rose to ask Her Majesty's Government what steps they have taken in response to the Independent Public Inquiry on Gulf War Illness (the Lloyd inquiry) and the Pensions Appeal Tribunal decision of
My Lords, I start by welcoming the Minister to the Dispatch Box, the noble Lord, Lord Drayson, being on an official visit to India. I look forward to her response. I also thank all those who will speak this evening, and those who have told me of their support but are unable to participate.
This debate relates to the 2004 Independent Public Inquiry on Gulf War Illness and the recent findings of the Pensions Appeal Tribunal. The public inquiry was a substantial piece of work, chaired by the noble and learned Lord, Lord Lloyd of Berwick, with the able assistance of Sir Michael Davies, the previous Clerk of the Parliaments, and Dr Norman Jones, a most highly respected member of the medical profession—an alpha-plus team of expertise.
Last month, the noble Lord, Lord Drayson, in answer to my Written Question about accepting the phrase "Gulf War syndrome" as a medical label, wrote,
"we have welcomed the decision"— that is, of the Pensions Appeal Tribunal—
"that Gulf War syndrome should now be used as an umbrella term covering any recognised medical condition caused by service and connected to the 1990–91 Gulf War".—[Hansard, 17/1/06; col. WA 100.]
That was precisely the proposal made in the inquiry of the noble and learned Lord, Lord Lloyd, over a year earlier. I welcome the sinner that repenteth.
As noble Lords will be aware, I was Chief of the Defence Staff throughout the first Gulf War. One of the difficult decisions that we faced was what protective measures to take when we received an updated intelligence assessment about Iraq's WMD capabilities in November 1990. I quote from the July 2004 report of the noble Lord, Lord Butler, which states that,
"according to the new intelligence, Iraq possesses the BW agents, pneumonic plague and anthrax and has weaponised them. Weapons are ready for immediate use".
Faced with that, it was right to take the clinical and other measures that we could to protect our personnel. Equally, having done it, the government of the day must deal with any adverse consequences of that decision. I was much encouraged by the sentiments expressed by the new Administration in 1997. Ministers stressed their sense of responsibility and their determination to do right by the veterans. The Government undertook to address Gulf veterans' concerns openly, sympathetically and seriously. An MoD paper entitled Gulf Veterans' Illnesses: A New Beginning listed 20 key points for action. Additional resources were to be made available. Fresh studies were put in hand to ensure that the MoD could respond "more urgently". It was all heady stuff. Sadly, expectations, so much aroused, grew fainter and fainter. The MoD embarked on an endless series of reviews, studies and researches. Whenever challenged to say what was happening, its response seemed to be that there had not yet been any conclusive outcome to its efforts, that further work was necessary and that millions of pounds were being spent.
In May 2003 I took part in a Starred Question tabled by the noble Lord, Lord Morris of Manchester, on Gulf War veterans. I pay tribute to the noble Lord, who has been so energetic and resolute in his efforts to help veterans. He is a fine example to us all. I asked,
"whether the time has not come for Her Majesty's Government to make ex gratia payments in settlement without further commitment rather than to drag out endlessly expensive litigation and inconclusive clinical trials? Surely a little magnanimity now would not only be cost-effective but would also serve to relieve the continuing anguish of veteran sufferers and their families".—[Hansard, 22/5/03; col. 935.]
That was the principal theme in my own evidence to the inquiry of the noble and learned Lord, Lord Lloyd. It took that view to heart. The time had come to—in the inquiry's words—
"reach agreement with the veterans".
I was pleased to see in the response of the noble Lord, Lord Drayson, to my Written Question—which I have already mentioned—that HMG have,
"recognised the need to bring an element of closure", for the veterans.
One swallow does not make a summer. I am not sure whether "an element of closure" is just one swallow or the full flock—the full closure that we would all wish to see. I like to think that Ministers are now expressing a willingness to meet the veterans and their representatives such as the Royal British Legion, which has been so helpful and active on behalf of the veterans, to reach a final settlement of this protracted affair. But the Government must approach such a get-together in, I would hope, a rather less confrontational way than has been symptomatic—I am tempted to say "syndromatic"—of their past treatment of veterans.
Indeed, I regret that no Minister, serving official or serving member of the Armed Forces was allowed by the MoD to appear before the inquiry. The MoD actively discouraged some individuals with experience and great knowledge of the veterans' illnesses from giving evidence. Commenting on the report of the noble and learned Lord, Lord Lloyd, during a debate in the other place, the Minister, Mr Caplin, stated that it,
"fails to take into full account the large amount of written evidence and material provided by the MoD".
No one should accuse this enquiry of shoddy work. In Mr Caplin's words:
"Lord Lloyd's report does nothing to change the Government's view that an inquiry will not answer the basic question about why some Gulf veterans are ill".—[Hansard, Commons, 18/1/05; col. 238WH.]
Surely the basic question is not that, but what to do to help those who are ill. The Minister even seemed to cast doubt on the impartiality of the inquiry because the noble and learned Lord, Lord Lloyd, was not prepared to reveal who had funded it as that was done anonymously. It is far from unusual for sponsors to wish to remain anonymous, and that wish should certainly be respected.
Such government reactions did nothing to improve relations with the veterans and those who have been trying to help them. Will Her Majesty's Government now express their regret about the long and protracted delays over eight and a half years since this Administration came to power, and confirm their acceptance of "Gulf War syndrome" as an umbrella term covering any recognised medical condition caused by service and connected with the 1990–91 Gulf conflict? Will they make a commitment to achieve, in the course of this year, full settlement and closure of this protracted affair? As the inquiry of the noble and learned Lord, Lord Lloyd, recommends, will they provide a fund for ex gratia payments made on a pro rata basis to all who make successful claims?
Such steps would help to heal over the many years of distress, even rejection, to which the veterans have felt so exposed. What a positive message that would send, too, to the younger generation of servicemen and women who are today exposed to danger on this country's behalf. They in time will become veterans, maybe with their own illnesses and disabilities to face. I ask Her Majesty's Government not to forget the younger generation's perceptions in their response tonight.
My Lords, my noble friend Lady Crawley can brighten any scene, no matter how low the cloud base, and I welcome her to this debate. I count this a privileged occasion, made so by an opening speech of high distinction and compelling integrity.
The noble and gallant Lord, Lord Craig, could not be more eminently well placed to lead this debate. Chief of the Defence Staff and a member of the War Cabinet during the 1991 Gulf War, no one is better qualified to assess the value of the inquiry to whose groundbreaking report this debate calls further attention. In a letter published by the Times soon after the inquiry reported, he warmly welcomed its findings. Signed also by the noble and gallant Lord, Lord Bramall—another former Chief of the Defence Staff—and by General Sir Peter de la Billiere, who commanded British forces in the field during the conflict, the letter recalled that the Duke of Marlborough, speaking in this House after Blenheim, said the best way to celebrate that great victory was,
"to do right by the soldiers who fought so bravely with me".
The Times letter went on that:
"The Lloyd report is in that proud tradition".
So too was the speech by the noble and gallant Lord, Lord Craig, today.
I have interests to declare in the debate—none of them pecuniary—as honorary parliamentary adviser over many years to the Royal British Legion, vice-president of the War Widows' Association, a governor of St Dunstan's, a co-opted member of the United States Congressional Committee of Inquiry into Gulf War illnesses, and the instigator of the inquiry conducted by the noble and learned Lord, Lord Lloyd of Berwick. I am grateful to him for accepting my suggestion that he should head the inquiry and for his report, one 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 our country. His purpose was not to apportion blame but to end deadlock and, by unravelling the truth, to let right be done.
I am indebted also to Sir Michael Davies, who is respected all across this House as former Clerk of the Parliaments, and to Dr Norman Jones, Emeritus Consultant Physician at St Thomas's Hospital, who sat with the noble and learned Lord, Lord Lloyd, at the inquiry and added powerfully to its impact.
Since our first debate on the Government's reaction to the inquiry's report, which I opened some six weeks after its publication, there have been many developments, all strongly supportive of its recommendations. They include the deeply moving plea to the Prime Minister from the right reverend Prelate the Bishop of Norwich and other Church leaders in East Anglia, prompted in part by the distressing case of a parish priest there, the Reverend David Peachell, who served with such dedication as Chaplain in the Gulf War and afterwards became afflicted by multiple undiagnosed illnesses.
Another major development was the letter sent jointly to all Scottish parliamentarians by the Right Reverend David W Lacy, Moderator of the General Assembly of the Church of Scotland, and Cardinal Keith Patrick O'Brien, the Archbishop of St Andrews and Edinburgh, calling for,
"urgent closure of the controversy on the basis of the scrupulously fair and balanced findings of the Lloyd report".
The letter went on:
"This is not an issue for party animus but one on which Scotland's public representatives and churches should work together to achieve a humane settlement without further delay".
Also important were the Pensions Appeal Tribunal's findings in the cases of Gulf veterans Daniel Martin, Mark McGreevy and Richard Hilling, which were that the Lloyd report was correct in stating that:
"Veterans of the Gulf War later develop an excess of symptomatic ill health over and above that to be expected in the normal course of events".
The tribunal's finding continued:
"The term 'Gulf War Syndrome' is the appropriate medical label to be attached to the excess of symptoms and a useful umbrella term for that label. It is highly regrettable that there was such a delay in the MoD accepting this approach".
No juggling with words can detract from the historic importance of the tribunal's decisions in the cases of Martin, McGreevy and Hilling, which so explicitly vindicated the stance taken by the noble and learned Lord, Lord Lloyd, in his report.
Already gossamer thin, the MoD's original case for seeking to discount the Lloyd report had now shrivelled to the most immodest of fig leaves. Indeed, all it amounts to now is repetition of the words, "Gulf War Syndrome is not a discrete medical condition". Even so, that fig leaf was called into service no fewer than five times in the MoD's response to my Starred Question on
"does not require the features involved to be caused by a single disease. For instance, Nephrotic Syndrome is a clearly defined clinico-pathological entity, yet it has upward of 40 different causes".
So much for the now threadbare fig leaf.
Very clearly—in fact clarity was never clearer—the need now is for the Government to catch up with the noble and learned Lord, Lord Lloyd; Sir Michael Davies; Dr Norman Jones; the right reverend Prelate the Bishop of Norwich and his co-signatories; the Moderator of the General Assembly of the Church of Scotland; Cardinal Archbishop O'Brien; Dr Jack Melling, former chief executive at Porton Down; Dr Harcourt Concannon, president of the tribunal; and the many other distinguished figures involved in unravelling the truth in this melancholy story.
At the very least, the Government must surely now make the tribunal's decisions known to every veteran of the conflict and act urgently, as a priority of priorities, on every case that could possibly be affected by them. After all, in the umpire's explicitly stated view, at least a year was lost by the MoD's failure to attend and give evidence to the Lloyd inquiry, and it is now 15 years since the conflict.
What is more, the Prime Minister, in his letter of
"a top priority and always will be for this Government".
The MoD, having accepted the tribunal's findings, but still not apologised for its strongly censured and "highly regrettable delay" in accepting the noble and learned Lord's approach, has caused profound dismay among veterans.
The admirable Flight Lieutenant John Nichol, whose bravery under torture in Iraq was seen by television viewers across the world and who is now president of the Gulf War veterans' branch of the Royal British Legion, told the inquiry:
"We weren't the enemy but that is exactly how Gulf veterans have been made to feel by the MoD".
Major Christine Lloyd, a widely respected nursing officer in the conflict, who is now 80 per cent incapacitated by multiple undiagnosed illnesses and still deteriorating, told the inquiry that there had not even been anyone to say:
"I am sorry . . . we should have believed you in the first place".
Major Lloyd also said that it was,
"an absolute disgrace that the MoD did not respond to the invitation to participate in the Inquiry".
Sadly, Reverend David Peachell, whose severe disabilities were raised with the Prime Minister by the right reverend Prelate the Bishop of Norwich, has spoken even more bitterly. He said:
"None of them are good enough to say 'sorry'. They are hoping we will die".
These and other veterans, all highly regarded for their service in the conflict, need more now than an "element of closure". Full and final closure is their aim and an understanding in Whitehall that, if their striving for that outcome has to go on, then go on it will until right is done.
For our part here, I suggest that we reflect that there is no higher parliamentary duty than to act justly to those prepared to lay down their lives in the service of this country and to the dependants of those who do so.
My Lords, I am grateful to the noble and gallant Lord, Lord Craig of Radley, for providing this opportunity to ask the Government what they are doing about this important issue. It allows me to ask a number of questions about the current and future management of long-term casualties of active military engagement, especially those with persistent psychological consequences. This whole sorry saga throws an unforgiving light on attitudes in the Ministry of Defence.
I am a psychiatrist and have had the opportunity of lengthy discussions with Professor Simon Wessely at the Institute of Psychiatry at King's College, London. He is a colleague and is the national expert in Gulf War symptoms and syndromes and, in my view, has conducted the most methodologically sound epidemiological studies of these problems.
Let me put Gulf War syndrome in its historical context. All wars throw up clusters of symptoms in response to the stress, fear and trauma of war. Everyone has heard of shell shock, the psychological outcome of the terrible traumas of the First World War, which disabled thousands of veterans for the remainder of their lives, I am sad to say. At the time, it was attributed to the noise and concussive effect of exploding shells. Even earlier, "soldier's heart", a cluster of symptoms attributed to the pressure on the heart of the straps binding heavy equipment to the soldier, was similarly disabling after the American Civil War. Similar so-called "effort syndromes" were well described in the Crimean war and the Indian Mutiny. Vietnam gave us "Agent Orange syndrome" and a number of others—and so on.
I remind noble Lords that psychological distress is often experienced, indeed, is usually experienced, as physical disorder—in fact, it is physical disorder. It is no good telling someone with muscle aches, pains, breathlessness, headache, severe fatigue, rashes and so on, that it is all in their heads, when it patently is not. Surely, we have learnt that much in the past 150 years. Do we have to keep repeating that because no gross physical pathology is associated with a disabling syndrome, it is not a serious illness worthy of the same level of care, treatment, support and practical help that those with obvious physical trauma expect automatically?
Is Gulf War syndrome different from those previous well-described conflicts? Probably not, for the most part; yet there remains a degree of uncertainty over about 20 per cent of the variance of causality of these syndromes. It is important to remember that the Gulf campaign was a great military success—and a medical one. There were no deaths from environmental or infectious diseases among American or British personnel, as there of course have been in war. The military medical authorities must have ended the campaign relieved not to have had to deal with large-scale casualties and delighted with the success of their preventive measures. Yet, 15 years on, that all sounds a little hollow.
I want to remind your Lordships of the established facts to date. UK gulf veterans experienced double the symptoms and feel worse—although physically they are still functioning fairly well, as a group—compared with non-deployed troops or those deployed in Bosnia. They had double the rate of psychiatric disorder, although that was not sufficient to explain all ill health; depression and substance misuse are in fact more common than with the usual post-traumatic stress disorder. There was certainly a reported link between the vaccines that they were given and later ill health, but that was not sufficient to explain all ill health either. Meanwhile pesticides, depleted uranium and exposure to nerve gas were never really plausible villains for UK forces.
However, the range of symptoms is similar to unexplained civilian syndromes—such as chronic fatigue syndrome, fibromyalgia, ME, total allergy syndrome and some others. That these syndromes result from stress and the causality of the Gulf War itself cannot now be in any doubt. Why is that so, if it was not such a stressful conflict nor traumatic in the traditional sense? The report of the noble and learned Lord, Lord Lloyd, eloquently describes what probably happened, as has already been mentioned by the noble and gallant Lord, Lord Craig. The malign effects of the very fear of chemical attack—and the counter-measures put in to try and prevent it—meant that for many months in advance of the conflict men were thinking and worrying about the hazards that they would be facing. It is understandable that the impact of those imagined threats should be profound.
It seems to me that the initial reactions of the authorities to Gulf War syndrome could hardly have been worse in terms of maintaining the confidence and trust of the Armed Forces and the populace. Indeed, that very alienation was likely to drive them into the arms of unhealthy supporters. The attitude that it was a storm in a teacup, or that those complaining really should be able to pull themselves together, or that it was possibly an attempt to get compensation were all talked of quite openly in medical communities. That is not a new view, as similar sentiments were expressed to and by the shell shock commission in 1922, but such views are now plainly unacceptable and ignorant.
No wonder a serious lack of trust developed between the public and veterans on one side, and the Government and military authorities on the other. Let's face it: it was a good story, involving many contemporary issues of public concern about the environment. We should also face up to how Gulf veterans have been ill-served to date by junk science and by their so-called advisers. Far too many quacks and charlatans have taken advantage of them. That is why it is crucial, not only for Gulf War veterans but for the current conflict and future similar conflicts, that the Government assert their superior moral authority to protect and care for these people. They need to be a little more sophisticated than they have been to date about the consequences of modern warfare.
My first question to the Government, then, is: what plans are in hand to ensure that they respond in timely manner to the inevitable emergence of the sequelae from the Iraq conflict, service in Afghanistan and future armed conflicts? Given the delays, obfuscation and generally resistive attitude to the Gulf War veterans, can we be reassured that it will not happen next time around and that the inevitable problems will be planned for?
Secondly, what steps are the Government and the military taking to change the culture of what I would regard as "concrete thinking" about physical and psychological disorders? Did this not go out with Descartes? We must recognise that psychological outcomes are as real and disabling as physical disorders, and that psychological disorders are readily compounded by modest physical hazards. That is, overall, what the report of the noble and learned Lord, Lord Lloyd of Berwick, said, and what we all agree probably happened. Recruiting soldiers resilient to all types of stress is not feasible.
Finally, what steps are the Government going to take to ensure that the current half of ex-servicemen—I am not talking just about the veterans—who now suffer from diagnoses of depression or anxiety yet who almost never receive any help from statutory services, and only rarely from service charities, can get the help they need?
This is a wider question than just that of the Gulf War veterans. However, I echo the calls of the noble and gallant Lord, Lord Craig of Radley, and the noble Lord, Lord Morris of Manchester, for some closure and a greater understanding of the effects of military engagement.
My Lords, I pay tribute to the noble and gallant Lord, Lord Craig of Radley, for all the tremendous work he does on behalf of those who serve, and have served, in the British Armed Forces. Apart from a long and distinguished career in the RAF and the Ministry of Defence at the highest levels—as your Lordships' House has already heard—he has continued to work selflessly for organisations like the RAF Benevolent Fund and the "Not Forgotten" Association.
The noble and gallant Lord, Lord Craig, and my noble friend Lord Morris of Manchester, who has himself done so much for disabled people and the Royal British Legion, have diligently pursued the Government in the interests of service veterans who served in the 1990-91 Gulf War and have suffered illness as a result. They, and the noble Baroness, Lady Murphy, are right to be concerned and have every right to hold the Ministry of Defence and the Government to account in your Lordships' House today.
We have debated this matter before, in December 2004. Recently, both the noble Lord, Lord Morris of Manchester, and the noble and gallant Lord, Lord Craig of Radley, have elicited Written Answers on this subject from Ministers. In raising this matter today, the noble and gallant Lord is pushing at an open door. The acceptance by the Pensions Appeal Tribunal, last October, of the umbrella term "Gulf War syndrome" to cover the variety of symptoms linked to service in the 1990–91 Gulf War has, after all, been welcomed by the Ministry of Defence.
"The Government hope that the use of the umbrella term will address the known concern of some Gulf veterans that we have not recognised a link between their ill-health and the 1990–91 Gulf Conflict".
However, he continued, the Government also welcomed the decision by the Pensions Appeal Tribunal, which,
"found that there was no reliable evidence to show that Gulf War Syndrome is a discrete medical condition. This confirms the view which the Ministry of Defence has consistently taken and which is based on the overwhelming consensus of worldwide medical and scientific opinion".—[Hansard, Commons, 24/11/05; col. 128WS.]
It is apparent from the MoD's statement that the PAT decision will make no difference to the way veterans will be treated and assessed. The MoD has explicitly said that its policy has always been to make awards in full where evidence of disablement is shown and where that disablement is due to, or aggravated by, service. It has consistently acknowledged that some veterans of the Gulf conflict have become ill, and that this ill-health may be due to their Gulf service. As the previous Minister for Veterans wrote in the Times in December 2004:
"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".
While Gulf veterans have undoubtedly suffered a range of illnesses, the fact remains that the mortality rates—rather than general levels of illness—for veterans of the 1990–91 conflict are less than those of the age-adjusted "Era" comparison group of service personnel: 755 to 765. The 755 deaths among Gulf veterans compares with approximately 1,206 deaths expected in a similar-sized cohort taken from the general population of the UK with the same age and gender profile. This in turn reflects the emphasis on fitness when recruiting and retaining service personnel.
While any death is a matter of great regret, the data show that veterans of the 1990–91 Gulf conflict do not suffer an excess of overall mortality compared to service personnel that did not deploy to the Gulf. So, despite what has already been said in the debate, neither would it, to my mind, be fair to give ex gratia payments to all Gulf veterans while ignoring those who served and suffered in other conflicts.
I do not think that the Government have to respond further to the inquiry on Gulf War illnesses undertaken by the noble and learned Lord, Lord Lloyd of Berwick. My speech to your Lordships' House on
The report repeatedly referred to 6,000 veterans who suffered from ill health due to their service in the 1990–91 Gulf conflict. But, as the MoD made clear, many of those thousands of claims were for disablement and illnesses unrelated to service in the Gulf War. In fact, the number of Gulf veterans in receipt of pensions or gratuities for unspecified, symptomatic Gulf-related illnesses was approximately 1,400 at the end of 2004, less than 3 per cent of the personnel who served in the Gulf.
I am glad that the MoD and the Government are committed to spending a total of about £8.5 million to research further into Gulf veterans illnesses. This work is vitally needed. I hope that the Minister will say more about the MoD's efforts in this regard in winding up the debate and assuage the heart-felt concerns raised in your Lordships' House today. The Ministry of Defence and the Government must never let up in their duty to provide the highest standard of care and support to Gulf veterans and their families, to whom this country continues to owe so much.
My Lords, perhaps I may start my contribution by paying a warm tribute to the noble Baroness, Lady Murphy. It is very refreshing to hear a new voice—at least to me—on this thorny subject. I hope that the Government will pay close attention to what she said.
The Royal British Legion has been pressing for a public inquiry into Gulf War syndrome—we now can call it that—since 1997. The Ministry of Defence has never said yes and it has never said no. All it has ever said was that the time is not yet ripe, even after 14 or 15 years. It is still waiting, it says, for scientific proof, on the cause of the illnesses, despite the fact that there is scientific proof that those who served in the Gulf were twice as likely to suffer from these symptoms as those who served in Bosnia or remained at home.
In answer to the speech of the noble Lord, Lord Truscott, I would say that this problem of Gulf War illnesses has never had anything to do with increased mortality; it is the problem regarding the symptoms, not necessarily leading to mortality, that has been beneath all the investigation. After pressing for so long, people lost patience and it was as a result of the noble efforts of the noble Lord, Lord Morris, that an independent public inquiry was in due course set up. I had the honour to be the chairman of that inquiry. It was never our remit to establish the scientific cause of the illness; it could not be and no one could have expected it to be. But it was our remit to establish the facts of how the veterans had been treated by the Ministry of Defence since their return from the Gulf. I propose to refer always to the Ministry of Defence, rather than to any particular Government. This is not a political issue. It is a coincidence that, in the 15 years since the first Iraq war, the Conservatives formed the Administration for the first half and there was a Labour Government for the second half. Although on coming to office in 1997 the Labour Government said that there would be a great new fresh start, I did not notice any difference.
Since we were investigating the facts relating to how the Ministry of Defence had treated the veterans, it seemed only sensible to invite the Ministry of Defence to send a representative to attend our inquiry. The representative need have attended only for a very short time, but the ministry declined. It said that it would serve no purpose. It was wrong about that. It would have served a very important purpose. It would have reassured the veterans that the Ministry of Defence was taking their complaints seriously. It would have cost the Ministry of Defence nothing to attend, however briefly, to explain its position, but it did not do so.
We listened to a great deal of evidence and, at the end, at the suggestion of the noble Lord, Lord Tyler, we renewed our invitation to the ministry to send someone to answer some of the questions that we wanted to put. I wrote in these terms:
"You may have seen that Paul Tyler MP on 21st July said that your appearance would do more than anything to restore trust between the veterans and the MOD. Many of the veterans have echoed the same point in their evidence. Paul Tyler asked me specifically to renew my invitation, which I now do. It seems to me that it could do no harm, and might do much good".
However, once again, that invitation was simply brushed aside. I am sorry to say that, once again, the Ministry of Defence lost another opportunity to reassure veterans that their interests and concerns were being properly taken into account.
I must mention something that I find difficult to mention. Instead of explaining sensibly why the ministry would not come to address us, however briefly, it became obsessed with how our inquiry had been financed. Over and over again, in answer to my questions, it wrote back to say, "Why have you not answered that question?" I explained as clearly as I could that we were financed by a private charity that wished to remain anonymous. For some reason, the Ministry of Defence found that hard to accept. I hope that, when she replies, the Minister will explain why it was so obsessed by the problem of how we were financed and why the ministry pressed that point so hard and could not accept our assurance that we were financed by a private charity that wished to remain anonymous.
I am sorry to say that, at one point, the Ministry of Defence went so far in reference to our inquiry as to put the word "independent" in quotation marks. That seems to suggest that, in the view of someone in the ministry, we were not truly independent. Again, I hope that the Minister, when she comes to reply, will specifically withdraw any suggestion that we were not independent. There was no evidence of any kind on which the Ministry of Defence could have put forward such a suggestion.
We did not of course expect the Ministry of Defence to accept our recommendations overnight, but we did expect a considered response. A considered response is what we never got. Instead, the ministry argued—I am glad that the point has already been made—that we had failed to take account of the large amount of written material put before us because, if we had, we could not have reached the conclusions that we did. That is a marvellous example of Ministry of Defence logic.
I agree that the Ministry of Defence put a large amount of material before us, much of it self-serving and suggesting simply that the Government were doing better than the Conservatives had done. The suggestion that we did not read that evidence—all three of us—was quite simply wrong and, I suggest, unworthy of a government department. Indeed, it was unworthy of the Prime Minister, who made exactly that point in a letter that he wrote to the right reverend Prelate the Bishop of Norwich on
One of the main issues at the hearing was the use of the term "Gulf War syndrome". We wanted to know why the ministry was so reluctant to accept that term—a term that was used by all the veterans and the public at large. Indeed, it was a term that the ministry itself was using until about 1997, when it suddenly changed tack—again, for reasons that were never explained. That was the issue in the Rusling case, which was decided in 2002. Sergeant Rusling had succeeded in establishing a basis for a claim on Gulf War syndrome. Yet the Ministry of Defence wasted a great deal of public money in appealing against that decision, only to lose on every issue that it had raised.
That, of course, brings me to the decision of the Pensions Appeal Tribunal in the Martin case on
In any view, the Martin case was a defeat for the Ministry of Defence. But how did it deal with the case? Somehow—and it almost beggars belief—it tried to turn the case into a victory. Here, again, I refer to the statement which the Ministry of Defence made on
"The Government hope that the use of the umbrella term will address the known concern of some Gulf veterans that we have not recognised a link between their ill health and the 1990–91 Gulf conflict. We hope that this will help to provide an element of closure"—
I am glad that the noble and gallant Lord, Lord Craig, highlighted that particular expression—
"for those who have sought some acknowledgement that their ill health is connected to their Gulf service".—[Hansard, 24/11/05; col. WS 149.]
How ungenerous can one be? An "element of closure"—it is a joy, a pure "Yes Minister" expression.
It does not end there. The next letter was sent on behalf of the ministry to the Times. It stated:
"However, there remains no basis for recognising Gulf War syndrome as a diagnostic label. The consensus of the medical community remains that there are too many different symptoms reported for this ill health to be characterised as a discrete medical syndrome".
That is not only unjust and ungenerous, but plain wrong. The ministry seems to be incapable of distinguishing between a diagnostic label—and Gulf War syndrome was a correct diagnostic label—and a discrete pathological entity, which it clearly is not and that we never even suggested was.
I am delighted that the noble and gallant Lord, Lord Craig, drew attention to the sentence in the Prime Minister's letter to the right reverend Prelate the Bishop of Norwich on
In answer in this House on
My Lords, I inquired as to when the time is up and I understand that it is 6.46 pm. I may be wrong about that. In any event, I assure the noble Baroness that I am at the end of my remarks.
One thousand three hundred and sixty-eight people have claimed on the basis of Gulf War syndrome and have had their claims defeated because of the attitude of the Ministry of Defence to that particular expression. Only one claim on that basis has succeeded. I want to ask: if the ministry is taking steps, has it written to the 1,367 others who claimed on that basis to say, "Sorry, we were wrong and you were right; this was the correct basis"? If the Minister can say that she has done that, I shall be gratified. If not, I hope that the ministry will do so quickly.
My Lords, I sincerely congratulate the noble and gallant Lord, Lord Craig, and thank him not only for initiating this debate but for his persistence in standing up for the victims of Gulf War-related illnesses. I also pay tribute to other Members of your Lordships' House, notably the noble Lord, Lord Morris of Manchester, with whom I have worked in the past on this issue, and the noble and learned Lord, Lord Lloyd of Berwick. His masterly and truly independent inquiry produced the report which gives rise to the debate.
Unlike other noble Lords, I have no military, legal, medical or scientific expertise to put before your Lordships' House. However, I have a long commitment to get to the truth of this issue. Way back in 1994, I was approached by those in Cornwall and the south-west who were suffering from severe illness as a result of their service in the Gulf, including Major Christine Lloyd, to whom reference has been made. At that time, the suggestion was made that there might be a link between the cocktail of inoculations that troops suffered before they went to the Gulf, or the use of organophosphate pesticides, which was a special interest of mine, or a combination of the two, and that that was giving rise to these serious illnesses. I therefore tabled a Parliamentary Question in the other place to the then Defence Minister Mr Nicholas Soames, who answered on
"in delousing some 50 Iraqi troops with a dusting powder".—[Hansard, Commons, 3/11/94; col. W1237.]
That proved to be misinformation. As your Lordships' House has already heard, we have had too much misinformation over the years. More than two years later, in December 1996, that same Minister, Mr Soames, had to make a grovelling apology to me in the other place and to the Commons. He had been wrongly briefed: several hundred British troops, their equipment and their living quarters had been sprayed with these extremely dangerous chemicals. The organophosphates had been bought locally in the Gulf with no clear warnings or treatment instructions in English. Unsurprisingly, there was a devastating result in certain cases.
That episode convinced me that the Ministry had been casual and irresponsible in its attitude to the health of those who had been serving their country so well in the most dangerous conditions. Nothing I have subsequently learnt during my years of working with the noble Lord, Lord Morris, and the Royal British Legion to seek justice for those victims of official neglect has changed my view. I want to pay particular tribute to the persistence of the Royal British Legion; notably, to Colonel Terry English, who has done so much on behalf of veterans.
In your Lordships' debate on
"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 . . . 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".—[Hansard, 21/12/04; col. 1728.]
The Commons Select Committee made a similar comment in its 1995 report:
"In responding to allegations of a Gulf War Syndrome MoD has been quick to deny but slow to investigate. MoD's response has been reactive rather than proactive and characterised throughout by scepticism, defensiveness and general torpor."
We have heard so many examples in the debate this evening, particularly from the noble and learned Lord, Lord Lloyd.
In the aftermath of the Pensions Appeal Tribunal decision in the case of Guardsman Daniel Martin last November, I and several Members of your Lordships' House questioned the Government on their grudging acceptance of the outcome. Today the Minister has a unique opportunity to show genuine generosity of spirit and awareness of the misery to our Gulf War veterans caused by so many official delaying tactics, so that she can correct the widespread perceptions to which so many of us are referring.
Specifically, I ask the Minister, first, to give the House an estimate of the total cost—in legal fees and civil servants' time—of resisting the claimants' case for recognition and compensation. Secondly, in the light of today's report that Professor Robert Haley in the United States has been awarded an annual research budget of some $15 million to establish the truth of Gulf War syndrome, what steps are the Government taking to ensure that his results are immediately accessible and acted on in the United Kingdom?
Thirdly, can she assure the House that each of the four simple recommendations contained in paragraph 283 of the Lloyd inquiry report have been, or are being, urgently implemented? First, that MoD should acknowledge that it was service in the Gulf that caused these illnesses; secondly, that "Gulf War syndrome" is an appropriate description; thirdly, that a fund for ex gratia payments should be set up; and fourthly, that the then 272 rejected claims should be reviewed? We know of course that there are many more now, as the noble and learned Lord, Lord Lloyd, said. Finally, bearing in mind the Martin and subsequent tribunal decisions, will the Minister further assure us that all outstanding similar cases will be speedily settled without further delay or unnecessary recourse to further tribunals, in the light of the precedent that has now been set?
In his letter to the Times, dated
"Gulf War veterans were found to experience significantly (26 to 32 per cent) more multi-symptom illness than veterans who did not serve in the Gulf and also more than veterans of the Bosnian conflict. Their conditions could not be explained by wartime stress or psychiatric illness. There is also growing evidence that an important component of Gulf War veterans' illnesses is neurological in character".
"Even though we cannot yet prove a causal relationship between the specific toxic insults to which veterans were exposed and each illness symptom, once it is accepted that service in that theatre of war is linked to a heightened risk of illnesses coming under the GWS umbrella label, the burden of proof on the veteran for the cause of their illness is lightened. Is this why the Ministry of Defence so resists the term Gulf War Syndrome?".
Today, the Minister can not only answer that very apposite question, but can also put to bed, once and for all, the absurd official semantic game surrounding the GWS term.
In our exchanges on
My Lords, I, like everyone else, am most grateful to the noble and gallant Lord, Lord Craig of Radley, for introducing this debate. I begin my contribution by making it clear that we on these Benches have every sympathy for veterans and ex-servicemen and women who have risked their lives for this country, some of whom now feel that it has let them down. Our servicemen and women deserve the very best, both by provision of the right equipment and resources when they go to war and the support that they get on their return home after the conflict is over, and also when they have left the Armed Forces. It goes without saying that it is crucial that the United Kingdom, through the Ministry of Defence, properly compensates with financial assistance members of the Armed Forces for ill health arising from their military service.
One of the veterans' main grievances is the way in which the MoD has handled their cases and the fight for awards through the war pensions scheme that they have had to undertake. I agree wholeheartedly with the call of the noble and gallant Lord, Lord Craig of Radley, for Her Majesty's Government to express their regret about the long and protracted delays experienced by veterans in the pursuit of their claims and the truth about their illness. When a person of such considerable experience and knowledge of the armed services, and in particular of the operational circumstances during the Gulf conflict, makes such a call, the Government should certainly sit up and take note.
The fact that the MoD did not choose to give evidence to the inquiry chaired by the noble and learned Lord, Lord Lloyd of Berwick, has been perceived by the veterans as symptomatic of the dismissive approach by the MoD to the whole problem of the Gulf War veterans. As the noble and gallant Lord has said, this attitude has done nothing to improve relations with the veterans. I mention this particular grievance in the hope that every effort should be made by the MoD to be seen as open and constructive as possible from now on.
This debate is set in the context of the Government's ambivalence towards our veterans. The debt of honour due to them is not being repaid. The burden of proof is now on a veteran to prove that his or her injuries were due to their service, whereas under the previous war pension scheme, the onus was on the MoD to prove that injuries were not due to service. This is just one example of how, step by step, our Armed Forces are being equated with ordinary civilian professions. This is simply not right. The Armed Forces stand alone in what they are asked to do and this uniqueness needs recognition.
I have said already, and must reiterate, that I agree with very much of what the noble and gallant Lord, Lord Craig of Radley, said in his speech. The noble and gallant Lord is and has been a most valiant advocate of the veterans' cause. There are, however, some who might question the significance of one aspect of his speech; namely, the call for the Government to confirm their acceptance of the phrase "Gulf War syndrome" as an umbrella term covering any medical condition caused by service and connected to the 1991 Gulf conflict. The Government have already had to accept the use of "Gulf War syndrome" as an umbrella term, but does it really advance the issue further? I submit that it is only useful in as much as the veterans feel it is a step in the right direction.
The Pensions Appeal Tribunal ruling in November 2005 was conclusive in finding that there was no reliable evidence that Gulf War syndrome is—as has been mentioned several times this evening—a discrete pathological entity. The ruling found that there is a Gulf War health effect, this being an increase in the incidence and severity of a variety of symptoms for Gulf War veterans. The crucial point is that it seems there is no identifiable set of symptoms unique to those with Gulf War service. There is an argument that it might, therefore, be more useful to adopt the Pensions Appeal Tribunal's use of the term "health effect" to differentiate this occurrence of a range of accepted symptoms from a new specific syndrome.
However, the real question to address is "what next?" We support the idea, proposed in the report of the noble Lord, Lord Lloyd, that the 272 unsuccessful cases should be reviewed. It would be helpful for the Government to indicate what steps they have taken, or will take, in this regard. We also support the noble and gallant Lord's call for the Government to commit to achieving a conclusion to all this. A real acknowledgement of the difficulties that the veterans have had to endure would be appropriate. I fully support the noble and gallant Lord's suggestion that Ministers should meet veterans and their representatives as soon as possible to try to achieve a satisfactory conclusion. Veterans are demanding this and, 15 years on, it is what they deserve. I look forward to the reply of the noble Baroness.
My Lords, in thanking the noble and gallant Lord, Lord Craig of Radley, I acknowledge his tenacity in following this issue, and the very professional expertise he brings to the subject. I was warned by my noble friend Lord Morris of Manchester that I would probably need an ejector seat for this debate, as feelings are running very high. Indeed, it has been a robust debate—and so it should be—but also an extremely informative one, which we will read very carefully at the Ministry of Defence.
The MoD has drawn a certain amount of flak, not all of it, I might suggest, deserved. However, I am grateful to the noble and gallant Lord for securing time for this debate, because this is an extremely important issue and I recognise that the concerns he raised, which have been shared by other noble Lords through their contributions this afternoon, are also felt by many outside this House.
It is essential that these issues should be fully debated and that the views of the House are carefully considered. Noble Lords will recall that my noble friend Lord Bach set out the Government's response to the report of the noble and learned Lord, Lord Lloyd, during the debate held on
As my noble friend Lord Bach made clear, we studied the noble and learned Lord's report carefully. We concluded at the time that it did not contain any new substantive or scientific evidence to support its conclusion and main recommendations. We have seen nothing since to change our view. The noble and learned Lord said that we should acknowledge that Gulf veterans are ill. My noble friend Lord Drayson said on
The Government have again been criticised in today's debate for not participating in the noble and learned Lord's investigation. We did not do so because we do not consider that an inquiry, public or unofficial, would contribute to answering the basic question of why Gulf veterans report more ill health than those who did not deploy. We have maintained that—and I should say to noble Lords that researchers into the illness of Gulf veterans did attend the inquiry—research independently overseen rather than any form of public inquiry or investigation will best allow us to understand and help veterans and their families to address these issues.
However, we provided a significant amount of published material to inform the investigation. I understand that the noble and learned Lord was encouraged by the format of that material. We do not consider that it was taken fully into account in his report. The report does nothing to change the fact that the wide range of research that we and others have sponsored over the years has shown no unique illness associated with service in the Gulf. As my noble friend Lord Truscott observed, to date we have spent over £8 million on research. The United States Government have undertaken some $300 million-worth of research and we have always monitored it closely for any lessons it may offer for our own veterans.
One of our first actions on taking office was to announce a package of measures aimed at addressing veterans' concerns. With such significant sums spent on research, I can say that our understanding of the ill health reported by 1990 and 1991 Gulf veterans is now much greater than when this Government first came to office. We have remained committed to the assurances we gave in that document, and this commitment continues today.
I find it difficult to understand, therefore, that some Members of this House remain unwilling to acknowledge the very real progress the Government have made with this important and complex issue. This is true not least of the report of the noble and learned Lord, Lord Lloyd. It has a tendency to concentrate on the problems experienced prior to May 1997, rather than any of the efforts that we have made since to find solutions and to help veterans. Nor does it acknowledge the way in which we have applied the lessons of the 1990–91 Gulf conflict to improve the position for the current Iraq deployment.
The Government recognised that we needed to be as transparent as possible about these sensitive medical and scientific issues. In contrast, we still find it somewhat surprising that the noble and learned Lord has been unwilling to disclose who sponsored and funded his investigation, thus raising questions about its true independence.
Let me make it clear—as the noble and learned Lord, Lord Lloyd, raised it himself in this debate—that his good intentions and those of his fellow panel members have never been doubted. But this House would expect full transparency of funding of our research and we can see no reason why his own investigation cannot meet that same widely respected protocol.
My Lords, what was doubted or seemed to be doubted was our independence. It is in relation to that that I would like, even now, a specific assurance.
My Lords, it is extremely difficult to pronounce on independence when one does not know who is funding and sponsoring a report. I think that that is the dilemma that the Government find ourselves in. As I said, we have no problem, and we have made it clear that the good intentions of the noble and learned Lord and his fellow panel members have never been doubted. I hope that, by my repeating that, he will know that the Government are sincere.
The noble and learned Lord's report suggests that 6,000 veterans are suffering from ill health due to service in the Gulf conflict. This figure is based on veterans who served in the Gulf in 1990–91 who have claimed a war pension. Many of their claims will be for disablements and illnesses arising from other parts of their service in the Armed Forces, unrelated to their service in the Gulf.
At the time of the publication of the report, the number of veterans in receipt of pensions or gratuities for unspecified, symptomatic Gulf-related illness was approximately 1,400, less than 3 per cent of the personnel who served in the Gulf. The personnel serving in the Gulf numbered 53,462. Nor is the report fair regarding the numbers who have been compensated under our "no fault" scheme. Only some 100 claimants failed to receive an award for Gulf-related illness, not the 272 stated by the report.
The noble and learned Lord also recommended that compensation or ex gratia payments should be paid to Gulf veterans. There I can only agree with my noble friend Lord Truscott—Gulf veterans already receive financial benefits through the war pensions scheme and Armed Forces occupational pension scheme. These are quite explicitly set to reflect the level of disablement resulting from illness or injury. We see no justification for making additional payments to particular Gulf veterans, thus giving one group of veterans more favourable treatment than others. I admit to being surprised that the noble and learned Lord saw merit in such a potentially unfair and divisive arrangement.
I now turn to the Pensions Appeal Tribunal decision of
The decision was equally helpful in reaching the clear conclusion that Gulf War syndrome does not exist as a discrete pathological entity. In other words, we accept that there are clear symptoms of illness, and in some cases these are severely disabling, but the tribunal confirmed that there is insufficient reliable evidence to support the view that there is some specific new disease caused by service in the Gulf. This, as your Lordships will be aware, is the view that the Ministry of Defence has consistently taken on Gulf War syndrome, based on expert medical and scientific opinion. The UK is not alone in this respect. No other country that sent troops to the Gulf recognises Gulf War syndrome as being a specific disease or condition. I should stress here that, contrary to some views, the United States authorities have not recognised Gulf War syndrome.
Perhaps it would be helpful to your Lordships if I explained briefly what the Ministry of Defence understands by the use of the umbrella term, and how we are applying it. First, it does not, as has been claimed in some parts of the media, represent a complete policy reversal by the ministry. For the reasons I have already mentioned, it does not involve the acceptance of Gulf War syndrome as a specific recognised disease; nor does the use of the umbrella term alter the MoD's position with regard to making an award under the war pensions scheme. It has never been the case that the department required that there be some particular label for an illness before a pension could be paid; the MoD awards in full whenever evidence of disablement is shown, and where this disablement is due to, or aggravated by, service. The acceptance of the umbrella term has not changed this fundamental feature of the war pensions scheme.
I should explain the position the Ministry of Defence takes concerning the use of the diagnostic label, "Signs and Symptoms of Ill-Defined Conditions", more commonly known as SSIDC. This is a diagnostic category within the World Health Organisation International Classification of Diseases, and has been mentioned in the debate today. It is used to describe ill defined symptoms and illnesses where there is no identifiable underlying disease. The evidence is that similar symptoms occur in service personnel who did not deploy to the Gulf, and in the general population. The difference is that the reported occurrence in Gulf veterans is significantly higher. We therefore accept the Gulf ill health effect, and give eligibility for compensation by using the widely recognised category SSIDC.
The Martin decision used "Gulf War syndrome" to cover not just Gulf illness, or SSIDC, but all other accepted conditions the tribunal considered to be causally linked to the 1990–91 Gulf service. I should mention that SSIDC remains in wide use throughout the world, including in Gulf studies published in the peer-reviewed medical literature.
How will the umbrella term be used? Following the statement by the Minister for Veterans, the Veterans' Agency will proceed as follows in cases where Gulf War syndrome is given as an umbrella term: the agency will list the accepted medical conditions, together with a separate assessment of the levels of disablement arising from each. It will then ensure that the certificate that it issues to record an award makes clear that the umbrella term applies to accepted conditions which are connected with 1990–91 Gulf War service. The umbrella term in this way provides the recognition that many veterans have sought of the link between their ill health and their service in the Gulf.
I should make it clear that there will be no direct increase in awards paid because of the inclusion of the umbrella term in an individual's assessment of his disablement. All disablement that is accepted as due to service will be, or will already have been, reflected in making an award.
There has been some criticism—my noble friend Lord Morris of Manchester and the noble and gallant Lord, Lord Craig of Radley, reiterated that criticism today—that the department has taken too long to recognise the connection between a veteran's ill health and their service in the Gulf. However, the principal issue raised by veterans claiming Gulf War syndrome before the Martin decision was that their conditions should be recognised as resulting from one specific Gulf-related disease. As I have said, there was, and remains, no scientific basis for doing this. The proposal to use Gulf War syndrome in a broader sense as an umbrella term is a new one. We have recognised the need to bring an element of closure—I disagreed with the view of the noble and learned Lord, Lord Lloyd, when he questioned the Government's good faith in using that term; the noble Baroness, Lady Murphy, also mentioned closure—for those who have sought some acknowledgement that their ill health is connected to their 1990–91 Gulf service. I hope that noble Lords will recognise and welcome this step.
I should add that at a Veterans Forum meeting chaired by the Minister for Veterans in December last year, the senior veterans organisations welcomed that development and considered the Government's move to be positive. It is sincerely hoped that we can build on this and that it will, indeed, help to provide an element of closure.
Noble Lords have asked me many questions this afternoon. I had originally 12 minutes in which to answer. Due to the overrun of time and so on I did not end up with 12 minutes. I hope that noble Lords will be patient when I say to them that I will certainly write to each one of them and answer each of their questions as I have run out of time.