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5.35 pm

Lord Astor of Hever: My Lords, the House will be enormously grateful to the noble Lord, Lord Morris of Manchester, for introducing this important debate. I, too, pay tribute to him, the noble and learned Lord, Lord Lloyd of Berwick, and the noble and gallant Lord, Lord Craig of Radley, for all the work that they have done over a long period on behalf of those affected by Gulf War illnesses. I am also grateful to the National Gulf Veterans and Families Association for making its position clear to me.

Gulf War I was unique. It was the most toxic war in western military history, and exposures suffered have now been shown to be associated with a pattern of symptoms and physical signs that were previously unknown. The report produced by the congressionally mandated Research Advisory Committee on Gulf War Veterans’ Illnesses has gone a long way towards answering some of the questions surrounding the term “Gulf War syndrome” and what it represents. I take this opportunity to thank the committee for its extensive and scientifically based research into a condition that has been little understood, often trivialised and treated as a stress-related condition. This report shows not only that Gulf War illness is not stress-related, as the noble Lord, Lord Morris of Manchester, said, but that it can no longer be marginalised or dismissed.

As we are all aware, Gulf War illness displays many different symptoms. Some of these are,

Previous studies have shown that higher rates of amyotrophic lateral sclerosis and brain cancer have been found than among other veterans. Moreover, according to the Lancet, these symptoms were suffered by 174,000 US veterans and somewhere between 6,000 to 12,000 British soldiers.

As the report states, it is now clear that,

It specifies that PB pills used to combat nerve agents and pesticides during deployment are “causally associated” with Gulf War illness. We can now see that for these soldiers their,

The Ministry of Defence has on its website a clear statement of its position on Gulf War illness. It says:

“Gulf Veterans’ illnesses issues remain a priority for the Government”.

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However, it goes on to say that,

Will the Minister tell the House whether the Government intend to revise their line to include the more up-to-date information from the report? Will she also say why it has not been updated given that the report was published on 17November last year? The Ministry of Defence website also states:

“We are committed to research aimed at improving the long term health of those veterans with persistent symptoms”.

This is highly relevant, because the report makes it clear that its findings should be seen as a basis for further investigation—primarily, of course, to research ways of helping those suffering from Gulf War illness, but also with regard to other related issues. It flags up the concerns about Gulf War veterans suffering from other diseases such as ALS, a progressive neurodegenerative disease that attacks nerve cells in the brain and spinal cord, and brain cancer. It suggests that these should be monitored for the foreseeable future. There are important questions about how to help to improve the health of Gulf War veterans, and further analysis is needed regarding the health of their children.

Will the Minister assure the House that the Government are committed to this new research? The noble and gallant Lord, Lord Craig of Radley, who was, as he said, Chief of the Defence Staff during the first Gulf War, has said that medical treatments for these conditions are needed to protect current and future military personnel at similar risk. Will the Minister tell the House what action will be taken to help to reduce the threat of this kind of illness in the future? In the US, especially in the light of the recent research, it is now a “national obligation” to make sure that the health of Gulf War victims improves and that nothing like this ever occurs again. This is made especially urgent by the many years during which Gulf War veterans have waited for answers and assistance. Will the Minister assure the House that plans are in place to make sure that the UK will also play its part in this national obligation? The noble Lord, Lord Gilbert, pointed out that our veterans have waited a long time. They and their families deserve our help.

5.42 pm

The Parliamentary Under-Secretary of State, Ministry of Defence (Baroness Taylor of Bolton): My Lords, we have had an interesting, if brief, debate. The one point that unites everyone in this House is the congratulations expressed to my noble friend Lord Morris on obtaining the debate but also in his sheer dogged persistence over many years in pursuing this campaign and starting it when, as noble Lords have mentioned, it was not a popular or fashionable campaign. As has been said, in those early days many people trivialised the issue and assumed that this was a stress-related illness. I was alarmed by the figure that was quoted by the noble Lord, Lord Thomas, from the press, in the context of their derogatory remarks about people who suffer from it.

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Having praised my noble friend Lord Morris, perhaps I can say that I was not too delighted that he reminded people how long ago it was that I first fought an election. We will leave that matter to one side. I would like to clarify and explain the Government’s position on Gulf veterans’ illnesses. It is, as other noble Lords have pointed out, a sad truth that some service personnel have been affected by ill health due to their time in the Armed Forces. I am sure that I speak for everyone in this House as well as everyone in Government in saying that we must make it clear that we are not only aware of the sacrifices they have made but that we also accept a duty of care to them. That is important and something I want to emphasise, because the Government take that duty of care very seriously. It is manifested in various forms, from research to better understand some of the conditions that our veterans suffer from, to medical assessments and NHS treatment for those who need it. I will later touch on another aspect, financial support, which is provided through MoD war pensions and Armed Forces occupational pension schemes.

We recognise that veterans may have particular needs. That is why in the Service Personnel Command Paper—which, it was mentioned earlier, was the first of its kind—we have committed ourselves to raising awareness among healthcare professionals in particular so that the needs of those who have served in the Armed Forces are met.

The noble and gallant Lord, Lord Craig of Radley, mentioned veterans’ organisations. There has been a breakthrough, which I know that he welcomes. I hope that he will have confidence in that because there is now a separate single point of contact for veterans. The committee that he asked about has met on two occasions already and is due to meet again soon. That will certainly lift the whole profile of the help that is available for veterans and I hope it will be constructive to all veterans.

In this debate, however, we are talking about a specific group of veterans—those who served in the Gulf in the 1990s—who have particular concerns about their health. We heard graphic descriptions about that this afternoon. I would like to take a moment to remind your Lordships that one of the first things that the Labour Government did after taking office in 1997 was to commission new research in this area. That was a mark of the serious intention on the part of Ministers from that date to take this issue seriously and try to find out what we could. That is why we have spent around £9 million funding expert medical research in this area.

That research has come to the same conclusion as the independent Medical Research Council report from 2003, which looked at all the UK and international research into these issues. The conclusion was that,

Of course, research work continues. Mention has been made today of the United States Institute of Medicine, which is currently considering the report published by the US Research Advisory Committee on Gulf War Veterans’ Illnesses. We look forward to seeing the outcome of that review. It is reasonable to

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have a review of the evidence that is presented by a set of experts. I congratulate my noble friend Lord Morris on having such a direct input into that committee, which shows the respect in which he is held on an international basis.

We have a copy of that report in the MoD, and people are looking through it. I read the executive summary because I did not feel competent to read all the technical, scientific and medical expertise in the main body of the document. It is important that we wait until we have time to examine it fully. The noble and gallant Lord, Lord Craig, said that it was reasonable to assess that report properly. It is a review of much of the evidence that has been put forward. However, it is important to bear in mind a couple of basic facts, not least that this report does not in itself identify a discrete pathological entity that is Gulf War syndrome. In some respects, therefore, we have not drawn the line in terms of definitions and in terms of causation. Obviously, we have to be willing to consider any credible new evidence, but the overwhelming consensus at the moment is that there are still too many symptoms and variations to have a syndrome according to the strict medical definition. Other noble Lords mentioned that as well.

As the noble and learned Lord, Lord Lloyd, said, the MoD changed its approach and acknowledged that the phrase “Gulf War syndrome” had become widespread, and we therefore reviewed our position in terms of the use of it and accepted it as an umbrella term to address the concerns of veterans who felt that there was a direct link between their service and their illness, and that that had not previously been recognised.

Lord Lloyd of Berwick: My Lords, would the noble Baroness not accept, even on the basis of the executive summary, that this committee, after six years has identified two specific causes as being the most likely causes of Gulf War syndrome? I identified those in my speech.

Baroness Taylor of Bolton: My Lords, the noble and learned Lord did identify those causes, but the report also states that Gulf War illness does not fit neatly into well established categories of disease. One of the important points that I want to make is about what the report says about future work and where the emphasis of that should be. While I recognise that the stance of the MoD does not go far enough for some people, it is important that we retain our evidence-based approach and that we follow the evidence that can be made available to us. We are always willing to look at new evidence when it is made available.

Lord Thomas of Gresford: My Lords, in assessing the evidence, what standard of proof does the ministry demand? Is it proof beyond reasonable doubt or proof that it is more likely than not that the causes identified in the US report are the actual causes? If the Government were facing a case in court, the standard would be “more likely than not”. Surely this report has reached that standard for all time.

Baroness Taylor of Bolton: My Lords, one of the problems is that there is a lot of contradictory evidence and a lot of ifs, buts, maybes and combinations. Indeed, some years ago it was suggested that the real issue was

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that there had been a cocktail effect whereby there was a combination of causes, as has been mentioned. While this report states that although there is a persuasive theoretical case, and although the case is compelling, little evidence is available to indicate whether or not Gulf War illness is associated with combinations of these exposures.

If one looks at this report and the various issues that are very serious for many people—I do not underestimate how serious issues of brain cancer or a whole range of disabilities are—trying to collect those all together and establish a single causation needs a great deal of study. It is right that Ministers do not jump to conclusions and we go to the people who have the best information. I would not in any way minimise the impact of illness on any veteran, but we should bear in mind that there are some puzzling statistics in all of this, not least if we look at mortality statistics. The figures that I have state that there were 980 deaths of those who had served in the first Gulf War, but if one does an age-adjusted comparison, one would have expected more deaths by a considerable factor. We must be careful about making simplistic conclusions. This report states that it is difficult to make simplistic conclusions about cause and result, and that is important.

Lord Craig of Radley: My Lords, I draw attention to the phraseology on page 10 under the heading “What the Weight of Evidence Tells Us About the Causes of Gulf War Illness”. The report states:

“An extensive amount of available information now permits an evidence-based assessment of the relationship of Gulf War illness to the many experiences and exposures encountered”.

Is the noble Baroness saying that the report does not give her and the Ministry of Defence the right weight of evidence to meet the type of challenge that would be required in a court of law?

Baroness Taylor of Bolton: My Lords, I am not trying to make judgments about what would happen in a court of law; I am trying to explain the complexities of the evidence, the fact that it is therefore right that experts in this field should be looking at this, and why peer review is important.

I am urged to look at the time, but perhaps I may deal with one other extremely important issue—I hope we can all agree that it is one of the important things to come out of the report. It concerns the approach that we should all take to veterans with this kind of illness. The section entitled “Research Priorities and Recommendations” says that the primary goal should be,

The committee recommends that the,

That is one of the things on which we must concentrate attention.

We are working to ensure that the right medical services are available for veterans and that general practitioners know that they have very serious responsibilities. Those should be among our primary goals. Although it is difficult to be absolutely precise about causation, and people will disagree on the weight of the evidence, there are things that we can do. One is to ensure that the war pensions and benefits to which

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veterans are entitled are paid. I wish to defend the statement of my noble friend Lord Tunnicliffe. He said that payments should be made in accordance with disability or injury and not on the basis of causation or, indeed, on the basis of the label put on any illness. Instead, payments should be made on the basis of need and the level of disability. It is also important that, looking forward, we concentrate our efforts on ensuring that the treatment and support available are as good as possible.

My honourable friend in another place, the Parliamentary Under-Secretary with responsibility for

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veterans, recently met the organisation responsible. He is hoping to build on that meeting and to work through one or two of the problems, such as the funding of specific types of research, and I hope that something positive can come out of that. However, I assure my noble friend and all Members of your Lordships’ House that the Government will look at the evidence very carefully and that we will ensure that it is considered by the right people. I am very pleased that we have been able to have this debate and I know that everyone in this House will take this issue seriously.

House adjourned at 5.58 pm.

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