HL Deb 02 February 1998 vol 585 cc479-98

6.5 pm.

Lord Morris of Manchester rose to ask Her Majesty's Government what steps they are taking to improve provision for ex-service men and women with Gulf War illnesses.

The noble Lord said: My Lords, I beg leave to ask the Question standing in my name on the Order Paper.

As anxiety grows hourly about the prospect of a second conflict in the Gulf, this debate is about the men and women who sacrificed their health in the service of this country in the first. Their claim to the attention of your Lordships' House is one of compelling priority. Having been fit and well when, in Kipling's words, the band began to play, many are now very seriously ill. Others have already gone to their graves with a deep sense of injustice, leaving behind aggrieved dependants, some of them wives who were widowed when young and fear poverty when they are old.

The Gulf War ended almost seven years ago and the debate provides an opportunity for Whitehall and Westminster to address with a new sense of urgency the problems and needs of those afflicted and bereaved. I am in no doubt that is how my noble friend the Minister will see this debate. Nor can anyone doubt the depth of commitment my honourable friend, Dr. John Reid, the Armed Forces Minister, brings to his responsibilities for those with Gulf War illnesses and their dependants. As I said publicly on 17th January, when a number of veterans returned their campaign medals to the Ministry of Defence, 1 am sure John Reid will come to be acknowledged as the best friend they ever had in Whitehall. No one knows better than my honourable friend that, fully to understand the sense of anguish and at times anger felt by veterans with unexplained and undiagnosed illnesses, you have to be one of them. But he is demonstrably on their side.

I have an interest to declare in the debate, but not a financial one, as The Royal British Legion's honorary parliamentary adviser for many years and a founder member of its Gulf War Group. The group was set up in 1993 to press for urgency in providing medical help and in dealing with war pensions and other forms of compensation. Since then its range of activity has grown to include every issue of interest and concern to the afflicted and bereaved.

Selected group members visited the United States to compare provision for veterans with Gulf War illnesses there and in the UK. They then wrote papers for the Commons Defence Committee that were included in its report to government. Other members were appointed to all of the epidemiological study teams investigating veterans' illnesses and are making a major contribution to the progress of research into their causes. Again, partly due to the Gulf War Group's pressure, the MoD's Medical Assessment Team was strengthened and work on encouraging veterans to come forward for medical assessment was given a higher profile.

Ably chaired by Colonel Terry English of the Legion, the group includes parliamentarians from both Houses of Parliament; representatives of the ex-service charities; Major Ian Hill and Flight Lieutenant John Nichol from the veterans' associations; and both senior doctors and members of the legal profession. Among the group's parliamentarians, no one has contributed more to its work than the noble Lord, Lord Burnham. Edwina Currie has also given long and distinguished service, while the noble Countess, Lady Mar, has made a strong and valued contribution on the use of organophosphates. Paul Tyler MP, a newer member, adds to the impact of an initiative that accords with the highest traditions of the RBL.

Yet while the group's work has been reassuring and of much practical help to veterans, many strongly insist that more urgency is needed to save lives. They are deeply concerned by Group Captain Coker's departure from the Medical Assessment Programme (MAP); and some complain not only about discontinuity in senior staffing but also of a lack of sympathy with their condition. It will thus be helpful to know what further action is being taken to restore the veterans' confidence in MAP.

There is concern also about serious delays in processing war pensions and preventable hardship among veterans in urgent need. One example is the case of Gunner Tom Ford, late of the 2nd Field Regiment Royal Artillery. He first applied for a war pension in 1996 but his case has yet to be fully addressed. Having fought Saddam Hussein and then struggled to cope with his Gulf War illness, Tom Ford now has to fight for his pension too. And, of course, even if and when he succeeds it will be no passport to la deice vita. Far from it: indeed to have to live on a war pension alone is to recall a moving further passage from Kipling: Think what 'e's been, Think what 'e's seen, Think of his pension an.—

GAWD SAVE THE QUEEN".

But week by week, month by month, year by year, Gunner Ford has to wait and wait and wait again even for his war pension.

I know my noble friend will want to have the processing of war pensions and war widows' pensions for Gulf War veterans and their widows urgently reviewed in the light of this disturbing case.

Meanwhile I shall be grateful for any information he has on when Group Captain Coker's long-awaited report on the findings of his initial review of the patients he has assessed will be published. Veterans hold Group Captain Coker in very high regard. They will be glad if he can be reinstated as Controller of MAP, and perhaps my noble friend could let us know if and when this might be possible when he replies to the debate.

Anything he can say about new initiatives to deal with shortcomings in the medical administrative system, of which many Gulf War veterans complain, will also be helpful. What is being done to ensure, for example, better maintenance of medical records for serving personnel and an efficient transition from medical services in the Armed Forces to the NHS when their engagements end? Again, can my noble friend say whether there is any likelihood in the near future of a veterans' register being established for men and women leaving the services?

My noble friend is aware that I first raised in 1996 in another place, with the then Armed Forces Minister, a possible link between the undiagnosed illnesses of some Gulf War veterans and the destruction by US troops in March 1991 of ammunition bunkers at Khamisiyah in Southern Iraq. UNSCOM inspectors later identified the site as an Iraqi chemical weapon storage plant and found there munitions containing chemical agent, a sombre reminder today of the awesome threat to human life of the sort of weaponry available to Saddam Hussein as he demonstrates yet again his absolute contempt for UN Security Council Resolution 687.

The Minister's reply to my question was that only one British serviceman was deployed in the area of the fall-out plume when the bunkers at Khamisiyah were destroyed. I understand that this must now be drastically revised upwards and I shall be grateful for any more precise details my noble friend has of the numbers of British service personnel who could have been contaminated by fall-out at Khamisiyah.

There's a further issue that threatens to become of increasing concern and is worthy of mention in this debate. I refer to the report of increasing birth abnormalities identified in Kuwaiti children. Not unnaturally, that is very disturbing to veterans of the Gulf War who want to see all available information on the nature and scale of what has been happening in Kuwait. After a recent visit there, when I talked at length with Ministers, including the Minister of Health—a doctor—I was convinced that much might be gained from increasing our knowledge of the very serious effects of the Gulf War on the health of the civilian population of Kuwait. That also is something on which my noble friend may wish to comment.

I come now to my concluding point. Governments are fond of saying—I speak as a former Minister—that with individual rights go responsibilities. That must ever be so and it is clearly true also that power, not least that of governments, carries with it heavy responsibilities. After all, what governments do conveys a more eloquent and enduring message than what they say. The relevance of all this is that the MoD is the biggest employer in western Europe: and thus how those who serve it and their dependants feel about its employment policies is highly important to the moral authority of government as a whole. As I said at the outset, I am totally sure that Ministers are deeply aware of this and I know that my noble friend, my parliamentary colleague for more than three decades, will respond to the debate both positively and with his customary humanity.

The vast majority of the British people want the most generous possible treatment for those afflicted and bereaved in their service. Our debt to them cannot be measured in money terms: but lack of money inflicts hurtful indignities. Let us, therefore, resolve today that the best way of demonstrating our regard and admiration for those who served us with such distinction and gallantry in the Gulf is to meet in full what I am sure your Lordships' House sees as an undoubted debt of honour.

6.14 pm.

Baroness Park of Monmouth

My Lords, I am extremely grateful to the noble Lord, Lord Morris, for initiating this important debate. As the Minister will know, I tabled a Written Question to his colleague, the Minister for the Armed Forces, in July of last year asking whether the findings of Group Captain Coker, submitted to the Gulf War inquiry when he was posted to the US in 1996, had been or were to be published. In reply, I was told that the first draft of a paper concerning the results for some 500 patients under the medical assessment programme had never been completed but that a total of 1,435 patients had now been seen by MAP and the consolidated results would be published later in the year.

I was also pleased to learn that Group Captain Coker would be closely concerned with the work, which would supersede his original draft. Indeed, I was favourably impressed by the energy and the resources put into addressing the question of Gulf War illness and the Gulf War veterans by Ministers. I read the paper,Gulf Veterans Illnesses, a new beginning, published by the MoD as evidence of the new approach on 14th July 1997. I wonder whether any of this would have happened without the long struggle conducted by my noble friend Lady Mar in this House and by the noble Lord, Lord Morris, and others, in the other place.

The MoD paper refers to the reports of dead animals, to scout tents and to the concerns expressed by the Department of Health in late 1990 about pertussis vaccine. It is no thanks to the MoD, I fear, that any of those issues have been identified and acted upon. On the contrary, questions on the first two were regularly rebutted, as were the concerns about the use of organophosphates by our own people. It is one of the saddest ironies that we are dealing with friendly, not enemy, action and its consequences and with a culture within the ministry which was, rightly I fear, characterised by the Defence Committee as, "instinctive defensiveness and insularity", and insensitivity of a high order. It is deeply unfortunate that most of the new research programmes set in train by Ministers will not be reporting until 1999 and 2000 respectively. Meanwhile, the clock ticks on for the veterans. Where is the review that was promised for the end of 1997, and is Group Captain Coker, who I understand is no longer working with the group, in agreement with the findings?

The MoD paper that I mentioned referred to the treatment of veterans still serving and said that they will be treated by the Defence Medical Services. If that refers to treatment in this country, I should be very interested to know how many are receiving such treatment and where. In December of last year it was still the case that virtually all the beds in at least one of the MDHUs were occupied by non-service geriatrics. When Group Captain Coker did his initial work, I believe that he was grossly overworked because, clearly, the Defence Medical Services had been cut to the bone under Front Line First, that splendid Treasury exercise in short-term economy and long-term disaster.

Were money and lack of staff the reasons why, although the Defence Committee recommended a full-scale epidemiological study as long ago as 1995, no real effort was made until July 1997? Equally, one of the constant themes of the veterans—and the issue is often raised in this House—has been the difficulty of access to medical records and, indeed, the loss or destruction of relevant medical events. The Defence Committee was told that 15,000 such events had been lost. Both my noble friend Lady Mar and I had quoted a figure of 10,000 (not all related, of course, to the Gulf War).

In the MoD paper we are told that, what can be found will be made public in due course", and that the Government intend, that veterans should have access to whatever information the MoD possesses which might he relevant to their illnesses and is determined that what can be found will be made public".

All that is very reassuring. I recognise that Ministers meant what they said and that both money and effort are being put into changing things for the better. But there is a very great burden of distrust which must be shifted. No amount of research, to be available two-and-a-half years hence, will help veterans who have been kept waiting for six years, who are ill and who may well wonder what their claims will be worth when the seven years, when the presumption for each claim is in the claimant's favour, run out.

The immediate question is: why is Group Captain Coker, the man who originally recognised that there was a case to answer but whose report was not published and the man who Ministers brought back and in doing so reassured many, no longer apparently involved? Why is there such a disastrous lack of continuity in the staff of MAP? Where are the detailed results that were to have been published at the end of 1997, once the new database had been created?

The Government must not lose the momentum of the actions that they have taken since July of last year. It is essential to establish a veterans' register, to reinstate Group Captain Coker and to ensure that the Defence Medical Services and MAP in particular have the staff to deal promptly and sensitively with the urgent needs of veterans who have had too little attention and have been up against a faceless bureaucracy when they needed prompt answers.

In another debate on organophosphates in June of last year, I urged that the research that was being funded jointly by the MoD, MAFF and the Health and Safety Agency should have an independent co-ordinator, with no ministry connections, free to take evidence under privilege, and someone who could not be required to delay or even suppress evidence on the grounds of some greater good. We, and the veterans above all, need to know that there are no more time bombs of undisclosed knowledge ticking away. In the context of the Statement we heard earlier today it is perhaps even more important than before for servicemen to be given cause to trust the Government and to feel that the services look after their interests. I know that the Minister has given proofs, as have his colleagues, of real concern, but this is a crisis of confidence. The veterans have rights and those rights have been ignored.

This is a moment when we must not wait for reviews and research groups and above all we must not allow the Treasury termites to eat away the serviceman's trust in his service. There can be nothing more important than that.

6.20 pm.

The Earl of Effingham

My Lords, I thank the noble Lord, Lord Morris of Manchester, for introducing this important subject in your Lordships' Chamber.

I must declare an interest. I work for The Royal British Legion, the country's leading ex-service charity, which receives no financial help from the Government and can only provide benevolent assistance and advice through donations to the Poppy Appeal. It is significant that the Legion's pensions department now handles over 90 per cent. of all claims going to appeals tribunals, of which there are some 10,000 annually.

The early announcement by the Minister for the Armed Forces, Dr. John Reid, of, Gulf Veterans' Illnesses: A New Beginning, the commissioning of new research and the more open approach to the disclosure of information have all been widely welcomed by veterans and the Legion alike. Nevertheless progress is inevitably slow and there is no immediate relief. The Legion continues to monitor the situation on behalf of the inter-parliamentary group and the veterans and to advise those who are suffering from possible Gulf-related conditions to ensure that they receive treatment and, where appropriate, apply for a war pension and/or compensation.

Since returning from the Gulf War in 1991, some British veterans have become ill. Many believe that this ill-health is unusual and directly related to their participation in Operation Granby. Ministers have stated that a fresh start has been made in dealing with this difficult and complex subject and have adopted three guiding principles: that all Gulf veterans will have prompt access to medical advice; that appropriate research will be carried out into veterans' illnesses and the associated factors: and that the Ministry of Defence will make available to the public any information it possesses.

A wide variety of explanations have been suggested for the illnesses reported by Gulf veterans. These include physical factors related to service in the Gulf, such as the effects of multiple vaccinations, taking NAPS tablets or exposure to pesticides; stress related and other psychological factors; as well as the possibility that there is no unusual pattern. What is not in dispute, however, is that many Gulf veterans are unwell and are concerned that their health may have suffered.

I would now like to address three special cases: first—the noble Lord, Lord Morris of Manchester, has already mentioned him—Tom Ford of the 2nd Field Regiment Royal Artillery. His claim for a war pension was made in July 1996 and the conditions for which he claimed were post traumatic stress disorder, chronic fatigue and chronic arthritis. He still has not heard whether he will receive a pension. As a result he is unable to meet financial demands regarding his house, and the housing association, which now owns it, has rented it back to him. He is a disillusioned man and believes he has been let down by the system. It is 18 months since his application was made and in the meantime the Legion has provided support to get him through the uncertain period. Can the Minister assure the House that the award of an interim payment will be considered, prior to a final decision by the War Pension Agency?

Secondly, is the Minister aware that a statement he is reported to have made to Gulf War veterans last July to the effect that the seven-year rule for claiming war disablement pensions would not apply in their cases is causing confusion and is in need of clarification? The veterans claim that they were told that the rule requiring the War Pensions Agency to disprove all claims by ex-service people within the first seven years of leaving the forces would be waived. Will the Minister also confirm that the period for claims against the Ministry of Defence for compensation has been extended from three to six years?

Thirdly, many reservists and Territorial Army personnel—over 600 people in all—deployed to Operation Granby in 1991-92 are being denied access to the attributable benefits for reservists scheme, or ABRS, on the basis that they were not medically discharged from Gulf War service. However, although approximately 420 of these people are in receipt of a war disability pension as a direct result of their Gulf War service, these same service men and women were not informed that they could have asked for a medical discharge. These veterans feel that they are being treated differently to regular soldiers and thereby discriminated against. This would appear to be a breach of the outline Ministry of Defence instructions, detailing allocation of volunteers, that they would not suffer financially as a result of the deployment but would be treated exactly the same as regular soldiers similarly deployed in terms of pension entitlements.

Now that the ABRS is fully effective, as from September 1996, what steps have the Government taken to correct the technical deficiency in the regulations to ensure retrospectively that those reservists in receipt of a war disability pension, as a direct result of their Gulf War service, receive their full pension entitlement?

A Ministry of Defence letter was sent to Mr. G. A. Parker, in April 1997 regarding his claim for a pension under the ABRS. It stated that in order to qualify for a pension he would have had to have been discharged from the Territorial Army as unfit for further military service. However, his record of service showed that he was discharged at his own request. On this basis therefore he did not qualify for a pension under the scheme. He was nonetheless advised to resign from the Territorial Army and not to apply for a medical discharge, although ill health was adversely affecting his ability to meet the required standards.

Finally, Territorial Army and regular reserve personnel who volunteered for Gulf War service were told by the Ministry of Defence that in the event that they should become a casualty they or their spouse would receive the same benefits as a member of the regular forces under the provisions of the ABRS. This advice was factually incorrect, I believe, and due to an anomaly in the regulations those who became ill and injured on embodied service would not qualify. Two Territorial Army soldiers, Messrs. Bristow and Rusling, brought this to the attention of the Ministry of Defence as early as 1991-92. To date only three reviews and subsequent awards of a pension under the ABRS have been made.

These veterans have been waiting for years to have their cases reviewed. Her Majesty's Government claim we owe them a debt. Has this debt been paid?

6.29 pm.

Baroness Strange

My Lords, I also am very grateful to the noble Lord, Lord Morris of Manchester, for his Question about provision for Gulf War illnesses. I have, as your Lordships will know well, an interest to declare as president of the War Widows Association. I reiterate the question we raised with the Minister, Mr. John Spellar, when we met him last June. It is that whatever decisions are made about a change of medical opinion on Gulf War illnesses, if anyone has since died as a result of these illnesses, his widow should be treated as a war widow and consequently receive a war widow's pension.

According to the figures issued by the Ministry of Defence to the Gulf Veterans Association last July—the last figures it received—since the Gulf War seven naval personnel, 65 from the Army, 56 from the RAF and four civilians have died. Causes of death have been stated as suicide, cancer, heart disease, or resulting from road accidents. The last may sound accidental, but such accidents could have been caused by nerve failure. As a result, several people who served in the Gulf now do not drive cars.

To my knowledge there are six widows who could be in a position to claim a war widow's pension. One, who lives at Portsmouth, is the widow of a petty officer who was responsible for opening up the air vents on his ship after a chemical attack. Another, whose husband died of bronchial carcinoma, is only 25 and has two young children. Her husband was a bandsman in the Royal Army Ordnance Corps, playing several brass instruments; so he must have had good lungs. As a bandsman he would have played outside in the Gulf area. Another is the widow of a lieutenant-colonel who served in tented accommodation in Blackadder Camp in the Gulf and who died of ischaemic heart disease, the surgeons at the autopsy saying that his heart was in much worse shape than that of a centenarian who had died just before. Another, whose husband died just before Christmas of brain tumours, has two young children, both with an identical rare heart disease. We would like to welcome those ladies into our association as war widows and give them what love and comfort we can. I urge the Minister to persuade the Government to show the same compassion for them.

6.31 pm.

The Countess of Mar

My Lords, I thank the noble Lord, Lord Morris of Manchester, for asking this Question and I echo his sentiments. The noble Baroness, Lady Park of Monmouth, also made some very telling comments. I was extremely moved by the remarks of the noble Baroness, Lady Strange.

I wish to declare an interest. I am patron of the Gulf Veterans Association. I have a great deal of personal contact with members of Her Majesty's Armed Forces who served in Operation Granby and now find themselves unexpectedly suffering from a wide range of illnesses which they attribute to their service.

I am deeply impressed by the integrity of those men and women, many of them from the Territorial Army and reserve forces. They were called up for service and went to the Gulf in the knowledge that they might be exposed to any of the chemical or biological weapons that were known to be in the Iraqi arsenal. They understood that the British Government would take measures to protect them from death or illness resulting from enemy action. What they did not expect was that they would die or become ill from the effects of what might be best described as an "own goal".

It is significant that this Question should be asked just a few days before the expiry of the seven-year period under Article 4 of the Service Pensions Order, and perhaps fortuitous that this morning I received a copy of the update to the Government's report, Gulf Veterans Illness: a New Beginning. It may be helpful to the Minister if I go through this in sequential order.

The Government state that the new targets for handling patients at the medical assessment programme (MAP) are now being met. If the number of adverse comments I have received about the way in which Gulf veterans are treated by the MAP doctors are any indication, I am not surprised that they are able to reach their targets, for their examinations are often cursory. Many of the Gulf veterans say that they will never attend the MAP again. I have never heard any criticism of the time when the programme was run by Group Captain Coker and Colonel Melia, despite the fact that they were working under the appalling conditions described by the reports of the House of Commons Defence Select Committee. Since the departure of those two doctors, it would appear that the MAP has developed an agenda which does not include medical diagnosis and treatment for the illnesses from which the veterans are suffering.

It may help if I give two examples from letters I have received from veterans. One attended the MAP on 8th November 1997 and was seen by Dr. Hall. The veteran had left his home in Scotland at 5.30 a.m. on the day of his appointment to be at St Thomas's Hospital on time. The doctor asked his name. When he replied, Dr. Hall told him there was nothing wrong with his memory in a tone which the veteran described as "sarcastic". The doctor then told the patient that he must stop smoking and drinking 18 pints of beer at the weekends. He simply would not listen when told that the veteran did not drink at all as he had only half a kidney—he merely repeated his statement over and over again.

The veteran also had a problem with his knee and, while under general anaesthetic, had experienced muscle twitching which his orthopaedic surgeon thought should be further investigated. Dr. Hall's response was to look into the man's eyes and tell him that he had no nervous damage whatever. Asked how he sustained the knee injury, the veteran explained that he had been filling the central heating boiler with coal for his parents. Dr. Hall's response was to ask why his parents had not filled their own boiler. The veteran goes on to say in his letter: At this time I was feeling very confused and becoming more and more distressed and was quite literally in tears. I could not understand his logic. He totally ignored my distressed condition and then asked me why I was there and what I wanted. I explained that I wanted treatment for my symptoms, to which he replied, there is no treatment. He then went on to tell me that he had been in the Vietnam War and proceeded to point out his medals which were hanging on the wall. He said he had come back from Vietnam with no problems whatsoever … Dr. Hall then went on to say that there was nothing wrong with me and that I should learn how to get on with people better and get on with my life".

He later says: I left there in a state of confusion and distress and felt absolutely suicidal".

In a covering letter he says: My main concern now is that anyone else who has to attend this programme should not only be prepared but that they should not go alone". and, as a demonstration of British troops' universal stoicism, My immediate reaction to all this is to throw the towel in, which is of course exactly what the MoD would wish and is perhaps their intention. I am gradually getting over it and no doubt will be able to laugh about it later".

Another veteran was seen by Dr. Spicer on 22nd December 1997. He has well documented exposure to organophosphate insecticides, initially diagnosed by Group Captain Coker. He had been told that he should ask for a follow-up appointment as his condition had deteriorated. This man has been diagnosed as suffering asthma and rhinitis, chronic fatigue and food intolerances as a result of his exposure to OPs. He had also suffered autonomic and peripheral nerve damage. He was told by Dr. Spicer that asthma was a common ailment; that chronic fatigue was a psychological problem in the heads of many Gulf veterans and was not due to Gulf service; that his deficiency in essential vitamins and minerals, a result of the food intolerances, could be cured if he purchased a box of multivitamins from a chemist; and that he did not believe the neurologist's findings of nerve damage as farmers had been using OP insecticides for years without ill effect and he had been using such insecticides in his garden without ill effect. The veteran's illness was not due to Gulf War service. My Lords, where has this man been?

In view of the veteran's deteriorating condition, Dr. Spicer was asked to read his Fmed 4, his medical records. He was also asked whether he would conduct a medical examination. He indicated that he was not interested in the veteran's case notes and that no medical examination would be undertaken. The notes were returned unopened. While he was in front of the doctor this veteran noticed a letter from D Med Health to the effect that no treatment should be offered as it would set a precedent for other Gulf veterans. When he asked to see his notes, permission was refused.

These are only two examples of the way in which attenders of the MAP are handled. I have reports of veterans' doctors being told there is nothing wrong with their patients when they have cancer or serious heart conditions, and I know that a number of these complaints have been sent to the Minister's honourable friend, the Minister for the Armed Forces. May I ask the Minister whether he believes that this treatment is in accordance with the objectives of the Government's papers on this subject? Will he also ask his honourable friend to instigate a full audit of the MAP, not some time this year, but as a matter of urgency? Does he accept that, even if these cases are a few out of many and others are treated properly, this is no way for doctors to treat patients; and what does he propose to do to rectify the situation immediately?

I look forward to the results of the research programmes, although it is a pity that they have taken nearly seven years to be arranged—not the fault of this Government, I hasten to add. May I ask the noble Lord why so many British troops were inoculated against smallpox when this disease was eradicated in 1980 and only the United Kingdom, the United States, Russia and China are permitted to hold small quantities of the virus for experimental purposes? The World Health Organisation specifically advises against vaccination except for workers in experimental laboratories. So what were the risks that were considered to be a danger to our troops? May I also ask the noble Lord what research has been carried out into the actual vaccine which was used? There have been a number of reports from American Gulf veterans of the adjuvant squalene and of a specific mycoplasma being detected in their blood. May I ask whether these will be looked for in British veterans?

Noble Lords will be aware of my interest in the health effects of exposure to organophosphates. The similarity of symptoms between farmers occupationally exposed to OPs and the Gulf veterans exposed to insecticides during their service in the Gulf was what drew my attention at the time of the first reports of unusual illness among the veterans. The OP investigation team appear to have made a thorough assessment of the use of insecticides during Operation Granby, but there are some very noticeable omissions which I intend to take up with the Armed Forces Minister at a later date. However, there are numerous reports from the veterans of spraying activities by people other than members of the environmental health units deployed in the Gulf. No mention is made in the OPITT reports of spraying by local Saudi labour or of evening spraying from a propeller-type aeroplane. May I ask the noble Lord why these reports have not been followed up to ascertain the pesticides used and the degree to which British troops were exposed? The reports are many and consistent, and relate particularly to Black Adder Camp.

As to the tents, I still find it difficult to accept that the tent in which a small quantity of the OP fenitrothion was detected in 1997, after it had been exposed to the elements, would not have had enough of the pesticide in its fabric to have affected the scoutmaster who purchased it in 1993, but that is a matter for debate. I also look forward to seeing the reports into CBW incidents, the anti-BW vaccination programme and the reports of dead animals.

The noble Lord, Lord Morris, and the noble Earl, Lord Effingham, both spoke at length about pensions and compensation. In the general context of financial provision, may I tell the noble Lord the Minister that I have been told repeatedly by Gulf veterans that the last thing they want is litigation. They simply want an acknowledgment that they are ill; they want treatment for their illnesses—though many recognise that their quality of life and level of fitness will never be what it was before they went to the Gulf—and they want pensions for which they do not have to fight every inch of the way. Many have only turned to the law because they are angry and frustrated. To a lay person like myself, it seems madness that veterans who have had conditions diagnosed by medical consultants in NHS hospitals should have to submit to further medical examinations by, as the Department of Social Security admits, generalists with no specific training in the illnesses reported by the veterans. There is no consultant on the Benefits Agency medical service lists. Do war pension agencies not trust the NHS?

I see that I have come to the end of my time. There is more that I should like to have said but I will now sit down.

6.45 pm.

Lord Wallace of Saltaire

My Lords, we have heard a number of very powerful speeches and, being less of an expert, it is not my intention to detain the House for long. I should like to touch on just two points, leaving aside the question of pensions, which was raised among others by the noble Earl, Lord Effingham. The first point I wish to raise is the question of openness and transparency; and the other is the lessons we have learnt for future conflicts from this experience.

We discussed earlier today a Statement on Iraq, which raised the question of chemical and biological weapons. It is clear that this conflict is unlikely to be the last in which British troops are engaged in which these risks will be suffered. Clearly, therefore, we must consider what we have learnt and what procedures are now in place. We must consider the international co-operation in which we are now engaged with our NATO allies, and perhaps others, to investigate the diseases and problems that have been encountered and the precautions that one should take against chemical and biological warfare. Those are questions which I hope the noble Lord the Minister will be able to answer.

I return to the question of openness and transparency. The comment of the noble Baroness, Lady Park, expressed exactly my own feelings as regards the need to be reassured that there are no more time bombs of undiscovered knowledge to come. The slow trickle of information from research publications within the United Kingdom and the United States worries those who have been through this experience. I refer to the incomplete information, incomplete records, and stories not yet fully confirmed, as to whether chemical weapons were released, and, if so, in what areas, and exactly which pesticides were used when.

I have consulted some of my colleagues on this subject. My noble friend Lord Falkland told me that his son served in the Gulf as an officer; and that the cocktail of chemicals which were given to him rapidly as he went out there caused him considerable problems in terms of lowering his level of immunity. It was not until he had left the Army and was in the United States that he realised that he was suffering from some long-term debilitation. He then went through a series of tests. The first assumption was that he suffered from the same Gulf War syndrome as did the Americans. It was not until some time had passed that the idea that British troops and American troops often had different experiences and had taken a different cocktail was understood. My noble friend Lord Winchilsea tells me that during his visit to Iraq in 1996 he was shown round a children's hospital in Baghdad which had a number of wards each containing 20 children from southern Iraq. They were all suffering from leukaemias and cancers. The doctors there were convinced that they had been exposed to chemical weapon fallout.

One learns a lot from these and other examples. Some of the reports have come from the "learned" press—from the Economist and others. They state that there has been a range of experiences not fully explained and not put together. I should like to hear from the noble Lord how far the United Kingdom and the United States are now working together to make sure that all information is collated and can be made available to those who have suffered.

6.47 pm.

Lord Burnham

My Lords, in common with other noble Lords, I must express my great thanks to the noble Lord, Lord Morris of Manchester, for putting down this Question. The noble Lord has been kind enough to refer to me. He told me earlier that he would do so and I remonstrated with him then because I have in fact done very little, and I am not being modest about that. He himself has been one of the stars of The Royal British Legion Committee under the chairmanship of the Director of Welfare, Colonel Terry English, to whom I and several other noble Lords who have spoken in this debate are much indebted for his help.

I believe it to be unfair to say that the services or the Ministry of Defence have ever ignored the problems which have arisen as a result of Gulf service. This has been a very, very complicated issue, and a developing one, getting steadily worse over the years. Much of the misconception surrounding it has been caused by the use of the word "syndrome". The noble Lord. Lord Morris, has been careful to avoid this, and talks instead of "illnesses"—a word which does not imply that there is any one single reason for what has happened. We must stop looking for a "syndrome".

An enormous amount of work has been done both in this country and in the United States, but there are still very few who understand the problem, and the MAPS programme does not really seem to be working. Almost every one of your Lordships who has spoken has referred to Group Captain Coker and I must add myself to this number. It is most important that the ministry should get him back into full harness. He is, as I understand it, at present on secondment in the United States, although he does spend some time here. It cannot be a very pleasant assignment for him to have, but he is without doubt the one man the sufferers trust and whom they feel understands their problems. If and when he does come back he must be given fair and unlimited access to allow him to investigate, without any comeback on him or his career if he does find anything.

One of the main difficulties is that we do not know the size of the problem. Having seen a report in a newspaper that 6,000 people were suffering from Gulf illness in this country, I recently asked the noble Baroness, Lady Hollis, to find out how many there were. In a complete and helpful reply I was told that 219 pensions had been granted out of 425 claims and that only a very small number had been turned down. Incidentally, I understand that that figure is almost exactly the same as the figure given in reply to a Question to the Minister in the previous government. However, a solicitor who specialises in these claims tells me that no cases have been settled. Perhaps the Minister can give us some clarification on this point. I am told that 1,000 have applied for war pensions and 2,000 for compensation. Noble Lords will see that there is an enormous variation in the figures: from 6,000 to 425 to 219.

We need a veterans' register. The total numbers were being recorded by the solicitor to whom I referred. However, many sufferers were encouraged to register directly with the Ministry of Defence and the solicitor has therefore lost count of the numbers. Establishing the numbers is vital, although I admit that it is difficult because of the different criteria used. In addition, in many cases it is by no means certain whether the illness derives from Gulf service. The Americans are trying to establish the degree of Gulf illness by comparing peer groups of servicemen who did not serve there and those who did to find out how their states of health compare. I understand that as yet there is no result which has any statistical validity.

I was rather alarmed by the reference by my noble friend Lady Strange to a petty officer who is suffering as a result of a chemical attack on the frigate on which he was serving. I am not aware that any chemical attacks took place during the Gulf conflict. My noble friend also mentioned a number of other alarming cases. They may or may not be the result of Gulf service, and that is one of the things that we have to establish.

There are so many oddities involved in this problem. It seems that no Frenchmen are suffering: could it be that French troops who served in the Gulf all came from the Foreign Legion and were used to serving in those areas? The same might apply to Iraqis and others working and living permanently on the ground. Most of the Americans who are suffering seem to come from their reserve forces and not from the regular army, so training may be of some account. Very little of the trouble is found among those who served in the front lines. Why did the Czechs find evidence of chemical weapons when no one else did? And so on. There is an endless number of variations.

The noble Countess, Lady Mar, has evidence, as she told the House recently, of malformed children whose illnesses seem to be derived from depleted uranium. I recently asked the Minister a Question regarding the toxicity of depleted uranium. I am grateful to him for his letter of explanation; all I can say with reference to that letter is that it serves me right for asking the Question. From a report which he enclosed with that letter, it seems that depleted uranium is unlikely to have any effect on servicemen. I note the noble Countess's reference to malformed children. It may be that depleted uranium is not a factor in Gulf illness among former servicemen, but we do not know.

Perhaps the Minister can help with the numbers. At the same time I must remind him, with the very greatest respect, that he is replying for the Government and not for his department. So much of this is a matter for the Ministry of Health and not for the Ministry of Defence. I hope that he will nevertheless be able to help us. I let him get away with it with reference to Northern Ireland and the case of the two imprisoned guardsmen, but I think that in this case he can probably give us what we want. The answers seem to lie squarely between the two departments. I suggest, with respect, that that provides further evidence of the need for a sub-Department of State to deal with service and post-service affairs.

This aspect of the problem arises again with the question of after-service care. I should not like to comment on the sad cases quoted by the noble Countess, but when a man suspects that he is suffering from a disease as a result of his Gulf service, has been seen by the appropriate authority and discharged into the hands of his GP, the GP is given his records. But have GPs any idea what to look for or how to treat that patient? I hope that GPs are now alerted to the existence of something that they may not know how to handle. With the disappearance of almost all service hospitals, GPs are the only immediate source of help and they will have to be trained. Very few will see a case of suspected Gulf illness, but it is vital that, if they do, they should know what steps to take.

As we speak, the problem is becoming increasingly important—not for the current sufferers, though their problems are great, but for those who may become sufferers in the future. Even more than with the current cases, the United States is concerned for its troops in the future if the Gulf crisis deepens and men are sent into Iraq on the ground. What are they likely to suffer from next time? What cocktail of injections have they been given?

Do those for whom it went wrong in 1990 and 1991 suffer from chemicals spread by the enemy or from what they were given to prevent them from so suffering? Undoubtedly there was a justified fear that Saddam Hussein had the capacity to employ chemical weapons and might use them. It would have been criminal to let the allied forces go into Iraq without protection. Exactly the same applies today. Let us pray that, if the worst happens and ground combat ensues, enough is known to get it right this time. Undoubtedly something—we do not know what—went wrong in 1991. Let us hope that it will not happen again and that the work that the Government are doing will be enough both to cure those who are ill now and to prevent others from becoming ill in the future.

6.58 pm.

The Minister of State, Ministry of Defence (Lord Gilbert)

My Lords, it is a melancholy duty to have to reply to a debate of this nature. As so often, I am forced to stand here agreeing with many of the questions raised but helpless to give answers to them, as I would normally have hoped to be able to do.

I echo the congratulations to my noble friend Lord Morris on raising this important subject. As I am sure he and other noble Lords agree, it is impossible not to understand the sadness, the anger and the sense of injustice on the part of many Gulf veterans at the way they believe they have been treated by successive governments. As your Lordships will know, a few short weeks ago I had the sad duty of having to receive back the medals from a dozen or so Gulf veterans who felt that returning them was the only way in which they could make their protest about what they saw as the unsatisfactory way in which they had been treated. I do not conceal from myself that the fact that only a dozen or so handed back their medals does not mean that there were not many more who felt just as strongly as did those who were present on that sad Saturday.

Before I address many of the remarks made in the debate, I should like to thank those noble Lords who paid tribute to the diligence of my honourable friend the Minister for the Armed Forces who brought a new urgency to the matter. As the noble Baroness, Lady Park, said, we must not lose the momentum of the steps taken last year, that momentum being due almost entirely to my honourable friend.

It may be helpful to the House for me to deal with the various points raised, though not necessarily in the sequence of the speeches. One of the first points on which I should like to touch is the position of Dr. Coker. As has rightly been said, it is a matter of considerable concern to many veterans. He is the one man in whom they had confidence. Anxiety was expressed today that he has been shunted off to Washington and is out of the mainstream of MoD activity with respect to Gulf War illness.

Dr. Coker is closely involved in preparing a detailed report on the first 1,000 patients, to which reference was made this evening by many noble Lords. That paper is in its final stages of preparation and will shortly be submitted for review and publication. I repeat, Dr. Coker is closely involved in its publication. As to whether or not it is appropriate for the doctor to work in Washington, all I can say is that he has been back to this country. He had a meeting with my honourable friend the Minister for the Armed Forces. In addition, in July last year, he was asked whether or not he would prefer to return to the United Kingdom and replied at that time in the negative for both personal and professional reasons. At the moment he is doing sterling work in association with the medical services of the United States. I hope that not only your Lordships but also the veterans will be comforted by the news of his continuing involvement in the MAP review.

My noble friend Lord Morris said that there was a feeling of a lack of sympathy at some of the interviews when individuals were being assessed. The noble Countess, Lady Mar, repeated that point. It is not within my power to comment on what happened at individual interviews. All I can say is that if there have been such cases—I in no way impugn the noble Countess—they are to be deplored. I shall certainly bring her comments to the attention of my honourable friend.

I noted what was said again by my noble friend regarding the case of Gunner Ford, repeated by the noble Earl, Lord Effingham. Gunner Ford is apparently suffering from post-traumatic stress disorder, chronic fatigue and chronic arthritis. Apparently he applied for a war pension as long ago as 1996. I shall certainly look into the question of whether or not interim payments would be appropriate or possible, but I cannot answer yea or nay from the Dispatch Box this evening. I shall obtain an answer for the noble Earl as soon as I can. The same applies in respect of the case of Mr. Parker, who was discharged in April 1997 and I shall also look into the question of whether or not correct advice was given to members of the TA as to the eligibility of their spouses to receive the same benefits as regular servicemen.

My noble friend Lord Morris called for a veterans' register. The call was echoed by the noble Lord, Lord Burnham, and others. That is a matter already being looked at within the MoD and I hope to be able to reply one way or another before too long. I am sure that my noble friend will recognise that the issue has wider implications. There are difficulties in ascertaining exactly where veterans are; many may be abroad. There are also implications for the organisation of government in that respect.

With respect to the Khamisiyah—another question raised by my noble friend and others—we have been trying to identify exactly which units of Her Majesty's forces may have been under the plume of the explosion at the time. It is proving extremely difficult, though the evidence I have seen shows that few British personnel were likely to have been exposed to any toxic materials in those circumstances and, if there were any, those who were would have been exposed for an extremely brief period of time. Exposure for such a period would not normally be expected to affect them medically.

Like the noble Lord, Lord Burnham, I was a little surprised to hear from the noble Baroness, Lady Strange, reports of a chemical attack on a Royal Naval warship. I heard of no such incident during the course of the Gulf War. However, I shall be happy to look into the question of the six widows if she will let me have details of those to whom she referred.

The question of tented accommodation was raised by the noble Baroness, Lady Strange, and the noble Countess, Lady Mar. I have already given the House as detailed an explanation as I possibly can with respect to the contamination of some tents. We are not likely to be able to obtain further information on that subject in the future.

The noble Earl, Lord Effingham, asked questions about confusion with the seven-year rule and the claim period being extended from three to six years. He believes that some clarification is necessary and that there are technical deficiencies in the regulations. I hold a detailed brief which I could read out, but it may detain your Lordships too long. I shall be happy to place on the record the answers to noble Lords' questions, but I ought to touch on other matters before I bring the debate to an end.

I was particularly struck by the questions asked by the noble Lord, Lord Wallace of Saltaire, regarding lessons for future conflict. However sad the events of the past seven years, they are matters to which we need seriously to address ourselves. What lessons have been learnt from the past? What are we doing about the future? What precautions should we take and what procedures are now in place?

The first thing which must be said with respect to any possible future conflict in the Gulf is that Ministers today, like previous Ministers, will be bound to take the best medical advice available to them. They have a responsibility to see that British forces are protected, in so far as is humanly possible, against chemical and biological weapons. The advice will relate both to what is known about the weapons available to a hostile power and the degree, given military deployments and what has happened under the UNSCOM regime, which has been very helpful, of the threat.

The United Kingdom and the United States are co-operating closely with respect to research programmes but we do not necessarily accept that the procedures the United States is putting in place are appropriate for this country. For example, I think I am right in saying that the United States recently decided that it would embark upon a programme of compulsory vaccination, if that is the right word, against anthrax for every single member of its forces. British Ministers at the moment have no plans for compulsory medical treatment for anyone. This is a matter which, quite properly, has to be reviewed from time to time. The question is whether or not we have a moral right to require a member of one of our services to accept medical treatment in advance—for prophylactic purposes—if that service man or woman is reluctant to accept that treatment. There is also the question of whether or not in the judgment of senior officers the fighting capability of that man or woman might be impaired were they not to accept the treatment that is considered appropriate.

One of the difficulties we have in facing any future conflict is that we cannot know as of now the full range of the diabolical agents at the disposal of Mr. Saddam Hussein. Others may come to light at any moment which will produce new problems and will need new types of protective treatment. There is full co-operation between this country and the United States. The United States is funding two important research programmes in this country. As far as I know, we have full access to all their research. They are in a position to spend far more money than we are in these matters. We have at least one official over there in constant liaison with the work that the Americans are doing in their research programmes.

I understand full well what the noble Countess, Lady Mar, meant when she said that veterans do not want litigation; they want recognition of their illness, they want treatment for it and they want pensions for which they do not have to fight. That is a menu of requirements with which few of us would quarrel. The only problem is that we have not yet been able to get medical diagnosis of the causes of some of these symptoms. Recognition of the illness is easier said than done. If you cannot diagnose the illness, you have a problem with the treatment for it. With respect to fighting for pensions, I accept entirely that we need to look again at the interface between the Ministry of Defence and the War Pensions Agency. I shall certainly draw the attention of my honourable friend the Minister for the Armed Forces to the many remarks that have been made in this respect in today's debate.

The noble Lord, Lord Burnham, raised many questions which highlighted the complexities of this matter. He asked a question which I asked myself almost as soon as I arrived at the MoD this time. He asked why the French did not have any units that suffered from Gulf-related symptoms. This could be a matter of where the French forces were deployed during the Gulf War. I suspect that that may well be an answer to the noble Lord's question. I had not realised until he raised the point that most of the American forces who suffered were reservists and not front line forces. There may well be some significance in that which I am sure the Americans will be looking at diligently.

The noble Lord said that GPs need training. I do not know whether they need training. I certainly think there is a case for advisory circulars going out—I am sure that some already have gone out—but the numbers involved do not justify further training.

A point has not been made this evening but I think I should mention it. I am aware that certain of the veterans think that they should go to various institutions that could care for them but that their local health authorities do not think that the money would be properly or best invested in sending them to those institutions. All I can say is that at the end of the day that has to be a matter of judgment for the local health authority. I can only hope that the number of cases where veterans are dissatisfied with that aspect of these matters is greatly diminished over time.

It is a sad occasion to have to stand at the Dispatch Box to discuss these matters. I am immensely grateful for the moderate way your Lordships have put their points to me this evening. I undertake to study the debate again in tranquillity. If there are any points that I have failed to touch on while I have been on my feet I will of course, as is my practice, write to noble Lords about them.

In conclusion, I should like to say that with the arrival of my honourable friend in the post of Minister for the Armed Forces—this point has been widely recognised in the House—the Government have increased dramatically the funds available for trying to get to the bottom of these matters, have accelerated the procedures of the MAP so that the waiting lists are much reduced and have greatly enhanced consultation with the veterans and their organisations and individual Members of this House. We are in no sense complacent. I shall certainly take away the messages that were left with me by noble Lords on both sides of the House. I can assure your Lordships that we have no intention of letting slip the momentum which, as the noble Baroness, Lady Park, was kind enough to acknowledge, we started last year.

Lord Burnham

My Lords, before the noble Lord sits down, I thank him for his comments. Perhaps I may ask him to pay particular attention in the replies that he will give to the numbers involved. I believe that to be very confused.

Lord Gilbert

My Lords, I am happy to do so.

House adjourned at eighteen minutes past seven o'clock.