§ Mr. Brian H. Donohoe (Cunninghame, South)I raise the sad case of Barry Donnan, who joined the Royal Highland Fusiliers in 1987 as a 16-year-old. As a young soldier, he was sent to Lockerbie in 1988 to pick up pieces of bodies that had fallen from the sky. After that he was sent to the Belize jungle, where he was accused of murdering an Army cook—a foreigner—who in fact died of a heart attack. The case was dealt with not by the Army, but in a civil court. After an eight-week trial, he was eventually found not guilty. On his return home in 1991, he was sent immediately to the Gulf. One of the many events he witnessed there was the burial of hundreds of Iraqi soldiers in a mass grave. Such events traumatised him, but he argues that inoculations and tablets supplied to the troops also contributed to his suffering post-traumatic stress disorder, among other disorders.
As a former trade union official, I had to represent social workers in the aftermath of Lockerbie. Six months after the disaster, not a single social worker was still in employment. All of them had to be pensioned off because of the stress that they experienced. Nor does a single policeman or fireman who served during the events of Lockerbie remain in service. As a 16 or 17-year-old boy, Barry Donnan was sent into the very middle of that disaster, but the Army gave no counselling. Nor did the Army offer the necessary support during his time in Belize and in the Gulf. As he says in his book, "Fighting Back" a copy—of which I have given to the Minister—he just lost it. After a break, he went absent without leave for some six months. On being captured, he was court-martialled and sentenced to 112 days in Colchester. No counselling was offered, and no attempt was made to look at the mental state of this youngster.
On his release from Colchester, he was immediately sent into the trauma of Northern Ireland. By his own admission, he had no clue where he was or what he was doing. Before being allowed on to the streets of Northern Ireland, every trooper normally completes an intelligence threat analysis course, but Barry did not have that certificate. I find that rather surprising, and it illustrates the events that surrounded the fusilier at that time.
Barry first came to my surgery on 14 March 1997. On 24 March, I wrote to the then Minister for an immediate review of his case. I have made subsequent representations to the present Minister and to his predecessor, but to no avail. Aspects of the case greatly concern me. When Barry applied for legal aid, his solicitors were informed that because the War Pensions Agency had given information to suggest that he was time-barred he would get no form of support from the Legal Aid Board. I have established that that was misinformation, but young Barry's situation still gives cause for concern.
In 1999, after three years of dealing with other matters, he came to tell me that his disability living allowance had been withdrawn. After a protracted fight with the then Minister with responsibility for social security, I established that that should not have happened and ensured that the disability living 180WH allowance was put back in place; however, it was at a lower rate. Barry's most recent argument is that he believes that his war pension is under threat. He says so on the basis that while he was in the ex-services mental welfare place in Hollybush, Ayrshire, he discovered that statements were being sent to the War Pensions Agency about how he was doing. He is of the opinion that that was threatening his war pension and is concerned that reports are being sent from the Ex-Services Mental Welfare Society to the War Pensions Agency. I have been told by the commodore in charge that that is normal because the armed forces are paying for his time in the Hollybush centre.
I am looking for two possible solutions. There is no doubt that the Ministry of Defence must change the way in which troops are dealt with and fully recognise that although their physical state is looked after well by the Army, their mental state is equally important to them. During developments in the deployment of armed forces around the world—the latest of which has been in Afghanistan, and before that they were in Kosovo—there does not seem to be the commitment that there should be to the mind of the individual and the traumas seen. One could argue that the lad was immature from the outset, but there is no difference between someone who joins the armed forces and someone who becomes a policeman or joins a local authority as a social worker. The experience of Lockerbie was so traumatic for the police and social workers that not one of them was still in that employment six months after the event. It surprises and appals me that the armed forces do not treat that mental element as they should; they must do so, and settle the case of Barry Donnan. I appeal to the Minister on that point.
Arguments that have been presented in correspondence suggest that another option is open to young Barry. He could join a group of some 30 ex-service men who are in some form of joint application to the Ministry of Defence and through that to the courts for a settlement. However, in his letter dated 27 August 2001, Barry states:
The group action issue is nonsense, the time scale is too long, only 30 ex-servicemen are being heard in the first instance, of which I don't belong, then, what ever the judge says is binding. So, maybe I won't ever get a fair hearing. My solicitors have made and struck many deals with the MOD lawyers, I am sure they will know the outcome before it even gets to the High Court. Perhaps, that is why the MOD are so keen to railroad me down that line.He now has no confidence in the system, which is what led me to apply for this Adjournment debate. I want the Minister and the civil service to wake up to the mental health issue in the armed forces and, particularly in Barry's case, to make some form of compensation. I look forward to the Minister's response.
§ The Parliamentary Under-Secretary of State for Defence (Dr. Lewis Moonie)I am grateful to my hon. Friend the Member for Cunninghame, South (Mr. Donohoe) for initiating this debate about his constituent, Mr. Donnan, and the important issues surrounding his claim for compensation against the Ministry. My hon. Friend will understand that because Mr. Donnan's case is due to be heard as part of a wider post-traumatic stress disorder group action in the High Court in early March, it would be inappropriate for me 181WH to discuss the details or to re-examine Mr. Donnan's case ahead of the judgment. The group action, of which Mr. Donnan's claim is a part, is significant litigation. The trial is likely to last up to five months with written judgment to be handed down in the autumn. I understand that Mr. Donnan will give evidence at the trial.
While recognising the emotive and sensitive nature of the issues raised by group actions, it is important that they are set within a factual context. I have corresponded with my hon. Friend about the case on several occasions, as have my predecessors. The way in which he approaches the debate is constructive and far removed from the lurid headlines favoured by some when dealing with similar cases.
I have read Mr. Donnan's book, "Fighting Back: One Man's Struggle for Justice against the British Army". He has endured a series of terrible personal tragedies that have contributed to his present suffering and I have considerable sympathy for his current plight. Stress-related medical disorders are recognised by the armed forces as potentially serious and disabling conditions. Post-traumatic stress disorder—PTSD—was not recognised internationally as a medical condition until the 1980s, but methods of treatment have subsequently developed in the medical world and the armed forces. The measures now in place to combat PTSD in the armed forces have evolved and been enhanced over a number of years to reflect our improving knowledge of the condition, its effects and the best methods of remediation. Each service runs active programmes aimed at prevention and treatment. Measures include pre-deployment and post-deployment briefing and, when practicable, availability of counselling in theatre.
The strategic defence review recommended that psychiatric services be enhanced and a review of the defence community psychiatry service has been completed. That resulted in proposals to enhance existing defence community psychiatric centres and the formation of two new centres: one in Scotland and one in England. Additionally, the armed forces are exploring ways of detecting PTSD at an early stage and of managing the condition according to the best clinical practice. That involves training service line managers so that they are better able to detect symptoms of stress-related conditions in their units and to act positively with individuals to resolve problems before seeking outside professional assistance from the defence community psychiatry service. A pilot programme was set up by the Royal Marines and has provided positive results.
Turning to litigation, the Ministry has received about 1,500 claims for post-traumatic stress disorder from former members of the armed forces, mainly relating to service during the Falkland and Gulf conflicts, and in Bosnia and Northern Ireland. Many of the claims contain similar allegations, so the Lord Chief Justice set up a group action in 2000. The allegations, in general terms, are that the Ministry was negligent in that it failed properly to recognise, diagnose and treat those said to be suffering from PTSD. The action consists of two groups. In group one the Ministry's alleged failure occurred before 15 May 1987 and in group two the earliest alleged failure took place after 15 May 1987. The reason for the two groups, as I am sure my hon. Friend is aware, is that prior to 15 May 1987 service personnel 182WH were prevented from pursuing claims against the Ministry of Defence under section 10 of the Crown Proceedings Act 1947. That section was repealed on 15 May 1987 and it was logical to separate the claims into those arising from incidents occurring before and those occurring after the repeal. Mr. Donnan's case forms part of the second group.
Compensation claims received by the Ministry of Defence are considered on the basis of whether the Ministry has a legal liability to pay compensation. Where there is a proven legal liability, compensation is paid. The amount of compensation is determined by common law principles which, broadly speaking, take account, as appropriate, of the individual's pain and suffering, the degree of injury, past and future financial losses, the level of care required and so on. The level of compensation can vary according to the individual's circumstances.
That Mr. Donnan suffers from PTSD is not questioned. I acknowledge that he receives a 100 per cent. war disablement pension and a service pension under the armed forces pension scheme. The nature of Mr. Donnan's disability is, therefore, not the issue to be determined by the court. It is important to emphasise that this litigation is not about the validity of PTSD as a psychiatric disorder—the Ministry accepts its validity—or about soldiers unjustifiably suing in respect of the natural and probable risks incidental to their calling. The claimants' case is that PTSD can be detected and prevented, and that proper systems would or should have achieved those objectives in the vast majority of cases.
The parties have agreed that the judge be invited to adjudicate on a range of generic issues that form the basis of the allegations. Those issues include: screening to exclude those vulnerable to PTSD from combat in the first place; briefing to prepare soldiers psychologically for combat; detection to enable the early identification by properly educated commanders and medical officers of those who are either at high risk of a PTSD or who suffer from one; debriefing to allow for the deployment of psychological intervention post trauma to ventilate or defuse its adverse effects, to educate the individual about those effects and enable him to seek help if necessary and to enable the employer to detect early or incipient morbidity; cumulative exposure, or the deployment of troops beyond their expected breaking point; our duty at discharge and the failure to carry out a thorough medical examination at discharge from the armed forces, and, therefore, to detect and treat psychiatric morbidity at that stage; the failure to deploy effective treatment modalities; Crown immunity and the question of whether section 10 of the Crown Proceedings Act 1947, which is relevant to breaches of duty that arose before May 1987, is appropriate in the light of the human rights that are now enshrined in British law; and causation, or the extent—if any—to which alleged breaches of duty caused or materially contributed to the claimants' psychiatric condition. The claimants' case highlights alleged failures in the Army, although their solicitors recently confirmed that the Royal Navy and the RAF were equally targets of criticism.
The Ministry acknowledges that some members of the armed forces may be subjected to traumatic experiences during their careers and may suffer stress as a result, but 183WH that does not necessarily mean that it has been negligent. However, it has a duty to ensure that service personnel receive proper treatment. If we fail in that respect, and the individual suffers loss or damage as a result, he or she may be entitled to compensation.
If I may, I shall leave PTSD to one side, and turn to matters that arise from Mr Donnan's service in the Gulf. The Government accept that some Gulf veterans have become ill and that many believe that their ill health is unusual and is related to their Gulf experience. There is now scientific evidence that Gulf veterans report more illnesses than other comparable groups, but there is no medical or scientific consensus about the causes of those illnesses. We remain open minded about the causes, and important research is under way.
§ Mr. DonohoeWhat are the time scales for that exercise? When will we have the final reports?
§ Dr. MoonieIt might be helpful if I point out to my hon. Friend, since the matter is one of my responsibilities, that some 12 research studies are still proceeding. Most of them will report during the coming year. Some of them are very detailed, others much more general. The various problems should be resolved within the next 12 months or so. However, we are afraid that we will again find that there is nothing specific involved after having expended a great deal of time, effort and money—resources have not been stinted in our attempts to identify the cause of the conditions that are complained of. We may be left with an inconclusive result and have to recognise that we will never get to the bottom of the matter. However, I assure my hon. Friend that any suggested causes will be actively followed up and that we will do our very best to find the cause, if there is one to be found.
As my hon. Friend is aware, we encourage all Gulf veterans who are concerned about their health to attend the Gulf veterans' medical assessment programme. That programme was set up in 1993 to provide as full a diagnosis as possible to veterans who were concerned about their health. Following consultation with the medical assessment programme, the examining physician writes to the doctor who referred the patient to provide diagnostic information and recommend any appropriate treatment. It is then that doctor's responsibility to take forward and monitor the treatment as he or she would for any other patient. Veterans who have left the armed forces will normally have a GP as their doctor and any recommended treatment will therefore be carried out within the NHS. Veterans can be referred to the medical assessment programme more than once.
Last year we re-issued our Gulf veterans' illnesses information pack. Copies of the pack have been sent to all GPs in the United Kingdom, service medical officers, prison medical centres and other interested parties. I understand that two appointments were made for Mr. Donnan at the medical assessment programme on 18 October 1999 and 16 November 1999, but that for reasons that are unknown to me he declined to attend both of them, or was unable to do so. He was referred by his GP because he was suffering from depression. The medical assessment programme provided advice in 184WH writing to the GP and offered to help in any way they could. I would take this opportunity to urge Mr. Donnan to make use of this facility, because it might still be of some benefit to him. The people have a great deal of experience in handling those who have had similar experiences to him.
Gulf veterans' illness issues remain a high priority for the Government, as evidenced by the Gulf veterans' medical assessment programme, the continuing support for research and the publication of new information whenever it becomes available. The Government have demonstrated their commitment to addressing Gulf veterans' concerns openly, honestly, and seriously and I assure my hon. Friend that we will continue to do so.
The Ministry's Gulf veterans' illnesses unit is drawing together a document for publication later this year which will identify the key health lessons arising from the aftermath of Operation Granby and the subsequent investigation of Gulf health issues. It will set out developments that have contributed to improved performance since 1991. Planned publication of this paper further underlines our commitment to address the concerns of veterans' groups who have expressed the worry that the shortcomings in the Gulf may be repeated in future. We are determined that that will not happen and that the lessons must be applied to future deployments.
As my hon. Friend knows, early in 2001 I was appointed Minister with responsibility for veterans' affairs. I have spent most of the intervening months improving my contacts with all the veterans' organisations in the UK, so far as I am able, and setting up a proper structure for the handling of veterans' matters. As a physician, qualified in psychiatry and public health, I can assure him that medical matters such as Mr. Donnan's case are high on my list of priorities. I shall be taking a personal interest in the development of the community psychiatry programme and in the development of means to identify some of the factors that I have outlined; that may prove part of the case that the judge will review in the action later in the year.
§ Mr. DonohoeThe Ministry of Defence could use other approaches to the matter, besides going to court. It seems to want to hide from its obligations. While the Minister's remarks have been encouraging in a general way, they will do nothing to help Barry Donnan. On past experience of dealing with the Ministry of Defence, most cases are settled before they reach court. I wonder whether the Ministry would want to move from a reactive approach—of driving matters towards the courts—to a proactive approach of solving problems.
§ Dr. MoonieI have to say three things in reply to my hon. Friend. First, Mr. Donnan has chosen to have his case included in the group action. I am therefore constrained in what I can say, because of the legal proceedings. Secondly, treatments are available for Mr. Donnan's condition. The Gulf veterans' medical assessment programme might be able to direct him towards further help. It is not true that we are doing nothing for Mr. Donnan. As I have suggested, we have provided a reasonable pension. I am conscious of the adjectives used to describe pensions, but the general procedures have been followed.
185WH We operate a generous scheme in the armed forces of both attributable and non-attributable benefits, through the War Pensions Agency, which is now, of course, part of my rapidly increasing area of responsibility. Mr. Donnan can rest assured that his pension is not subject to the reports on him supplied by the facility that has been treating him. Rather, the procedure was used by the association to justify his continued treatment and costs at the facility. Obviously it is necessary to show whether he would derive further benefit from treatment.
I cannot comment in detail on the case, but, to summarise, I have great sympathy for Mr. Donnan's predicament. I do not like our soldiers to suffer as he has done. Unfortunately, when the Ministry is accused of negligence and I consider that unjustified, it is necessary to take a robust stance. In the present instance, that is my general view, which is why the actions are proceeding. Generally, I assure the hon. Gentleman that I am conscious that people can be mentally as well as physically damaged by their service to the Crown, and I shall ensure that the services that we provide to them in turn are as good as they can be to deal with any future problems that they experience.