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Lord Lloyd of Berwick: My Lords, what was doubted or seemed to be doubted was our independence. It is in relation to that that I would like, even now, a specific assurance.

Baroness Crawley: My Lords, it is extremely difficult to pronounce on independence when one does not know who is funding and sponsoring a report. I think that that is the dilemma that the Government find ourselves in. As I said, we have no problem, and we have made it clear that the good intentions of the noble and learned Lord and his fellow panel members have never been doubted. I hope that, by my repeating that, he will know that the Government are sincere.
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The noble and learned Lord's report suggests that 6,000 veterans are suffering from ill health due to service in the Gulf conflict. This figure is based on veterans who served in the Gulf in 1990–91 who have claimed a war pension. Many of their claims will be for disablements and illnesses arising from other parts of their service in the Armed Forces, unrelated to their service in the Gulf.

At the time of the publication of the report, the number of veterans in receipt of pensions or gratuities for unspecified, symptomatic Gulf-related illness was approximately 1,400, less than 3 per cent of the personnel who served in the Gulf. The personnel serving in the Gulf numbered 53,462. Nor is the report fair regarding the numbers who have been compensated under our "no fault" scheme. Only some 100 claimants failed to receive an award for Gulf-related illness, not the 272 stated by the report.

The noble and learned Lord also recommended that compensation or ex gratia payments should be paid to Gulf veterans. There I can only agree with my noble friend Lord Truscott—Gulf veterans already receive financial benefits through the war pensions scheme and Armed Forces occupational pension scheme. These are quite explicitly set to reflect the level of disablement resulting from illness or injury. We see no justification for making additional payments to particular Gulf veterans, thus giving one group of veterans more favourable treatment than others. I admit to being surprised that the noble and learned Lord saw merit in such a potentially unfair and divisive arrangement.

I now turn to the Pensions Appeal Tribunal decision of 31 October 2005. My honourable friend responsible for veterans made it clear in his Statement on 24 November 2005 that the Government welcomed the decision by the tribunal in the case of Guardsman Daniel Martin. The tribunal accepted the use of Gulf War syndrome as an umbrella term for ill health caused by service and connected with the 1990–91 Gulf War. We know that some veterans have been concerned that the link between their ill health and their service in the Gulf has not been recognised. The tribunal's decision gives a formal means of providing such a recognition, and it is for this reason, not least, that we welcome it.

The decision was equally helpful in reaching the clear conclusion that Gulf War syndrome does not exist as a discrete pathological entity. In other words, we accept that there are clear symptoms of illness, and in some cases these are severely disabling, but the tribunal confirmed that there is insufficient reliable evidence to support the view that there is some specific new disease caused by service in the Gulf. This, as your Lordships will be aware, is the view that the Ministry of Defence has consistently taken on Gulf War syndrome, based on expert medical and scientific opinion. The UK is not alone in this respect. No other country that sent troops to the Gulf recognises Gulf War syndrome as being a specific disease or condition. I should stress here that, contrary to some views, the United States authorities have not recognised Gulf War syndrome.
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Perhaps it would be helpful to your Lordships if I explained briefly what the Ministry of Defence understands by the use of the umbrella term, and how we are applying it. First, it does not, as has been claimed in some parts of the media, represent a complete policy reversal by the ministry. For the reasons I have already mentioned, it does not involve the acceptance of Gulf War syndrome as a specific recognised disease; nor does the use of the umbrella term alter the MoD's position with regard to making an award under the war pensions scheme. It has never been the case that the department required that there be some particular label for an illness before a pension could be paid; the MoD awards in full whenever evidence of disablement is shown, and where this disablement is due to, or aggravated by, service. The acceptance of the umbrella term has not changed this fundamental feature of the war pensions scheme.

I should explain the position the Ministry of Defence takes concerning the use of the diagnostic label, "Signs and Symptoms of Ill-Defined Conditions", more commonly known as SSIDC. This is a diagnostic category within the World Health Organisation International Classification of Diseases, and has been mentioned in the debate today. It is used to describe ill defined symptoms and illnesses where there is no identifiable underlying disease. The evidence is that similar symptoms occur in service personnel who did not deploy to the Gulf, and in the general population. The difference is that the reported occurrence in Gulf veterans is significantly higher. We therefore accept the Gulf ill health effect, and give eligibility for compensation by using the widely recognised category SSIDC.

The Martin decision used "Gulf War syndrome" to cover not just Gulf illness, or SSIDC, but all other accepted conditions the tribunal considered to be causally linked to the 1990–91 Gulf service. I should mention that SSIDC remains in wide use throughout the world, including in Gulf studies published in the peer-reviewed medical literature.

How will the umbrella term be used? Following the statement by the Minister for Veterans, the Veterans' Agency will proceed as follows in cases where Gulf War syndrome is given as an umbrella term: the agency will list the accepted medical conditions, together with a separate assessment of the levels of disablement arising from each. It will then ensure that the
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certificate that it issues to record an award makes clear that the umbrella term applies to accepted conditions which are connected with 1990–91 Gulf War service. The umbrella term in this way provides the recognition that many veterans have sought of the link between their ill health and their service in the Gulf.

I should make it clear that there will be no direct increase in awards paid because of the inclusion of the umbrella term in an individual's assessment of his disablement. All disablement that is accepted as due to service will be, or will already have been, reflected in making an award.

There has been some criticism—my noble friend Lord Morris of Manchester and the noble and gallant Lord, Lord Craig of Radley, reiterated that criticism today—that the department has taken too long to recognise the connection between a veteran's ill health and their service in the Gulf. However, the principal issue raised by veterans claiming Gulf War syndrome before the Martin decision was that their conditions should be recognised as resulting from one specific Gulf-related disease. As I have said, there was, and remains, no scientific basis for doing this. The proposal to use Gulf War syndrome in a broader sense as an umbrella term is a new one. We have recognised the need to bring an element of closure—I disagreed with the view of the noble and learned Lord, Lord Lloyd, when he questioned the Government's good faith in using that term; the noble Baroness, Lady Murphy, also mentioned closure—for those who have sought some acknowledgement that their ill health is connected to their 1990–91 Gulf service. I hope that noble Lords will recognise and welcome this step.

I should add that at a Veterans Forum meeting chaired by the Minister for Veterans in December last year, the senior veterans organisations welcomed that development and considered the Government's move to be positive. It is sincerely hoped that we can build on this and that it will, indeed, help to provide an element of closure.

Noble Lords have asked me many questions this afternoon. I had originally 12 minutes in which to answer. Due to the overrun of time and so on I did not end up with 12 minutes. I hope that noble Lords will be patient when I say to them that I will certainly write to each one of them and answer each of their questions as I have run out of time.

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Thursday, 2 February 2006.

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