Gulf War Veterans

– in the House of Lords at 8:24 pm on 17 October 2001.

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Photo of Lord Morris of Manchester Lord Morris of Manchester Labour 8:24, 17 October 2001

rose to ask Her Majesty's Government what new consideration they are giving to the problems and needs of Gulf War veterans with still undiagnosed illnesses and the dependants of those who have died.

My Lords, speaking as a veteran of parliamentary debates on Gulf War illnesses over many years--indeed almost for a decade now--both here and in another place, I welcome my noble friend Lord Bach to this evening's debate and look forward to his, as it were, "maiden" speech on what I know he appreciates is a subject of high importance to the ex-service community. At the same time I record my appreciation to his ministerial predecessors, my noble friends Lord Gilbert and Lady Symons, for their unfailing courtesy in replying for the Government to the four previous debates I have opened on the problems and needs of Gulf veterans.

None of us here, least of all my noble friend, wants to see the afflicted and bereaved of the Gulf conflict made to suffer the added strain and hurtful and demeaning indignities that preventable delay in dealing with their concerns can impose. There was no delay in their response to the call of duty. Nor should there have been any delay in discharging our debt of honour to act justly to them. That was, and is now, much the best way--better by far than words of praise--of showing our regard and admiration for those who served this country with such gallantry in the Gulf War 10 years ago.

Yet sadly, as I found when spending an evening with many of them recently after performing the opening ceremony of the National Gulf War Veterans and Families Association's new premises in Kingston-upon-Hull, there is widespread feeling among veterans and bereaved families alike that they are not being justly treated. Indeed, some talk of being,

"discarded now by officialdom as 'yesterday's people'".

It was through my right honourable friend John Prescott, the Deputy Prime Minister and Member of Parliament for Kingston-upon-Hull East, that the association invited me to perform the opening ceremony. He is highly regarded by them, and I take this opportunity warmly to thank him, on their behalf, for his abiding readiness to listen and practical concern to help when and where he can.

The association's officers and members recalled during my evening with them two veterans, both now deceased, whose cases I referred to in opening the debate on Gulf War illnesses on 15th January 2001. I had raised first the case of Major Ian Hill whom I had known for many years. He was in touch with me shortly before the debate to say that his health had again deteriorated and that his medical condition was now described by his doctor as one of "total burnout". His wife Carol, on whose devoted care he relied crucially both day and night, was also severely disabled with a "crumbling spine". In the final weeks of Ian's life they were left trying to cope in inappropriate housing, and my last news of him before his death was that he had then become registered blind.

The other case I raised in my speech on 15th January was that of Hilary Jones, ex-Queen Alexandra Royal Army Nursing Corps. I described hers as distressing as any case of which I was aware. Terminally ill and living alone, she was deeply hurt by delays in dealing with her war pension appeal; and as in Ian Hill's case, her entitlement to a 100 per cent war pension was accepted only after she had died. Both Hilary and Ian went to their graves with a deep sense of injustice having succumbed to illnesses which were never fully diagnosed. They are widely mourned among Gulf veterans.

It was cases like these which led The Royal British Legion to describe its own experience of dealing with Gulf War pension appeals as "nothing short of shocking". Anyone contesting that assessment should read a ministerial reply of 22nd September to representations that I had made for Shaun Rusling of the Gulf Veterans and Families Association. The reply states that the MoD's Gulf War database,

". . . confirms that at the end of July 2001, 253 appeals made by veterans had been heard by the independent Pensions Appeal Tribunal. Of these, 125 were successful".

Therefore, almost 50 per cent of appellants were found, by independent assessors, to have been receiving less than their war pension entitlement. And in further endorsement of The Royal British Legion's description of the treatment of appellants as "nothing short of shocking" I repeat that, in the cases of Ian Hill and Hilary Jones, notwithstanding their terminal illnesses, full war pension entitlement was denied until after they had died.

No one underestimates the scale of the hideous inhumanity of the terrorist attacks on New York and Washington on 11th September; and the Prime Minister was eminently right, in his Statement in another place on 14th September, in seeking to put them into perspective. But many Gulf veterans were disturbed by the impression they felt could have been given that the conflict in which they were involved was of scant significance. First, they quote in particular the comment that,

"In the Falklands War, 255 British servicemen perished, and during the Gulf War we lost 47".

Reacting to this, Gulf veterans say that it was over 10 years out of date. They point out that the cost in British lives was very much higher than 47 and that it is still increasing month by month. Since the conflict, says the MoD, 496 more of our troops have died, of whom 88 took their own lives. Thousands more, all of them A1 when hostilities began in 1991, are in broken health and--again recalling the cases of Ian Hill and Hilary Jones--many of them are terminally ill. Gulf veterans also state that deaths among innocent civilians in Kuwait caused by the conflict were high and continue to rise.

And the second extract that veterans quote from the Statement on 14th September is the comment that:

"The limits on the numbers that they [terrorist groups] kill . . . are only practical and technical. We know that they would, if they could, go further and use chemical, biological or even nuclear weapons of mass destruction".--[Official Report, Commons, 14/9/01; col. 606.]

The reaction of veterans to this is to say that any understanding of the significance of the Gulf conflict has to start from the fact that it was on a scale bigger than any that British troops had been involved in since the Korean War. It was also the first in which chemical or biological weapons were deployed against our troops since 1918. Moreover the MoD and the Pentagon were convinced they would be used. So too were our troops deployed to the Gulf. They like millions more across the world had seen in TV reporting, only months before the conflict began, the stark effects of Saddam Hussein's use of these weapons against tens of thousands of Iranian civilians. And US and British commanders not only expected their use in the Gulf War, but calculated the likely death toll. Thus the Pentagon sent 150,000 body bags to the Gulf.

So when the conflict started our troops were not acting on the assumption that their adversaries "would, if they could" use such means of mass destruction as biological and chemical weapons. They knew these weapons were already deployed against them by a fanatical enemy who had only recently used them utterly without scruple or mercy in attacks on the civilian population of a neighbouring Muslim country. And Gulf veterans, now in broken health, many with severely debilitating but still undiagnosed illnesses, trace some of the worst of their problems to the MoD's preparations for their role in facing the reality of living within range of Iraqi weapons known to be carrying chemical, biological and nuclear warheads.

The MoD correctly assessed the threat but not all the health risks of its measures. Of the 17.3 per cent of veterans Professor Simon Wessely's report in the January/February edition of the BMJ described as believing they are suffering from "Gulf War Syndrome", more and more attribute their illnesses to the protective measures taken to counter anticipated health risks. The measures taken comprised a multiple immunisation programme of unprecedented range and intensity--a veritable blitzkrieg on the immune system--that included protection against anthrax, then known to be stockpiled in Iraq; the first-ever issue of pyridostigmine bromide (NAPS) tablets as an antidote to biological agents; and the deployment of toxic sensors and pesticides, including organophosphates, to prevent fly-borne diseases.

Now that British forces face another enemy with and prepared to use chemical and biological weapons, I invite my noble friend to detail the action so far taken to rectify shortcomings in the measures taken to protect our troops in the Gulf. I invite my noble friend also to comment on the anguish and at times anger felt by the afflicted and bereaved that the public inquiry, for which The Royal British Legion has been pressing the Prime Minister for over two years now, has still to be agreed. The failure to institute an inquiry is deeply unfortunate. For ultimately there will have to be one, not only in fairness to Gulf veterans with undiagnosed illnesses but to avoid repetition of the mistakes made in preparing for that conflict in future deployments.

Meanwhile, I have been asked to establish this evening the total legal costs so far incurred by the MoD in responding to compensation cases raised by Gulf veterans; and also whether, and at what cost to them, veterans bringing such cases have been or will be asked to contribute to costs.

My noble friend will be aware of the certainty with which veterans with undiagnosed illnesses say that their suffering was caused by measures taken to protect them. They know they were taken with the best of intentions; but that does not lessen their suffering from problems still to be fully addressed. Nor are they concerned only about their own plight. Their backing for an urgent and wide-ranging public inquiry was founded also on a desire to ensure that our Armed Forces would be thoroughly prepared and better protected in future deployments.

Sadly, one shortcoming that could now be repeated is the failure to safeguard our troops from the ill effects of a multiple immunisation programme. In fact we were told by the then Minister, in the debate on 15th January, that the final results of work on "possible adverse health effects" of the inoculations given in the Gulf conflict were not available. Speaking earlier in that debate, the noble and gallant Lord, Lord Bramall, said that,

"one glaring question stands out above all others. Was the cocktail of inoculations . . . liable to cause, in some individuals, a harmful chemical or physiological reaction that would lead to loss of future immunity?".--[Official Report, 15/1/2001; col. 1014.]

He went on to say that he was "staggered" to have been told some months earlier, by the then Minister, that a planned medical study of the effects of dispensing all the inoculations at the same time--"including the medical histories of those who had subsequently so tragically suffered"--had not yet been undertaken.

The noble and gallant Lord, Lord Bramall, strongly insisted that this should have been done at the outset because it was by far the most likely common factor in causing subsequent indisposition or worse; and on 15th January he asked the then Minister for the results of the study. He said:

"It must by now have been carried out--if it has not been, that can only mean that the Ministry of Defence is not serious enough about getting at the truth".--[Official Report, 15/1/01; col. 1014.]

To which the Minister replied:

"He will be disappointed when I tell him that the final results are not expected until 2003".--[Official Report, 15/1/01; col. 1021.]

So the only honest answer to anyone who in 1990--about to be given 14 inoculations within a fortnight--had asked about their likely health effects would have been:

"We will not be able to tell you for another 13 years".

The Minister was, of course, correct in saying her reply would disappoint the noble and gallant Lord, Lord Bramall. It visibly did so: for to him, as he had already told the House, it meant that,

"the MoD is not serious enough about getting at the truth".

I know that my noble friend will want to respond to the justified concern here and in another place about the worrying implications of this for our troops now deploying. Perhaps my noble friend would comment also on what further help is being considered for those who, in the words of his predecessor to the noble Lord, Lord Bramall, "so tragically suffered" after multiple immunisation in the Gulf conflict. In particular, my noble friend might reflect on the possible relevance of the vaccine damage payments legislation in compensating them.

Another question raised with me is whether it is intended again to issue NAPS tablets as an antidote to biological weapons; and, if so, what instructions are now being issued on their use? And can my noble friend confirm that there are sufficient stocks of pesticides, other than organophosphates, available to protect troops deployed to arid desert regions in what could be a protracted conflict?

A further question of concern to veterans is what action has been taken to improve medical record-keeping? Records were often incomplete after the Gulf conflict, making it difficult to confirm the nature of treatment given and to diagnose veterans' medical problems. Other concerns are: first, whether, if reservists are now to be called upon, the same benefits as for regulars will be payable in the case of injury or death; secondly, with the closure of all military hospitals except Haslar, whether enough beds and medical specialists will be available to treat the number of casualties we could be confronted with; and, thirdly, since current hostilities are likely to prove traumatic for the troops most involved, what arrangements have been made for aftercare and counselling for those who deploy and for families left behind.

All of us know that Gulf War illnesses are rarely discussed now without mention of the very heavy use of depleted uranium (DU) during the conflict; and many noble Lords will be aware of Granada TV's recently networked film "Back to the Front" which included extracts from a US Army training video made before the Gulf War by Dr Douglas Rokke, a highly regarded expert on the health effects of exposure to DU.

Dr Rokke was later sent to the Gulf to investigate contamination there from the use of DU and to "devise a way of cleaning it up". He is seen in the film saying:

"We found that nobody there knew what was contaminated, how to manage contamination or how to provide medical care to casualties. It was a mess".

He went on:

"The British Government knew because they approved the video and training materials developed. I had a British officer assigned to work with me".

It will be helpful now to have my noble friend's response to these disclosures and, more particularly, to the contrast between Dr Rokke's comments and ministerial assurances here and in another place that there was and is no danger in the use of DU. I invite him also to respond to the valuable recent report from the British Geological Survey (BGS).

That report, like Dr Rokke in his training video, looks beyond heavy metal poisoning in stating that:

"Unlike materials such as cadmium, exposure to uranium may also result in health effects due to the presence of its inherent radioactivity".

In discussing DU used in military conflicts, the report goes on to say that those likely to be exposed include rescue workers and field staff associated with the clean-up and decommissioning of vehicles and sites attacked by DU weapons. The BGS report, no less than Dr Rokke's video and subsequent comments, calls seriously into question what Gulf veterans have been told. I know my noble friend will want to respond to me about this as fully as he can when he speaks.

I ask him also now to explain why the MoD's own report on the use of DU made no attempt to estimate the interactive effects of combining exposure to DU with multiple immunisation. He will know that this question, posed by doctors of high distinction and raised in the House soon after the MoD's report was published, is now of urgently renewed importance. Yet it has still not been answered.

Gulf veterans with still undiagnosed illnesses and bereaved families strongly resent being told to accept that mistakes made were not deliberate. They know as well as anyone in Whitehall that decisions about protective measures often have to be made on a "needs must" basis; but they will never accept that the victims of mistaken decisions alone should be left to cope with their consequences. They rightly insist that the nation, not the individual, should meet the cost of such decisions. That quintessentially is the case for a most urgent review of the MoD's current stance on further help for those who, and I quote the words again,

"so tragically suffered from mistaken decisions".

The way a nation treats those who are prepared to lay down their lives in its service, and the dependants of those who do so, is ultimately more revealing of its moral worth than all the oratory of its leaders. By that defining test, the men and women that this debate is about deserve well of this House.

Photo of Lord Burnham Lord Burnham Conservative 8:40, 17 October 2001

My Lords, the noble Lord, Lord Morris of Manchester, has a long-standing and well deserved reputation for his concern for all those who suffer or have disabilities of any kind. He has been a prominent and very hard-working member of The Royal British Legion's committee set up to study the effects of illness arising out of service in the Gulf during Operation Granby. This is now a problem which has been of great concern for more than 10 years and it is appropriate that your Lordships should again have the opportunity to debate the matter. The noble Lord is much to be congratulated on raising it. His closing words sum up the difficulties that we are facing. At the same time, I should like to pay tribute to Colonel Terry English of The Royal British Legion for his work for Gulf veterans.

The noble Lord, Lord Morris, has not left undone those things which he ought to have done, but the current scare word is "anthrax". It would seem that the realities of the problem are far exceeded by the media coverage that it is receiving, but anthrax has been a matter which has concerned the Ministry of Defence for some time. I hope that the Minister will be able to bring the House up to date.

In November 1998 the anthrax immunisation programme of voluntary immunisation for service personnel and MoD civilians was suspended when the licence for the current stocks of vaccine ran out. It seems that the sole supplier, the Centre for Applied Microbiology and Research, suffered production problems, but did not inform the Ministry of Defence until October, a month after full delivery should have been completed.

The then Minister, the noble Lord, Lord Gilbert, assured those concerned with defence matters in both Houses that there was no long-term problem. However, the first new supplies of anthrax vaccine were not received until January of this year, 27 months after the problem was first discovered. But supplies are now available and all members of the UK Armed Forces will have access to the highest level of protection possible against this potential biological warfare agent.

So far, so good. Members of the Armed Forces will be able to get protection if they so wish. It is likely that the dangers of anthrax infection, in spite of what we have seen in the evening papers today, have been wildly overstated. But perhaps I may take the opportunity to ask the Minister what is the current situation regarding major supplies of anti-anthrax vaccine appropriate for large numbers of the population, should it be so needed.

When The Royal British Legion delegation visited the United States a year ago, it received a statement from Congressman Metcalf on squalene in anthrax vaccine. I say this not for the first time: I do not know what I am talking about--perhaps the Minister can discover for me in due course--but it is suggested that this may be sufficient to call for an end to the anthrax vaccination programme. Is there any justification for the concern about squalene and does it indicate the possible need for a change in policy?

This is merely one aspect of the problems arising from the exposure of members of the Armed Forces to various illness inducing agents. Both in this country and in the United States, great efforts have been made to establish whether a common agent has caused these problems or indeed whether those who have suffered do so because of their service in the Gulf or exposure to anti measures which have gone wrong. Rightly, tests have been made on peer bodies or control groups of those who did not serve in the Gulf to find out what is their incidence of disease or premature death.

As the noble Lord, Lord Morris, pointed out, in both countries record keeping and retrieval have been less than satisfactory. But that is past and gone and those who are working on the problem today have to do their best with what they have. During Operation Granby there was no evidence of any chemical alarms, all of which are regarded as having been false. For instance, both in the United States and over here, the Sabbahiyah Girls' School incident is regarded as being due to nitric acid and not a mustard gas agent. To this day it is being denied, as the noble Lord suggests, that chemical or biological weapons were employed anywhere in the Gulf. Therefore without doubt we have a problem in that some other explanation of the illnesses is required. I am not certain that we have one.

In the United States, the problem is being taken most seriously. Last year The Royal British Legion again visited America and the noble Lord, Lord Morris, accompanied the party. The Department of Defense, the Department of Veterans' Affairs, the American Legion and the Walter Reed Hospital have all clearly worked hard to establish the causes of the problem or problems, and what can be done to alleviate them. Much water has passed under the bridge and it is time that we received from the Government a further interim report.

Throughout work on Gulf problems runs the strain of depleted uranium, as the noble Lord has said. It is a matter which is not restricted to the Gulf, but certainly obtained in Bosnia as well. Rather like anthrax, the scare seems to have been exaggerated. There is little doubt that depleted uranium in itself is neither toxic nor dangerous. However, there may well be danger when the depleted uranium takes the form of a metallic dust following an explosion. I hope that in his reply the Minister will be able to bring the House up to date on current thinking.

It is very good news that in this country we now have a sub-department of the Ministry of Defence, under Dr Moonie, which concentrates on veterans' affairs. That will enable all the bodies working on the problems--it has to be said that they have not always been in unison--to have one department to which they can address their concerns.

Having established the sub-department, it will be easier and more convenient to establish a veterans' register. I hope that this is being done, or has been done. The lack of documentation on Gulf problems arises at least in part from the lack of such a register, although of course that is only a small part of the difficulties regarding the documentation of Gulf problems. With the possibility of operations in an ecologically dangerous area in the near future, it is to be hoped that the Ministry of Defence has learnt the lessons of the Gulf War and will get it right next time. I hope that there will not be a next time, but I fear that there may be.

Photo of Baroness Park of Monmouth Baroness Park of Monmouth Conservative 8:49, 17 October 2001

My Lords, I speak in the gap because I was afraid that I would not be able to get here in time for the debate. I apologise to the House.

At a time when we are once more preparing to send our troops into battle, it seems intolerable that we have still done nothing for this small group of people who came back sick from the Gulf 10 years ago. The War Pensions Agency acknowledged in 1998 that illness occurred in relation to Gulf service, which is a fairly plain statement.

The damage to these lives has arisen not from enemy action but because of our long drawn out refusal to recognise that the men whom we cheerfully dispatched hale and hearty to war returned sick men. We are still ignoring both the American findings and the 1997 medical report of the MoD itself.

I am very glad that there is a Veterans Affairs Office, but it has been in position for some time now and I should like to know what it is doing about pensions. It would be difficult to think of a more striking example of perverse behaviour in the way of morale raising than what is going on still for these veterans.

At long last we have provided some justice for the prisoners of the Japanese. We are looking at a very small group, but what the Government do or do not do for them sends a most significant message to soldiers about to go into battle. They should be able to count on just and equitable treatment--and treatment early rather than late--and not the prospect of being fobbed off once they have served their term. That is what it feels like to them.

What guarantee is there that we are better prepared this time for the troops to encounter a chemical threat? What lessons have the Government learnt? I hope they have learnt some, because it seems to me that a small group of people have suffered unduly and are still suffering.

Photo of Lord Clement-Jones Lord Clement-Jones Liberal Democrat 8:51, 17 October 2001

My Lords, we last debated this subject, as the noble Lord, Lord Morris, pointed out, in January of this year on the 10th anniversary of the Gulf War. I believe that this is my fourth debate on the subject in the past few years. Despite the temptation, noble Lords will be pleased to hear that I shall not repeat what I said on those occasions, but I hope that the Government will take it as read that we on these Benches very strongly support the noble Lord, Lord Morris, in his long campaign for justice for Gulf veterans.

In our previous debate we talked at length about the issue of depleted uranium and whether the MoD was being wholly frank about depleted uranium and its effects. In that context, I was quite surprised, to put it mildly, to see correspondence in May this year from Dr Moonie to Llew Smith, MP, which appeared to constitute a reply to a question which Mr Smith had asked all of 18 months earlier on the subject of testing veterans for depleted uranium. Although the information contained in the answer on retrospective exposure assessment was helpful, it does show just how slow progress can be on the issue of compensation and justice for Gulf veterans.

In the 10 months since the previous debate a series of papers have been published and there have been a number of other developments. Even so, the Government have essentially not changed their line on compensation for Gulf War veterans or taken to mediation the claims of those taking legal redress.

There are some 1,866 legal claims from Gulf veterans currently in the pipeline. In May, in a Written Question, I asked whether the MoD had plans to follow the Lord Chancellor's guidance on mediation published on 23rd March. In announcing the new initiative by the Government--and I believe that the Minister was then with the Lord Chancellor's Department and he may recollect what he said at the time--the Lord Chancellor said:

"This Government want to lead the way in demonstrating that legal disputes do not have to end up in court. Very often there will be alternative ways of settling the issues at stake which are simpler, cheaper, quicker and less stressful to all concerned".

The noble Baroness, Lady Symons, who at that time was the Minister responsible in the House of Lords, replied by letter. She said, fairly bluntly, that,

"The Ministry of Defence does not consider mediation on compensation for Gulf Veterans an appropriate way forward at the present time".

She went on to say, however, that the Government would be,

"tireless in its efforts to understand the reasons why some Gulf veterans are now ill".

I wonder whether the Minister, having now served in both the Lord Chancellor's Department and the Ministry of Defence, has any different reply on that subject.

To many of us, the strategy of the Ministry of Defence is to play for time. The essence seems to be to commission endless research papers while having no intention of actually compensating the veterans. Some of the research carried out has, of course, been valuable, particularly that of Professor Nicola Cherry of Manchester University, and I should like to look at this more closely presently.

I am, however, rather baffled why we needed to have the latest piece of research from the Gulf Veterans Medical Assessment Programme, which published a paper in the BMJ this September. This concluded that,

"substantial numbers--17.3%--of British Gulf War Veterans believe they have Gulf War Syndrome which is associated with psychological distress, a high number of symptoms, and some reduction in activity levels".

I am not quite sure why we have had to wait 10 years for that astounding conclusion. Equally bizarre is the research from Professor Lee and others published in the Journal of the Royal Army Medical Corps in June this year which concluded that 80 per cent of the second cohort of 1,000 veterans were "well".

Of greater value have been the conclusions of Professor Cherry's studies published in Occupational and Environmental Medicine in May. These are: that while not accepting that there is such a condition as Gulf War syndrome, nevertheless Gulf veterans report more illness than non-Gulf veterans; that the severity of the symptoms is greater in Gulf than in non-Gulf veterans; and that three factors are consistently related to severity--the number of inoculations, days spent handling pesticides and days exposed to smoke from oil fires--and that the former two warranted further investigation.

Following publication of this research, in answer to another Written Question the noble Baroness informed me that a team--I assume this is concerned with the Gulf Veterans Assessment Programme--has completed work on blood samples taken from Gulf veterans to test the hypothesis that multiple vaccinations may have triggered physiological changes. It seems incredible that we still do not have this data after 10 years. Can the Minister say when publication of these findings is expected?

When will the MAFF research into the effects of exposure to OP pesticides be completed? Likewise, the Porton Down research into the adverse effects of the combination of vaccines and NAPS tablets given to the troops in the Gulf, both of which were mentioned by the noble Baroness in her reply to me? What other research to test the link between these two exposures and Gulf illness is being carried out?

While the research has been carried out the MoD has been stalling on compensation for Gulf veterans. However, it has emerged in the meantime that it has been paying out record sums--some £100 million--to a variety of deserving and not so deserving individuals: £387,000 for negligent treatment of warts; £541,000 for injury from slipping on oil; £377,000 for failure to prevent frostbite. If these claims can be satisfied, why not those of the Gulf veterans?

There are two further important issues; first, squalene. I have seen the letter of reassurance from the Minister, Dr Moonie, in the press, categorically denying that this was added to vaccines administered to Gulf veterans. Can the Minister repeat this assurance? If he can, what investigations were made to allow him to do so? How can the Ministry explain the positive tests for squalene carried out by the Tulane Medical School in Louisiana?

The second issue is abnormalities which may be experienced by veterans' children. Evidence from the States, in a major study of 30,000 parents, seems to be suggesting that both male and female veterans conceive children with birth defects at a much higher rate than normal. Are the Government monitoring this? Are they carrying out their own research?

It is hardly surprising that both among Gulf veterans and supporters there is a large degree of impatience. The wheels of the MoD have ground exceeding slow. In correspondence it says that it is willing to engage in dialogue where there is no discussion of liability, but that is central to the veterans' case. It is almost as if the MoD is insisting that there must be a single "syndrome" before liability can be accepted. If that is the case, then the Minister should make it clear.

The only conclusion I can draw is that the Government's piecemeal approach to this whole subject is quite unacceptable. Should not there now be a full public inquiry as we had into BSE and CJD, for which the Royal British Legion has been pressing? I hope that the Minister can bring a fresh government response tonight. We badly need to draw a line under the whole episode, all the more so in view of the new involvement in prospect for our troops. What kind of precedent can the way that our Gulf War veterans are treated be for the health of our current troops? I hope that we can give our current troops every confidence that they will be dealt with properly in future, and that means treating our Gulf veterans in a proper fashion.

Photo of Lord Vivian Lord Vivian Conservative 9:00, 17 October 2001

My Lords, I am grateful to the noble Lord, Lord Morris, for introducing a debate on this subject. Perhaps I may say from the outset that we owe a huge debt of gratitude to the British servicemen who fought in the Gulf in Operation Granby.

Almost 3,000 members of the 53,462 forces of the United Kingdom who served in the Gulf conflict have been seen by doctors looking into Gulf war syndrome. No cause for the wide range of symptoms has ever been found, but in the past illnesses have been blamed on biological weapons, smoke from burning oil wells, exposure to depleted uranium or vaccinations. There is no doubt that many hundreds of them have contracted illnesses since then. The Conservative government put in place a series of scientific inquiries into the causes of the illnesses, and the present Government have added more. Those scientific studies must run their course before we can be in a position to make conclusive judgments. But no stone should be left unturned in the search for the truth about Gulf War syndrome. Meanwhile, we must keep open minds and ensure that veterans receive not only our sympathy but also our strong support in obtaining the very best health care from the National Health Service and other care agencies.

At the beginning of 2001, the MoD released details of 477 Gulf veterans who have since died. It said that 69 had developed cancer, 60 had suffered from diseases of the circulatory system and about 85 had committed suicide or died of injuries "undetermined whether accidental". In almost all the categories there were more deaths among a control group of personnel not sent to the Gulf. However, the figures may now have changed. I ask the Minister if he will update us on the current figures. The MoD said that the figures for the cancer deaths were,

"markedly less than one would expect amongst a similarly sized group of the same age and sex from the civilian population".

However, an MoD-funded study into the health of Gulf veterans, published in April 2001, indicated that Gulf War veterans were twice as likely to complain of ill health as other men and women in the services. Although there had been no excess deaths or hospital admissions, the study revealed that they had suffered from a "significant decline in health". I believe that the MoD denied that the figures indicated that veterans suffered ill health problems, but rather that they indicated that when Gulf veterans complained of symptoms they tended to be more severe.

The Ministry of Defence has been criticised for failing to provide the financial and medical help needed by veterans suffering illnesses caused by the Gulf War. The Defence Select Committee demanded urgent action to improve veterans' quality of life. In its report on Gulf veterans' illness, published in April 2000, it concluded:

"The government's record has been far less impressive in respect of improving the quality of life of ill veterans. We wish to see a great deal more progress in terms of ensuring Gulf veterans have access to adequate financial provision and to appropriate medical treatments and advice . . . Urgent action is required in both these areas if it is to fulfil the debt of honour which it has acknowledged".

I now turn to the subject of depleted uranium--used for its extreme hardness and density--which has been blamed for illnesses among soldiers who fought in the Gulf War and among Iraqi civilians. Concerns have also been expressed about its use in operations over Kosovo.

The most common uses for depleted uranium ammunition are in main battle tank shells (the UK has stocks for its Challenger tanks) and in aircraft cannon. The US A-10 "tank buster" aircraft carries a 30mm cannon in its nose which uses depleted uranium ammunition. A-10 operations accounted for the depleted uranium ammunition use in Kosovo. British forces did not use any depleted uranium ammunition in Kosovo.

The alleged dangers of the use of DU ammunition have been examined both by the MoD in this country and by the US Department of Defense, and their investigations are continuing. So far, their studies have concluded that expended DU ammunition presents very little danger to civilians and service personnel.

The Ministry of Defence asserted in its study on the testing for the presence of depleted uranium in UK veterans of the Gulf conflict:

"There are a number of ways in which some UK troops could have been exposed to DU during the Gulf conflict. However, it is judged that any radiation effects from these possible exposures are extremely unlikely to be a contributory factor to the illnesses currently being experienced by some Gulf veterans. Furthermore, because the kidney is the organ most susceptible to the toxic effects of (soluble) DU, and given the transient nature of any acute kidney damage, the symptoms which are most likely to be exhibited now in individuals who have ingested or inhaled large quantities are those of chronic kidney damage, although such damage could have been caused by a number of other unrelated factors. Chronic kidney damage has been observed in a very small number of those veterans who have so far attended the MAP (Medical Assessments Programme), although in each case this damage has been directly attributed to other specific diseases".

The Ministry of Defence announced on 8th September 1999 that the Gulf War veterans tested for depleted uranium in Canadian tests and concerned by the results would be given the opportunity to be re-tested in Britain. The effects of depleted uranium are also being studied by a group of six experts appointed by the Royal Society, and the World Health Organisation has set in train a study to set standards on depleted uranium and define minimum levels of contamination.

In January 2001, there were widespread reports in the domestic and international media about possible exposure of British and allied forces to depleted uranium in the Balkans. Allegations were made that the health of peacekeepers in Bosnia or Kosovo may have been affected by their deployment. It was suggested that some peacekeeping personnel may have become ill as a result of exposure to depleted uranium in the Balkans.

In January 2001, the MoD made the following statement:

"Handled in accordance with the regulations, DU shells present no hazard to our forces. We have long recognised, however, that on the battlefield its debris might present a hazard from chemical toxicity, in the same way as any heavy metal such as lead, and a low level radiological hazard. The risk from chemical toxicity would arise from ingestion of the soluble depleted uranium oxides, and the radiological risk primarily from inhalation of the insoluble depleted uranium oxides. These risks arise from the dust created when DU strikes a hard target such as an armoured vehicle. In its massive form, as expended rounds or solid fragments, it is a negligible hazard".

In view of the concern, the MoD announced an additional appropriate voluntary screening programme for our service personnel and civilians who have served in the Balkans.

We on these Benches welcomed the extra medical checks on servicemen to give them peace of mind and enable them to understand the issue more clearly. But I must stress that no decision on the future use of depleted uranium ammunition should be taken for political reasons, as it is one of the very few armour piercing weapons that can destroy enemy armour.

Evidence accumulated by some scientists since the Gulf war, where 10-times as much depleted uranium was used, has linked DU to birth defects in Iraq and long-term illnesses, including cancer. But none of the research has been conclusive. However, it is important to consider that either the use of, or storage of, chemical weapons by Iraqi forces in the region, as well as the oil fires caused by retreating Iraqi forces, could go some way to explaining the reported proliferation of cancers and other health conditions in southern Iraq.

In conclusion, I support the comments made by my noble friend Lord Burnham, especially on the subject of anthrax, as well as those made by my noble friend Lady Park. The same applies to the remarks made by the noble Lord, Lord Morris, particularly his point about pensions. The situation is nothing less than scandalous. As stated earlier, the Government's record has not been impressive in respect of improving the quality of life of veterans who are ill--if they wish to fulfil the debt of honour that they have acknowledged.

I am aware that these veterans have access to the full range of services available through the NHS or, if still serving, through the Defence Medical Services. In addition, the medical assessment programme has contributed to improving veterans' conditions in various practical ways. But can the Minister state what new action is being taken to improve the lot of these veterans? This country has always provided the necessary medical cover for our servicemen. That is a large contributory factor to the high morale that exists in our superbly well-trained Armed Forces today. It is critical that this high morale is sustained. It is our duty to ensure that no stone is left unturned to assist these veterans if our Armed Forces are to fight effectively to win wars.

Photo of Lord Bach Lord Bach Parliamentary Under-Secretary, Ministry of Defence, Parliamentary Under-Secretary (Ministry of Defence) (Procurement) 9:10, 17 October 2001

My Lords, I am very grateful to my noble friend Lord Morris of Manchester for, once again, providing us with an opportunity to debate the Government's approach to Gulf veterans' illnesses. My noble friend's active interest in the subject is well known, and I welcome his involvement. I am also grateful to all noble Lords who have taken part in tonight's debate.

As has been said, this is my introduction to debates on the subject. It is fitting that we should be talking about veterans at a time when our own servicemen and women are putting themselves at risk in another theatre of war with their usual bravery, as did those veterans of the Gulf war. As the noble Lord, Lord Vivian, has just said, this House is always the first to acknowledge the huge debt that we owe to our servicemen and women, whether in the present or in the past.

Having mentioned the noble Lord, Lord Vivian, perhaps I may welcome him to his new position on the Opposition Front Bench. He is a noble Lord with great experience, and great distinction, in the defence field. I very much look forward both to working with him and no doubt to disagreeing with him from time to time, though I suspect that that will not be very often. In the same breath, I should also like to thank the noble Lord, Lord Burnham, who served so well on the Opposition Front Bench for many years. He and I were, as it were, opposite each other for a very short period of time in the summer of this year. All Members of the House will recognise the fact that he behaved towards me, who was absolutely brand new to the Ministry of Defence, with sympathy, tolerance and good humour. We wish him the very best for the future.

Since our previous debate on the subject in January of this year, to which reference has been made, the Government have undertaken much work on Gulf veterans' illnesses issues generally, and specifically addressed the concerns of those Gulf veterans who are ill. In the limited time available to me, I shall attempt to highlight some important developments since January, and to touch upon work that the Government have in hand.

I want to make it quite clear at the beginning of my response that I shall not be able to answer the many proper questions that have been put to me this evening. However, I guarantee to write to noble Lords with the answers to their questions as soon as I am able to do so after the debate. I shall, of course, do my best to answer some of the questions raised.

As has also been said, on 14th March this year the Prime Minister announced the appointment of my honourable friend Dr Lewis Moonie as Minister for Veterans Affairs. This was an important development for all Armed Forces veterans, including Gulf veterans, as they now have for the first time a single ministerial focal point for any queries or problems that may arise as a result of their service. The appointment reflects the Government's determination that veterans' issues should be handled in a co-ordinated and joined-up way to ensure a properly integrated approach.

An interdepartmental veterans task force, supported by a veterans' forum, has been established to assist the Minister, and its first meeting will take place next month. The veterans' forum, including representatives of the veterans' groups, enables them to articulate to us their principal concerns. The first meeting was on 24th July and was a great success. We believe this will develop a close relationship with key veterans' organisations.

The veterans' plenary forum met for the first time yesterday. It was a very successful meeting, with more than 200 representatives from veterans' groups attending. Its importance was highlighted by the attendance not only of Dr Moonie but of my right honourable friend the Secretary of State--at a time when, as your Lordships will know, his time is extremely precious.

As part of this more integrated approach, the War Pensions Agency was transferred to the Ministry of Defence. I know that that has caused a little disquiet among some veterans. However, there is no question of the WPA losing its impartiality as it remains bound by the legislation that underpins the War Pensions Scheme. The agency's decisions in respect of individual cases will continue to be based on the case facts, the standard of proof required by law and contemporary medical understanding. Claimants for war pensions have, and will continue to have, a right of appeal to the independent Pensions Appeal Tribunal service, part of the department of my noble and learned friend the Lord Chancellor. The War Pensions Agency is working hard to reduce the amount of time it takes to consider claims.

Certain claims have been made in relation to compensation and certain questions have been asked in relation to costs. I think they are worthy of an attempt to answer. My noble friend Lord Morris asked about costs of the MoD. Details are not readily available. Learned counsel was consulted on 15th April 1997 and Treasury solicitors have provided ad hoc legal advice since, but costs are not readily available.

I want to make it absolutely clear that it is not the case that the Ministry of Defence or its legal advisers have ever made financial demands on claimants. If claimants' solicitors have sought additional funding for their clients, that has not followed demands from the ministry. Veterans should take this up with their solicitors, if they have concerns.

The noble Lord, Lord Clement-Jones, raised the issue of compensation, as he has in the past. I have to say--this would apply to any Minister standing at the Dispatch Box--that when compensation claims are submitted they are considered on the basis of whether or not the department involved, in this case the Ministry of Defence, has a legal liability to pay compensation. When there is a legal liability to pay, compensation is of course paid. To have any lesser standard, bearing in mind that this is taxpayers' money, would not be a sensible thing for any government.

We have made a concession to Gulf veterans by undertaking not to rely on the defence of limitation under the Limitation Act 1980 without giving solicitors prior notice. I tell the House that as of 30th September this year we had 1,890 active notices of intention to claim from veterans and members of their families in respect of illness allegedly arising from the Gulf conflict. However, the Ministry has yet to receive any writs or claims of sufficient detail.

The veterans' forum is but one way in which the Government keep in touch with veterans and their representatives. An updated information pack published in January of this year about the illnesses of Gulf veterans has been sent to all GPs in the United Kingdom as well as to those other interested parties, including health professionals and those in the Defence Medical Services. Over 48,000 copies have now been dispatched. The Ministry of Defence's Internet website is frequently updated and is an increasingly valuable way of making information public. Gulf Update, the newsletter produced by the Ministry of Defence's Gulf Veterans' Illnesses Unit, is published every six months and sent to several hundred veterans, parliamentarians and other interested parties. The veterans and others continue to contact the MoD via our freephone helplines and receive appropriate assistance. In addition, there is a considerable amount of correspondence.

Of course these issues are rightly much scrutinised by Parliament, both here and in another place. Some 70 parliamentary Questions have been tabled on the subject of Gulf veterans' illnesses and on depleted uranium since January. Noble Lords may recall that in May the Minister for veterans' affairs and the head of the Gulf Veterans' Illnesses Unit gave evidence on both topics to the House of Commons Defence Select Committee. Their evidence and a memorandum submitted to the committee by the Ministry of Defence have been published.

The Gulf veterans' medical assessment programme has been running now for many years and in that time has seen over 3,200 patients. Since January, over 150 patients have been seen. There was an increase in referrals earlier in the year which I believe was a reflection of the considerable media attention given to depleted uranium and because more health practitioners are now aware of the Gulf veterans' medical assessment programme rather than due to an increase in the numbers of veterans becoming ill. The annual underlying trend in referrals continues to decline.

Up to September, the results of an analysis of a satisfaction questionnaire showed that 96 per cent of medical assessment programme patients who responded were satisfied and 26 per cent added comments to express the extent of their satisfaction. However, we should not be complacent. A significant proportion of the medical assessment programme's patients live a long way from London and some find it difficult to travel. As a trial, since May a small number of patients are being seen at a clinic held approximately every two months and run by the head of the Gulf veterans' medical assessment programme in Northallerton, North Yorkshire. Patients are given exactly the same assessment as they would have received had they come to London and early indications are that this trial is a success.

On 29th June the MAP published a paper on its clinical findings of the second thousand service and ex-service patients to be examined. Of those examined, 80 per cent were well and 20 per cent were unwell. The authors of the paper defined those who were unwell as having an active disease or symptoms interfering with daily living. Of the 20 per cent who were unwell as defined, 70 per cent had psychiatric disorders. This demonstrates the importance of the psychiatric referral network that has been established. As noble Lords will know--I shall not go into detail now--the Government have identified mental illness as one of our three health priorities and have addressed it in the mental health national service framework. Much extra investment has been put into that for the next year.

Research into what all noble Lords would agree is the complicated issue of Gulf veterans' illnesses is continuing and further results of Ministry of Defence-funded research have become available in the past few months. I was surprised to hear criticism of the fact that research was taking place. Imagine the criticism there would be if research was not taking place. It is important, both for the veterans themselves and for the Ministry of Defence, that research is done properly and that time is taken on it so that the conclusions can be relied on.

On 12th April, a team from Manchester University published its results from a study looking at the ill health of Gulf veterans. It found that although Gulf veterans report greater severity of symptoms than those who were not deployed to the Gulf, the overall severity of their symptoms is not high. Those findings also suggest that vaccinations and the handling of pesticides might be a cause of certain patterns of ill health. Research in both areas is ongoing. The interaction works at the defence science and technology labs at Porton Down are working on organophosphate pesticides, sponsored by the Department for Environment, Food and Rural Affairs, work at Manchester Royal Infirmary and work at King's College, London.

In July last year, the University of Manchester team reported the results of their independent study into mortality among Gulf veterans. We have updated those figures every six months. Between 1st April 1991 and 30th June this year there were 496 deaths to Gulf veterans, compared with 494 in a comparison group who did not deploy to the Gulf. That means that there was essentially no difference in overall death rates between the Gulf veterans and the controls. Deaths due to external causes, particularly road traffic accidents, were slightly more common among Gulf veterans. We are researching that further.

A paper by a team at Guy's, King's and St Thomas' School of Medicine entitled Ten Years On; What do we know about Gulf War Syndrome? noted:

"No evidence has emerged to date of neither distinct biomedical abnormalities nor premature mortality", among Gulf veterans. The programme of research initiated by the Government to investigate the possible adverse health effects that might result from the combined administration of the nerve agent pre-treatment tablets and vaccines used during the conflict is also making progress. Such a thorough and complicated study takes time and final results are not expected until 2003.

Another government-funded study is examining the reproductive health of Gulf veterans and their partners and the health of their children. Results are expected to be published next year.

The Ministry of Defence has spent approximately £4.7 million on the studies described. It is estimated that they will cost another £1.5 million to complete. We continue to monitor research undertaken in the United States.

I am conscious that I am beyond my time, but I believe that the debate has not reached its conclusion, so I hope that noble Lords will bear with me, because depleted uranium has also been mentioned and I have a little to say about it. The possible health effects of depleted uranium-based ammunition are a cause for concern among veterans and their families as well as in the Ministry of Defence. In particular, a link has been suggested between exposure to depleted uranium and the illnesses being experienced by some Gulf veterans. As the noble Lord, Lord Vivian, said, the Government are taking urgent steps to put in place an appropriate voluntary screening programme. We have constituted an independent oversight board comprising eminent scientists and representatives of the veterans' organisations to take forward and oversee proposals recently published for public consultation. We emphasise that it is vital that the arrangements that are put in place are technically well founded and properly validated. We recognise that that process is taking some time.

The consultative processes and the independent oversight board are a clear demonstration of our intention to be open in developing plans for a screening programme. The oversight board met for the first time on 27th September.

On 22nd May, the Royal Society published a report on its independent review of the health hazards of depleted uranium-based ammunition. Its main thrust strongly supports our view of the radiological risks posed by DU on the battlefield, which is that its use in the Gulf and the Balkans has presented only an extremely low health hazard to UK forces.

Anthrax was also mentioned during the debate. I have little to say about it today except that in March the Ministry of Defence announced its intention to resume anthrax immunisation in April. On 21st May we resumed the voluntary immunisation programme for personnel deployed in operations to the Gulf, together with some specialist units. We shall offer anthrax immunisation as it has previously been offered to personnel on the basis of informed voluntary consent.

Of course, we hope that in the current crisis we shall have learned lessons from what happened 10 years ago. However, I do not believe that tonight noble Lords will expect me to go into detail about what specifically has and has not been done in the field of protecting our servicemen and women. The Ministry of Defence wants to be as open as possible with the House. I shall go as far as I can in letters to noble Lords with the details that they seek.

This debate has highlighted the concern for Gulf veterans. I was going to talk in some detail about the war pensions scheme. However, time is against me and, as not much mention was made of that subject during the course of the debate, I shall leave that part of my speech until another day.

The Government's position is that we are committed to dealing with Gulf veterans openly, honestly and fairly. We believe that we have made considerable progress since our previous debate. We shall continue to treat this matter as a high priority, and we are always ready to listen to suggestions for improvement. As I said, research on a broad range of topics is continuing into what is a difficult subject. Answers will not be found overnight.

In the meantime, in the consultation that we carry out we shall keep an open mind about the causes of the ill health that has been experienced. We shall continue to do what we can to assist veterans who are unwell and the families of those who, sadly, have died. We remain committed to addressing the health concerns of Gulf veterans. I conclude by again thanking noble Lords who have taken part in this short debate.

House adjourned at twenty-seven minutes before ten o'clock.