HC Deb 08 April 1982 vol 21 cc1119-24 12.35 pm
Mr. Frank Hooley (Sheffield, Heeley)

My constituent John Andrew Bennett was extremely keen to join the Army and especially wished to serve in one of the Guards regiments. So he went along to the local Army careers information office to inquire about it. Unfortunately, he has a medical history of epilepsy, but he declared that frankly at the outset to the careers information officers.

He was referred for a medical examination to a civilian doctor, Dr. Flint in Sheffield, who apparently carries out preliminary medical examinations on behalf of the Armed Forces. He was duly examined on 9 October 1980 and declared by Dr. Flint to be fit for enlistment. Naturally, he was delighted about that as it opened the way to his desired career. After some time, no doubt taken up with the usual documentation, he gave up his civilian job on 9 February and reported to join the Coldstream Guards on 16 February at their depot at Pirbright in Surrey.

What happened next is unclear to me. It was decided at the depot that a further medical examination was required and he was referred to a consultant neurologist at the Cambridge military hospital in Aldershot, where he was declared unfit for military service. He was discharged from the Army on 27 March with an effective service of one month and 25 days. I have the discharge certificate, which states: Not finally approved for Army service—Queen's Regulations 1975, para. 9.380". The discharge certificate shows his conduct as exemplary, so clearly there can be no other reason for his discharge than medical.

Naturally, Andrew Bennett was bitterly disappointed by that decision. It put an end to the career on which he had set his heart. He gave up civilian employment to go into the Army, which is no light decision in these days with 3 million unemployed, and he found himself worse than back at square one.

His father was also outraged by the events, with his son at first declared fit for enlistment and subsequently turned down on medical grounds. He approached me about the matter and I wrote to the Ministry of Defence. The Minister's reply was that a claim for compensation could be submitted to a body known as the Ministry of Defence Claims Commission. Such a claim was duly submitted by Mr. Bennett's solicitors on behalf of his son on 8 July 1981.

That body appears to be somewhat dilatory and halfhearted in its dealings and had to be reminded on many occasions that it was still dithering about the claim. After a delay of six months, which I regard as inordinate and as evidence of some incompetence or an uncaring attitude, the claim was firmly turned down in a letter dated 27 January 1982. To be more accurate, it was turned down in two letters. One letter was dated 27 January 1982 and one was dated 25 January 1982. Both were signed by different people, but the texts are identical. The defence claims commission is so dithering and incompetent that it has to write twice in exactly the same terms on exactly the same claim. No doubt somebody can look into that.

After joining up to serve in Her Majesty's Forces in September or October 1980, by January 1982—14 months later—Mr. Bennett found that his preferred career was not feasible. The matter appeared to have been mishandled, either by the medical authorities or otherwise, and his claim for compensation had been flatly turned down after considerable delay.

A number of important questions arise on this case and on the general process of enlistment. There is the question of the medical history of epilepsy. In a letter to the father, Mr. D. Bennett, a Major Bethell of the Caterham Company, Guards depot, wrote: Army Medical Regulations specifically state that any history of epilepsy automatically prevents any enlistment. The civilian physician who saw your son prior to his arrival here should have been aware of this. That letter was dated 24 March 1981 and I have it in my possession.

On that basis there was clearly some incompetence or negligence on the part of the doctor who originally examined Andrew Bennett in Sheffield. He should have known that any history of epilepsy ruled out Andrew from an Army career. He should have told him so right from the word go.

However, the letter that was ultimately received from the Ministry of Defence Claims Commission, which I have in my possession, states: Army Medical Regulations do not specifically state that any history of epilepsy automatically prevents enlistment and therefore the orginal decision to accept your client for enlistment was a valid medical opinion based on the Consultant's knowledge of your client's medical history which he fully considered. In the event, your client's discharge was the result of a legitimate difference of medical opinion within the parameters of normal medical/clinical judgment. Those two statements cannot both be true. Somebody is not telling the truth. I am inclined to think that Major Bethell, as a serving officer, probably knows the Army medical regulations. I have a strong suspicion that somewhere along the line the legal advisers of the Ministry of Defence Claims Commission are wriggling and twisting to get out of meeting a reasonable claim for compensation. Whoever is at fault, they cannot both be right.

On the one hand, a formal letter to Mr. Bennett—not a telephone conversation or something like that—presumably from the commanding officer of the company, said quite categorically that any history of epilepsy rules out a man from joining the forces. I have no medical qualifications to judge whether that is sensible or not, but that is what is said. The Ministry of Defence Claims Commission categorically says the opposite; that that is not true. In that case, prima facie, there is some grievous error in the handling of the enlistment process on one side or the other.

This matter has had a highly unfortunate and damaging effect on a young man's career. Had he been told at the outset that he was not acceptable, he would have stayed in his civilian job. He would, no doubt sorrowfully., have abandoned any prospect of going into the Guards and oriented himself differently. However, on receipt of the original clearance by the doctor in Sheffield, naturally he thought that he could go ahead and do what he wanted. The subsequent disappointment was all the more bitter and grievous a blow.

Presumably some documents in relation to Mr. Bennett's enlistment were sent to Pirbright, or possibly Ito the Ministry of Defence in London, in advance of Mr. Bennett's turning up at Pirbright. Presumably they must have contained some reference to his medical history. In that case, why was he not advised to hold his hand, to stay in his job and not to turn up at Pirbright until there had been a closer investigation into his medical condition? That point should be cleared up.

When Mr. Bennett arrived at the Guards depot, why was there a gap of 4½ weeks before the next medical examination—the fateful one that ruled him out—took place? If there was any uncertainty about his medical condition, surely the matter should have been settled before he got there. However, once he had got there, any uncertainty about his fitness could surely have been dealt with within two or three days. I do not understand why he was kept there for 4½ weeks before being sent to the military hospital at Aldershot for a final decision.

I turn to the more general questions raised by the case. In his letter to Mr. Bennett's father, Major Bethell wrote: I am sure you will appreciate that physical fitness and the ability to complete basic training are of prime importance not only to the Army but to the potential recruit and to this end extremely high medical standards are insisted upon. I have no quarrel with that. That is a sensible, straightforward and honest statement. Anyone serving in a modern army—or in any army—must be physically fit. A professional soldier must measure up to a high standard of physical fitness and Majoy Bethell's comments are absolutely right.

However, surely it is incumbent on the Army recruitment authorities to ensure that all medical formalities are completed before enlistment and before a potential recruit gives up his job and commits himself to the Army. Surely we should not have a system under which a man or woman can be admitted to the forces in all good faith, on the assumption that his or her career is definite, and find after four or five weeks later—or perhaps even longer—that another medical test is required which could disqualify him or her.

I cannot understand why it is beyond the wit of the administrative authorities of Her Majesty's forces to settle such matters, particularly when there is some previous, openly declared medical condition that could put in doubt the person's fitness for service. I do not understand why someone should be required to give up his job, leave home and to cut off all his ordinary family contacts to enlist and should then be told "I am sorry, but we bungled or cannot agree on the medical examination and you're out. That's it." By then, it is probably too late for the individual to take up his previous job and to renew his connections.

What general advice and instruction is given to civilian doctors who carry out medical examinations on behalf of the Armed Forces about the medical conditions that automatically disqualify someone from entry into the forces? There is a flat contradiction about epilepsy in two official documents. One comes from a serving officer and the other comes from the claims commission. Other medical conditions may automatically disqualify someone from joining the Army. That is fair enough. For example, a heart condition, short-sightedness or deafness could automatically rule out entry into the forces. No one would quarrel with that, because physical fitness is important.

However, are clear and definite instructions given to those who carry out the preliminary medical examination so that they can say at the outset that they are sorry that, although the person involved is keen to join the forces, his condition rules him out? That is fair because everyone will know where he is. A person who in good faith says that he would like to join the Army but unfortunately has a physical disability or a minor difficulty is entitled to be told whether that rules him out. The doctors should be given clear and explicit instructions of the requirements so that they cannot be accused of incompetence or negligence.

The case is unfortunate. The boy was keen to go into the Army. He thought that he had been accepted, but within a few weeks he was summarily rejected. The least that should happen is for the Ministry to offer an ex gratia payment in recognition of the boy's disappointment and the mishandling of his case. A penetrating examination is needed of the medical requirements and the instructions given to doctors. I want a categoric answer to why the two letters are flatly contradictory because someone is telling lies.

12.51 pm
The Under-Secretary of State for the Armed Forces (Mr. Gerry Wiggin)

It is customary on such occasions to congratulate the hon. Member who has raised the subject. I freely and gladly do that. I handle a large number of individual cases relating to all three Services and to different categories. My door is always opon to hon. Members. Sometimes it is easier to discuss personal or medical matters in private, not only to save embarrassment to the individual but because it gives me greater freedom than I am given when making a speech from the Dispatch Box.

The hon. Member for Sheffield, Heeley (Mr. Hooley) will agree that the fitness of members of the Armed Forces is of the highest importance. The events of the past few days have shown how important it is that all who serve in Her Majesty's Forces are ready and able to go wherever required as a result of having the highest possible mental and physical standards.

I shall explain the process of entering the Army and how the medical requirements are processed. On application at a recruiting office a man is given a number of forms to complete, one of which is a medical form. He has to take that to a local doctor nominated by the Army who will, on the Army's behalf, make an initial examination and provide an assessment of his general health based on a system known as Pulheems. The individual, or the parent in the case of a junior, has to complete a questionnaire declaring any past complaints or special medical consultations.

Assuming that the information obtained from the initial application forms gives grounds for proceeding further, after further tests at a recruit selection centre the man is offered a job vacancy and, all being well, he is enlisted into the Army.

I turn to the specific case of Andrew Bennett. I have every sympathy with Andrew in his disappointment at being found unfit to serve in the Army. I assure him that the last thing that the Army wants is to turn away suitable recruits. Even at a time of good recruiting levels we are always short of people of the right calibre. I assure the hon. Gentleman that I have looked carefully into this case.

When Andrew applied to join the Army, he and his father were open about his epilepsy, which started at the age of 11 and continued for some time. However, it had given him no trouble for some years. At that stage he was seen by both the local doctor and by a civilian physician on the question of his epilepsy. Both felt that there was no medical reason why he should not be allowed to proceed with his entry to the Army.

Andrew attested on 2 February 1981. He joined the Pirbright depot on 16 February. On seeing him on 17 February, the Pirbright medical officer immediately expressed concern about Andrew's history of epilepsy. He felt that a further investigation was justified.

The hon. Gentleman asked me about delay. Andrew was seen immediately he arrived by the unit MO. He was referred to a consultant. In the circumstances, the fact that that took a month is regrettable. However, I think that the hon. Gentleman would agree that there are much longer waiting periods for seeing consultants in other areas. Naturally, the MO wished Andrew to see an expert.

I emphasise that the overriding concern throughout the case has been Andrew's interests as well as the needs of the Service. It was on those grounds that the MO felt that it was necessary to have a further opinion from a consultant neurologist to the Army medical authorities. In the event, Andrew was seen by a civilian consultant neurologist at the Cambridge military hospital, Aldershot, on 20 March 1981. His opinion was clear—that Andrew should not be accepted for military service.

What has happened in this case amounts to a matter of medical judgment. The first doctors to see Andrew considered that he was fit—he may be, in the normal sense of the word. The doctors in the Army medical service, however, who are aware of the environment to which young Servicemen are exposed, judged that he was unfit for military service. Andrew has had epilepsy in the recent past and there is no guarantee that the condition will not recur, especially under conditions of extreme duress. I am extremely sorry that that has to be the outcome, but I feel sure that it is the right one.

The hon. Gentleman referred to the handling of the case and compensation. There is no intention of implying that the civilian doctors who examined Andrew, particularly the consultant who first examined him on the question of his history of epilepsy, failed to discharge their responsibilities properly.

I am sorry that the impression was given by an officer who wrote to Mr. Bennett senior last March that there were regulations that any history of epilepsy automatically prevented any enlistment and that the civilian physician should have been aware of that. There are regulations on the subject. Doctors who examine recruits for the Army have copies of those regulations and should be familiar with them. In this case one would have expected the doctor to look up those regulations. I shall read the relevant sentence under the general heading of Nervous System a. Epilepsy: It states: Proven epilepsy, with a few exceptions, is to be assessed P8. It is unwise, however, to base the diagnosis on the history of one fit. There are a few exceptions. Unfortunately, this is where Major Bethell was wrong. An ordinary layman such as the hon. Gentleman or I would agree that, knowing that P8 means virtual exclusion, the same interpretation as that of Major Bethell could be read into the sentence. That is the precise wording of the regulations. I am sure that they must remain so, but the wording led to that minor misunderstanding and the difference between the two documents that Mr. Bennett senior was sent.

The decision must rest with the Army in the final instance. The Army's neurologist's opinion was that Andrew was not fit for military service. Even the existence of a normal encephalograph reading would not eliminate the possibility of latent epilepsy, which could recur.

A claim for compensation was made by solicitors on Andrew's behalf. My Department has taken advice from the Treasury Solicitor on the legal merits of the claim. The position is that as this is a matter of legitimate difference of medical opinion no negligence occurred on which a legal claim for compensation can be based. Mr. Bennett's solicitors were advised, and Mr. Bennett wrote a further letter to my Department in February complaining of the outcome. Following that letter, I had expected, as had my officials, further communications from Mr. Bennett or from the hon. Gentleman. The letter was not replied to as it did not appear to call for a reply.

I am sorry that the claims commission duplicated a letter—clearly there was clerical inefficiency which will no doubt be looked into—and that there was delay in handling this claim.

Mr. Hooley

If there is a medical history of, say, epilepsy, and bearing in mind the rather clever phraseology of the regulation, is there no possibility of a second opinion being obtained before the man enlists?

Mr. Wiggin

In this case, a second opinion was obtained.

Mr. Hooley

Before enlistment?

Mr. Wiggin

The original GP who examined the young man said that in his view there was no problem. The young man then went to a consultant—before joining the Army—who also said that there was no problem. He then joined the Army. The unit MO questioned the previous decisions and the consultant neurologist agreed with him. We are faced with total disagreement between the two GPs and between the two consultants.

It is unfortunate that the young man's ambitions have been fractured by that difference of opinion. We must take the consultant neurologist's view. This is not an area where we can afford to take the slightest risk.

The hon. Gentleman suggested that we should reconsider the procedures. I am sure his remarks will he noted. I, too, am concerned that people should not give up their jobs to join the Services only to find, for an unexpected reason, that they are medically excluded from making the Services their career. It is destressing to deal with such cases, and I am sorry that on this occasion the Bennetts should be so upset.

It would be presumptuous of me to advise Andrew to put this matter behind him and to concentrate on his future career, but I hope that the hon. Member for Heeley will feel that his constituent's rights and concerns have been given a great deal of attention and that the outcome is the right one.

Nothing that I or the Department have said precludes Andrew Bennett from taking legal advice on the possibility of instituting proceedings against the Department. He is entitled to do that, although clearly that legal advice must come from his own advisers and not from me.

1.3 pm

Sitting suspended.