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The Earl of Effingham: My Lords, I thank the noble Lord, Lord Morris of Manchester, for introducing this important subject in your Lordships' Chamber.

I must declare an interest. I work for The Royal British Legion, the country's leading ex-service charity, which receives no financial help from the Government and can only provide benevolent assistance and advice through donations to the Poppy Appeal. It is significant that the Legion's pensions department now handles over 90 per cent. of all claims going to appeals tribunals, of which there are some 10,000 annually.

The early announcement by the Minister for the Armed Forces, Dr. John Reid, of, Gulf Veterans' Illnesses: A New Beginning, the commissioning of new research and the more open approach to the disclosure of information have all been widely welcomed by veterans and the Legion alike. Nevertheless progress is inevitably slow and there is no immediate relief. The Legion continues to monitor the situation on behalf of the inter-parliamentary group and the veterans and to

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advise those who are suffering from possible Gulf-related conditions to ensure that they receive treatment and, where appropriate, apply for a war pension and/or compensation.

Since returning from the Gulf War in 1991, some British veterans have become ill. Many believe that this ill-health is unusual and directly related to their participation in Operation Granby. Ministers have stated that a fresh start has been made in dealing with this difficult and complex subject and have adopted three guiding principles: that all Gulf veterans will have prompt access to medical advice; that appropriate research will be carried out into veterans' illnesses and the associated factors; and that the Ministry of Defence will make available to the public any information it possesses.

A wide variety of explanations have been suggested for the illnesses reported by Gulf veterans. These include physical factors related to service in the Gulf, such as the effects of multiple vaccinations, taking NAPS tablets or exposure to pesticides; stress related and other psychological factors; as well as the possibility that there is no unusual pattern. What is not in dispute, however, is that many Gulf veterans are unwell and are concerned that their health may have suffered.

I would now like to address three special cases: first--the noble Lord, Lord Morris of Manchester, has already mentioned him--Tom Ford of the 2nd Field Regiment Royal Artillery. His claim for a war pension was made in July 1996 and the conditions for which he claimed were post traumatic stress disorder, chronic fatigue and chronic arthritis. He still has not heard whether he will receive a pension. As a result he is unable to meet financial demands regarding his house, and the housing association, which now owns it, has rented it back to him. He is a disillusioned man and believes he has been let down by the system. It is 18 months since his application was made and in the meantime the Legion has provided support to get him through the uncertain period. Can the Minister assure the House that the award of an interim payment will be considered, prior to a final decision by the War Pension Agency?

Secondly, is the Minister aware that a statement he is reported to have made to Gulf War veterans last July to the effect that the seven-year rule for claiming war disablement pensions would not apply in their cases is causing confusion and is in need of clarification? The veterans claim that they were told that the rule requiring the War Pensions Agency to disprove all claims by ex-service people within the first seven years of leaving the forces would be waived. Will the Minister also confirm that the period for claims against the Ministry of Defence for compensation has been extended from three to six years?

Thirdly, many reservists and Territorial Army personnel--over 600 people in all--deployed to Operation Granby in 1991-92 are being denied access to the attributable benefits for reservists scheme, or ABRS, on the basis that they were not medically discharged from Gulf War service. However, although

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approximately 420 of these people are in receipt of a war disability pension as a direct result of their Gulf War service, these same service men and women were not informed that they could have asked for a medical discharge. These veterans feel that they are being treated differently to regular soldiers and thereby discriminated against. This would appear to be a breach of the outline Ministry of Defence instructions, detailing allocation of volunteers, that they would not suffer financially as a result of the deployment but would be treated exactly the same as regular soldiers similarly deployed in terms of pension entitlements.

Now that the ABRS is fully effective, as from September 1996, what steps have the Government taken to correct the technical deficiency in the regulations to ensure retrospectively that those reservists in receipt of a war disability pension, as a direct result of their Gulf War service, receive their full pension entitlement?

A Ministry of Defence letter was sent to Mr. G. A. Parker, in April 1997 regarding his claim for a pension under the ABRS. It stated that in order to qualify for a pension he would have had to have been discharged from the Territorial Army as unfit for further military service. However, his record of service showed that he was discharged at his own request. On this basis therefore he did not qualify for a pension under the scheme. He was nonetheless advised to resign from the Territorial Army and not to apply for a medical discharge, although ill health was adversely affecting his ability to meet the required standards.

Finally, Territorial Army and regular reserve personnel who volunteered for Gulf War service were told by the Ministry of Defence that in the event that they should become a casualty they or their spouse would receive the same benefits as a member of the regular forces under the provisions of the ABRS. This advice was factually incorrect, I believe, and due to an anomaly in the regulations those who became ill and injured on embodied service would not qualify. Two Territorial Army soldiers, Messrs. Bristow and Rusling, brought this to the attention of the Ministry of Defence as early as 1991-92. To date only three reviews and subsequent awards of a pension under the ABRS have been made.

These veterans have been waiting for years to have their cases reviewed. Her Majesty's Government claim we owe them a debt. Has this debt been paid?

6.29 p.m.

Baroness Strange: My Lords, I also am very grateful to the noble Lord, Lord Morris of Manchester, for his Question about provision for Gulf War illnesses. I have, as your Lordships will know well, an interest to declare as president of the War Widows Association. I reiterate the question we raised with the Minister, Mr. John Spellar, when we met him last June. It is that whatever decisions are made about a change of medical opinion on Gulf War illnesses, if anyone has since died as a result of these illnesses, his widow should be treated as a war widow and consequently receive a war widow's pension.

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According to the figures issued by the Ministry of Defence to the Gulf Veterans Association last July--the last figures it received--since the Gulf War seven naval personnel, 65 from the Army, 56 from the RAF and four civilians have died. Causes of death have been stated as suicide, cancer, heart disease, or resulting from road accidents. The last may sound accidental, but such accidents could have been caused by nerve failure. As a result, several people who served in the Gulf now do not drive cars.

To my knowledge there are six widows who could be in a position to claim a war widow's pension. One, who lives at Portsmouth, is the widow of a petty officer who was responsible for opening up the air vents on his ship after a chemical attack. Another, whose husband died of bronchial carcinoma, is only 25 and has two young children. Her husband was a bandsman in the Royal Army Ordnance Corps, playing several brass instruments; so he must have had good lungs. As a bandsman he would have played outside in the Gulf area. Another is the widow of a lieutenant-colonel who served in tented accommodation in Blackadder Camp in the Gulf and who died of ischaemic heart disease, the surgeons at the autopsy saying that his heart was in much worse shape than that of a centenarian who had died just before. Another, whose husband died just before Christmas of brain tumours, has two young children, both with an identical rare heart disease. We would like to welcome those ladies into our association as war widows and give them what love and comfort we can. I urge the Minister to persuade the Government to show the same compassion for them.

6.31 p.m.

The Countess of Mar: My Lords, I thank the noble Lord, Lord Morris of Manchester, for asking this Question and I echo his sentiments. The noble Baroness, Lady Park of Monmouth, also made some very telling comments. I was extremely moved by the remarks of the noble Baroness, Lady Strange.

I wish to declare an interest. I am patron of the Gulf Veterans Association. I have a great deal of personal contact with members of Her Majesty's Armed Forces who served in Operation Granby and now find themselves unexpectedly suffering from a wide range of illnesses which they attribute to their service.

I am deeply impressed by the integrity of those men and women, many of them from the Territorial Army and reserve forces. They were called up for service and went to the Gulf in the knowledge that they might be exposed to any of the chemical or biological weapons that were known to be in the Iraqi arsenal. They understood that the British Government would take measures to protect them from death or illness resulting from enemy action. What they did not expect was that they would die or become ill from the effects of what might be best described as an "own goal".

It is significant that this Question should be asked just a few days before the expiry of the seven-year period

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under Article 4 of the Service Pensions Order, and perhaps fortuitous that this morning I received a copy of the update to the Government's report, Gulf Veterans Illness: a New Beginning. It may be helpful to the Minister if I go through this in sequential order.

The Government state that the new targets for handling patients at the medical assessment programme (MAP) are now being met. If the number of adverse comments I have received about the way in which Gulf veterans are treated by the MAP doctors are any indication, I am not surprised that they are able to reach their targets, for their examinations are often cursory. Many of the Gulf veterans say that they will never attend the MAP again. I have never heard any criticism of the time when the programme was run by Group Captain Coker and Colonel Melia, despite the fact that they were working under the appalling conditions described by the reports of the House of Commons Defence Select Committee. Since the departure of those two doctors, it would appear that the MAP has developed an agenda which does not include medical diagnosis and treatment for the illnesses from which the veterans are suffering.

It may help if I give two examples from letters I have received from veterans. One attended the MAP on 8th November 1997 and was seen by Dr. Hall. The veteran had left his home in Scotland at 5.30 a.m. on the day of his appointment to be at St Thomas's Hospital on time. The doctor asked his name. When he replied, Dr. Hall told him there was nothing wrong with his memory in a tone which the veteran described as "sarcastic". The doctor then told the patient that he must stop smoking and drinking 18 pints of beer at the weekends. He simply would not listen when told that the veteran did not drink at all as he had only half a kidney--he merely repeated his statement over and over again.

The veteran also had a problem with his knee and, while under general anaesthetic, had experienced muscle twitching which his orthopaedic surgeon thought should be further investigated. Dr. Hall's response was to look into the man's eyes and tell him that he had no nervous damage whatever. Asked how he sustained the knee injury, the veteran explained that he had been filling the central heating boiler with coal for his parents. Dr. Hall's response was to ask why his parents had not filled their own boiler. The veteran goes on to say in his letter:

    "At this time I was feeling very confused and becoming more and more distressed and was quite literally in tears. I could not understand his logic. He totally ignored my distressed condition and then asked me why I was there and what I wanted. I explained that I wanted treatment for my symptoms, to which he replied, there is no treatment. He then went on to tell me that he had been in the Vietnam War and proceeded to point out his medals which were hanging on the wall. He said he had come back from Vietnam with no problems whatsoever ... Dr. Hall then went on to say that there was nothing wrong with me and that I should learn how to get on with people better and get on with my life".
He later says:

    "I left there in a state of confusion and distress and felt absolutely suicidal".

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In a covering letter he says:

    "My main concern now is that anyone else who has to attend this programme should not only be prepared but that they should not go alone".
and, as a demonstration of British troops' universal stoicism,

    "My immediate reaction to all this is to throw the towel in, which is of course exactly what the MoD would wish and is perhaps their intention. I am gradually getting over it and no doubt will be able to laugh about it later".

Another veteran was seen by Dr. Spicer on 22nd December 1997. He has well documented exposure to organophosphate insecticides, initially diagnosed by Group Captain Coker. He had been told that he should ask for a follow-up appointment as his condition had deteriorated. This man has been diagnosed as suffering asthma and rhinitis, chronic fatigue and food intolerances as a result of his exposure to OPs. He had also suffered autonomic and peripheral nerve damage. He was told by Dr. Spicer that asthma was a common ailment; that chronic fatigue was a psychological problem in the heads of many Gulf veterans and was not due to Gulf service; that his deficiency in essential vitamins and minerals, a result of the food intolerances, could be cured if he purchased a box of multivitamins from a chemist; and that he did not believe the neurologist's findings of nerve damage as farmers had been using OP insecticides for years without ill effect and he had been using such insecticides in his garden without ill effect. The veteran's illness was not due to Gulf War service. My Lords, where has this man been?

In view of the veteran's deteriorating condition, Dr. Spicer was asked to read his Fmed 4, his medical records. He was also asked whether he would conduct a medical examination. He indicated that he was not interested in the veteran's case notes and that no medical examination would be undertaken. The notes were returned unopened. While he was in front of the doctor this veteran noticed a letter from D Med Health to the effect that no treatment should be offered as it would set a precedent for other Gulf veterans. When he asked to see his notes, permission was refused.

These are only two examples of the way in which attenders of the MAP are handled. I have reports of veterans' doctors being told there is nothing wrong with their patients when they have cancer or serious heart conditions, and I know that a number of these complaints have been sent to the Minister's honourable friend, the Minister for the Armed Forces. May I ask the Minister whether he believes that this treatment is in accordance with the objectives of the Government's papers on this subject? Will he also ask his honourable friend to instigate a full audit of the MAP, not some time this year, but as a matter of urgency? Does he accept that, even if these cases are a few out of many and others are treated properly, this is no way for doctors to treat patients; and what does he propose to do to rectify the situation immediately?

I look forward to the results of the research programmes, although it is a pity that they have taken nearly seven years to be arranged--not the fault of this Government, I hasten to add. May I ask the noble Lord

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why so many British troops were inoculated against smallpox when this disease was eradicated in 1980 and only the United Kingdom, the United States, Russia and China are permitted to hold small quantities of the virus for experimental purposes? The World Health Organisation specifically advises against vaccination except for workers in experimental laboratories. So what were the risks that were considered to be a danger to our troops? May I also ask the noble Lord what research has been carried out into the actual vaccine which was used? There have been a number of reports from American Gulf veterans of the adjuvant squalene and of a specific mycoplasma being detected in their blood. May I ask whether these will be looked for in British veterans?

Noble Lords will be aware of my interest in the health effects of exposure to organophosphates. The similarity of symptoms between farmers occupationally exposed to OPs and the Gulf veterans exposed to insecticides during their service in the Gulf was what drew my attention at the time of the first reports of unusual illness among the veterans. The OP investigation team appear to have made a thorough assessment of the use of insecticides during Operation Granby, but there are some very noticeable omissions which I intend to take up with the Armed Forces Minister at a later date. However, there are numerous reports from the veterans of spraying activities by people other than members of the environmental health units deployed in the Gulf. No mention is made in the OPITT reports of spraying by local Saudi labour or of evening spraying from a propeller-type aeroplane. May I ask the noble Lord why these reports have not been followed up to ascertain the pesticides used and the degree to which British troops were exposed? The reports are many and consistent, and relate particularly to Black Adder Camp.

As to the tents, I still find it difficult to accept that the tent in which a small quantity of the OP fenitrothion was detected in 1997, after it had been exposed to the elements, would not have had enough of the pesticide in its fabric to have affected the scoutmaster who purchased it in 1993, but that is a matter for debate. I also look forward to seeing the reports into CBW incidents, the anti-BW vaccination programme and the reports of dead animals.

The noble Lord, Lord Morris, and the noble Earl, Lord Effingham, both spoke at length about pensions and compensation. In the general context of financial provision, may I tell the noble Lord the Minister that I have been told repeatedly by Gulf veterans that the last thing they want is litigation. They simply want an acknowledgment that they are ill; they want treatment for their illnesses--though many recognise that their quality of life and level of fitness will never be what it was before they went to the Gulf--and they want pensions for which they do not have to fight every inch of the way. Many have only turned to the law because they are angry and frustrated. To a lay person like myself, it seems madness that veterans who have had conditions diagnosed by medical consultants in NHS hospitals should have to submit to further medical examinations by, as the Department of Social Security admits, generalists with no specific training in the

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illnesses reported by the veterans. There is no consultant on the Benefits Agency medical service lists. Do war pension agencies not trust the NHS?

I see that I have come to the end of my time. There is more that I should like to have said but I will now sit down.

6.45 p.m.

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