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Mr. Brian H. Donohoe (Cunninghame, South) (Lab): I thank the Speaker for calling the debate so early. As we have recently had the reports from Lord Lloyd of Berwick, this is an opportune occasion to debate the question. I would rather not be here; I would rather all the problems that have been encountered by the veterans had been addressed by the Government. Unfortunately, however, that is not the case.
The debate surrounding the question of Gulf war illnesses is particularly relevant to Garry Hope, one of my constituents. Garry was born on 4 July 1973. He joined the Army in September 1989 as a signaller in the Royal Highland Fusiliers and went on to fight against Saddam's regime in 1991. Subsequent to that he did tours of Northern Ireland and Belize, before leaving the Army in June 1994. He now works as a residential child care worker in Ayrshire.
Because of the problems that have been identified as affecting Garry, he has been awarded a 40 per cent. war pension. That is based on him suffering from what is known as post-traumatic stress disorder. He has a claim outstandingI think that it was submitted a couple of months agoin respect of Gulf war syndrome, but he has been informed that he may have to wait an inordinate amount of time for his case to be heard. That is the first point on which I seek a response from my hon. Friend the Minister today. Why are claims that have been submitted taking so long to be resolved? I want him to address that question urgently.
All the troops involved argue that, as a consequence of being in the Gulf war, they suffer from various physical problems. They have swelling of joints and muscular pain, and many suffer from permanent dizzy spells as well as periodic memory problems. Those are all problems for them in living a life as near to normal as possible.
I have been steeped in the subject of Gulf war syndrome for a considerable time, since March 1997, and have perhaps considered it more closely than I would otherwise. Like many Members of Parliament, I have become very concerned about what I am learning and about what has not been done but could have been done by the Government. I last secured a debate on the subject for another constituent on 8 January 2002, which is just over three years ago, but in many ways nothing seems to have moved on since then. More than anything, I want to establish what has happened between that date and today.
In the debate in 2002, reference was made to a number of different research documents that were being explored and research projects that were being undertaken by various people. In responding to me on that occasion, my hon. Friend the Member for Kirkcaldy (Dr. Moonie), then the Under-Secretary of State for Defence, said:
"The Government accept that some Gulf veterans have become ill and that many believe that their ill health is unusual and is related to their Gulf experience. There is now scientific evidence that Gulf veterans report more illnesses than other comparable groups, but there is no medical or scientific consensus about the causes of those illnesses. We remain open-minded about the causes, and important research is under way."
At that point, I asked whether the Minister could clarify the time scales for that exercise. He said:
"It might be helpful if I point out to my hon. Friend, since the matter is one of my responsibilities, that some 12 research studies are still proceeding. Most of them will report during the coming year. Some of them are very detailed, others much more general. The various problems should be resolved within the next 12 months or so. However, we are afraid that we will again find that there is nothing specific involved after having expended a great deal of time, effort and moneyresources have not been stinted in our attempts to identify the cause of the conditions that are complained of. We may be left with an inconclusive result and have to recognise that we will never get to the bottom of the matter. However, I assure my hon. Friend that any suggested causes will be actively followed up and that we will do our very best to find the cause, if there is one to be found."[Official Report, Westminster Hall, 8 January 2002; Vol. 377, c. 183WH.]
I want to know from this Minister today or, if that is not possible, perhaps in writing, exactly what has happened to all that research undertaken some three years ago, and where the Government are intent on taking this matter.
Part of the problem concerns the inspections undertaken at, I believe, St. Thomas' hospital by Professor Lee. Among the veterans attending there is a consensus that the process and system is not structured to investigate the historical nature of the veterans' health, in the way that they believe should be done. They argue that this is due to Professor Lee not having access to the civilian medical records. I checked this and found that Garry Hope's own GP, a Dr. Walker of the Frew Terrace surgery in Irvine, was not contacted by Professor Lee. Something has to be done because if a history is not used, the investigation does not show an up-to-date position of the persistent problems and erratic nature of an individual's health.
It is widely thought among the veterans themselves that the process is somewhat prejudicedthat it is almost part of a propaganda machine. That is wrong and it has to be addressed. There is, it seems, a trend of belief developing from the medical assessment programme to the effect that veterans are imagining the illness or becoming paranoid about their situation, and that there is no truth in the fact that they are suffering. This has clearly been contradicted by a document published by the research advisory committee on Gulf war illnesses in the United States on 12 November 2004. It was then stated by the veterans themselves:
that would be obvious in the circumstancesbecause
"it was known that the Iraqis had chemical and biological weapons, and it was thought likely that they would be used. But stress alone could not explain the illnesses. There was something else as well. Once again we see no reason why the MOD should not admit that fact."
In addition, as I mentioned, there was the Lord Lloyd report undertaken in the summer. The Government and
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MOD argued that that was an unofficial investigation into the question and did not choose to have a representative present. In calling it unofficial, for whatever reasonI would like to know the reasonthey raise some questions. Why do they refuse to recognise the inquiry, and why did they not choose to show that they were willing partners by being represented at it?
We have to bear it in mind that the Americans have recognised the condition of Gulf war syndrome and we have not. They are now working toward a better understanding and a way forward for veteransa way that is far more proactive than veterans in this country have perhaps seen. That, it is argued, has been achieved by dedicated finance being made available to resolve the situation and to draw a conclusion as speedily as possible. If the Government and the MOD do not feel that enough time has passed, that may be due to their dedicating only around £2 million to research on the issue. It could be argued that that is a lot of money, but in terms of the consequences that we are really faced with, I suggest that the veterans see it as no more than a token gesture in comparison with the funds made available on the other side of the pond.
Something is needed to demonstrate to all involved that the Government may be in a position to reach a conclusion to the whole question. It would be good if the MOD could do something to reinstate the legal aid which was, I understand, withdrawn when the last group action for the veterans concluded. That would allow other solicitors to relaunch an action. Otherwise the tendency for veterans to think that there is a conspiracy, as they say whenever I meet them, will grow. The Government's actions have not put that tendency to bed. We are moving towards a situation that I do not like: the Government are almost discredited in the eyes of those people. That is the last thing we want in people who fought for their country.
Another aspect concerns what happens in other countries. I have referred to what happens in the United States, but other countries who were allies in the Gulf offensive have come to terms with the situation and dealt with their veterans more progressively. I understand that a lot of research has been done, and I want all those resources to be harmonised internationally so that the troops concerned are satisfied and we can put the matter to bed once and for all. Until we have another inquiry to draw all the strands together in a way that is acceptable to the veterans, we will not be able to bring the matter to a conclusion.
Finally, I draw the Minister's attention to paragraph 35 of the Lloyd inquiry, in which it is recalled that before the 1997 election the Prime Minister said:
Nothing like that has happened, and unless and until all the issues that I have raised and others are addressed by the MOD and the Government, people will continue to come to our surgeries about the matter. Recent early-day motions on the subject have been signed by more
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than 100 Members. All of that would come to an end if the concerns that I have raised were examined and we were able to tell our constituents that the Government were listening.
The Parliamentary Under-Secretary of State for Defence (Mr. Ivor Caplin) : I begin by congratulating my hon. Friend the Member for Cunninghame, South (Mr. Donohoe) on securing this debate to discuss the important case of his constituent, Mr. Garry Hope. My hon. Friend will realise that, because he advised my office only a little over an hour ago of the details that he related to the Chamber, I will not be able to be specific about Mr. Hope in my response. However, I will write to him about his constituent and I can respond to the general points that he made this afternoon.
This Government have always given the concerns of the 199091 Gulf veterans the highest priority. This important and highly complex issue will continue to receive the close attention that it deserves. However, I remind the House of the Government's approach to Gulf veterans' illnesses, about which my hon. Friend concluded his comments.
By way of background, I can tell the Chamber that more than 53,000 UK armed forces personnel were deployed to the Gulf in 199091, a minority of whom are ill. We all want to know why that is, but there is no medical or scientific consensus on the cause or causes of ill health among some Gulf veterans.
I remind the Chamber about the key facts concerning Gulf veterans' mortality. The latest statistics, which were published yesterday, 17 January 2005, show that, overall, there have been 687 deaths compared with 688 in a comparison group that was not deployed to the Gulf. That is significantly lower than would be expected in the general UK population, for which the equivalent number is 1,085.
I am sure that my hon. Friend will recall that in July 1997 we published a policy statement, "Gulf Veterans' Illnesses: A New Beginning", which set out how we proposed to address the health concerns of veterans. Many of the commitments that we made in that document have been fulfilled, but I assure the House that it continues to underpin our activities at the Ministry of Defence.
"Medical Assessment Programme. Second, there will be appropriate research into veterans' illnesses and factors that might have a bearing on these. Third, the MoD will make available to the public information it possesses that is of potential relevance".
This afternoon I will say something about each of those areas.
I shall deal first with the medical assessment programme, which has been running since 1993. In that time it has seen more than 3,400 patients, some more than once. Mr. Hope attended the programme on 22
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November 2004. I strongly recommend that veterans of the 199091 Gulf conflict and of Operation Telic attend the programme if they have any concerns about their health.
Mr. Donohoe : Why is it that, when veterans attend the programme, no record is sent by their GP to the professor, or whoever it is, who examines them?
Mr. Caplin : If my hon. Friend will forgive me, I will come back to him on that issue. I want to talk about further details that are available about the programme on the MOD websitewww.gulfwar.mod.uk. We plan to publish a revised information pack about the programme next month.
I have stated the importance of research in this area to the House before. There is scientific evidence that 199091 Gulf veterans report more ill health than comparable groups, but the pattern of ill health is not unique to Gulf veterans. They report the same symptoms and conditions as do UK Bosnia veterans and UK military personnel who did not deploy to the Gulf. The only difference is the increased frequency with which Gulf veterans report such symptoms.
It is worth recalling that specific diseases, disorders or medical conditions and syndromes each have common features such as a set of physical signs and/or symptoms that distinguish them from other medical conditions. Gulf veterans do not present with an identifiable and distinct pattern of symptoms or signs. The consensus of the international scientific and medical community, following extensive research on the matter, continues to be that there is insufficient evidence to enable that ill health to be characterised as a unique Gulf-related illness or syndrome.
I know that my hon. Friend will accept that the Government's approach must be guided by the scientific and medical evidence. That is why we do not recognise Gulf war syndrome as a medical condition. The term "Gulf war syndrome" is not found in the international standard used around the world by physicians and scientists for distinguishing diagnosable disease categories, which is stated in the World Health Organisation's "International Classification of Diseases", 10th edition. Therefore, the Government simply cannot accept the recommendation in the report by Lord Lloyd that the term "Gulf war syndrome" be used as a label.
However, that does not stop Gulf veterans who are ill receiving a war pension and attributable benefits under the armed forces occupational pension schemes. Such pensions are not awarded for a list of disorders but for any disablement that can be accepted as having been caused or made worse by service. That will be the case for Mr. Hope.
At the end of September 2004, about 2,800 Gulf veterans were in receipt of a war disablement pension. Additionally, 2,290 Gulf veterans had received a gratuity for disablement assessed at less than 20 per cent. There will be some overlap between those figures as some individuals will have received first a gratuity
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and then a pension. Those figures include awards for both Gulf-related and non-Gulf related injuries or illness, because our statistics do not enable us to distinguish the origin of the disablement. MOD officials liaise with their colleagues in the health service to ensure that periodic reminders are issued to hospitals and GPs about the priority treatment arrangements available to Gulf and other veterans for injuries and conditions for which they receive pensions. Veterans of the Gulf conflict can and do receive compensation in the form of war pensions and armed forces pensions on the same basis as all other veterans.
We see no case for another of Lord Lloyd's recommendationsthat one group of veterans should be singled out for preferential treatment by way of an ex gratia payment on top of the pensions they already get.
We want to find out why some Gulf veterans from that first conflict are ill. Our current research programme, to which my hon. Friend referred, will cost at least £8.5 million to complete. The Medical Research Council provides independent, scientific advice on the research programme. It has undertaken an independent, scientific review of all the UK research work that has been carried out into Gulf veterans illnesses in an international context. The results of that review, including recommendations for future research, were published in May 2003. The MOD has noted the MRC's conclusions and recommendations for further research, and additional funding will be made available as necessary.
The third strand of our approach is openness. We have made an enormous amount of information public in response to inquiries from veterans and others and we will continue to do so. I stress that the well-being of personnel whom we deploy is of the greatest importance to us, and we have made some important improvements since the 199091 Gulf conflict. For example, we have introduced a new operational medical record form that is now in use. We ensure that troops are immunised routinely so that personnel do not receive a combination of vaccines upon deployment, and we have arrangements to limit the effects of post-traumatic illnesses within the armed forces which have been developed over a number of years. They will continue to be reviewed in the light of medical developments in the field of stress management and treatment.
On 4 November last year, I announced the publication of a paper entitled "The 199091 Gulf Conflict: Health And Personnel Lessons Identified". That set out what we have already done to improve policies and procedures since the Gulf conflict and assesses how those have been applied to the current Iraq deployment. Of course, the MOD is aware of the report of the US research advisory committee on Gulf war veterans illnesses, and we have noted it with interest. Its report is a review of some existing research with which we were already familiar.
There are areas in the report that we believe are not supported by the balance of scientific evidence. For
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example, it does not take into account a recent important paper by the US Institute of Medicine, which states that there is insufficient or inadequate evidence to determine whether an association exists between low-level exposure to sarin and long-term adverse health effects. We also note that much of the research that is drawn on to formulate the recommendations was carried out by members of the committee, which raises some concerns about objectivity. I also say to my hon. Friend that the US does not, as he stated, recognise the term "Gulf war syndrome"; I have explained why in relation to the WHO document.
MOD officials work closely with their US counterparts to ensure that the UK has full visibility of all American research into Gulf health issues. A senior international forum meets regularly at official level, and includes representatives of the United States, Canada, New Zealand and Australia who share information of benefit to all veterans, not just those from the 199091 Gulf conflict. I have invited ministerial colleagues from those countries to a summit on veterans issues in the UK, which will be held in March.
My hon. Friend raised the matter of Lord Lloyd's report. I have touched on some of its recommendations, but I would like to take the opportunity to comment on it further. We have studied it carefully, but we believe that it contains no new substantive or scientific evidence to support its conclusions and recommendations. It also fails to take into full account the large amount of written evidence and material provided by the MOD to Lord Lloyd's inquiry. We did not participate in person in his investigation because we believe that it is only through independent scientific and medical research that we are ever likely to establish the causes of ill health in some Gulf veterans. The possibility remains that we may look again at the issue of a public inquiry on this matter, but Lord Lloyd's report does nothing to change the Government's view that an inquiry will not answer the basic question about why some Gulf veterans are ill.
The report gives the impression that 6,000 veterans are suffering from ill health due to their service in the conflict. I must point out that only a minority are receiving a war pension for Gulf-related illnesses. Although these veterans served in the Gulf, many of the claims relate to physical injuries suffered in the Gulf or to disablements and illnesses unrelated to their service in the Gulf conflict. The number of veterans in receipt of pensions or gratuities for unspecified symptomatic Gulf-related illnesses is approximately 1,400, less than 3 per cent. of the personnel who served in the Gulf.
Additionally, only about 100 claimants have failed to receive an award for Gulf-related illnesses, not the 272 recommended for review by the Lloyd report. Other claims, as I said to the House at the time, relate to physical injuries suffered in the Gulf or to disablements and illnesses unrelated to their Gulf service. As my hon. Friend will be aware, I announced at Defence questions on 29 November that the MOD will re-examine the 100 or so cases that do relate to Gulf-related illnesses, where
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those can be identified. I can tell the Chamber that that review is advancing well.
In conclusion, we at the MOD have been surprised by Lord Lloyd's reluctance to disclose who sponsored and funded his investigation. That contrasts directly with the Government's policy of openness and transparency, set
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out in our policy document, "Gulf Veterans' Illnesses: A New Beginning", which we have consistently followed for eight years and will continue to follow in the future.