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Earl Attlee: My Lords, I am grateful to the noble Countess for introducing this important Question. Before starting I should declare my interest. As a serving officer in the TA, I use NBC protection equipment designed and tested at Porton Down. In war I may be expected to use the nerve agent pre-treatment sets (NAPS) to which the noble Countess referred. She is quite right to address these matters and to ask the most searching questions of the Minister.
My understanding is that NAPS have been used for short periods by Porton Down staff when handling nerve agents. This was to provide temporary increased protection when carrying out slightly hazardous procedures. The noble Countess is quite right to ask about the long-term use of NAPS. It is known that many soldiers in the Gulf conflict stopped using NAPS because of the side effects which were not very pleasant.
It is quite difficult to discover any information, even on the military net, about the problems which the noble Countess has raised. As I do not "need to know" there would be something wrong if I could find out. It is important that our hard won knowledge of NBC matters is kept to us and our allies only.
The MoD constantly trawls for volunteers at Porton Down. Frequently, approaches are made to candidates on NBC courses. The regular soldiers that I meet are rather reluctant to volunteer. Those that have volunteered may not be in a position to give the information for the reasons that I have already given.
I do not know much about Porton Down, but I would suggest that there are two broad areas of military interest. The first is the study of NBC agents and, in particular, methods of design, production, delivery and, most important, protection. It is important that we know how to produce NBC agents so that we can deter first use by an enemy and also detect a potential enemy's means of production.
The second broad area is that of NBC protective equipment. Our NBC protective equipment is some of the best available in the world. It is relatively easy to make individual protection equipment (IPE) that is impregnable or very lightweight and comfortable. The difficulty is to design IPE that provides full protection and is robust enough for the battlefield. Soldiers have to be able to continue to operate in a contaminated environment, so the equipment has to be breathable and not so heavy that the heat build-up is intolerable.
The equipment that is designed at Porton meets those requirements very well and the establishment continues to improve it, so much so that British IPE was very attractive to other allied soldiers in the gulf. Furthermore, I contend that Saddam Hussein was deterred from using chemicals to any great extent
As I said, the noble Countess is right to ask such questions and the Minister should answer them as best he can. I should like to ask the Minister what extra pay and allowances (over and above normal rates of pay) are available for servicemen who volunteer for the tests. If the Minister cannot answer that question now, perhaps he could write to me.
Baroness Jay of Paddington: My Lords, I am grateful to the noble Countess for tabling this extremely significant Unstarred Question. I hope that the noble Earl, Lord Attlee will forgive me if I do not follow him on the military details that he raised. My concern is with the broader health issues which the noble Countess mentioned. I am sorry to hear that her initial response from the Minister has been that some of the questions that she raised range so much more broadly than the terms of her original Question on the Order Paper that he may find it difficult to reply. I do not think that that should prevent us re-emphasising some of the issues to which the noble Countess has rightly drawn our attention with her usual comprehensive approach to these extraordinarily difficult subjects and the great authority that she has built up as a result of studying these matters over a long period.
The question which the noble Countess asked at the end of her remarks is perhaps the most important. I refer to the publication of the academic research that exists on organophosphates. Obviously, it is completely inappropriate, not to say scientifically unethical, for that material not to be publicly available if it has the impact on public policy which the noble Countess suggested. I feel strongly that the noble Countess is right in saying that in this instance the scientific concern about keeping something for the research journals should be overridden.
The noble Countess explained in some detail the ethics of human research guidelines which are familiar to all of us who have been involved in this area in one way or another. Of those ethical guidelines, four are probably of paramount importance in this connection. I refer first to the questions: Has the well-being of the person concerned in the research been considered paramount? Has consent really been freely given? Have there really been no inducements to take part in that research? Have those who have taken part in the research truly understood the purpose of that research? As the noble Countess explained, all of those aspects are enshrined in clear international guidelines, but common sense tells us that they must be susceptible to a little bending when one is dealing with research in a military situation.
The next question is whether those who have taken part in the various experiments that have been outlined are indeed chronically sick or have suffered only temporary side-effects. I am interested in the letter which the chief executive of the Chemical and Biological Defence Establishment at Porton Down, Dr.
The examples that were given by the noble Countess show that that cannot be the entire truth. When the Minister replies, I should be grateful if he could expand on the statement that was made by Dr. Pearson only last month in reply to my honourable friend.
The noble Countess also referred to the so-called "Gulf War syndrome". She explained in some detailthis was re-emphasised by the noble Earlthe particular problems which arose for troops in that conflict. Again, we have to ask questions about whether those people are chronically sick, whether that sickness can be attributed to what was happening in the Gulf and whether there is, in a sense, an abrogation of responsibility because it is difficult to carry out epidemiology on people who are now dispersed in many walks of life in different parts of the world.
Surely we need a thorough "look-back" exercise by the Ministry of Defence. I hope that such an exercise would be in collaboration with the Department of Health. We need to know precisely what is happening. It has been suggested that an independent scientist should be appointed to look into the situation of the troops and veterans who report suffering from Gulf War syndrome. We need to try to sort it out between those two departments.
It is interesting that the United States Department of Defence has recognised the problem. It has given compensation and has erred on the side of generosity. Perhaps the Minister will explain why the British Ministry of Defence has taken such a different point of view.
As the noble Countess said in conclusion, in the absence of absolute proof about something that has been going on for over 40 yearsthat is what the chief executive saidit is difficult to be precise about exactly what causal effects follow one another. The sadness for those of us who are very much newcomers to this subject is to feel that there is a sense in which everybody in the department of defence at Porton Down is being extremely reticent about something which may have been regarded originally as a question of military security, but which has now become a question that is much more related to health.
The Parliamentary Under-Secretary of State, Ministry of Defence (Lord Henley): My Lords, I appreciate the noble Countess's anxieties following my letter to her today in response to her letter of last week that she was worried that I was trying to dodge the issues and was not going to respond to some of her points. I think that is the implication. I assure the noble
It might help if I start by explaining a little about what the Chemical and Biological Defence Establishmentthe CBDEis and does, and what its function is. As the noble Countess knows, it is an agency of my department, the Ministry of Defence. Its role is to ensure that our Armed Forces have effective protection against the threat which chemical or biological weapons may pose. That threat is very real, as the noble Earl, Lord Attlee, made quite clear. Everyone should bear that in mind. It was very real in the Gulf and it is still a very real threat. It is therefore essential that we have effective protective measures against that threat. Without such protective measures, there is little point in going on. It is a threat of continuing anxiety. A significant number of states are thought to be seeking such weapons.
It is clear that the way ahead is for a web of deterrence which comprises effective protective measures, thereby reducing the utility of chemical or biological weapons, and broad arms and export controls, which Her Majesty's Government will continue to pursue.
Obviously, as part of this programme it is necessary to use service volunteers, first, to assess the ability of service personnel to function with new equipment and procedures; to develop medical countermeasures to protect service personnel; and to evaluate the effects of very low and medically safe concentrations of chemical warfare agents on the ability of unprotected personnel to operate normally.
The studies involving service volunteers began in the 1920s and now involve between 100 and 200 volunteers each year. The purpose of the volunteer studies programme is to ensure that any protective measure is acceptable from a military point of view andthis is importantis safe before it is recommended for introduction into service. Such measures need to be evaluated first in the safety of a laboratory or hospital environment, with full medical and scientific back-up at hand.
The principles of how volunteer studies are to be conducted are enshrined, as the noble Countess made clear, by international agreement in the Helsinki Declaration. Further detailed guidance and rules are provided by the Royal College of Physicians in London. I reject the noble Countess's allegations that we do not respect the principles of that declaration, and I shall deal with that point in due course.
The programme is supervised by an independent panel of experts who form the CBDE ethics committee. The role of that committee is to ensure the safety of the subjects and to safeguard the scientific staff who carry out the human studies from criticism which may be informed or otherwise. They evaluate each protocol in advance and give their approval only where they are satisfied that there will be no harm to the health of the volunteers. All human studies at CBDE are conducted with volunteers drawn from the three armed services, who apply in response to requests officially promulgated months in advance. They are free to withdraw from a study at any time without having to give any reason. The procedures, the expected effects and all possible risks are discussed with them in lay terms by an officer in advance and at each stage of the tests. The noble Countess referred to that point, and if she has allegations that matters are otherwise, I should be more than happy to look at those allegations; I have none.
In studies involving the taking of a drug, half of the volunteers will take medication containing the active drug and the other half will take medication consisting of an inert substance. All medication will look alike, with its identity disguised from both subjects and the scientists until the study is finished. This is a placebo-controlled randomised double-blind study procedure which is widely accepted as best practice in this field.
Typically, volunteers come to CBDE for two week periods. That length of time may, for instance, be required for the intensive tests of sustained physical and mental work carried out in individual protective equipment under controlled climatic conditions representative of cold or hot areas of the world in which they may be sent to operate in the future. Effects caused by a drug under study are recorded carefully. Aspects of mental performance such as memory, the speed and accuracy of mental arithmetic, manual target tracking and dexterity, and the ability to remain alert and notice small change are measured repeatedly in performance tests. Where possible, the efficiency of the volunteer is also measured in carefully controlled military exercises. As the effectiveness of a drug to protect against agents of chemical warfare cannot be studied on man, the final choice between several possible drugs is made on the basis of their acceptability and freedom from side effects.
In response to a question from the noble Earl, I should say that volunteers are recompensed for the inconvenience at a rate of £1.66 per test, which amounts typically to a little over £200 for a two-week study. The payment is subject to tax. The noble Countess cannot allege that that is a denial of the principles of the Helsinki Declaration; and it is not an excessive inducement to take part in those tests.
On arrival at CBDE Porton Down, volunteers are given a full medical examination. They have the study explained to them in lay terms by an officer who is not involved in the study. They are advised that they may leave at any stage without any explanation, and at the end of the study they are given a further medical examination to ensure that they have suffered no harm. In addition, there is no history of service doctors in their
That is the principle of informed consent by which we abide and by which we shall continue to abide. We shall continue to say to veterans that if they wish to go to their GP, the CBDE and the Ministry will release their medical records to assist in the investigation of their cases, as appropriate. Information is provided to medical practitioners so that they can judge whether any of the experiences throughout the individual's service career has any relevance to their current medical conditions. That information will be released, if necessary.
Unless the noble Countess can provide me with individual cases, there is no evidence over the past 40 years to suggest that service volunteers who have participated in studies at the CBDE Porton Down have suffered any harm to their health, or that any of them were not volunteers, as the noble Countess alleged. If she can produce evidence to suggest that they were not volunteers, I shall be more than happy to look at it.
I should add that the MoD is grateful to all service personnel who have served as volunteers in studies at CBDE Porton Down, as their participation has been vital in ensuring that members of the Armed Forces are provided with the most effective protective measures possible against a threat that chemical or biological weapons may be used against them. Such studies are vital to the defence of the realm, and we are grateful to those servicemen who have helped achieve the high standards of protection that are available for the members of the UK Armed Forces.
Perhaps I may say a word or two on the allegations about Gulf War illness. There is no medical or scientific evidence of any mystery illness linked to Gulf War service. All those who suffer have been found to suffer from recognised conditions. There is no known medical evidence of long-term reactions to vaccines when administered together or over a short period of time.
Further, we have received notification of 420 potential claims in respect of the alleged Gulf illness. They detail a wide variety of symptoms, the vast majority of which are common among the general population. What I can saythis has been repeated by me, and by my honourable and right honourable friends in the other placeis that all claimants have been encouraged through their solicitors to come for medical assessment by military medical specialists. Less than half have so far accepted that offer. I have to refute flatly the allegation made by the noble Countess that the MoD has refused to do anything.
I shall say a word or two about the report referred to by the noble Countess from the US Senate produced by Senator Rockefeller. It is a highly selective report in that it chooses to ignore the outcrythis was mentioned by the noble Earlthat would have resulted in the US and the UK if Iraq had used its nerve agent and our troops had not been given medical protection from NAPS. That drugI am not sure that I can pronounce the name as well as the noble Countesspyridostigmine bromide, was licensed to my department in August 1993 by the
As I said earlier, in the final analysis there has been no evidence during the past 40 years to suggest that service volunteers who participated in studies at Porton Down have suffered any harm to their health. If the noble Countess wishes to produce evidence, I shall be prepared to look at it. I believe that the safety of service volunteers is deemed to be of paramount importance and no study will take place without the express approval of the independent ethics committee. Her Majesty's Government are satisfied that the Ministry of Defence and the Chemical and Biological Defence Establishment at Porton Down have shown a high and proper degree of responsibility for the health and safety of volunteers who have participated in studies at Porton Down.
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