Armed Forces Bill

Lord Alton of Liverpool Excerpts

Thursday 3rd March 2016 Grand Committee

[Earl Howe]

My Lords, without wishing to preclude further debate on this amendment, it may be for the benefit of the Committee if I confirm the announcement made by my ministerial colleague in another place on 29 February. This was that the option of receiving a lump sum of £140,000 will be extended to veterans in receipt of a war pension for diffuse mesothelioma who were diagnosed before 16 December 2015 and also to those who have yet to have a claim accepted. We listened to the views of parliamentarians and ex-service organisations, particularly the Royal British Legion, which commented that the Government had “done the right thing” in announcing these changes to the compensation pay-out.

[Lord Alton of Liverpool (CB)]

My Lords, I support the amendment moved by the noble Lord today in Committee. I apologise to the Committee, as, although I attended some of the Second Reading debate, duties elsewhere in the House prevented me from being able to be present for the Minister’s reply. I therefore did not speak at that stage and I crave the indulgence of the Committee in speaking today.

Noble Lords might know that I currently have before the House a Private Member’s Bill which has received a Second Reading. It enjoyed all-party support and would provide funding for research—to which the noble and gallant Lord just referred—into the causes of mesothelioma, a disease which the Government themselves predict will take a further 60,000 British lives. We have the highest incidence of mesothelioma anywhere in the world. No effective treatment exists; there is no cure and once diagnosed, the average patient dies within a few months.

On introducing that Bill, and in relation to our Armed Forces, I said that,

“the failure of the 2014 Act to include provision for compensation for our servicemen who die of mesothelioma is a glaring anomaly. The British Legion, the Royal Navy & Royal Marines Charity, the Royal Navy Royal Marines Widows’ Association, the Royal Naval Association and others all support calls for change”.—[Official Report, 20/11/15; col. 385.]

I contrasted at the time the position of a 63 year-old civilian, who might expect to receive around £180,000 in compensation, compared with a veteran’s entitlement to a year’s worth of war pension which, paid at the maximum rate for a non-married naval veteran, amounts to just £31,000. I argued then that veterans should be offered compensation at least equal to that which the courts and the Government have decided that civilians deserve. The unequal treatment of our servicemen and servicewomen amounts to a serious breach of the Armed Forces covenant, which is supposed to ensure that veterans are not disadvantaged because of their service.

I am particularly grateful, therefore, that the department has recognised that this is an anomaly that needs to be rectified, and I strongly welcome what the noble Earl, Lord Howe, said to the Committee a few moments ago. Of course, this echoes what his honourable friend in another place, the Parliamentary Undersecretary, recently told the House of Commons. He will also know that there was not just that anomaly: there was an anomaly within the anomaly in that a very small group of people—some 60—had been excluded from the scheme because of the way in which the timeline in the announcement fell. It is particularly good that the noble Earl has been able to say today that that will be removed—that the effect of the amendment that the noble Lord, Lord West, has put before the Committee will be realised.

The noble Earl will also know, especially given his previous duties at the Department of Health, that this is a disease that does not have a cure and needs much more basic research. He will also know that until the mid-1960s, blue asbestos—crocidolite—was widely used in the insulation of Royal Navy vessels. In consequence, many Royal Navy personnel have died of mesothelioma, particularly those working in boiler rooms and in engineering trades but also those on board ships during refits.

Professor Julian Peto, in an analysis for the Royal British Legion, estimates that a further 2,500 Royal Navy personnel will die of mesothelioma between now and 2047. On 8 December 2015 I asked the noble Earl in a Parliamentary Question how the Government intend,

“to assist members of the armed forces who are diagnosed with mesothelioma in the future; and what assessment they have made of whether those individuals should receive financial support at least equivalent to that of civilians diagnosed with the disease”.

The noble Earl replied that this was “a complex matter” and that:

“The Department commissioned advice from the Independent Medical Expert Group to look at mesothelioma and the awards paid through the WPS”.

The noble Earl promised an announcement and we have now received that.

However, if I may say so, there were also written into this and other Questions tabled at the time questions about the levels of research and indeed the data collection by the Government. I refer particularly to the comments of Commodore Rhod Palmer, who is a third-generation Royal Navy sailor diagnosed with mesothelioma in April 2015. Incidentally, he is one of those who would have been excluded from the new compensation scheme—the anomaly within the anomaly. He said:

“No amount of money will ever compensate sufferers and their families for a preventable death. However, it is a real breakthrough that the Government will treat all current and future sufferers of mesothelioma exposed to asbestos during their Service under comparable terms as civilians. This payment allows patients with mesothelioma to make arrangements to maximise their quality of life during this terminal illness and to support the family that they leave behind”.

He went on to say:

“Looking to the future, I strongly encourage further funding of research into advancing the treatment of this devastating condition”.

The noble Earl will recall that when he was at the Department of Health I moved an amendment to the Mesothelioma Act to provide financial support from the levy on the insurance industry, which was defeated by a handful of votes. At the time four insurance companies were voluntarily supporting research and the noble Earl believed that many of the other 120 insurance companies covered by the levy would voluntarily join the other four in supporting research into this killer disease. Sadly, I have to inform the noble Earl and the Committee that the opposite has happened, with only two companies now voluntarily supporting research. In supporting this amendment and welcoming this week’s announcement, I ask the noble Earl to study the correspondence that I have sent him today, which includes a letter sent on 18 February to Mr George Osborne, the Chancellor, by Professor Sir Anthony Newman Taylor CBE of Imperial College, urging him to release LIBOR funds—referred to by the noble Lord, Lord West—to help fund a national mesothelioma research centre, which Imperial wishes to create with the National Heart and Lung Institute, the Royal Brompton Hospital, the Institute of Cancer Research and the Royal Marsden Hospital. Incidentally, in that letter Sir Anthony says that the current rate of death is around 3,000 a year. He says:

“There is an urgent need to find curative treatment for this awful disease”.

He says that modern genetics hold great promise but that,

“sadly, to date, mesothelioma has not been the focus to achieve this at any research centre in the UK, or, as far as I am aware, at any centre worldwide”.

The Committee will recall the decision of the Chancellor to transfer some £35 million from the fines levied on the banks for attempting to manipulate the LIBOR interest rate. That money was transferred to the MoD for use in supporting the Armed Forces community. The proposal from Imperial College would be an imaginative use of some of those funds to help to find cures for a disease which has claimed too many lives among members of our Armed Forces. Following our debate today, therefore, I would be grateful if the noble Earl would write to me with a considered response to Sir Anthony’s initiative.

I shall conclude with a word about data collection within the Armed Forces. In February 2014, I asked the Government,

“how many of the annual fatalities caused by mesothelioma involve former members of the armed forces; what data are kept on the cause of death of former servicemen; and what research they plan to commission into the incidence of mesothelioma amongst former servicemen”.

The then Parliamentary Under-Secretary, the noble Lord, Lord Astor of Hever, replied:

“Data on the number of annual fatalities caused by mesothelioma does not identify those who were former members of the Armed Forces … The MOD has no plans to commission research into the incidence of mesothelioma amongst former Service Personnel”.—[Official Report, 11/2/14; col. WA 125-6.]

It is the duty of the department to do that, and it should have such plans. I encourage the noble Earl to revisit this issue. This should not be a case of don’t ask, don’t say. This is about people’s lives and our duty of care towards them. Anecdotes and speculative figures are no substitute for hard-edged data and empirical research, and today I again ask that data collection be instigated.

The noble Lord pursued this argument in June last year when he asked Her Majesty’s Government:

“What data is collected about the incidence of mesothelioma among members of the armed forces; what studies of this issue have been conducted; what estimates they have made of the future incidence of mesothelioma among service men and women and of connected fatalities”.

Those questions still have to be answered, and I hope today’s debate will help us to attend to that. In reply the Minister said:

“The MOD has not conducted studies or research about mesothelioma”.

Surely it is high time it did.

The London School of Hygiene & Tropical Medicine produced an estimate in 2009 that about 2,500 Royal Navy veterans will die from mesothelioma between 2013 and 2047. Surely, we should be commissioning research across the services to establish what the likely incidence will be and, more importantly, what we can do to avert this suffering and these deaths. Surely we should be supporting the work of our scientific community and offering hope to those who have been diagnosed with this horrible disease.

[Lord Empey]

My Lords, I support the amendments and welcome the statement from the Minister. It was sobering when the noble Lord, Lord West, said at an earlier stage that he and others played snowballs with this material in vessels. Sadly, anybody who comes from an industrial city such as mine with shipyards and other related businesses knows that that was common practice. Dust and fibres were brought into homes on clothing, and that transferred the disease to families, which is why in 2001, when I was Enterprise Minister, I set aside £180 million to cover what we considered to be the compensation required for people who had previously worked for shipyards, which were a nationalised business at the time, to cover deaths to 2050. The noble Lord, Lord Alton, who has done enormous work on this issue over recent years, says the same thing—that that is the sort of timescale.

What is not mentioned is that while some people think this disease is literally dying out, it may be in this country, but it is not dying out in the world. I am sure we have all seen the horrifying photographs of women in the Indian subcontinent surrounded by mountains of this material which is coming off ships that are being scrapped on beaches in Bangladesh, India and Pakistan. They are being dismantled, and these women are sorting this stuff out. It is horrifying to think of the downstream consequences that will produce. Therefore, anybody who thinks this matter is going to be settled in a few years is wrong.

In the amendments in my name in this group I want to draw attention and attempt to raise awareness through publicity among former members of the armed services who may be at risk or who may be susceptible to this disease. It is important that ex-service personnel and their families are made aware of the changes that are now taking place. I was also hoping for a monitoring process to ensure that the comprehensive and prompt detection of cases is also part of it. If people have been exposed, while it may not be currently curable the management of the disease can be handled. I had two neighbours who got this disease; it was a terrible death that they suffered. One of those individuals spent just one year of his entire career in the shipyard, where he, from time to time, went through an area where the electrical materials were being covered in asbestos. One exposure to one fibre, if you are susceptible, can be enough. That was 40 years earlier. It does not discriminate between a person’s normal health, class or physical condition. It is just one of those things: some people are susceptible and others are not. It does not matter whether you are exposed to it for one day or for 20 years. If you are susceptible, you are susceptible.

--- Later in debate ---

[Earl Attlee]

My Lords, I am grateful for the progress that has been made by the Government in expanding the scheme. When I supported my noble friend Lord Freud with the Mesothelioma Act, I could not understand why it was not extended to MoD personnel. My question to the Minister is about research. Many noble Lords raised the issue of research, which could have very great benefits. What lines of research are available? When I was with my noble friend Lord Freud, I understood that there were not that many good avenues for research. I have not found any areas of research that might provide some benefits.

[Lord Alton of Liverpool]

Perhaps I can help the noble Earl because his noble friend Lord Prior of Brampton has been extraordinarily helpful on this subject and, as recently as two weeks ago, convened a meeting at the Department of Health which I attended. Many of the people involved in current research into mesothelioma were present. The big issue they all raised was sustained funding. The noble Earl, Lord Howe, knows far more about this than me so I am sure he will deal with it in his reply. The noble Earl, Lord Attlee, can be reassured that there is a lot of interest within the research community but it comes down to funding.

[Earl Howe]

My Lords, I thank the noble Lord, Lord West of Spithead, for raising this critical issue. Mesothelioma—as the noble Lord, Lord Alton, outlined—is a devastating disease that changes the lives of not only the people diagnosed with it but also those who care about them: their families and loved ones. The fact that life expectancy after diagnosis can be so tragically short is why it is so important to ensure that we get the support right for those affected by the disease.

The arrangements we announced will give veterans and their families greater control over their finances and choices to suit their individual needs. So, subject to finalising the necessary legislative changes, lump sums of £140,000 will be able to be paid from 11 April 2016. The lump sum will be provided through the well-established war pensions scheme, administered by Defence Business Services Veterans UK. Veterans UK currently prioritises claims for mesothelioma and will continue to do so. Claimants will be given a choice of either the new lump sum or the existing war pension payments. The noble Lord, Lord Empey, spoke about the need to raise awareness and I fully understand that concern. Defence Business Services Veterans UK will write to existing and new war pensions scheme claimants diagnosed with diffuse mesothelioma to explain that they have the option of the current payment arrangements or the new lump sum. The Veterans Welfare Service will be on hand to help claimants understand the lump sum option.

Defence Business Services cannot offer independent financial advice, so claimants will be advised to seek independent financial advice and to discuss their decision with their families. In addition to the announcements we made and to raise awareness of the lump sum option, details were given on the same day to ex-service organisations for them to publicise to their members.

On detection and treatment of mesothelioma, when individuals leave the Armed Forces their healthcare needs become the responsibility of the National Health Service. Most people with mesothelioma will therefore see their GP first if they are worried about symptoms. Regrettably, there is no reliable screening test for mesothelioma. The aim of screening is to pick up cancers at an early stage of the disease before symptoms develop. At the moment it can be difficult to diagnose mesothelioma since the usual tests for lung diseases often appear to be negative. Additional monitoring—as proposed in Amendment 22—outside of encouraging those worried about symptoms to contact their GP as early as possible would therefore not help detect cases any earlier.

We are, however, engaging with NHS bodies on disseminating information to GPs, respiratory clinics and other healthcare professionals so that when they treat a veteran with mesothelioma caused by military service they can also direct them to the GOV.UK website and the Veterans UK helpline. They have details of how to make a claim under the war pensions scheme and the new lump sum option. I hope that the Committee will agree that this shows that we are absolutely committed to supporting veterans with mesothelioma, and the wider Armed Forces community.