Westminster Hall
Wednesday 5 February 2003
[Mr. Frank Cook in the Chair]
Gulf War Illness
Motion made, and Question proposed, That the sitting be now adjourned.—[Mr. Ainger.]
9.30 am
Mr. Paul Tyler (North Cornwall): I am grateful for this timely opportunity to raise the issue of Gulf war illness. My purpose is simple: I want to ensure that our troops are not exposed to any unnecessary risks to their health, as they were in the 1991 Gulf war, if and when they are engaged in hostilities in or near Iraq. I hope and pray that such a war never has to take place, but if it does, I would never forgive myself had I not drawn attention to the lessons of the last war. I know that I speak for many others. I am a member of the Royal British Legion Gulf war group, and am only too well aware of the suffering of so many veterans in that conflict. I am delighted that the hon. Member for East Hampshire (Mr. Mates), who is also on that group, is present, as are several hon. Members from all parties who share my anxiety.
Clearly this is an appropriate moment to pay tribute to that group and to the veterans' associations. I must especially thank Colonel Terry English, chairman of the group and Royal British Legion director of welfare, and Professor Malcolm Hooper of the university of Sunderland, for their help in bringing together so much evidence for the debate. I also pay tribute to Lord Morris of Manchester, who has been a determined and persistent supporter of all Gulf war veterans. Recent ministerial answers to his questions in the other place have increased, rather then dispersed, our concerns.
Why should we be worried, because surely the Ministry of Defence is capable of managing the inoculation programme, the application of pesticides and any other possible threat to the long-term health of our troops? I hope so, but frankly the omens are not encouraging. Organophosphate pesticides are extremely dangerous chemicals, as the House knows. They were originally developed by the Nazis in the second world war. From my long-term involvement as chairman of the all-party organophosphate parliamentary group, I am aware that they are now supposedly subject to rigorous controls. However, it was not always so.
Despite ever louder warnings from medical and environmental scientists, it was only in the late 1980s that the Health and Safety Executive issued a comprehensive advice sheet on the dangers. In the early 1990s, I established that other Departments were totally unaware of the serious risks of both acute and chronic health hazards. Even farmers, who were forced to use them for sheep dips by the then Ministry of Agriculture, Fisheries and Food, were left in the dark.
Guidance note MS 17, which has been updated since the 1980s, provides the following succinct and official description of the signs and symptoms of acute OP poisoning. They include
- "those related to excessive activity of the autonomic nervous system: miosis (pin-point pupils), blurred vision, lacrimation, excessive salivation, cold sweats, bronchorrhorea, cardia arrhythmias/badycardia with decreased cardia output and hypotension; . . . those related to over-reactivity of voluntary muscle: tremors, impaired co-ordination; and . . . non-specific symptoms: headache, giddiness, loss of appetite, nausea and diarrhoea."
There are other signs, too, which I need not go into. My point is simply that a great many of the signs and symptoms have been found among troops suffering from Gulf war illnesses. Some are chronic, some are long term, and they are very serious.
As information about the 1991 conflict became available to parliamentarians, I was concerned to know how many of our troops were exposed to OPs, in what conditions and with what precautions. I asked the then Minister for the Armed Forces a parliamentary question. I shall quote his answer extensively because it is extremely important. He said:
- "I am aware of only 10 British service personnel who would have been involved with organ-phosphorous pesticides used by United Kingdom forces during the Gulf conflict. These 10 were members of a medical team involved in delousing some 50 Iraqi troops with a dusting powder containing 1 per cent. malathion at the prisoner of war enclosure at Quaisuma. Malathion is recommended in standard therapeutic textbooks as a treatment of choice for lice infestation and several preparations are commercially available in the United Kingdom, including body lotions and shampoos.
No clinical evidence indicative of exposure to organo-phosphates has been found among the service personnel who have come forward with concerns about their health related to service in the Gulf. No specific research into organo-phosphorous has therefore been carried out in relation to the alleged Gulf war syndrome, though evidence from all relevant sources is closely monitored."—[Official Report, 3 November 1994; Vol. 248, c. 1237.]
- "It has become clear, as the House now knows, that organophosphate insecticides were used more widely in the Gulf than we had been led to believe. I regret that the information given to the Defence Select Committee and to other hon. Members in the past few years has proved to be incorrect."—[Official Report, 15 October 1996; Vol. 282, c. 680.]
Many hundreds of our service personnel were exposed to dangerous chemicals in the Gulf, and it was not reassuring to learn about Ministry of Defence lack of competence and transparency, but worse was to follow.
Claims that OPs were used only by trained operatives, with proper precautions and protective clothing, have been specifically challenged by Sergeant Tony Worthington, who has clear photographic evidence. He has shown that operatives were exposed to massive doses of OPs and other pesticides in vapour form. We still do not know whether those OPs, apparently bought locally in Saudi Arabia, were of a type that was banned for use in the UK. We can be sure, however, that any warnings and instructions for use were in a language that was unintelligible for those unsuspecting service
personnel. It is not surprising to note that Professor Cherry's research found an association between exposure to pesticides and symptoms of Gulf war illness. Parallel research in the USA is equally alarming.After that dreadful experience, surely the Ministry of Defence learned its lesson. On 7 January, just a few weeks ago, I tabled a parliamentary question that was answered by the current Minister with responsibility for the armed forces. My question was:
- "To ask the Secretary of State for Defence if he will take steps to ensure that British service personnel are not exposed to organophosphate pesticides when on operations in the Middle East."
In view of the 1991 disasters, I expected a promise to avoid such risks. Instead, he replied:
- "The use of pesticides remains an essential component of force protection against the threat of insect borne disease. It is the policy of the Department only to procure pesticides approved under the Control of Pesticides Regulations 1986 or to seek approval from Pesticides Safety Directorate (PSD) of the Health and Safety Executive (HSE) to store items in United Kingdom, for use in overseas locations.
Those pesticides are only supplied to and used by trained personnel, who are fully equipped with the appropriate personal protective equipment."—[Official Report, 7 January 2003; Vol. 397, c. 79W.]
So let us get to the truth of it. I have a number of questions for the Under-Secretary. If he cannot answer them all today, I hope that he will write to me. What OPs have been shipped to the Gulf—full names, please—and are they all approved for use in the UK? Will only fully trained operatives be used in the spraying and swing-fogging of any pesticides? Will protective suits and other precautions be employed? What studies of the effect of strong Gulf sunlight on the conversion of malathion into more toxic compounds have been undertaken? What other pesticides have been supplied and are intended for use? Has lindane been supplied, with all its inherent dangers? Pyrethroids are known to be nerve poisons that have a powerful synergistic action with OPs.
Will DEET be issued to troops? It also has a synergistic effect with other pesticides. In 1991, much stronger solutions of DEET than those used in holiday packs were issued. Will those be issued again? What consideration has there been of the cumulative effect of OP exposure and administration of nerve agent pre-treatment set—NAPS—tablets, which attack the same target enzymes in the blood? What assessment has there been of the findings of Mackness and others that Gulf veterans have greatly depressed levels of para-oxonase in their serum? What steps have been taken to prevent repetition of the problems this time? British troops serving their country—serving us—have every right to expect their Government to take all precautions to avoid unnecessary risk, but the evidence is not encouraging.
Another controversial aspect of the preparations for the 1991 hostilities was the inoculation programme. Many Gulf veterans who have since developed serious illnesses have given us evidence of administration of vaccines that was at best slap-happy and at worst downright irresponsible. The combination, in quick succession, of a cocktail of vaccines, quite outside the normal protocols, seems absurdly ill-considered and out of control in many units.
I am no medical expert: others in the Royal British Legion team are far more qualified that I am to deal with such matters. Indeed, other hon. Members in the Chamber have relevant experience, and I hope that they will contribute. The best that I can do is to refer to the submissions made to the United States congressional hearings that we facilitated in the House of Commons last July. For example, the evidence given to those hearings by Professor Graham Rook contained this summary:
- "The Hypothesis that we put forward in 1997 was that long-term changes in the balance of the immune system could be caused by multiple vaccinations. This would be exacerbated in psychologically and physically stressed individuals and also by the chemical exposures and this could lead to a diverse range of symptoms including mood changes. So, I am going to show you that five new types of information have come forward to show the hypothesis was not as crazy as it was thought originally and it is within the epidemiology and the immunology done . . . it is important because it was saying that giving a massive load of vaccines in the Gulf War could have systemic effect on their overall immune systems for many years after."
I must remind the Under-Secretary of the moving evidence given by Samantha Thompson, widow of Nigel Thompson. She said of her late husband:
- "Nigel was a Petty Officer in the Royal Navy Fleet Air Arm and served in the Gulf War in 1991. Shortly after returning from the Gulf he started displaying the symptoms of Motor Neurone disease. Nigel always believed his terminal condition to be attributable to his active service in the Gulf. Right up to his death he fought tirelessly on behalf of Gulf War illness. Nigel also repeatedly called for an independent public inquiry into what went wrong during Operation Desert Storm that left so many military personnel ill or dying."
Meanwhile, the indefatigable Shaun Rusling, who leads the National Gulf Veterans and Families Association, has identified a series of official decisions recognising Gulf war illness despite Ministry of Defence obstinacy. I quote just one. Mr. Alex Izett, a former Royal Engineer, was accepted to have been damaged by the vaccinations by a pensions appeal tribunal just last December. The tribunal found:
- "We accept you were vaccinated and we looked at the MOD letter 24.01.01. We note the posity of the vaccination date: we therefore accept the evidence Autoimmune induced osteoporosis caused by vaccines."
That is absolutely specific. I believe that the case may not be contested further by the Ministry. Perhaps the Under-Secretary can confirm that.
Mr. Mike Hancock (Portsmouth, South): I have been involved in Mr. Izzet's case, and I understand that he has received a letter from the Ministry saying that it will not contest the decision, but for 12 years it has contested his case. Mr. Izzet has said more than once that he has been close to suicide, which he has attempted at least twice, because of the perilous state that he is in. Indeed, he no longer lives in the United Kingdom because he is so depressed about how he has been treated.
Mr. Tyler : I know that my hon. Friend has been a valiant champion on behalf of not only that veteran, but others as well. It shows the seriousness of many of the cases. Mr. Izzet's case may have a happy ending. I certainly hope so. Perhaps the Under-Secretary can confirm that.
Has the Ministry of Defence learned anything from that muddle and the potentially damaging consequences? Again, the omens are not good. Just a few weeks ago, batches of anthrax and other vaccines were washed up on south Dorset beaches. I asked the Secretary of State for Defence to explain where they came from, expecting him to say that it was nothing to do with the Ministry and that the UK Government did not know the source of the vaccines, as mislaying them at such a sensitive time and in such apparently incompetent circumstances would be peculiar and too mind-boggling to contemplate.
To my amazement, the Under-Secretary replied:
- "The anthrax vaccine found on the South Dorset coast is from a batch produced by the centre for Applied Microbiology and Research and purchased by the Ministry of Defence in February 2001. Because ampoules from the batch were issued to a large number of units it has not yet been possible to identify how they came to be in the sea. As far as we are aware, this is the only vaccine found, although a number of other pharmaceutical products, including drugs, have been recovered. Investigations into the source of the items found are continuing."—[Official Report, 27 January 2003; Vol. 398, c. 635W.]
That is pretty peculiar. What is more peculiar, however, is that no one has taken the trouble to tell me the result of those investigations.
Dr. Andrew Murrison (Westbury): A few wags in the press have suggested that the crate of anthrax vaccine on a south Dorset beach might have something to do with the fact that HMS Ark Royal reputedly steamed past that beach a short while before it was discovered. Does the hon. Gentleman think that the fact that the uptake
of the anthrax vaccine in the Navy has only been 28 per cent., compared with 78 per cent. in the Army, might have something to do with it?
Mr. Tyler : The hon. Gentleman has professional qualifications and more information than I have on that matter. I am grateful to him for his comment.
The critical consideration is that the Ministry of Defence knows that the anthrax vaccines belong to that Department, but it has no idea how they got from A to B. That does not give me much confidence that it knows what it is doing to its service personnel. I want to emphasise that it is our troops who are being treated in such a way. It is extraordinary. No wonder they are losing confidence in the political direction and overall command.
The Ministry does not know what it is doing. To paraphrase the Duke of Wellington, "I don't know what effect our Ministry of Defence will have on Saddam Hussein, but, my God, they terrify me!"
Other hon. Members wish to contribute, and I hope that I have made my central point. The sorry saga of the suffering of the 1991 Gulf war veterans is an appalling reflection on the way in which successive Governments have treated them. Even worse than that would be a failure to learn the lessons and to avoid repeating them now. As I said, I hope and pray that Iraq and its dictator can be brought back to their senses without military action, but if British troops are deployed on our behalf it would be truly scandalous if they were also exposed to an unnecessary risk to their health by their own military planners in the Ministry of Defence. It would be the chemical equivalent of friendly fire.
Mr. Deputy Speaker : It is advisable to remind the House that it is customary in 90-minute Adjournment debates to commence the first of the three winding-up speeches 30 minutes before the end. We have 41 minutes before that time and six right hon. and hon. Members are present who wish to speak, only three of whom have given prior notice. I appeal to all concerned to make their remarks pertinent, concise and to be brief when receiving or making interventions.
9.49 am
Dr. Brian Iddon (Bolton, South-East): I congratulate the hon. Member for North Cornwall (Mr. Tyler) on securing this timely debate. My interest in Gulf war illnesses has arisen as a result of a constituency case, like that of so many other right hon. and hon. Members. Also, like the hon. Gentleman, I want to ensure that if we go to war again in the Gulf we do not make the same mistakes that we probably made in 1990–91.
A few days ago, on 20 January, it was admitted in the other place, in a written answer given by the Under-Secretary of State for Health, Lord Hunt of Kings Heath, in response to a question from Lord Morris of Manchester, that the current recommendation from the Centre for Applied Microbiology and Research at Porton Down, which manufactures the anthrax vaccine, is that it should be used alone, not in combination with other vaccines. That information is included in the product summary that is provided to doctors with the vaccine. The patient information leaflet also asks patients to inform their doctor if they are taking other medicines.
My concern is that, as has been admitted, members of the armed forces were given more than one vaccine at the same time, as well as other medicines such as pyridostigmine bromide, an acetylcholinesterase inhibitor used as a nerve agent pre-treatment medicine. The question is, what limitations are placed on the administration of other vaccines and medicines and, if such limitations exist—especially if they existed at the time of the Gulf war—are they, or were they, taken into account? It seems strange that we went to the Gulf war in coalition with all our allies and yet, while the Americans seem to have accepted that new illnesses have arisen as a result of that conflict, the Ministry of Defence cannot entirely share those views.
On 25 June last year, the United States research advisory committee on Gulf war veterans illness produced an interim report, which pointed out that there is increasing objective evidence that a major category of Gulf war illness is neurological. The US Government at present support 224 research projects, which involves $213 million.
On 28 October, the honourable Leo S. Mackay, Deputy Secretary of Veterans Affairs, reported to that committee that Dr. Simon Wessely's research group in London had concluded, in an article published in the British Medical Journal, that the ill health suffered by Gulf war veterans cannot be explained by stress or other physiological disorders. That is certainly the conclusion that many British Gulf war veterans have obviously reached.
On page 5 of the American report, we find the statement:
- "Most important, we want to send a message to veterans. That science is finally beginning to unravel the mysteries of Gulf War illnesses. That this Administration is committed to pursuing new science, medical breakthroughs and new treatments. And that, finally, there is reason for hope".
Professor Bob Haley of the university of Texas has described three Gulf war syndromes, for which he has provided evidence from his research and that of other scientists. At least one category of Gulf war illness appears from the evidence available to be neurological in character. Magnetic resonance spectroscopy suggests a loss of neurons in selected brain areas in ill veterans, in particular in the brain stem and basal ganglia. The same veterans show cognitive problems and/or joint and muscle problems.
The Americans have provided evidence that ill veterans who drive vehicles are significantly more at risk of being involved in road traffic accidents than others. Significantly, the Ministry of Defence recently admitted to me in a written answer to a parliamentary question—it can be found in Hansard, 7 November 2002, column 455W—that that is also the case in the United Kingdom.
The heart rate measurements of US Gulf war veterans show dysregulation of the autonomic nervous system. They suffer from amyotrophic lateral sclerosis, ALS, at
about twice the expected rate. They demonstrate an increase in the cold sensory threshold. Audiovestibular tests show abnormalities of central vestibular function and they exhibit elevated dopamine levels in the brain.Ill US veterans have low levels of an enzyme called paraoxanase in their blood. The Ministry of Defence has admitted to me in another written answer that that is also the case with British Gulf war veterans who are ill. That enzyme is responsible for breaking down organophosphates. Interestingly, those veterans who worked side by side with those who have become ill, but have not become ill themselves, have normal levels of that enzyme in their blood stream.
As has been demonstrated, organophosphate insecticides were widely used during the Gulf war, for example, to spray the tented areas and the troops themselves—they were issued with insecticide sprays. More importantly, an estimated 100,000 of our troops were exposed to organophosphate nerve agents, mainly during demolition of the Khamisiyah ammunitions depot. There is some evidence that the symptoms suffered by some Gulf war veterans are similar to those of others— for example, farmers who regularly dip sheep have been exposed to substantial amounts of organophosphates.
Let us compare the American conclusions—please note that these were obtained by several research groups—with those of our Government-supported Gulf war illness research unit, which has concluded that many thousands of British veterans who are suffering from illness cannot attribute that illness to agents such as the organophosphates that they encountered during the Gulf war. The Sunday Times covered that subject in a story of 24 November.
The MOD-funded researchers at Guy's, King's and St. Thomas' school of medicine in London, however, studied only 49 Gulf war veterans with neurological symptoms and compared them with 29 without problems. While the general health of those who were ill was poorer than that of other ex-servicemen, no brain damage could be detected.
Professor Simon Wessely is quoted as saying:
- "In the past we have shown incontrovertibly that Gulf War veterans are sicker than similar groups but what this study shows is that the health effects are not associated with neurological problems".
Professor Malcolm Hooper at Sunderland university, however, said:
- "I find this research frankly astonishing, unpersuasive and"—
- "statistically insignificant".
Dr. Iddon : I know Malcolm Hooper well because I worked with him at the university of Durham for some time. He was trained as a professional organic chemist.
Who is right? That is the big question now. I suggest to the Government that they should combine their research efforts with those of the Americans and, perhaps, those of other scientists worldwide, to seek the
truth. I was pleased to learn from the Ministry that Professor Bob Haley has been invited to Britain to discuss his work with other British scientists.We are not spending enough in the United Kingdom on unearthing the truth, whereas the Americans have taken the problem far more seriously. Recently, the Government have involved the Medical Research Council in research, but that effort comes a bit late, especially for those Gulf war veterans who have died, possibly—I stress "possibly"—as a result of their illnesses. I must admit that enhanced mortality is not yet proven, although enhanced morbidity rates are. At present, however, I am inclined towards believing the American results merely because the Americans have not fixed their minds and have invested considerably more pro rata than we have in research.
It is becoming clear that we have made mistakes in preparing our armed forces for the Gulf war. With the precautionary principle in mind, will my hon. Friend the Under-Secretary assure us that the same mistakes will not be made again if we go to war again in that region?
Finally, I apologise, Mr. Deputy Speaker, as I will have to leave a few minutes before the end of the debate at 11 am, as I am chairing a session of a conference in Church house.
9.59 am
Mr. Michael Mates (East Hampshire): I shall be extremely brief. First, I congratulate the hon. Member for North Cornwall (Mr. Tyler) on the timely way in which he introduced this debate. I serve with him on the Gulf war veterans' disease committee of the Royal British Legion and I acknowledge that the Ministry of Defence is trying, slowly, to get to the bottom of the matter.
I do not yet convict the Under-Secretary of some of the lack of sensitivity and urgency that some of his predecessors have shown, as I believe that he is trying hard to proceed with the matter and to get the facts. I hope that he is as frustrated as we are at the snail's pace with which progress is being made. I do not expect him to say so, but I hope that by urging him to get a move on and to bring this long and sorry saga to a conclusion he will start to throw his considerable weight about at the Ministry of Defence and to urge people to move a little faster.
The real point of my brief intervention is this. There is no doubt that there was a certain amount of shambles the last time that we went to war in the Gulf. There is no doubt that there were reasons for that—we were in a new area and we were not properly prepared, or expecting, to put our troops into the sort of dangers that chemical and biological weapons can cause. There was an explanation for the shambles, therefore. This time round, 11 years later, there can be no excuse, and I hope that the Under-Secretary will give us an unequivocal assurance that all the plans have been properly made, all the research done and all the best opinions sought as to how to protect our troops, should they have to face such dangers—of course, we all hope that they will not. Without that unequivocal assurance—this is a good time for the Minister to give it—our troops should not be sent in to face such dangers.
10.1 am
Mr. Kevin McNamara (Hull, North): Like the hon. Member for East Hampshire (Mr. Mates), I shall be brief. First, I congratulate the hon. Member for North Cornwall (Mr. Tyler) on obtaining this debate. It is timely, and it gives the Government an opportunity to state what precautions they are taking if our troops in the Gulf are engaged in warfare, and what steps they will take to prevent any such war having a history similar to that of the previous Gulf war.
The hon. Member for North Cornwall and my hon. Friend the Member for Bolton, South-East (Dr. Iddon) have set out the scientific facts. I did not know that many of the words that they used existed. I am aware, however, of the effects of the use of chemicals and vaccinations on Gulf victims.
I have the good fortune to have the headquarters of the Gulf Veterans Association in my constituency. Shaun Rusling is one of my constituents. In the past decade, the correspondence that I have received from him and from others in my constituency who are associated with the GVA has become a small mountain—a mountain that expresses despair and frustration. They despair because they wonder what they have done wrong. They feel that they are victims. Why have they been let down by the Ministry of Defence? Why are their claims that they are now very ill, but that they were not before they went to the Gulf, not being treated seriously and effectively?
In the early stages, correspondence from the Ministry of Defence on the subject almost showed indifference. I hope that that is changing. There seems to have been a change in atmosphere in the past few years. The soldiers thought that they were forgotten. They had or had not got pensions. It was almost as though the Ministry view was, "Sad. We don't know what's happened and we're not really too worried about it." It was due only to the public pressure of Shaun Rusling and others that the Ministry was forced, tardily, to take an interest and to take tentative steps to find out what had happened.
Hon. Members have compared the situation here with what the United States Government have done and the way in which they have treated their veterans. The same comparison has been made with Canada and France. A very different picture emerges here than in those other countries.
I hope that we will get two things out of this debate. I know of the interest that my hon. Friend the Under-Secretary takes in the matter and of his professional experience. I hope that there will be a further push and a greater sense of urgency from the Ministry of Defence. As the hon. Member for East Hampshire said, I also hope that none of our troops will face the same shambles if they are engaged in a war, that they will be properly protected and have full knowledge of what is being done to them and that full records will be kept. One of the greatest crimes is that there are no adequate records of what was given to the troops, and they do not always know what they were given.
10.5 am
Annabelle Ewing (Perth): I, too, congratulate the hon. Member for North Cornwall (Mr. Tyler) on securing this important and timely debate. I am aware that he and other hon. Members present have been assiduous in pursuing a campaign for justice for Gulf war veterans.
I concur with the hon. Member for North Cornwall in his condemnation of the shabby way in which successive United Kingdom Governments have dealt with the veterans of the 1991 Gulf war conflict. I understand that 500-plus veterans have died post-conflict and that many thousands are ill and suffering from debilitating illnesses. Many of them are deteriorating daily, which is obviously upsetting for them, but also for their families.
What has been the Government's response? They have stalled, procrastinated and refused to recognise the problem and to deal with it properly. To deal with a problem, we must first recognise its existence. The Shaun Rusling case is undergoing an appeal and is sub judice, but I wrote to the Minister on 20 November 2002 to ask what budgetary estimates had been made as to the cost of appealing. Unfortunately, I have not yet received a response. Perhaps I shall get an answer today.
Hon. Members who have spoken have mentioned research. The money allocated for research is unsatisfactory. An unfavourable comparison has been made with the amounts being spent in the United States, for example. Will the Minister state for the record whether he is satisfied with the level of funding? Will he explain what the level is for 2003–04 and say what percentage that represents of the entire Ministry of Defence budget?
No proper compensation is available to Gulf war veterans. There is no specially targeted medical support. The pleas of the Royal British Legion for a full, independent public inquiry have been ignored to date, which is unfortunate. The issue is of key importance, as the Ministry of Defence may be about to make exactly the same mistakes again, which would be unacceptable and unforgivable. I and other hon. Members hope that there will not be another conflict in the Gulf, but the Prime Minister seems to be set on that path irrespective of what the United Nations may do. It is not clear that the Government have learned lessons from the 1991 conflict and intend to pursue different measures. Indeed, it seems that they remain complacent. I and other hon. Members want to hear what they are doing differently, in particular on organophosphates and vaccines.
A debt of honour is long overdue to Gulf war veterans. Indeed, a Government who send soldiers to war have a duty of care towards them. It was not exercised in the first Gulf war conflict. That was compounded by the fact that the UK Government have refused since then to take real measures to help those veterans. This time round, I hope that the Government will do the right thing by our troops. I hope that they will have learned the lessons and will act upon them. Surely it is not acceptable for any troops to be subject to the same shabby treatment as the veterans of the 1991 Gulf war conflict.
10.9 am
Dr. Ian Gibson (Norwich, North): I, too, am pleased to take part in this debate secured by the hon. Member for North Cornwall (Mr. Tyler). I have a feeling of déjà vu, as my first Adjournment debate in 1997 was on this subject. The issue has not progressed very far in terms of our understanding of the causes and uncertainties associated with these illnesses. At the last meeting of the
Liaison Committee a few weeks ago, at which, of course, the Chairmen of various Select Committees met my right hon. Friend the Prime Minister, my right hon. Friend was asked whether the necessary precautions had been taken to protect troops being deployed to the Gulf from these illnesses, and the answer received was a rather curt yes. I, too, would like to be reassured that we are learning the lessons from the past.Reference has been made to the work that is going on in the United States. I have studied the epidemiology, in which other hon. Members are also interested, as we have had these debates many times. Epidemiological evidence must be taken seriously, and it is often hard to prove: let us remember how long it took to prove the associations of tobacco and smoking through epidemiological technologies. My hon. Friend the Member for Bolton, South-East (Dr. Iddon) has also referred to the work that has gone on in the United States on the symptoms, the illnesses and the diagnosis of veterans. Multi-symptom illnesses are associated with each veteran, which makes it difficult to associate one particular illness with one particular cause. There is no doubt, however, as has been admitted for years, that Gulf war veterans are ill and have problems. Although we cannot work out the cause or multiple causes, that does not mean that we should not take the matter seriously.
The United States seems to be ahead of us in this area. The Institute of Medicine, which is part of the National Academy of Sciences, has recommended the setting up of a national centre of war-related illnesses and post-deployment health issues, recognising that many veterans from many conflicts require a unit to examine these problems intensively and not in a piecemeal way.
If I may make an aside, a reference was made to Malcolm Hooper during an earlier exchange. In a letter submitted to The Lancet, which I have been asked to review, his title is emeritus professor of medicinal chemistry and his address is given as the school of sciences, university of Sunderland. Although that is true, it is also true that he is chief scientific adviser to the Gulf Veterans Association. I hope that we will not let the initials after our names get in the way of this debate, as we should be examining the evidence. We can all score points in relation to who is a greater expert in a smaller and smaller field.
My final point is about the depletion of uranium, of which there has been no mention whatever. A document on the health effects of depleted uranium munitions has been produced by the prestigious Royal Society in this country. Those munitions were used in the 1991 Gulf war. It is known that they produce harmful radioactive contamination in the battlefield environment, and they contaminate troops who have the insoluble uranium oxides in their systems for a long period, if not for life. It is alleged that the Iraqis learned only 12 months after the war ended that DU—depleted uranium—had been used on them and that no advice was given to troops in the United States or here of that use. UK Gulf veterans have been found to have DU in their urine, although it
is difficult to quantify levels of that internally. Other sorts of cancers are alleged to be associated with it, and epidemiological studies are ongoing.
Dr. Moonie : As a respected scientist, will my hon. Friend tell us what are the differences between the likely clinical effects of depleted uranium and those of ordinary uranium?
Dr. Gibson : If I knew the answer to that, I would have a Nobel prize. Studies are ongoing in that area, and we do not know the nature of what happens to uranium oxide.
Dr. Moonie : Will my hon. Friend accept that there is no chemical or medical difference whatever in the effects of isotopes of a substance?
Dr. Gibson : We do not know that. I am not prepared to get into a scientific debate about the origins and what happens to a compound once it gets in the body when research is ongoing in that field. We need a staged study, and we need to know how much of the substance has been taken in, where it goes and so on, which is admitted in the Royal Society document. In Iraq, for example, depleted uranium levels are associated with cancers in children and birth defects in the Basra region, where levels are three times higher than in Baghdad. Many other birth defects have been associated with that, and finer and more intense research is needed, as there are serious implications of using those compounds. If events in Iraq proceed, and depleted uranium is used, it will end up causing many health effects, about which our troops need to know.
To finish on an anecdote, this weekend I met a young person in the Norfolk area who is going out to Kuwait today to serve. That person had to purchase their own uniform, and many of their associates had not been issued with chemical combat uniforms. That is alleged, but I have no reason to believe that it is not true, and that person is in the eye of storm. The Minister has a job to do to convince many of us that we have learned the lessons and that some of the problems that have been associated with Gulf war illnesses will not happen again.
10.16 am
Mr. Mike Hancock (Portsmouth, South): Like other Members, I congratulate my hon. Friend the Member for North Cornwall (Mr. Tyler) and the hon. Member for Bolton, South-East (Dr. Iddon), both of whom made excellent contributions. They are demanding assurances that are being sought by all of us in this Chamber today, and, more importantly, by the men and women who will go to the Gulf area on our behalf, and by their families.
Historically, many people will be going to the Gulf for the second time. I met a young man—he is not so young now—who went to the Gulf the first time round and was there for only a matter of days. He received a cocktail of immunisations, and within five or six days, he was medivac'd out of the area back to Germany, where he was in hospital for some time. When he made a claim, he found that not one record had been kept of him having had the injections and having suffered a bad effect, despite the fact that there was a record of him being
medivac'd back to Germany. There was no indication of what he had been given or of the cause and effect of the illnesses that he suffered, and his military career was put on hold for several months.That man has now gone back to the Gulf—his unit was part of the logistics unit that is already in the area—but he was very nervous about what injections he would be given and he wanted assurances. I sent him a copy of the evidence given by the Minister to the Defence Committee with the hope that that might provide him with assurances that, this time round, proper records would be kept, and that service personnel would be informed in advance of what they would be given, when they would be given, and who would be responsible for the record keeping. We know from evidence that the Minister has given to the Defence Committee that our past performance in relation to keeping medical records is lamentable. To his credit, he has assured the House, the Defence Committee and the armed forces that that situation has been turned around. I hope that that turns out to be true.
As other Members have said, historically the Government's commitment to tell the truth on these issues is poor—it has had to be forced out of them. The answers given have been changed, and apologies have been given. Shaun Rusling and the Gulf Veterans Association have sought three things, which the Government have failed to give them. The first is recognition of the issue that they are trying to raise, the second is for the truth to be told, and the third is for justice to be granted to them. The hon. Member for Perth (Annabelle Ewing) was right to imply that there is a moral stain on this country because of the way in which we have failed to address the historic issues that we have faced.
Excuse after excuse has been put forward for why numbers of these young men and, in certain cases, women, have died. I remember visiting the United States as a member of the Defence Committee, and encountering the argument about the number of young people who have died in horrific accidents or extreme sporting activities. The excuse used then was that that was fairly normal after having returned from war, because they had been excited by the experience and had had an adrenalin rush, and, for a period after coming home, felt that they needed continuous excitement and thrill in their lives. That does not persist for 10 years, however, and people are still dying in those circumstances. The answer that was given as to why so many young people had died in horrific accidents or in suicides has now been virtually ruled out by the Americans. We must therefore return to address those issues.
My hon. Friend the Member for North Cornwall raised the issue of protection for people who might use organophosphates in the Gulf on this occasion, but that is not the only question. Will those troops who follow them be properly protected and warned about what has gone on in advance of their move into an area? Are we absolutely sure about what substances our allies will use in any action? One of the difficulties in the previous conflict was the difference of opinion about whether the Americans had told us what they were using at different stages.
Those Members in this Chamber today could repeat long lists of their experiences in relation to Gulf war veterans in their areas, but the case of Mr. Alex Izett is a classic one. For 10 years, the Ministry of Defence denied all of his claims. It fought tooth and nail, and letter after letter went from this country, via me and other Members, to Mr. Izett at his home in Germany. He won his case, and received recognition with a vaccine damage award, and within days of that award being given the Ministry of Defence wrote to say that it would not contest it. Why did he have to go through such a traumatic experience? Why was his family life destroyed when, 11 years on, we have recognised that we owed him a debt? Is it so much to ask that those individuals and their families whose lives have been destroyed should be dealt with properly and fairly?
The Minister's outburst today seemed to be an over-reaction to what Members were saying. To be critical of the qualifications of someone who is advising the Gulf veterans was beyond him.
Dr. Moonie : Will the hon. Gentleman give way?
Mr. Hancock : No. The Minister will have nearly 15 minutes to make his reply, and I will stay to listen as I have listened to his other comments.
Mr. Hancock : No, not pathetic. Your outburst against your colleague today, when he tried to address the issue, showed me once again that this issue touches a raw nerve as far as you and the Ministry of Defence are concerned. I do not know why, because you were not responsible—
Mr. Deputy Speaker : Order. The Chair was not responsible.
Mr. Hancock : I am delighted to absolve you, Mr. Deputy Speaker, from any of that responsibility and from any implication that I may have hinted at. Just as you were not responsible, the Minister was not responsible, and I cannot understand why current Ministers in the Ministry of Defence will not do what many of them promised to do when they were in opposition, namely to sort out the matter and give support to the Gulf veterans, which is what they asked for, and were promised, six or seven years ago. How sad it is that, today, we are firing warning shots to make sure that our service men and women will be properly protected this time round. I hope that the lessons will be learned, but it is sad that, 11 years on, we are demanding justice for men and women who have not had even an inkling of light in their campaign so far.
10.23 am
Dr. Andrew Murrison (Westbury): I must declare an interest. As recorded in the register, I am an ex-service man and a current reservist, and I am a member of the Royal British Legion. I also have relatives serving in the Gulf, so this debate is germane to me, and I welcome the opportunity of contributing to it.
I retain an open mind on Gulf war syndrome and illness. I must confess, however, that having been employed in the Royal Navy in the early 1990s, I recall feeling that we were doing less than we might to take seriously the concerns of service men, and particularly that our record was comparing unfavourably with that of the United States in relation to its service men. It was clear at that time that the USA was taking the travails of its service men and ex-service men a great deal more seriously than we were of our people in the UK. In mitigation, it was probably drawing from its experience in the Vietnam conflict which, fortunately, was an experience that we were spared.
Nevertheless, I was concerned at that time because of the poor record keeping to which other Members have alluded and the general lack of urgency in relation to putting in place research to try to clarify exactly what was going on. The hon. Member for Portsmouth, South (Mr. Hancock) put his case well, particularly in relation to record keeping, and I hope that the Minister will assure us that measures are now in place to ensure that proper, meticulous records are kept of the state of health of our service men and of exactly what they are exposed to.
As I said, however, I remain of an open mind on this issue, and it is important, in what is evidently an emotive subject, to bring some scientific clarity and light to it. It is important to quote the British Medical Journal of February last year. Members who take an interest in this matter will recall that Guy's, King's and St. Thomas's school of medicine has taken a particular interest in Gulf war syndrome and illness and has conducted studies on it. If I may paraphrase the British Medical Journal—time is short—it said in relation to illness following war that no single presentation is common to all modern wars, that variations seem to be determined by the nature of combat, contemporary medical knowledge and important health beliefs and fears, and that illness related to the Gulf war does not stand apart from that of other conflicts. That is important because the study considered post-conflict illness from the Boer war to the present day. While no one denies that veterans of the Gulf war are ill, that needs to be examined in the context of other conflicts going back to the beginning of the previous century.
We need to be clear, however, about what we are dealing with this time. I hope that the Minister will assure us in a few minutes that we will put in place the research that is necessary to study that to which our people are being exposed, and that we shall keep adequate medical records. We risk doing the same again because we are exposing our people to much the same risks as in 1991, and potentially more of them. We need assurances that everything has been done to reduce the risk that they face.
I accept that Ministers have put effort into ensuring that we do not have multiple vaccination as we did in the early 1990s, but there is some way to go to win over the hearts and minds of our service men and women. The vaccination rate among our service people is very low: it is less than 50 per cent., as the Prime Minister reiterated in an oral answer to me a couple of weeks ago. The figures are 28 per cent. in the Navy, 46 per cent. in the RAF and 78 per cent. in the Army. To a great extent, that is related to perceived risk—there is no doubt about that—but it would also be interesting to know what the
differential is within the Army. If these differences are due to perceived risk, I would expect those units in the front line—the teeth elements of the Army—to be vaccinated at a higher rate than those in the support arms. I would be grateful if the Minister could comment on that.Time is short, so I shall wrap up with the words of Colonel Terry English, who has criticised the Government by saying that
- "a much earlier investigation of this whole issue would have given today's soldiers the confidence to take inoculations."
The figures suggest that that battle has not been won. I would be extremely grateful if the Minister were to say what he is doing now to ensure that the uptake of necessary vaccinations is going ahead a little more successfully than it has hitherto.
10.29 am
Mr. Colin Breed (South-East Cornwall): Like other hon. Members present, I am experiencing a certain déjà vu, because within weeks of being elected in 1997, I accompanied my constituent, Major Christine Lloyd, on a visit to the Minister with responsibility for the armed forces. Major Lloyd had vaccinated troops and had been vaccinated herself, and had suffered certain effects for a considerable time. We were promised then that the incoming Labour Government would be open and honest in all their dealings with the Gulf war veterans, but, some six years later, the Ministry of Defence's persistent quibbling over terms such as "syndrome" and "illness" and its behaviour in cases such as those of Shaun Rusling and Major Christine Lloyd fall far short of those promises and of the responsible attitude that the Department should adopt.
Although it is accepted that there is no single clear cause or symptom of Gulf war illness, the MOD must acknowledge that the various ailments suffered by veterans are neither mere coincidence nor psychosomatic. Shaun Rusling, the head of the National Gulf Veterans and Families Association, has called for an independent medical programme and investigation into the whole issue of Gulf war illness, taking it away from the MOD and from any possible bias or perceived bias towards its interests. We would support that. By broadening the scope of the medical assessment programme, all soldiers who have served in action would have access to an impartial and expert medical advice centre separate from the military alternatives.
Although the MOD has published figures to show that there is "essentially no difference" between the mortality rates of Gulf war veterans and other service men who were not deployed to the Gulf, they do not take into account the severity and nature of the ongoing illnesses that are being suffered. The widespread suspicion and anxiety about this issue is detrimental to the morale of veterans and of other service men, particularly in the current climate.
I also support the documentation proposals, because we want to know what steps the MOD has taken to ensure that better records are kept of the substances—such as organophosphates—that are being used, or are intended to be used, and what vaccines are being administered to troops, how they are being administered, in what order and according to what timetable. The US Government have made efforts to
improve medical record keeping in theatre, and we must do the same. Furthermore, veterans and their GPs must be given swift and uninhibited access to medical records, and more strenuous efforts must be made to keep a better record of all service men when they leave the forces, so that their mental and physical health can be properly monitored.The seven-year rule for applications for war pensions must be waived in the case of Gulf war veterans. The MOD cannot and must not duck its obligation to make provision for soldiers and civilians suffering ill health as a result of time spent in theatre by focusing on the terminological niceties of these collective ailments. I want to know what lessons have been learned from the last Gulf war—that has not really been spelled out—and how they have affected preparations for possible action in the area in the coming months. We know that the MOD claims not to be administering vaccine cocktails any more, but will that make any difference if the vaccines are still the same ones? What is the medical evidence to support the new action? Have there been any alterations to the protective kit issued to troops and non-military personnel in the light of those lessons? In Saif Sareea, there were not enough NBC—nuclear, biological and chemical—protective suits to go round. I hope that we have now had confirmation that alterations have been made.
The current situation with regard to voluntary vaccinations is difficult to understand. When my hon. Friend the Member for Hereford (Mr. Keetch) visited our troops in the Gulf recently, that was clearly their No. 1 concern. United States troops have been vaccinated against anthrax, yet ours are offered such vaccinations as an option. One can forgive them for thinking that the MOD wants to avoid further costly law suits, as it has not yet determined the cause of Gulf war syndrome or illness. Either the vaccination is safe or it is not, and the Government should make a proper recommendation.
Dr. Murrison : Is the hon. Gentleman suggesting that anthrax vaccination should be compulsory for our troops?
Mr. Breed : It should not be made compulsory, but people should be given clear advice and the Government should give a clear recommendation on whether they believe that the vaccination should be given.
Dr. Murrison : I hate to rise in defence of the Government, but, to be fair, their advice is fairly clear.
Mr. Breed : If the advice is clear, that has certainly not been communicated to the troops.
Mr. Breed : I am grateful for the Minister's confirmation that the Government's recommendation to the troops is entirely clear. Perhaps he will explain just how it has been communicated.
The Government must not shirk their responsibilities or place service men in an impossible situation. Their vaccine policy as it currently stands could be interpreted as an abdication of responsibility.
Mr. Breed : In the way that I have just described.
As for the discovery of batches of vaccine on the Dorset beaches, it is totally disingenuous to suggest that the Ministry cannot determine where those batches came from. There are clear scientific methods for calculating exactly where material from ships emanates from, using tides and so on. It is a well-tried scientific means of explaining these things, and it is used for environmental purposes all the time—to decide where oil spills come from, for example. We could easily determine from exactly which ship those batches of vaccine came.
Yesterday, we were in this Chamber discussing tragic deaths in Army barracks. Today, we are talking about Gulf war illness. Does the Minister accept that there is a growing view that the MOD appears to follow a clear strategy when dealing with these problems? First, it denies everything. Secondly, under pressure, it apparently agrees to a review. Thirdly, it strings out the process, prevaricates and tries to convince everyone that there is nothing in the allegations, despite mounting evidence to the contrary. That does nothing to enhance the reputation of the Government or of the MOD, and it seems to many people that the Government will spend whatever is necessary to defend themselves against any action or any claim for compensation from anyone at any time.
10.37 am
Mr. Keith Simpson (Mid-Norfolk): I also congratulate the hon. Member for North Cornwall (Mr. Tyler) on raising this subject. He has long experience of and dedication to the cause of the Gulf war veterans, as do many of the hon. Members here today. The purpose of this debate is to address the concerns of the Gulf war veterans and their families, especially as British troops are being deployed for a possible conflict in the Gulf even as we speak.
I spent a large part of my professional career as a military historian, writing about the first and second world wars and interviewing thousands of veterans of both. Their experiences were the same as, and often far more traumatic than, those of the veterans of the Gulf war. I was also a special adviser at the Ministry of Defence in the lead-up to and during the Gulf war. I am only too aware of the decisions that had to be made very quickly and often with inadequate information, and, in the case of vaccination, with the most appalling option of difficulties. That is offered not as a defence, but merely as an observation.
Mr. Hancock : The hon. Gentleman has just told the Chamber that he was present during those deliberations. Will he explain why the decisions about inoculations were taken in such a rush, when the planning was several months in the making? It would appear that he is now suggesting that the decisions on what inoculations service personnel would have was rushed through without proper information being available.
Mr. Simpson : No, I am making two points. First, Saddam Hussein invaded Kuwait and a decision had to be made very quickly to deploy British troops, so many of the actions taken had to be rushed. Secondly, we were
aware at the time that Saddam Hussein had chemical and biological capability. That represented an option of difficulties. It is never easy to make such decisions, as anyone who has experience in government will know. I hope that if the hon. Member for Portsmouth, South (Mr. Hancock) becomes a Minister one day, he will realise what the consequences of his decisions may be.Tens of thousands of Gulf war veterans in the United States and the United Kingdom, and their families, are convinced that there is such a medical condition as Gulf war syndrome. The debate that we are having today covers five points. First, is there a definition of Gulf war syndrome or illness? One of the things that has come out of this debate, as well as all the previous debates and the medical evidence, is that there is no agreement on this. The Ministry of Defence genuinely believes that there is no such thing as a syndrome that is unique to the veterans of the Gulf war. However, the pensions appeal tribunal last year accepted the term "Gulf war syndrome", finding that the condition was attributable to a veteran's service. So there is major disagreement on this matter.
Secondly, is it possible medically and scientifically to identify a specific Gulf war illness or syndrome? Again, there is mixed evidence. There is disagreement between the MOD and the veterans over its origins and over the specifics. There is even disagreement among the medical and scientific experts and those with a background in this field. That has been displayed today, given the backgrounds of the Minister and the hon. Member for Norwich, North (Dr. Gibson). These are major problems, and they are not simply academic. They go to the root of the question. My hon. Friend the Member for Westbury (Dr. Murrison) has referred to the fact that the United States Department of Defence's war syndrome study found that Gulf war syndrome was a manifestation of established post-combat syndrome, which arises out of all combats. That is rejected by many Gulf war veterans.
Thirdly, have the Gulf war veterans shown medical symptoms and levels of mortality higher than the control group? We have just had the latest MOD figures for the period from 1 April to 31 December 2002, which showed that 571 Gulf war veterans had died, but 574 people in a control group of service personnel had also died. So, is there any real difference? We have to get into the specifics, and a number of hon. Members have done so. A recent study in the United States showed that US military personnel who served in the Gulf were twice as likely to contract motor neurone disease as others. That study must be reviewed by an independent scientific panel. The United States Department of Veterans Affairs—a very powerful organisation, which has money and political clout—immediately offered disability and survivor benefits to veterans with the disease.
Fourthly, has the MOD shown a willingness to investigate this issue, to be transparent and to consider awarding further compensation when necessary? There is no agreement on this. Colleagues who have spoken in the debate so far have accused the Ministry of being slow, ignorant and more concerned about financial compensation, and said that information has to be dragged out of it little by little. I am a little more
sympathetic, having been inside the Ministry and seen that it is often more a question of cock-up than conspiracy.
Mr. Tyler : Will the hon. Gentleman give way?
Mr. Simpson : I am trying to give the Minister more time to speak, but as the hon. Gentleman initiated the debate, I will give way to him.
Mr. Tyler : The admission of a former senior adviser in the Ministry of Defence that a cock-up could have caused this problem just as much as a conspiracy is amazing. I am grateful to the hon. Gentleman for that.
Mr. Simpson : With respect to the hon. Gentleman, we are perhaps becoming a little hysterical. I am saying that when it comes to administration, it is more likely to be a cock-up than a conspiracy. The logistical problems involved, with the medical records and everything else, are absolutely enormous. Like my hon. Friend the Member for Westbury, I conclude that the onus is on the Ministry of Defence. It must now recognise that not only Gulf war veterans but many independent observers no longer automatically believe what it is saying, and that we may have to have, at the very least, an independent review of the evidence available from the Ministry and from the Gulf war veterans.
I want to give the Minister as much time as possible to respond to this debate, so I shall make my final point. As hon. Members have said, there is no doubt that the information that is available from the last conflict should be considered rationally, and that the onus should be on the Ministry of Defence to provide that information to the military personnel who are now being deployed to the Gulf, and to their families. If there are any major problems or weaknesses, it is right and proper that they should be identified. Equally, those of us who have relatives or friends about to be deployed to the Gulf will know that it does not help them or their morale if issues are raised for which there is no scientific or medical background. A fine balance has to be struck, but I accept that the onus of responsibility lies with the Ministry of Defence.
10.45 am
The Parliamentary Under-Secretary of State for Defence (Dr. Lewis Moonie) : It is difficult to know exactly where to start when winding up a debate such as this. I am certainly grateful for the opportunity to set Members' minds at rest, although I suspect—I shall check my records—that all of them have at one time or another received one of my eight-page letters on Gulf war veterans' illnesses or on depleted uranium. If any hon. Members have any questions of any kind, or if there is anything that they do not understand—which, I am afraid, seems clearly evident from their contributions today—my door is always open. They can come and see me to discuss it. They can tell me their concerns and I will discuss them frankly and openly. I do not want to get involved in a qualifications parade, but as someone with higher qualifications in psychiatry and in public health, I am probably uniquely qualified in the House to talk about many of these subjects, with the possible exception of the hon. Member for Westbury (Dr. Murrison), with his medical background.
I want to dispose of the argument about depleted uranium as quickly as possible. Depleted uranium has exactly the same effects as ordinary uranium. No scientist in the world could provide any basis for suggesting anything else. There is no difference in the chemical effects of isotopes. There are differences in the radiological effects of isotopes, because some decay more quickly than others and produce more radioactivity. Depleted uranium—as its very title would suggest to anyone with even modest intelligence—has less radiation in it than ordinary uranium.
Dr. Gibson : My hon. Friend is very distinguished and promotes himself very well, but has he read the Royal Society report, which accentuates the measures that I suggested should be taken on the different isotopes, what happens to them in the human body, whether they are filtered out, and so on? A huge area of research needs to be done on this subject, and my hon. Friend has no right to say that we know anything, when an august body such as the Royal Society says that we need to put more time and effort into this research and to find new methodologies to assess what isotopes—
Dr. Moonie : That is quite long enough, I think, Mr. Deputy Speaker. If my hon. Friend wants to send me any documentation, I shall be happy to look at it. In fact, I shall read it with great interest, but, frankly, anyone who tries to suggest that there are medical differences—other than those due to radioactivity—between the effects of isotopes is talking out of the back of his head.
I have a passionate desire to get to the bottom of any problem such as this one. It is utterly abhorrent to me—it is anathema—to think that we might be ignoring any medical effect that could be taking place as a result of anything that we have done. I would not for a moment countenance the Department in any obfuscation, any delay or any attempt to push this matter under the carpet. It would be unthinkable to do that.
I hope that the hon. Member for Portsmouth, South (Mr. Hancock) will accept that there is a recognition that people are sick. There is no denial of that whatever. There may have been in the past; there is none now. I believe that if we talk about a syndrome, it is incumbent on us to show that there are scientific reasons for saying that such a syndrome exists. So far, no evidence whatever has been produced to back that up. I cannot find any reputable medical source that will accept that a separate syndrome exists. To me, it is unthinkable that one should call it that. There is no medical reason for doing so. That is not to say—
Mr. Tyler : Will the Minister give way?
Dr. Moonie : No. I do not have time.
That is not to deny that people are sick—of course they are. That is not to say that they should be denied treatment for their illnesses when we can find something to give them—of course they should be treated. That is not to deny that they should be compensated if they are disabled as a result of their illness. So far as I know, anyone who has a disability, irrespective of what it is
labelled as, receives the compensation due to them. If they have not, they must come forward and check with the—
Mr. Tyler : Will the Minister give way?
Those people must check with the veterans' agency or through the Department to see what else can be done. If they are disabled, under our regulations, they should be compensated for the disability in exactly the same way as anyone else is.
Mr. Tyler : The Minister will have noted that I very carefully asked for a debate on Gulf war illness, not syndrome, so I am with him on that. Will he give an explicit assurance, in response to the points that were made earlier, that if anyone takes any vaccination, the Ministry will take full legal responsibility for any consequent illness that may occur?
Dr. Moonie : May I cover vaccines as I go through my text? Otherwise, my speech will get even more disjointed. I take due note that the hon. Gentleman has used the term "Gulf veterans' illnesses". I think that it has been used by everyone today and that is correct.
Mr. Hancock : Will the Minister give way?
Dr. Moonie : I do not have time to give way again. I want to cover as quickly as I can the points that have been raised. Many hon. Members have rightly referred to the arrangements for current deployments. I stress that the well-being of the personnel whom we deploy is of the greatest importance to us. We have made some important improvements since the 1990–91 Gulf conflict. We have made improvements in medical record-keeping through the introduction of a new operational medical record form, which is now in use. That should ensure that health events while on deployment are recorded much more systematically than in the past.
Again, like any other record, it is up to those in the field to maintain records properly. That is something over which I have much less control. I cannot look over everyone's shoulder when they are conducting a medical examination, much as I would like to occasionally, but we have strengthened the central administration of our medical services appropriately. That strengthening and the recognition by the vice-chief of the defence staff of the importance of medical issues have ensured that the chain of command has been left in no doubt as to the importance of maintaining accurate historical records of deployment, where people go, what they are given and what happens to them. I hope that that will work much better than it did at the beginning of the 1990s.
The Gulf conflict revealed shortcomings in medical preparedness. A number of personnel were not up to date with their service standard vaccinations. The standard of vaccinations is the same as the standard of vaccinations given to everyone in the population. An adequate body of literature shows that, in general use, those are absolutely safe. One can never give a 100 per
cent. guarantee on anything, but the widespread use of normal vaccinations is well documented. It is no different for our people. What we have ensured this time is that forces that are being deployed have had all the routine vaccinations that they should have. There should be no requirement this time to give anyone a cocktail of vaccinations in the Gulf.I cannot give a 100 per cent. certain answer on that. We have a voluntary programme. Although I and my colleagues have agonised over this, I still think that we should retain a voluntary programme, despite the difficulties it gives us with differences in uptake, particularly on anthrax. We have maintained the voluntary programme.
When vaccines are administered, informed consent is given. There seems to have been some doubt in people's minds as to whether they have recently been asked to sign a waiver in relation to any effects that might arise. That is not the case. They have been asked to sign a form saying that the effects of the vaccinations and the reasons for giving them have been made clear to them and they have refused to have them. A proper record of that should be kept. People may get to the Gulf and change their minds, in which case they may be given inoculations more quickly, and they ought to be. It should be a tiny percentage of the people being sent there.
We have greatly improved the briefings that are given to personnel on health-related matters. Up-to-date medical intelligence briefings are now routinely commissioned for the area of the world where it is judged that our forces might operate. Personnel deployed in operations receive pre-deployment and in-theatre briefings on health and hygiene matters based on the assessment of the conditions that they may meet. The briefings include information on things such as protection against biting insects, personal hygiene, how to acclimatise, operating in arduous environments and malarial prophylaxis, which is important.
There are also briefings on the nature and management of combat reactions and other psychological stresses of conflict. Arrangements are made to try to limit the effects of post-traumatic stress disorder in the armed forces. We have been trying to do that for many years. I have no idea yet whether that will be effective, but we are aware of those effects and are trying to make progress in the light of what is still very limited medical knowledge of how to prevent them.
Health and safety instructions have been issued to the crews of vehicles loaded with depleted uranium ammunition and to the units that support them. Those instructions make it clear that the risks from DU are far lower than those from other hazards arising from military operations, but they include advice on procedures for minimising contamination by use of respiratory protective equipment, protective clothing and other procedures, particularly for those who may end up going into a vehicle that has been struck by a DU round.
I should mention in passing that 35 United States soldiers have fragments of depleted uranium buried in them as a result of friendly fire during the last Gulf conflict. They have been followed up ever since, and not one of them has shown any signs of heavy metal poisoning, which is what one would expect as a result of
such contamination. It is amazing how little effect a relatively large amount of the substance can have. One would expect heavy metal poisoning, which as everyone knows is usually characterised by effects on the kidney. So far, they have found no effects on the kidney whatever.On anthrax vaccines washed up on beaches, I must admit that that would be a monumental embarrassment to any Government. I assure hon. Members that there is nothing I would like better than to find out who was responsible for it. Until now, despite strenuous efforts by my Department, we have been unable to do so. I assure hon. Members that those efforts are continuing and will continue until we get to the bottom of it, if we ever do. However, I cannot work out why that would imply a dereliction of duty towards our soldiers. It is not a case of the Navy throwing the vaccines away rather than administering them. As a former commander in the Navy said, it is much more likely that sailors do not think that they are exposed to those risks on board ship, so they are much less likely to take up the vaccine. We have noticed that the uptake of anthrax vaccine among strike units that are likely to be deployed is very high compared with other units. Perceived risk in a voluntary situation is always likely to lead to a higher uptake.
Anthrax should be administered alone. The procedures that we have introduced should have ensured that it has been. Again, I cannot say that that will be done in 100 per cent. of cases, but if it is administered alone in the vast majority of cases we can set our minds at rest.
Anthrax vaccination will be given alone. It is fairly extensive: four injections over six months. Full protection is not achieved until the end, but significant protection is achieved with the first dose. It is important to realise that there has never been a case of a serious reaction to our anthrax vaccine. Although it is voluntary, if personnel feel that there is any chance of their being exposed to anthrax, they should certainly take the vaccination to get protection.
It was argued that research is being carried out at a snail's pace. Indeed, the research has been very slow. That is not in our hands. We have no control over the speed of research. If people come to me and suggest any line of research that we should follow up, and there are good scientific reasons for doing so, we will fund it. I give that absolute assurance to hon. Members today.
I recognise the strength of feeling about this matter, and the depth of feeling among veterans. We will do whatever we can. If hon. Members have any constructive suggestions to make to us, we will consider them with the same care as we are examining Professor Haley's work from the United States. We have asked the Medical Research Council to review that work and to see whether any further research can be done. Good research must always be properly—
Mr. Deputy Speaker (Mr. Frank Cook): Order. We have arrived at the time when we must move on to the next topic for our consideration, which is agriculture in West Dorset. I regret to say that the Under-Secretary of State for Environment, Food and Rural Affairs, the hon. Member for Scunthorpe (Mr. Morley), is not in his place to listen to the debate. Perhaps some of his colleagues might transmit that news to him. [Interruption.] He has just arrived, to my great relief.
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