WEDNESDAY 28 APRIL 1999

MR DOUG HENDERSON, MP and MR MIKE TONNISON

  100.  Contractors are not entitled?
  (Mr Henderson)  The War Pensions Agency relationship is framed around service.

  101.  Is that going to be a British Aerospace financial responsibility if one of their personnel out in support of the Armed Forces is injured or taken ill?
  (Mr Henderson)  That would be a contractual matter.
  (Mr Tonnison)  The policy of the MAP is that we will see at MAP anybody who was working in direct support of British forces.

  102.  Is that worth looking at again? If now so much of our work, hitherto done by full time professional soldiers, sailors and airmen is now going to be done by contractors, will it not be an inducement by contractors to send their personnel if any are injured if the cost is borne by the Ministry of Defence and not by the contractors?
  (Mr Henderson)  Chairman, that would be very much a contractual relationship between the MoD and the contractor. It could even vary in different circumstances.

  103.  But you said there should be a degree of consistency in applications of financial reward.
  (Mr Henderson)  Yes, for those for whom the MoD is responsible but if a contractor enters a contract, part of the cost of the contract is the risk which the contractor is exposed to and that is covered by the contractor's contract and should not be a charge on the state. On the other hand, if there is a reduced cost in the contract and the state accepts responsibility for the risk then that could apply.

  104.  Have you had any people complaining about the way this is operating?
  (Mr Henderson)  I have not but I am told the Department has had a number of small ones.

  105.  Could you drop us a note on this?
  (Mr Henderson)  We would be very happy to.

  106.  Minister, I want to return to this issue of the onus of proof after six or seven years because you did not, as I understand it, give us a direct answer.
  (Mr Henderson)  I did give you a direct answer. There is no change to the regulation but the matter is under review as part of a more general review.

  107.  Can I give you the opportunity to correct the answer you gave to the House in oral questions on 22 February 1999 when in answer to Dr David Clark you said: "The Minister will know that, according to convention, after six or seven years the onus of proof switches against the claimant—that is, the veterans. Will he assure the House today that that will not occur in the case of the Gulf War veterans?" Your reply was: "I recognise my right hon. Friend's interest and expertise in this subject. I am pleased to confirm that his interpretation is correct on this question." That was an incorrect answer on 22 February?
  (Mr Henderson)  The correct position is that we are reviewing this. There is no change to the current position as at this moment. My answer in February related to the future and we are reviewing this. A review will be conducted in due course.

  108.  You have confirmed that Dr Clark's interpretation of the question was correct?
  (Mr Henderson)  I have given him an interpretation in relation to the future that there is a review and that the intent is that no-one should be disadvantaged. The current position is there is no change to the regulation and the review is still taking place.

  109.  I am sorry to press this. Dr Clark said "Will he assure the House today that that will not occur in the case of the Gulf War veterans?" ie this change of the onus of proof after seven years. You have said to the House "I am pleased to confirm that his interpretation is correct on this question". The answer clearly is incorrect on the basis of what you have told us today.
  (Mr Henderson)  No, what I said to Dr Clark was——

  110.  Will you take measures to inform the House?
  (Mr Henderson)  What I was saying to Dr Clark was that was looking to the future and that no-one should be disadvantaged. The current situation is that there is no change but the matter is still under review. The seven years, of course, is only becoming a practical matter now, 1992 to 1999. Lest there be any doubt I will make sure that Parliament is aware of the exact situation as of tomorrow. I am not saying I will answer the question tomorrow but the position as of tomorrow.

Chairman:  That is very helpful.

  111.  Can I come back to the Medical Assessment Programme, we have had one or two references to it. The management audit makes a number of suggestions as to how communication with patients could be improved, including the establishment of a user group to be consulted by MAP. How quickly will you be able to act on these recommendations?
  (Mr Henderson)  We are hoping to act as quickly as possible. We are looking at the various documentation and how that can be improved. We are also looking at, for instance, the follow up to patients so that they are not only getting clinical advice but they are getting, in a sense, social work follow up. We want to put that into effect immediately so that the patient is aware and can make comments about the treatment they have to say whether they think the treatment is satisfactory or whether they want to be reassured on further treatment. That is an important point that the report draws out and we want to act on that immediately. The documentation as well, we want to bring that up to date. That will take a little time but we will not want to delay this.

  112.  The MoD plans to reintroduce a psychological and psychiatric assessment component to the MAP's capabilities. Why was the MAP's psychological and psychiatric assessment capability removed in the first place? Why do you intend to use non-MoD consultants?
  (Mr Henderson)  I do not know the answer to that.
  (Mr Tonnison)  Well, it was not removed in the first place, the question was the flow of veterans got to the point where the Wroughton establishment, which some of the Committee will be aware of, could not cope with the flow and the decision was made that the psychiatric resources at Wroughton would be available to the serving personnel rather than non-serving personnel. This issue was addressed by the Royal College of Physicians in 1995 in their report and indeed I think it was mentioned in the Committee's report of 1995.[8] The reason that we are re-introducing it is that it is clear from the thousand patient paper by Group Captain Coker and others that a component of this is psychiatric assessment in terms of a need, that is what some veterans have said to us. On the other hand, some veterans have been wholly hostile to any suggestion that this has a psychiatric dimension. We proceeded very cautiously. The reason we are going through the process that we think we are going to go for with the regionalised assessments is psychiatric assessment is not something you where go to a consultant, have one session and then go home, you have to keep going back. If we centralised it in London we would have great difficulty in doing that. The other thing is that we believe, and this is an experiment, if we are able to refer a patient to a regional network consultant, that consultant will be more able to connect that patient to his local resources and local provision of health. As I said, it is experimental. The theoretical basis I have just explained to you; ask us again in a year whether that is paying off and perhaps we will be able to tell you. That is the reason.

  113.  In response to Mr Blunt you said that you would be reviewing that.
  (Mr Henderson)  We are reviewing it.

  114.  And tomorrow you will give a statement.
  (Mr Henderson)  I will give a statement in relation to the position as at tomorrow.

  115.  Can Members of the Committee have a copy of that on the board of the House of Commons?
  (Mr Henderson)  When I do issue a statement I will let you have a copy.

  116.  Chairman, I am afraid to say that I have a horrible feeling that might not be quite good enough. I may want to raise this on a point of order with Madam Speaker because clearly the answer to Dr Clark, given your answer today, was not correct. I give notice to the Minister that that is what I intend to do.
  (Mr Henderson)  You have to proceed as you think fit. I am saying to you as there is some doubt on this I will make the position clear as the position stands tomorrow.

Chairman:  I think that is very reasonable. I think if ministers were held responsible for every word immediately said in a Committee I am afraid they would not come. Thank you very much to you both. The issue, as far as we are concerned, is going to be a continuing one. We will probably be issuing a report, probably after our visit to the Untied States, and perhaps when something else comes of some significance, Minister, we can reserve the right to invite you back to talk to us. Thank you very much.