HC Deb 15 March 1999 vol 327 cc502-4W
Mr. Steinberg

To ask the Secretary of State for Defence (1) what continuing research is in progress on depleted uranium under the medical assessment programme;[74718]

(2) for what reason testing for depleted uranium has been omitted from the overt list of standard tests carried out at the medical assessment programme; [74717]

(3) what tests for depleted uranium have been undertaken under the medical assessment programme; and what consent for such testing was sought from those tested. [74719]

Mr. Doug Henderson

The primary purpose of the Gulf veterans' Medical Assessment Programme (MAP) is to investigate the medical complaints of UK Gulf War veterans and, so far as possible, to diagnose what they are suffering from and recommend appropriate treatment, or provide reassurance if no illness is found.

When the MAP was first established in 1993, its first Head, Wing Commander (now Group Captain) Bill Coker, initially carried out those tests he felt necessary on clinical grounds to establish a diagnosis. When the number of patients referred to the MAP increased, he carried out a number of screening tests, similar to those then used by the US Department of Defense's Comprehensive Clinical Evaluation Programme (CCEP), which is broadly equivalent to the MAP. These screening tests did not include a test to detect the presence of uranium because Group Captain Coker had not previously seen any features in patients to indicate that such testing was clinically necessary. The US experience had suggested that the urinary excretion of uranium was only significantly increased in those veterans with retained fragments of depleted uranium (DU). As MOD was not aware of any UK Service personnel who had sustained shrapnel injuries from DU-based ammunition, it was not thought necessary to screen routinely for uranium excretion, although testing could be carried out on a case by case basis if clinically indicated. Any other tests considered clinically appropriate would also be performed, these additional tests varying from patient to patient. This system of investigation was in place at the time of the Royal College of Physicians' (RCP) clinical audit in 1995.

The RCP's subsequent report, published in July 1995, endorsed the MAP' s professional independence and integrity and made specific comments on how the Programme could be improved. However, with the exception of a recommendation concerning psychiatric assessments, the RCP did not recommend any changes to the tests and examinations carried out by the MAP.

The baseline tests currently carried out on MAP patients by St. Thomas's Hospital on the MAP's behalf are very similar to those which were in place at the time of the RCP audit in 1995. They are as follows:

  • Full blood count and sedimentation rate (FBC/ESR)
  • Full biochemical screen, including renal function tests (urea, electrolytes and creatinine), liver function tests (LFT), calcium and blood sugar
  • Immunoglobulin analysis
  • Creatine kinase
  • Thyroid function tests (TFT)
  • Serological screening tests
  • Chest X-ray (CXR)
  • Ultrasound abdominal scan
  • Electrocardiogram (ECG)
  • Urinalysis
  • Peak-flow lung measurement (to determine the necessity for vitalography)

A management audit of the MAP has recently been conducted, looking at all aspects of patient care and the service provided by the Programme. A final report is in preparation and MOD expects to receive this shortly. We intend that this will be made public in due course. This work will then be followed by a clinical audit which will include a review of the range of tests and examinations currently undertaken at the MAP.

The tests listed are the baseline investigations at the MAP; additional investigations and/or referrals to other consultants/specialists are sometimes required for particular patients. As part of this, any tests which are considered clinically appropriate by the examining MAP physician, which could include those to detect the presence of uranium, are arranged. However, MAP physicians have not so far considered it clinically necessary to conduct tests on any MAP patients to detect the presence of uranium.

Contrary to some recent media reports, the MOD is not conducting testing in relation to the possible exposure of Gulf veterans to DU, secret or otherwise.

On 16 December 1998, Official Report, columns 520–22, I announced that I had asked my officials to collate the information which the Department possesses concerning mechanisms which could be used to test for the presence of uranium in the human body. I expect to publish the results of this work shortly and will make arrangements for copies to be placed in the Library of the House.

The MAP is not a research programme and it is not involved in any research concerning DU. Although the Ministry of Defence is funding a range of studies into aspects of Gulf veterans' illnesses, none of these are specifically aimed at investigating the relationship between possible exposure to DU and the illnesses being experienced by some Gulf veterans.

The Ministry of Defence is well aware that a link has been suggested between DU exposure and Gulf veterans' illnesses. However, this is only one of a number of factors which have been suggested as causes of Gulf veterans' illnesses and, pending further medical and scientific evidence, MOD is keeping an open mind on this issue. MOD would be very interested to see any new relevant information on this subject.