rose to ask Her Majesty's Government what consideration they have given to the Report of the Independent Public Inquiry on Gulf War Illnesses, conducted by the Lord Lloyd of Berwick.
My Lords, I am most grateful to all noble Lords who have joined me for this, as it were, finale before the Christmas adjournment. Clearly there must, and will, be other opportunities to consider the Lloyd report and at more length; but Peers who wanted to be here with us, had that been possible, well understood the timeliness now of a first look at the outcome of an inquiry born and bred in your Lordships' House.
I have interests to declare—not pecuniary—as Honorary Parliamentary Adviser to the Royal British Legion, as Vice-President of the War Widows Association, as a co-opted member of the United States Congressional Committee of Inquiry into Gulf War Illnesses, and as the instigator of the inquiry to whose groundbreaking report this debate calls attention.
I am much indebted to the noble and learned Lord, Lord Lloyd of Berwick, for accepting my suggestion that he should conduct the inquiry and most warmly congratulate him on a report of huge importance to thousands of men and women now in broken health—many of them terminally ill—who were prepared to give their lives in the service of this country and to the dependants of those who did so.
No one was more fitted or better qualified to conduct the inquiry than the noble and learned Lord, Lord Lloyd. Scrupulously fair and balanced in its judgment, his report's conclusions are presented with excelling clarity and a relentless and compelling logic. Its purpose is not to apportion blame but to end deadlock and, by unravelling truth, to let right be done.
Other distinguished lawyers describe the Lloyd report as a work of sustained forensic brilliance. By stricken veterans and the bereaved families, it is hailed as a triumph of social concern over official indifference: a treatise of transparent integrity and humanity.
The wide acclaim won by the report, both here and abroad—nowhere more than in the United States—reflects high credit on the legal profession in this country. As a lawyer himself, I am sure my noble friend Lord Bach will want to acknowledge today the extent of the noble and learned Lord's achievement.
For my part I also want to record deep appreciation of the invaluable contributions of Sir Michael Davies, known to and immensely respected by all of us here as former Clerk of the Parliaments, and of Dr Norman Jones, emeritus consultant physician at St Thomas's Hospital, who served the MoD with distinction in the period immediately following the conflict. Their unwavering commitment to the inquiry added powerfully to its impact.
Vijay Mehan too has my admiration for his crucially important administrative role. Without his dedication, as the report says, the inquiry could never have gone forward. I pay tribute also today to the Royal British Legion—notably Brigadier Ian Townsend, Colonel Terry English and Frances Hoy—for their abiding constancy in pressing the case for an inquiry. Without their commitment the inquiry would never have been conceived.
How then did it come about? It was at the Legion's 1997 annual conference that an independent public inquiry into Gulf War veterans' illnesses was first called for. The call was unanimously renewed year after year; but the Government, while stating that their mind was not closed to an inquiry, had repeatedly resisted one. Ministers remained unconvinced that it would help and time was not ripe. Only through research, they said, were the causes of Gulf War illnesses likely to be established. Yet 14 years on, veterans with medically unexplained illnesses were still locked in what the Legion described as "a long hard battle" to have them accepted as service-related. Of Gulf War widows, the Legion added:
"They would have been better treated had their husbands been in the US and not British armed forces".
They stated also that,
"science has not explained their illnesses", and concluded by requesting the Prime Minister to institute,
"a full public review of the position of veterans, to instigate a process of conciliation . . . and to make good by ex-gratia payments the deficiencies of the war pensions scheme".
Their letter prompted me to make one further, but unsuccessful, plea to the Prime Minister to institute an inquiry and then to consult widely on the possibility of finding a retired High Court judge to conduct an independent public inquiry.
In a public statement on
As the report says, the veterans now want above all else a clear recognition by the MoD that they are ill because they served in the Gulf. The noble and learned Lord, Lord Lloyd, finds them entitled to that recognition, for which he presents an unanswerable case.
The next question addressed by the inquiry concerned the nature of veterans' illnesses. In the years after the conflict, many veterans were told, both here and in the United States, that they were not physically ill. Their illnesses were "all in the mind". And it is now clear, says the report, that this was not so. A small proportion of veterans presented the classic symptoms of post traumatic stress disorder, but that could not account for the great majority of Gulf veterans' illnesses. Any doubt about that has since been removed by publication in the United States on
There was, then, something else causing these illnesses. The noble and learned Lord, Lord Lloyd, considered a range of possibilities. First, a multiple immunisation programme that included anthrax and plague vaccines and tablets that contained pyridostigmine bromide to protect against nerve agents. Some veterans received as many as 14 injections in two days. This, the report says, is the most likely explanation for the illnesses of personnel who were prepared for the Gulf, but never deployed. Secondly, there is the indiscriminate spraying of tents with organophosphate pesticides—the so-called sheep-dip effect. Thirdly, exposure to nerve gas, including sarin, from the demolitions by US forces of the Iraqi chemical arms depots at Khamisiyah. And fourthly, the inhalation of depleted uranium dust.
The most likely explanation, the report says, may be a combination of more than one cause against a background of stress, since at least some of the causes are thought to have a potentiating effect on each other. In these circumstances the inquiry found it unacceptable for the MoD to tell veterans,
"yes, you are ill, but since we do not know which of the possible causes has caused your particular illness, we are not going to admit that it is due to your service".
Research must go on, but that is not a reason for refusing to admit that veterans are ill because they served in the Gulf.
The inquiry's next question was what the illnesses should be called. Veterans have always used the term Gulf War syndrome. That is the name used by the mass media. But although the name is just a label, the MoD has been unable to accept it. It might be said that the word "syndrome" is medically incorrect. But the definition used by the inquiry is:
"A collection of symptoms and signs which tend to occur together, and form a characteristic pattern, but which may not necessarily always be due to the same pathological cause".
Thus, even if more than one cause is operative, there is no medical reason why the symptoms should not be described as a syndrome: and even if there were it is hard to see what the MoD has to lose by accepting the term the veterans prefer. The Lloyd report says:
"People who are ill like to have a name for their illnesses. Rather than tell a child that his father died of 'Symptoms and Signs of Ill Defined Conditions' [the label used by the MoD] it is surely better to tell him that he died of Gulf War Syndrome".
Are veterans satisfied with the way they have been treated by the MoD? The Lloyd inquiry's answer is "No". They feel "let down and rejected" in the words of the noble and gallant Lord, Lord Craig, to the inquiry.
Flight Lieutenant John Nichol, whose bravery under torture in Iraq was seen by television viewers across the world, told the inquiry:
"The MoD says it has spent £8.5m on research since 1997. That's about £1.2m a year.
Compare that with the nearly £8m a year the MoD spent on entertainment. That's £8.5m in seven years on research to save dying veterans and £8m in one year on entertainment".
"We weren't the enemy, but that is exactly how Gulf veterans have been made to feel by the MoD".
It is tragic that John Nichol is made to feel so embittered. The report also quotes the House of Commons Defence Committee's comment on delays in commissioning epidemiological research that the MoD had been,
"quick to deny but slow to investigate . . . reactive rather than proactive and characterised by scepticism, defensiveness and general torpor".
On organophosphate pesticides the Commons' committee found:
"a culture of resistance that pervades much of the MoD . . . a deep-seated reluctance to respond positively to external stimuli . . . and a blithe assumption that everyone else is wrong".
The inquiry noted too the bitter complaints of many veterans about the MoD's failure to take any part in its proceedings. Paul Tyler MP told the inquiry that it was extremely important for a Minister to appear. He said:
"The symbolism would be very powerful indeed in restoring some confidence".
But no Minister appeared and a valuable opportunity was lost that would have cost the MoD nothing.
The Lloyd inquiry asked the department to pay heed in particular to the view of the noble and gallant Lord, Lord Craig, that the absence of closure after so many years is now indefensible.
The noble and learned Lord, Lord Lloyd, came last to the question of compensation. This did not figure largely in the evidence of veterans themselves. However, it did in the evidence of the noble and gallant Lord, Lord Craig, Major General Peter Craig, and Michael Mates MP, a former defence Minister, among others.
The report's four recommendations call, first, for the MoD to acknowledge publicly that veterans with war pensions or lump-sum payments are indeed suffering injury or disease related to their service in the Gulf; secondly, to fund ex gratia payments on a pro-rata basis to all veterans who had made successful claims; thirdly, to arrange for claimants who had their claims rejected to have them reviewed; and, fourthly, for the illnesses to be called Gulf War syndrome.
Ministerial comments on the report give the strong impression that those making them have not read even its opening paragraphs. They appear to be derived from what officials and others have told them it says. The only alternative to the assumption is that they have knowingly and wilfully misrepresented the inquiry. One reads that the Lloyd inquiry ignored much of the written evidence provided by the MoD, but in fact most of it was already well known to members of the inquiry even before being copied to them. Indeed it was all, or almost all, publicly available on the department's website.
My Lords, the noble Lord is very well informed on this subject, but he is now trespassing into the time of other noble Lords who wish to speak in this debate.
My Lords, I was approached earlier by one of our colleagues, who is here now, to say that it was understood that, since I was opening the debate, there could be some flexibility. Nevertheless, I am near to concluding.
My Lords, I am grateful to the noble Baroness, Lady Park and my noble friend Lady Andrews. Almost all of the MoD's written evidence was publicly available on the department's website, from which it was simply downloaded and dressed up as new and substantive evidence on scientific and other issues. It was, of course, already woefully outdated by extremely important and new evidence from the United States, in particular the findings on
The MoD has yet to respond in any way either to the GAO's report or to that of the research advisory committee, notwithstanding their profound importance to thousands of British servicemen and servicewomen. Notwithstanding ministerial undertakings to inform Parliament of the outcome of Porton Down's work on the safety or otherwise of the multiple immunisation programme, and to update us by this month on the effects for British troops of the fallout from the explosions at Khamisiyah, no more has yet been said. So much for the inquiry having ignored new and substantive evidence and the MoD's claim to "political transparency".
General Sir Peter de la Billiere, who commanded our forces in the first Gulf conflict, joined noble Lords recently in recalling that, speaking in this House after Blenheim, the Duke of Marlborough said—
My Lords, the Duke of Marlborough said that the best way to mark that great victory was to do right by the soldiers who fought so bravely with him. The Lloyd report, as has been said, is in that proud tradition, and I honour the noble and learned Lord and all who worked with him to make it happen.
My Lords, I have had the honour to support the noble Lord, Lord Morris of Manchester, in the British Legion's fight for the needs of the Gulf War veterans since 1996—eight years, in which a dwindling number of men and women have grown more ill while they waited for recognition that their seriously impaired health has been due to the effects of their service in the first Gulf War, in 1991. They were then given multiple injections and vaccines, despite the fact that the Department of Health, it later proved, had warned against possible adverse reactions from such a cocktail but had been ignored.
The then government admitted that. They also admitted, in 1997, that thanks to administrative errors in the Ministry of Defence, medical records had been lost when data were transferred from one computer to another. Of those, a number were known to be related to Gulf War veterans. When the veterans tried to gain access to those records, at least one was told, "Certain injections and medication administered during the Gulf War campaign were classified secret". So the Army medical directorate itself had to tell veterans that, in view of the classification, it had no access to those records and was not authorised to possess the information.
The Defence Committee noted also that, despite a series of denials to the noble Countess, Lady Mar, in this House, organophosphates and pesticides had been used in the Gulf and could be a factor to be considered. A briefing note (No. 3) in June 1993 stated categorically:
"A wide range of OP compounds had been extensively used by British personnel during Operation Granby".
I am going over that familiar ground because this is only one—only too typical—instance of what the Defence Select Committee called "the culture of resistance" in the MoD.
That has led the ministry, sadly, throughout the past 12 years—of course, the virtual destruction of the Defence Medical Services by the previous government did not help—to insist that no executive decision can be taken until an ever-lengthening series of research projects has been carried out. That has been demonstrated in the list of MoD-generated papers in the appendix to this admirable and extensive report. Nothing, it seems, can be done until the research has been completed. In the mean time, men sicken and die or become more ill, while, as the Defence Select Committee said, the MoD has alas been quick to deny, slow to investigate and reactive rather than proactive.
The only thing that can break this logjam—I beg the Minister to hear this—is for Ministers to take an executive decision to act on what is known before it is too late. There have been promises—many promises. In 1997, the Prime Minister said in the run-up to the election that there would be a public inquiry. The new Minister promised action and a new beginning. What happened? There followed the creation of the Veterans Agency, subsuming the War Pensions Agency into the MoD, the creation of the Gulf Veterans Illness Unit and a newsletter.
As is not unusual, the Government's idea of action was to create organs of government. They appear not to know how to respond, at least in this instance, in practical human terms, nor have they shown any understanding of the personal factor; that is, the need of the veterans that the justice of their case should be acknowledged. The presence of the Minister or at least a senior MoD official at the inquiry, even as an observer, would have sent a significant message. But, of course, the Government did not want to send one.
It is amazing that the MoD still says that it does not rule out an official inquiry, but remains of the view that the only way to establish the cause of ill health in some Gulf veterans is through scientific and medical research. Annex D of the report before us lists 10 pages of the many reports and research projects undertaken from 1994 to 2004. Some are presumably still continuing. There is no doubt that Ministers take a continuing interest in this issue and have had benevolent intentions. Alas, however, there has been no will to act in the one practical way that would matter.
However, the present admirable, independent and exhaustive report must surely be accepted and should make it unnecessary for an official inquiry that is at present contemplated only in the far distant future, if ever, to be carried out. The latest US report must equally provide a conclusive assessment of the justice and well founded nature of the Gulf veterans' claims, based on extensive research. The US, after all, funded at least one of the MoD inquiries in the UK. In the US, as here, there was initial scepticism and a view that "it was all in their minds". That attitude, it seems, has changed.
I have taken part in no less than eight full debates on this issue, starting in 1996, and there were at least two major Defence Select Committee reports in the other place. Throughout that time, I am sad to say that the ministry has taken refuge in setting up yet more research projects while denying veterans access to their records—where they still existed—which they needed to fight their case. Perhaps I may urge the Minister to fulfil the promise of action given in 1997—a promise which I believe was given in good faith—and to take heed of the wise words of the two US Congressmen quoted in the report.
In the US, too, there has been indifference, bureaucratic inertia and whitewash. But, as one Congressman said,
"We understand the loss of an arm, but not the total debilitation of Gulf War illness. Because we did not understand, that does not mean we should not compensate them".
After 14 years, it was time, he thought, to reach finality. The Americans have looked at 100,000 veterans with symptoms of Gulf War illness. They have carried out extensive research, some of it in conjunction with the UK. The MoD has always claimed to be closely associated with and informed about the US research. I hope therefore that it will now accept the US assessment and act without further delay to meet the needs of the veterans. As long ago as 1994, under the previous government, the Defence Select Committee at that time could not help contrasting the attitude of the MoD with that of the US Government.
The services are under great pressure today with too many demands chasing too few soldiers. How the Government behave in the light of this inquiry will send a critically important signal to those now serving and to those who might think of doing so. No government can afford to be seen to be unable or unwilling to act in the face of the evidence provided both by the present inquiry and the forthcoming US report, nor can they afford to be seen to be careless of the well-being of soldiers.
Incidentally, I should like to be assured that the change in the burden of truth criteria which was pushed through in the Armed Forces (Pensions and Compensation) Bill will not be applied retrospectively or in any way against the interests of the Gulf War veterans.
The Government and the Ministry of Defence have never denied that a number of British veterans from the 1990–91 Gulf War have suffered from serious illnesses as a result of their service during Operation Granby. The Minister, my noble friend Lord Bach, himself said in a letter published in the summer of 2001 that the MoD had,
"no doubt that a number of veterans are, or have been, ill as a result of service in the Gulf".
"This Government has always accepted that some veterans of the 1990–91 Gulf conflict have become ill and that some of this ill-health is related to their Gulf experience".
Acknowledged health issues, recognised by the Government, include a variety of debilitating health problems, including chronic fatigue, muscle pain and wasting, asthma, arthritis, skin, memory and gastrointestinal problems. Obviously, the MoD and the Government have an obligation to provide medical and financial support to all those affected.
I welcome the fact that Her Majesty's Government are currently spending some £8.5 million on researching the scientific background to the illnesses suffered by the Gulf War veterans. Nevertheless, I must admit to having some severe reservations about the report of the noble and learned Lord, Lord Lloyd of Berwick. He has, of course, had a very distinguished legal career, but I feel obliged to raise a number of issues which I regard as flaws in the report. I regret that the noble and learned Lord is not in his place today in order to respond in person.
Despite frequent requests from Ministers, repeated in the letters set out in the appendices to the report, we are still no nearer to discovering who funded the inquiry. It is disingenuous to call upon the MoD to be more transparent when the backers of this report are unwilling to be so themselves.
Is there foreign involvement or a possible conflict of interest? I understand that the report cost around £60,000 to produce. Your Lordships deserve to know the facts if we are to give this report due weight. I wonder whether in due course my noble friend Lord Morris of Manchester could shed light on these points. I also believe that the report plays fast and loose with some of the facts.
My Lords, I am obliged to my noble friend and I rise to respond to his question. I understand that the final cost of the Lloyd inquiry was less than £60,000 compared with the £1.68 million spent on the Hutton inquiry, and the £130 million on the Savile inquiry into the Bloody Sunday shootings. The noble and learned Lord, Lord Lloyd, received no money from either side of the controversy, indeed no money from anyone for the arduous work he performed.
I recommend that my noble friend should look urgently—before the end of the debate, if possible—at paragraph 3 of the report of the noble and learned Lord, Lord Lloyd. He will see there a very clear statement.
My Lords, I am obliged to my noble friend for that response, and of course I am not impugning in any way the integrity of the noble and learned Lord, Lord Lloyd. I simply want to say that I would be grateful if the actual funders were named. They are not named in the report, although reference is made to a charitable trust and a couple of donations.
I return to the text of the report, which repeatedly refers to 6,000 veterans suffering from ill health due to their service in the first Gulf War. But, as the MoD makes clear, many of those thousands of claims for disablements and illnesses are unrelated to service in the Gulf War.
The number of Gulf 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 War. Only some 100 claimants have failed to receive an award for Gulf-related illnesses, not the 272 stated in the report. Of the latter, more than half related to diagnosed disorders such as traumatic physical injuries, lower back pain or coronary disease. The Minister for Veterans has already pledged to review the rejected cases linked to Gulf illnesses.
Of the 53,500 personnel who served in the first Gulf War, only 35 veterans, or a sample of 0.06 per cent, provided evidence to the tribunal presided over by the noble and learned Lord, Lord Lloyd. Surprisingly, the report ignores the fact that mortality from all causes among the Gulf veterans (663) is consistent with the comparable group of service personnel with the same age and gender profile who did not deploy to the Gulf (675) and is significantly lower than would be found in the UK's general population (1,032).
The report provides no new evidence to support its claims and fails to appreciate that research and three scientific surveys, both in the UK and the US, have failed to implicate multiple vaccines, neurotoxins or depleted uranium as a cause of ill-health among Gulf veterans.
On page 55 the report states:
"We agree that on this question, even after fourteen years, the jury is still out".
It recognises that some veterans are suffering from post-traumatic stress disorder.
The report's argument to recognise Gulf War illnesses as "Gulf War Syndrome" is, to my mind, puzzling. It quotes a definition of a "syndrome", which appears unique—a point mentioned by my noble friend Lord Morris—as,
"A collection of symptoms and signs which tend to occur together, and form a characteristic pattern, which may not necessarily always be due to the same pathological cause".
The Oxford Concise English Dictionary defines a "syndrome" as,
"A group of concurrent symptoms of a disease".
Which disease is the one that has been identified?
The British Medical Association's Complete Family Health Encyclopaedia—which I confess to having on my bookshelf—defines a "syndrome" as,
"A group of symptoms and/or signs that, occurring together, constitutes a particular disorder".
The contention of the noble and learned Lord, Lord Lloyd, that the MoD should simply adopt a term which the veterans prefer, even if it makes no sense and lacks any precision, seems extraordinary. The report states that,
"People who are ill like to have a name for their illnesses"— but I think people prefer to have the right name and diagnosis.
Perhaps I may quote a few medical and scientific experts. The London School of Hygiene and Tropical Medicine published its study of 40,000 former Gulf soldiers last July—a trifle more than the 35 who participated in the report before us—and concluded that the soldiers were more likely to report symptoms, but that similar symptoms were reported by both those who served in the Gulf and those who did not. The pattern of both groups was thus the same, suggesting that the former group was not exposed to a range of influences significantly different from the latter.
As Major-General Craig wrote in the Times on
As to depleted uranium, Professor Brian Spratt, chairman of the Royal Society working group on DU munitions, said that the exposure would have been "too low" in the Gulf to cause serious health problems. And Professor Mark Peakman, from Guy's, King's and St Thomas's School of Medicine, who has carried out research on the effect of vaccines, said that he did not believe the multiple vaccines administered were to blame either. However, he has admitted that the theory that vaccines and chemicals interacted in some way "still lurks".
A case also exists for further research into the use of organophosphorus pesticides during the Gulf conflict.
It would not, to my mind, be fair to give ex gratia payments to all Gulf veterans while ignoring those who have served and suffered in other conflicts.
Regrettably, I think the noble and learned Lord's report has even muddied the waters and confused vital issues. There is no simple ready answer to the illnesses and suffering of those brave men and women who served this country during the Gulf War. But I hope that the Ministry of Defence and the Government will never forget their solemn obligation to support the Gulf War veterans and their families and will continue to investigate thoroughly the causes of any illnesses resulting from their remarkable service to the people of the United Kingdom.
It is becoming slightly embarrassing for me to have to acknowledge that I worked in that Kremlin-like establishment, the Ministry of Defence, in the past. There is a real paradox between the ethos of the MoD and the individual armed services. In the Army, Navy and Air Force we are trained to look after our people in both peace and war. The duty of care extends from the top to the bottom. The fierceness of the recent debates about regiments reflects the centuries of loyalty, both of the soldiers to the regiment and the regiment to the soldiers. We have such good Armed Forces because they know that they can rely on their comrades and their leadership.
Yet what have we seen from the Ministry of Defence in recent times? Whether justly or not, its reputation is one of cover-up, lack of transparency and unwillingness to support the troops when they are in distress. In my short time in your Lordships' House, I have heard the Government Front Bench stonewall over the need for a public inquiry into the allegations of abuse at Deepcut and I have been involved while the Government legislated to change the balance of evidence needed to prove service disability. The Government have been introducing redundancy and cutbacks just as our Armed Forces are involved in global operations.
We all know that grieving families report time and time again the difficulties of getting information out of the Ministry of Defence. The Ministry of Defence still ignores the recommendations of your Lordships' Select Committee over the tragic accident to the Chinook that crashed into the Mull of Kintyre. As the noble Baroness, Lady Park of Monmouth, said, this is not good for recruiting, retention or the morale of our Armed Forces. They need to know that when we send them off to dangerous, but vital, tasks, we will give them every help before, during and after each operation. This includes a duty of care in terms of protection, be it body armour or, as we are talking about in today's debate, vaccination and protection from harmful chemical or biological agents.
Those of us who have been subjected to military inoculations understand that mistakes might very well occur in the desire to protect against every possibility, particularly when things are done at short notice. During operations, the implications of exposure to other agents, be they pesticides, atmospheric pollutants or hostile warfare substances, may not be fully appreciated at the time. All this is completely understandable. What is not understandable is the unwillingness of the Ministry of Defence subsequently to be as helpful as possible, to use every means to find causes and to reassure its people in the services and their families.
In looking at illness caused by service in the first Gulf War, the Defence Select Committee, which has already been alluded to by a number of noble Lords, reported in 1995 that:
"In responding to allegations of a Gulf War Syndrome MoD has been quick to deny but slow to investigate".
It went on to say that:
"MoD's response has been reactive rather than proactive and characterised throughout by scepticism, defensiveness and general torpor".
Nine years after that report, and 14 years after the event, the MoD refused to take part in the independent public inquiry under the noble and learned Lord, Lord Lloyd of Berwick. I shall not spend much time on the reading of the MoD's briefing by the noble Lord, Lord Truscott. I totally reject what he said. It was a very good report.
In that report, if one looks at the medical annexes, there is a catalogue of the continuing feelings of resentment of the people involved towards the MoD for its mishandling of this sensitive issue. The inquiry gives simple answers to the questions that have caused so much distress to so many veterans and their families. It confirms that those who are receiving war pensions and gratuities are ill and that their illness was caused by service in the Gulf. It identifies the likely causes and confirms that the illness is rightly described as a syndrome—Gulf War syndrome, in fact. Other countries have had similar problems. Most importantly, the report states that our sick veterans remain unsatisfied with their treatment.
Paragraph 283 of the Lloyd report gives four simple recommendations that the authors believe could go far to restore trust and confidence. These are that the MoD should acknowledge that it was service in the Gulf that caused the illness; that Gulf War syndrome is an appropriate description; that a fund for ex gratia payments should be set up; and, finally, that the 272 rejected claims should be reviewed. There are just four recommendations.
I do not doubt that today the Minister will again give us an unhelpful reply. Those who believe they are suffering from Gulf War syndrome will continue to feel aggrieved. The reputation of the MoD as a good employer will continue to go downhill. Perhaps, more importantly, we will remain further away from an objective truth about the undoubted illnesses that many of our veterans suffer.
Will the Minister explain what cause is served by this intransigence? If we have damaged our servicemen, even while trying to protect them, we must ensure that we recognise that and, if necessary, compensate them. I hope that it is not about financial compensation. The report evaluates that and shows that the amounts we are talking about are trivial in terms of the defence budget.
Finally, given the ever-worsening image of the Ministry of Defence, will the Minister undertake to consult his colleagues more widely about promoting a new culture of openness and public awareness in the department? Perhaps the culture of secrecy, which is understandable on operational security matters, has become too extended into personnel issues. The MoD needs to take a more enlightened view of its responsibilities for its people.
My Lords, I, too, congratulate my noble friend Lord Morris of Manchester on securing this debate, on all the hard work he has done over the years for Gulf War syndrome sufferers, and on ensuring that this report was produced. I also commend the noble and learned Lord, Lord Lloyd of Berwick, and his colleagues, Dr Norman Jones and Sir Michael Davies for producing the report. I believe that it is a very good summary of what is, to many, a very confusing picture. It has made a very good contribution to delineating what is fact and what is opinion. Teasing through this thicket of fact and fiction has been no easy task.
It is hard not to be moved by the suffering described by the many Gulf War veterans who gave evidence to the inquiry. There is no doubt that they have been, and are, ill, and some are very ill indeed. The question which had to be answered was whether this undoubted illness was due to their having been in the Gulf in 1991. The answer to that specific question is yes, at least for many.
The evidence for that is now pretty clear and has emerged from a number of studies. Perhaps the most convincing of those, at least to me, is that of Professor Simon Wessely at King's College, who published his work in the British Medical Journal in December 2003. He studied a very large group of several thousand Gulf War veterans and compared them with a very strictly controlled group of war veterans who had been in Bosnia. They were well matched in every way, and he showed quite clearly that ill health of one sort of another, whatever that was, occurred twice as commonly in the Gulf veterans than in the Bosnian veterans. That figure of twice the number of subjects with symptoms was confirmed by Professor Nicola Cherry in another well controlled study.
It is also of some interest, and perhaps part of the problem, that the types of symptoms and illnesses suffered were very similar in the two groups. Veterans got them twice as often if they had been in the Gulf than if they had been in Bosnia.
That similarity of symptoms makes it very difficult to ascribe any single individual's particular case to the Gulf, since the same symptoms may occur in any veteran and, indeed, in the general public. That is why it has been so important to carry out these types of carefully controlled epidemiological studies—to nail down the fact that there was indeed something more going on in the Gulf. In the absence of any more specific symptoms or tests, we do not have much else to go on.
There is one set of statistics to which the noble Lord, Lord Truscott, referred, which is reassuring, at least so far. There do not seem to have been any more veterans dying in the 13 years since the Gulf War than veterans of other wars, and considerably fewer than in an age and sex-matched control group from the general population. If it is any compensation—although possibly not much—it seems that veterans of any conflict can look forward to living longer than the rest of us.
Once we get beyond the fact that something different was indeed going on in the Gulf which contributed to subsequent ill health, we are in the realms of increasing uncertainty. For example, although a number of researchers have made valiant efforts to demonstrate specific defects in the brain, the nerves or the blood, these can be regarded only as interesting but unproven. More research is needed to see whether they are real. This area of research is bedevilled by methodological problems and it is easy to get misled by enthusiasm.
Furthermore, there is a long list of potential culprits which might have caused the illnesses. My current favourite is the multiple vaccines they were given, perhaps with the pyridostigmine in the NAPS they took. Others no doubt will have their own favourite culprit. However, the point is that in the absence of stronger evidence than we have at present, we may argue until the cows come home about what might have caused it. Yet, meanwhile, we must face the fact that whatever the cause or causes, the set of symptoms which make up the Gulf War syndrome exist and patients suffer.
Of course more research is necessary if we are to avoid the same mistakes in the future, but meanwhile, and despite the difficulties in making a clear-cut definitive diagnosis, these veterans who are suffering should receive some compensation. I hope that my noble friend the Minister will recognise that not to do so now will increasingly be seen as not only unwarranted but uncaring, especially at a time when we have cause to be particularly grateful to our troops in the field.
My Lords, I congratulate the noble Lord, Lord Morris of Manchester, on initiating the debate. It is probably the sixth such debate in which I have taken part since being in this House. I also congratulate him on being the only begetter of the Lloyd inquiry. As a result of that inquiry, the issues are now much clearer and they provide a better basis for debate.
On previous occasions, I have described the MoD's responses as bizarre. As is clear from the responses that have been given during the past few weeks, they need to be described as bloody-minded. The response of the Ministry of Defence and the Minister for Veterans, Ivor Caplin, to the Lloyd report was in three parts. First, they attacked the funding of the report. Secondly, they stated that it revealed no new,
"substantive scientific evidence to support its conclusions and recommendations".
Thirdly, they said that it failed to take into account the substantive or scientific written material provided by the MoD.
The response on funding has all the hallmarks of the tactics employed by the Alastair Campbell school of political warfare—when in the wrong, create a diversion. Throughout the inquiry as it is, the Minister for Veterans and the MoD adopted a grudging tone of voice. Look at the letters at the back of the inquiry report, particularly those on funding.
This casting doubt on the funding was pretty rich coming from a Minister who had failed to fund or indeed to set up an inquiry himself. What hidden conflict of interest might there be—and I notice that the noble Lord, Lord Truscott, adopted virtually identical language to that adopted by the Minister for Veterans—which would invalidate the conclusions of the report? In what circumstances would the source of funding—
My Lords, I said that the noble Lord adopted virtually identical language. I am sure that it could well have been taken from the parliamentary reports of what the Minister for Veterans had to say. I give the noble Lord the full benefit of the doubt in the circumstances, depressing though it may be.
In what circumstances would the source of funding make a difference to the report's conclusions? I leave it to the Minister to reply. One can conclude only that it was a tactic designed to hide ministerial embarrassment over the quality of the report.
The Government's response that the inquiry produced no new evidence is also spurious. The fact is that the role of inquiries such as this is often to put together existing evidence, assess it and reach conclusions—a task which the inquiry has done well.
The Minister and the MoD throughout refused to take part in the inquiry on the grounds that they did not accept that it was necessary to restore confidence among servicemen and women in the MoD. It is clear the Royal British Legion and many MPs will and have testified to the contrary, as my noble friend Lord Garden has made clear as an ex-serviceman. Many would go further and say that the MoD's refusal to settle the issue satisfactorily has had and will continue to have an adverse effect on service recruitment and retention—a point made by the noble Baroness, Lady Park.
The key question that the inquiry had before it—an inquiry that had an extremely distinguished panel—is whether the ill health and mortality of Gulf veterans is unusual and is related to service in the Gulf. The evidence of Professor Simon Wessely and Professor Nicola Cherry, referred to by the noble Lord, Lord Turnberg, who, after all, should know his onions in the medical field, was absolutely crucial. Both believe that the interaction of vaccines was the key issue. Professor Wessely was quoted as saying:
"There is a big Gulf War health effect".
Professor Cherry is quoted as saying:
"I will go to my deathbed swearing that there is a problem amongst this group of people".
There are four or five strong possible causes, to which the noble Lord, Lord Turnberg, referred, either in combination or singly, for the illness of Gulf veterans: multiple vaccines, organophosphates, exposure to nerve gas and depleted uranium dust. Professor Malcolm Hooper as a result asked why we insisted on a single cause when multiple factors are at work. Indeed, the conclusions of the congressional research advisory committee were very similar. It said that a substantial proportion of Gulf War veterans are ill with multi-symptom conditions not explained by wartime stress or psychiatric illness. In parenthesis, I should say that in general the United States authorities are demonstrating themselves to be considerably more sympathetic than the Ministry of Defence here.
As the precise cause has not yet been identified, the Ministry of Defence has not been prepared to admit any responsibility. Nor is it prepared to admit, even after 14 years, the use of the term "Gulf War syndrome". The time is never right for a public inquiry; instead, we are offered endless research—to what purpose becomes less and less clear over time. However, as the noble and learned Lord, Lord Lloyd, points out, if the MoD is prepared to use the label SSIDC, which stands for symptoms and signs of ill-defined conditions, why on earth is it not prepared to use the term "Gulf War syndrome"? They are both umbrella terms to cover multiple causes. It is typical of the illogical approach adopted by the MoD.
Then there is the key recommendation of the inquiry. There are now a finite number of veterans in receipt of war pensions, whose illnesses are the result of one or more causes resulting from the first Gulf War. The report recommends that the MoD should accept, effectively, that that is Gulf War syndrome, settle with the claimants and make appropriate ex gratia payments. At present, the MoD is demonstrating nil magnanimity and nil imagination. As the noble and gallant Lord, Lord Craig, said to the inquiry in evidence, absence of closure is indefensible. Never did an ex-serviceman speak a truer word.
My Lords, I start by declaring an interest as honorary president of the Earl Haig branch and the Kent County branch of the Royal British Legion. I am also a trustee of the Astor of Hever Trust, which has given charitable donations to the Royal British Legion over many years. I make no apology in paying tribute to the Royal British Legion for its hard work on this issue over many years.
We are indebted to the noble Lord, Lord Morris of Manchester, for the opportunity to debate this report. He has indefatigably championed the cause of ex-service people, as the parliamentary adviser to the Royal British Legion over many years. It was the noble Lord who succeeded in obtaining the services of the noble and learned Lord, Lord Lloyd of Berwick, and his colleagues to hold this inquiry. It would be difficult to have found a more competent and reliable panel to conduct the inquiry. I would also like to add my thanks to the noble and learned Lord, Lord Lloyd, and his inquiry panel for producing such a balanced and coherent report and recommendations.
We on these Benches recognise that this issue has been difficult for the MoD to cope with given that there has been no definite medical evidence upon which to establish a pattern of illness arising from the Gulf War. The report's recommendations now provide the Government with a unique opportunity to close this long-running chapter in the lives of many who have suffered after serving in the Gulf during the period 1990–91. There has been cross-party support for the report.
It is critical to relieve the burden of veterans and their families. This group of people have been ignored by the MoD and this report is a considered and convincing case for recognition.
The report proposes the setting up of a fund to compensate, by way of proportionate ex gratia payment, those who still suffer. This would show that the Government recognise the personal cost that these individuals and their families have paid in serving the Crown. This is surely not too much to ask of the Minister for Veterans whose duty is to support veterans in need. As the noble and learned Lord, Lord Lloyd, says in his recommendations:
"It seems to us that with the termination of any legal proceedings against the MoD, and with the results of the three epidemiological surveys to hand, now is the time to reach agreement with the veterans".
We welcome the Minister's agreement to review the cases of 114 applicants whose claims for war pensions have been rejected. But the acceptance of the label of Gulf War syndrome is critical to move this impasse forward. Gulf War syndrome, already recognised—as the noble Lord, Lord Morris, noted—by the war pensions tribunals, will not only allow financial recompense to be paid but, equally important, will allow general practitioners and others to recognise and treat the symptoms individual sufferers are displaying without further delay.
I look forward to the Minister's response and hearing whether the Government will implement the four recommendations that the noble Lord, Lord Garden, mentioned. That would not only meet the immediate needs of the veterans themselves and their dependants but also restore trust. I need not remind noble Lords that members of the Armed Forces enter into an unconditional contract on joining which can entail them losing their lives in the service of this country. The Lloyd report has attracted support from the media and at all levels of society. It is vital that those who are already familiar with its contents encourage others to read it so that they better understand the arguments.
Since its publication there have been a number of letters published in national newspapers calling for the implementation of the report's recommendations, not least one signed by the noble Lord, Lord Morris, and the noble and gallant Lords, Lord Bramall and Lord Craig, both former Chiefs of the Defence Staff, and General Sir Peter de la Billière. In another place, Early Day Motion 81 has already attracted 93 signatures.
The recommendations of the inquiry offer the chance to break the longstanding deadlock over Gulf War illnesses.
My Lords, first I commend my noble friend Lord Morris of Manchester on securing this debate—I am not sure that I commend him on securing it on this particular day so close to Christmas—and, much more importantly, on his huge commitment to the issue which we are discussing today but, more widely than that, on his commitment to the whole issue of disability both in the Armed Forces and outside. The whole House admires him for what he has done. That is not to say that he and I do not fall out from time to time, but that is certainly done on my side with enormous respect.
The Government have always given the concerns of 1990–91 Gulf veterans the highest priority. This important and highly complex issue will continue to receive the close attention that it deserves. We are well aware of the interest shown by veterans and parliamentarians in the independent investigation by the noble and learned Lord, Lord Lloyd, but before I respond on the points raised about the conclusions and recommendations of the investigation, I will briefly remind the House of the Government's approach to Gulf veterans' illnesses issues.
Over 53,000 UK Armed Forces personnel deployed to the Gulf in 1990–91; and a minority are ill. We all want to know why that is. The fact is, however, that there is no medical or scientific consensus on the cause or causes of ill health among some Gulf veterans. I remind the House of the key facts relating to Gulf veterans' mortality. The latest statistics show that overall there have been 663 deaths compared to 675 in a comparison group who did not deploy to the Gulf. That is also significantly lower than would be expected for the UK general population as a whole; namely, 1,032.
In July 1997, within four months of coming to power, we published a policy statement, Gulf Veterans' Illnesses: A New Beginning, which set out how we proposed to address veterans' health concerns. Many of the commitments that we made in that document have been fulfilled, although you would not believe it listening to some of the extravagant speeches made in this House this afternoon. That policy statement continues to underpin our activities. It makes clear that first, all Gulf veterans will have prompt access to medical advice from the Gulf Veterans' Medical Assessment Programme; secondly, that there will be appropriate research into veterans' illnesses and factors that might have a bearing on these; and thirdly, that the Ministry of Defence will make available to the public information that it possesses which is of potential relevance. I will say something about each of these three areas.
The Gulf Veterans' Medical Assessment Programme has been running since 1993, under the previous government and this Government. I pay tribute to the measured way in which the noble Lord, Lord Astor of Hever, spoke in this debate, as is usually the case. It contrasted with the tone taken by some other noble Lords. The programme has seen over 3,400 patients since 1993, some more than once. We remain committed to the long-standing arrangement that war pensioners should be given priority in NHS hospitals for examination or treatment relating to their pensioned disablement, subject always to the needs of overall medical priorities.
Secondly, there is scientific evidence that 1990–91 Gulf veterans report more ill health than other comparable groups, but that the pattern of this 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 reminding the House that specific diseases, disorders, or medical conditions and medical 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 or distinct pattern of symptoms or signs.
The consensus of the international scientific and medical community, which seems to be dismissed airily by some speakers, following extensive research on the matter, is that there is insufficient evidence to enable this ill health to be characterised as a unique Gulf-related illness or syndrome. Our approach must be guided by the scientific and medical evidence, which is of importance here, rather than being something that can just be dismissed. 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, the tenth edition of the World Health Organisation's International Classification of Diseases. The Government cannot therefore accept the Lloyd recommendation that we should use the term as a matter of convenience.
Of course, 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 which can be accepted as caused or made worse by service. I can tell the noble Baroness, Lady Park, that the new scheme will not affect the right of veterans of the first Gulf War.
At the end of September 2004, about 2,800 Gulf veterans were in receipt of a war disablement pension. At that date, 2,290 veterans had received a gratuity for disablement assessed at under 20 per cent. There will be some overlap between those figures, as some individuals will have received first a gratuity and then a pension. The figures include awards for both Gulf-related and non-Gulf-related injuries or illnesses, as our statistics do not enable us to distinguish the origin of the disablement.
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 the recommendation of the noble and learned Lord, Lord Lloyd, to single out one group of veterans for preferential treatment by way of an ex gratia payment on top of the pensions that they already get.
Of course we want to find out why some veterans from the Gulf conflict are ill; our current research programme 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 the review, including recommendations for future research, were published last year. The third strand of our approach is openness. We have made an enormous amount of information public in response to inquiries from veterans, and continue to do so.
I want to 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 that conflict. We have introduced a new operational medical record form which is now in use; published a paper on
The Ministry of Defence is aware of the report of the Research Advisory Committee on Gulf War Veterans' Illnesses in the United States and has 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 which are not supported by the balance of scientific evidence. For example, the report does not take into account a recent important paper by the US Institute of Medicine, which states that there is insufficient and 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 drawn on to formulate the recommendations was carried out by members of the committee, which raises some concerns about objectivity.
I turn to the investigation of the noble and learned Lord, Lord Lloyd. We have studied the report carefully, as we would any other material of potential relevance to the issue. We believe that it contains no new substantive or scientific evidence to support its conclusions and recommendations and, frankly, it also fails to take into full account the large amount of written material provided by the MoD.
This report supports our view that an inquiry, whether official or unofficial, would not answer the basic question of why some Gulf veterans are ill. The possibility remains that we may look again at this matter, but we maintain that it is only through scientific and medical research that we will ever be likely to be able to establish the causes of Gulf veterans' illnesses. That is the reason Ministers and officials did not attend the noble and learned Lord, Lord Lloyds's, investigation. The report does nothing to change the Government's view of whether an inquiry will answer the basic question about why some veterans are ill.
The report gives the impression that 6,000 veterans are suffering from ill-health due to their service in the Gulf conflict. I must point out that only a minority are receiving a war pension for Gulf-related illnesses. Although all 6,000 served in the Gulf, many of the claims relate to physical injuries suffered in the Gulf or for disablements and illnesses unrelated to their Gulf service. The number of veterans in receipt of pensions or gratuities for unspecified, symptomatic Gulf War-related illnesses is approximately 1,400, less than 3 per cent of the personnel who served in the Gulf conflict. Additionally, only some 100 claimants have failed to receive an award for Gulf-related illnesses, not the 272 recommended for review by the Lloyd report. The others relate to physical injuries suffered in the Gulf or for disablements and illnesses unrelated to their Gulf service. Of course, my honourable friend the Parliamentary Under-Secretary of State for Defence and Minister for Veterans announced that the MoD will re-examine the roughly 100 cases that do relate to Gulf-related illness where these can be identified.
I have to say that we are surprised by the reluctance of the noble and learned Lord to disclose who sponsored and funded his investigation. It is a valid question. We know from paragraph 3 of the foreword to the report that a private trust funded the inquiry. We know from that paragraph that two other substantial donations helped to fund the inquiry. Why can we not know who funded the inquiry? Why is there a secret about it? I have to say that this contrasts with the Government's policy of openness and honesty set out in our policy document Gulf Veterans' Illnesses: A New Beginning. I very much hope that my noble friend Lord Morris will be able to tell us, when he winds up the debate—
My Lords, no, he does not do that. You are the last to speak.
My Lords, no he does not, it is an Unstarred Question.
My Lords, my noble friend referred more than once in his speech to the figure of £8.5 million being spent on research. Is he aware that the United States Government have already spent some 250 million dollars? That comparison concerns many Gulf War veterans and bereaved families. They want to know why we cannot take more into account the research findings across the Atlantic that have, frankly, been much better financed than ours.
My Lords, I mentioned the £8.5 million once in my speech. I should say that that is the least we will be spending on research. I should imagine that we will probably spend more. Of course, I am afraid that in this field we do not compete with the Americans—as in so many other fields to do with the Armed Forces. But I think that the scientific research that we are considering and have ordered has been of the highest quality. I am a little surprised by the noble Lord's question, because it seems that the tenor of some of the speakers in this debate suggests that all of that research is quite unnecessary. They seem to be asking, "Why are we bothered with it at all? Why do we not just take account of whichever witnesses happen to want to give evidence to the inquiry?".
I repeat my question and shall certainly give way to any noble Lord who wants to answer it. Who funded this inquiry? I look forward to the reply.
My Lords, perhaps the noble Lord can say what the problem is. I do not think that any of us understand why the noble Lord and his colleague in the Commons are so exercised by this issue. What is the potential conflict of interest? What is the malign interest that could possibly affect the outcome of the inquiry?
My Lords, the noble Lord belongs to a political party that always says, at least, that it believes in openness in matters of this kind. I think that that is right. Why, on this occasion, is he so quick to rush to the defence when no information is given about funding?
My Lords, I shall not give way again. I have made my point and I have not had an answer to the question that I legitimately raised.
My Lords, my noble friend asked me a question and I shall be very brief in answering it because of the time. In paragraph 3 of his report and on other occasions, the noble and learned Lord, Lord Lloyd, made it very clear why he has not felt able to dishonour a pledge of privacy to people who wanted confidentiality. I understand that certainly none of them had any axe to grind. He has not varied his position at all. This is an independent inquiry, properly so called.
My Lords, he certainly says that about the private trust. Later in paragraph 3, he also mentions that there are two other substantial donations,
"for which we are very grateful".
He does not say that the makers of those donations do not want to be named.
In short, the Government do not agree with the conclusions and recommendations of the very distinguished noble and learned Lord, Lord Lloyd. However, I reassure the House that the Government are committed to addressing the complex and difficult issue of Gulf veterans' illnesses, to understanding why some veterans of the first Gulf conflict are now ill, and to providing them with appropriate support.
We have also made every effort to learn from the lessons of that conflict. Of course, we cannot guarantee that deployed forces will not suffer injury or ill health, but we are doing everything that we can to minimise the risk.