect of the transport of nuclear materials. [73300]

Mr. Ingram: LAESI neither provides safety guidelines or regulations, but provides the Local Authorities and Emergency Services with information on contingency arrangements for accidents during the transport of nuclear weapons, special nuclear material and new and used submarine reactor fuel (known collectively as Defence Nuclear Materials). Our arrangements, as detailed in LAESI, have regard to all current statutory requirements, including Radiation (Emergency Preparedness and Public Information) Regulations (REPPIR), and are kept under regular review.

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