The Parliamentary Under-Secretary of State, Ministry of Defence (Lord Astor of Hever)
My Lords, I also congratulate the noble Lord, Lord Morris, on securing this further debate on illnesses in Gulf veterans and I thank him and other noble and noble and gallant Lords for taking part. The noble Lord has been a long and true champion of veterans and the wider disabled community, and I am proud that 40 years ago, my late uncle, John Astor, was one of the architects, along with the noble Lord, of the Chronically Sick and Disabled Persons Act 1970—the Alf Morris Act. The noble Lord has raised the sensitive issue of Gulf veterans’ illnesses on a number of occasions and many in the veterans community hold him in high esteem, as I found out when I was privileged to hold a number of honorary positions with the Royal British Legion.
The first duty of Government is the defence of the realm. We have a moral responsibility to look after those in our Armed Forces, particularly when they are prepared to risk life and limb on our behalf. So let me begin by setting out the new coalition Government’s priorities in this area.
As the Prime Minister has said, we want to create an atmosphere in which we as a nation back, revere and support our military. There has never been a formal document setting out precisely what this means, and that is why for the first time this Government will create a tri-service military covenant. The Prime Minister is passionate about this. It will be the foundation of the new Government’s far-reaching strategy for and obligations to our service men and women, their families and, of course, veterans. It is long overdue. More broadly, we will ensure that the Armed Forces have the support they need and that veterans and their families are treated with the dignity they deserve. It is important to set out the broad principles that drive our approach and how this Government will go further.
Let me turn now to the specifics of Gulf veterans’ illnesses. As the noble Lord would expect, I have gone into this matter in some detail with officials. The Government are open-minded on the issue of the illnesses reported by some veterans of the 1990-91 Gulf conflict. Our priority is to ensure that Gulf veterans who are ill do receive appropriate medical care. Gulf veterans with concerns about their health should seek a referral to the Ministry of Defence’s Medical Assessment Programme at St Thomas’ Hospital. This facility gives free and speedy general and mental health examinations by an expert doctor with great experience of veterans’ health issues. The MoD pays the travelling expenses of attending veterans and will also arrange overnight accommodation for those travelling long distances. Over 3,500 Gulf veterans have used this service, where each individual receives an examination and clinical tests, dependent on their case.
The service provided by the Medical Assessment Programme remains popular with those who attend. Indeed, the programme provides valuable back-up support for the Department of Health and the devolved Administrations who, with support from the MoD, are running six community health pilots for veterans at NHS trusts across the country. The pilots, which will be evaluated later this year, will provide key input into planning future provision across the NHS. Financial support for veterans and their dependants is provided through the Ministry of Defence war pensions or Armed Forces occupational pension schemes. For those veterans who need additional support, the Veterans Welfare Service exists to provide help and advice to veterans, their families and dependants.
To date the MoD has spent around £9 million in funding expert independent medical research on Gulf veterans’ illnesses issues. This research has come to the same conclusion as the independent Medical Research Council report from 2003 which looked at all the UK and international research into these issues—namely that,
“there is no evidence from the UK or international research of a single syndrome related specifically to service in the Gulf”.
As recommended by the Medical Research Council, one area where we are looking specifically at the needs of Gulf veterans is rehabilitation. We are spending £430,000 on specific research into rehabilitative therapies for those with persistent symptoms. We expect this work to conclude in 2012.
Lord Lloyd of Berwick
Before the noble Lord leaves the question of causation, I hope he will come back to the point made so clearly by the noble Lord, Lord Morris, that we now know the answer on causation from the much more extensive research carried out in the United States.
Lord Astor of Hever
My Lords, I am coming to the United States reports in a while. Lessons identified from the 1991 conflict have been implemented for other operations. So far there has been no similar problem with unexplained illnesses.
The noble Lord, Lord Morris, was the first British parliamentarian to be co-opted on to a US congressional committee of inquiry into Gulf War illnesses. I can assure the noble Lord that the Government are well aware of the interest in the publication of the United States Institute of Medicine update on the Health Effects of Serving in the Gulf War, published in April, and that of the US Research Advisory Committee on Gulf War Veterans’ Illnesses, published in 2008. We look forward to seeing the US authorities’ comments on the reports before commenting in any detail from the UK perspective. Indeed, we understand that the US Department of Veterans Affairs has formed a task force specifically to look at the Institute of Medicine updated report and to make recommendations. Defence Ministers, particularly myself, and officials will consider any findings carefully.
We are aware of the frustration that some feel with the pace of work associated with these reports but they address complex scientific and medical issues. We have noted, however, that the Institute of Medicine report mirrors the findings of the Medical Research Council review of research into UK Gulf veterans’ illnesses published in 2003. In particular, the Medical Research Council review recommended giving priority to research aimed at improving the long-term health of Gulf veterans with persistent symptoms.
We further note that the Institute of Medicine report supports the international majority view and the MoD’s long-standing position that NAPS tablets given to service personnel and OP pesticides are not the cause of ill health reported in some Gulf veterans. This should be reassuring to UK Gulf veterans concerned about such health issues.
Noble Lords and the noble and gallant Lord, Lord Craig, will be aware that the MoD’s vaccines interactions research programme, costing some £4.5 million, was an in-depth examination of the potential adverse health effects of the combination of medical countermeasures administered to troops in the 1990-91 Gulf conflict. The overwhelming evidence from the programme was that the combination of vaccines and tablets offered to UK forces at the time of the conflict would not have had adverse health effects. This programme has been the subject of a level of scrutiny far in excess of what might be expected in similar research. As well as peer review prior to publication, all stages of the study were overseen by an independent panel of experts and veterans’ representatives.
I know that exposure to OP pesticides during the 1990-91 Gulf conflict is of concern to some veterans. The MoD continues to monitor ongoing research in this area through its involvement in the Official Group on Organophosphates, chaired by Defra. Although the effects of acute exposure to OP pesticides are well understood and undisputed, no such incidents occurred during the deployment of UK troops to the Gulf in 1990-91, although OP pesticides were undoubtedly used.
While we are always willing to consider credible new evidence, the overwhelming consensus of the scientific and medical community is that there are too many symptoms for the ill health reported by Gulf veterans to be characterised as a syndrome according to the strict medical definition. However, MoD reviewed the position on its use and accepted it as an umbrella term, addressing the concern of those veterans who feel that the link between their service and their illnesses has not been adequately recognised.
We know that this does not go far enough for some, but we believe that we must take an evidence-based approach. The medical and scientific evidence published so far does not support the claim that veterans of the first Gulf conflict are suffering from a specific illness that differs from those experienced by individuals who served elsewhere.
Data from the medical assessment programme continue to support the results of the independent research. Gulf veterans seen as part of the programme complain of similar symptoms to the general veteran population, and most should be cared for by standard NHS resources. No unusual pattern of disease has emerged, nor is there evidence of unusual neurological or other disorders among Gulf War veterans. The same high standard of medical care and treatment is therefore as appropriate for them as it is for all veterans.
Gulf veterans, like other veterans, have access to a wide range of support: medical support at the medical assessment programme, financial support for any injuries caused by service and practical support through the Service Personnel and Veterans Agency welfare service. We are undertaking further research to offer tailored rehabilitation support. There is insufficient credible evidence to suggest that we should treat this group differently from other groups of veterans who report similar health problems.
I know that the noble Lord, Lord Morris, is not going to go away. I give him a commitment today that I am happy to meet him with officials to hear any concerns that he may have. I thank him for raising his concerns again—concerns that affect people who have sacrificed so much on our behalf, and to whom we owe a great deal. I assure him that the Government are committed to helping them through treatment, rehabilitation and research. We also reaffirm the moral obligation to treat those who serve, their families and veterans with fairness and dignity.