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Lord Garden: My Lords, I thank the noble Lord, Lord Morris of Manchester, for setting in hand the inquiry which led to such a clear and effective report from the noble and learned Lord, Lord Lloyd of Berwick.
It is becoming slightly embarrassing for me to have to acknowledge that I worked in that Kremlin-like establishment, the Ministry of Defence, in the past. There is a real paradox between the ethos of the MoD and the individual armed services. In the Army, Navy and Air Force we are trained to look after our people in both peace and war. The duty of care extends from the top to the bottom. The fierceness of the recent debates about regiments reflects the centuries of loyalty, both of the soldiers to the regiment and the regiment to the soldiers. We have such good Armed Forces because they know that they can rely on their comrades and their leadership.
Yet what have we seen from the Ministry of Defence in recent times? Whether justly or not, its reputation is one of cover-up, lack of transparency and unwillingness to support the troops when they are in distress. In my short time in your Lordships' House, I have heard the Government Front Bench stonewall over the need for a public inquiry into the allegations of abuse at Deepcut and I have been involved while the Government legislated to change the balance of evidence needed to prove service disability. The Government have been introducing redundancy and cutbacks just as our Armed Forces are involved in global operations.
We all know that grieving families report time and time again the difficulties of getting information out of the Ministry of Defence. The Ministry of Defence still ignores the recommendations of your Lordships' Select Committee over the tragic accident to the Chinook that crashed into the Mull of Kintyre. As the noble Baroness, Lady Park of Monmouth, said, this is not good for recruiting, retention or the morale of our Armed Forces. They need to know that when we send them off to dangerous, but vital, tasks, we will give them every help before, during and after each operation. This includes a duty of care in terms of protection, be it body armour or, as we are talking about in today's debate, vaccination and protection from harmful chemical or biological agents.
Those of us who have been subjected to military inoculations understand that mistakes might very well occur in the desire to protect against every possibility, particularly when things are done at short notice. During operations, the implications of exposure to other agents, be they pesticides, atmospheric pollutants or hostile warfare substances, may not be fully appreciated at the time. All this is completely understandable. What is not understandable is the unwillingness of the Ministry of Defence subsequently to be as helpful as possible, to use every means to find causes and to reassure its people in the services and their families.
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In looking at illness caused by service in the first Gulf War, the Defence Select Committee, which has already been alluded to by a number of noble Lords, reported in 1995 that:
"In responding to allegations of a Gulf War Syndrome MoD has been quick to deny but slow to investigate".
"MoD's response has been reactive rather than proactive and characterised throughout by scepticism, defensiveness and general torpor".
Nine years after that report, and 14 years after the event, the MoD refused to take part in the independent public inquiry under the noble and learned Lord, Lord Lloyd of Berwick. I shall not spend much time on the reading of the MoD's briefing by the noble Lord, Lord Truscott. I totally reject what he said. It was a very good report.
In that report, if one looks at the medical annexes, there is a catalogue of the continuing feelings of resentment of the people involved towards the MoD for its mishandling of this sensitive issue. The inquiry gives simple answers to the questions that have caused so much distress to so many veterans and their families. It confirms that those who are receiving war pensions and gratuities are ill and that their illness was caused by service in the Gulf. It identifies the likely causes and confirms that the illness is rightly described as a syndrome—Gulf War syndrome, in fact. Other countries have had similar problems. Most importantly, the report states that our sick veterans remain unsatisfied with their treatment.
Paragraph 283 of the Lloyd report gives four simple recommendations that the authors believe could go far to restore trust and confidence. These are that the MoD should acknowledge that it was service in the Gulf that caused the illness; that Gulf War syndrome is an appropriate description; that a fund for ex gratia payments should be set up; and, finally, that the 272 rejected claims should be reviewed. There are just four recommendations.
I do not doubt that today the Minister will again give us an unhelpful reply. Those who believe they are suffering from Gulf War syndrome will continue to feel aggrieved. The reputation of the MoD as a good employer will continue to go downhill. Perhaps, more importantly, we will remain further away from an objective truth about the undoubted illnesses that many of our veterans suffer.
Will the Minister explain what cause is served by this intransigence? If we have damaged our servicemen, even while trying to protect them, we must ensure that we recognise that and, if necessary, compensate them. I hope that it is not about financial compensation. The report evaluates that and shows that the amounts we are talking about are trivial in terms of the defence budget.
Finally, given the ever-worsening image of the Ministry of Defence, will the Minister undertake to consult his colleagues more widely about promoting a new culture of openness and public awareness in the department? Perhaps the culture of secrecy, which is understandable on operational security matters, has
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become too extended into personnel issues. The MoD needs to take a more enlightened view of its responsibilities for its people.
Lord Turnberg: My Lords, I, too, congratulate my noble friend Lord Morris of Manchester on securing this debate, on all the hard work he has done over the years for Gulf War syndrome sufferers, and on ensuring that this report was produced. I also commend the noble and learned Lord, Lord Lloyd of Berwick, and his colleagues, Dr Norman Jones and Sir Michael Davies for producing the report. I believe that it is a very good summary of what is, to many, a very confusing picture. It has made a very good contribution to delineating what is fact and what is opinion. Teasing through this thicket of fact and fiction has been no easy task.
It is hard not to be moved by the suffering described by the many Gulf War veterans who gave evidence to the inquiry. There is no doubt that they have been, and are, ill, and some are very ill indeed. The question which had to be answered was whether this undoubted illness was due to their having been in the Gulf in 1991. The answer to that specific question is yes, at least for many.
The evidence for that is now pretty clear and has emerged from a number of studies. Perhaps the most convincing of those, at least to me, is that of Professor Simon Wessely at King's College, who published his work in the British Medical Journal in December 2003. He studied a very large group of several thousand Gulf War veterans and compared them with a very strictly controlled group of war veterans who had been in Bosnia. They were well matched in every way, and he showed quite clearly that ill health of one sort of another, whatever that was, occurred twice as commonly in the Gulf veterans than in the Bosnian veterans. That figure of twice the number of subjects with symptoms was confirmed by Professor Nicola Cherry in another well controlled study.
It is also of some interest, and perhaps part of the problem, that the types of symptoms and illnesses suffered were very similar in the two groups. Veterans got them twice as often if they had been in the Gulf than if they had been in Bosnia.
That similarity of symptoms makes it very difficult to ascribe any single individual's particular case to the Gulf, since the same symptoms may occur in any veteran and, indeed, in the general public. That is why it has been so important to carry out these types of carefully controlled epidemiological studies—to nail down the fact that there was indeed something more going on in the Gulf. In the absence of any more specific symptoms or tests, we do not have much else to go on.
There is one set of statistics to which the noble Lord, Lord Truscott, referred, which is reassuring, at least so far. There do not seem to have been any more veterans dying in the 13 years since the Gulf War than veterans of other wars, and considerably fewer than in an age and sex-matched control group from the general
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population. If it is any compensation—although possibly not much—it seems that veterans of any conflict can look forward to living longer than the rest of us.
Once we get beyond the fact that something different was indeed going on in the Gulf which contributed to subsequent ill health, we are in the realms of increasing uncertainty. For example, although a number of researchers have made valiant efforts to demonstrate specific defects in the brain, the nerves or the blood, these can be regarded only as interesting but unproven. More research is needed to see whether they are real. This area of research is bedevilled by methodological problems and it is easy to get misled by enthusiasm.
Furthermore, there is a long list of potential culprits which might have caused the illnesses. My current favourite is the multiple vaccines they were given, perhaps with the pyridostigmine in the NAPS they took. Others no doubt will have their own favourite culprit. However, the point is that in the absence of stronger evidence than we have at present, we may argue until the cows come home about what might have caused it. Yet, meanwhile, we must face the fact that whatever the cause or causes, the set of symptoms which make up the Gulf War syndrome exist and patients suffer.
Of course more research is necessary if we are to avoid the same mistakes in the future, but meanwhile, and despite the difficulties in making a clear-cut definitive diagnosis, these veterans who are suffering should receive some compensation. I hope that my noble friend the Minister will recognise that not to do so now will increasingly be seen as not only unwarranted but uncaring, especially at a time when we have cause to be particularly grateful to our troops in the field.
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