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Gulf War Illnesses

Volume 620: debated on Monday 15 January 2001

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8.27 p.m.

rose to ask Her Majesty's Government what further consideration they are giving to the needs of Gulf War veterans with still undiagnosed illnesses and of the dependants of those who have died.

The noble Lord said: My Lords, in opening this debate, I warmly congratulate my noble friend the Minister on joining the Privy Council and welcome her aboard. Nothing in my parliamentary life has given me me greater joy than being made a privy counsellor 23 years ago.

As Clement Attlee said:
"The way a nation treats its citizens in greatest need is ultimately more revealing of its moral worth than all the oratory of its leaders".
By that and the no less-defining test of how a nation meets the compelling duty to act justly to those prepared to lay down their lives in its service—and the dependants of those who do so—the people this debate is about deserve well of your Lordships' House.

My principal concern, on the eve of the 10th anniversary tomorrow of the outbreak of fighting in the Gulf War, is for the service men and women who sacrificed their health and well-being in the conflict and for the dependants of those who sacrificed their lives.

Many veterans with still undiagnosed illnesses—scores of them terminally ill—now rank among the most needful of our fellow citizens. They include people known to me from my work, over many years, as Honorary Parliamentary Adviser to The Royal British Legion, and as a founder member in 1994 of its Gulf War Group of parliamentarians, medical and legal specialists, veterans of the conflict and ex-service charity leaders. Other members of the group, ably chaired by Colonel Terry English of The Royal British Legion, have included the noble Countess, Lady Mar, the noble Lord, Lord Burnham, Michael Mates MP and Paul Tyler MP; and Flight Lieutenant John Nichol among others from the veterans' associations.

Medically A1 when they went to the Gulf, more and more of those who fought there were in broken health soon after coming home. Of the 452 who have since died, 83 took their own lives. One of the veterans now seriously ill and known to me personally, Major Ian Hill, wrote on 15th December to the Prime Minister recalling a pledge he was given as Chairman of the Gulf Veterans' and Families' Association that:
"No stone will be left unturned to alleviate the physical, mental and social suffering of Gulf veterans".
Major Hill's medical condition is now described as one of "total burn out" and his future as,
"a slow and agonising death sentence".
He recently became registered blind and his wife, on whose care he relies day and night, is also severely disabled with "a crumbling spine". They have to cope in inappropriate housing. Thinking about this debate earlier this month, I intended to refer to the case of Major Hilary Jones, ex-Queen Alexandra Royal Army Nursing Corps, as the most distressing of any of which I was aware. Living alone and terminally ill, she was denied a 100 per cent war pension. Hilary was recently described to me as,
"trying desperately to get her affairs in order while she can still attempt to do so."
Very sadly, I heard last week that she had died. In deep anguish a friend, going to her funeral last Friday, said that she will be,
"just another statistic before anything is done".
None of us here wants Gulf veterans in broken health to suffer the gratuitously added strain and demeaning indignities of long delays in settling their rightful claims. There was no delay, 10 years ago, in their response to the call of duty. And there can be no excuse now for failure to meet in full our debt of honour to them.

This 10th anniversary is a timely moment to reflect that the Gulf conflict was on a scale bigger than any British troops had been involved in since the Korean War. It was also the first in which chemical and biological weapons were deployed against British troops since 1918; and they seemed certain to be used. The stark effects of Saddam Hussein's use of these weapons against Iranian civilians had been widely televised only months before. Both US and British commanders expected their use to involve a high level of fatalities, the Pentagon as many as 150,000.

MoD correctly appreciated the threat, but not all the health risks of the protective measures taken. These comprised an immunisation programme of unprecedented range and intensity—a veritable blitzkrieg of the immune system—that included protection against anthrax; the first ever issue of Pyridostigmine Bromide (PB) as antidote to biological agents; and the deployment both of toxic sensors and pesticides, including organophosphates, to prevent fly-borne diseases.

Veterans say many of their illnesses were caused by the immunisation programme; inappropriate use of PB tablets; the effects of toxic substances; pesticides such as organophosphates; the heavy deployment of depleted uranium; massive oil pollution from burning the oil wells; and the normal stress of war, made worse in the Gulf by the imminent threat of chemical and biological weapons.

Military training in preparation for the conflict is not questioned, but veterans blame flaws in administrative back-up for many of their problems. They include poor documentation in recording treatments of and the protection given to the individuals deployed; inadequate training and instructions for using antidotes for biological exposure, not least NAPS tablets; failure to record the nature of toxic substances; and poor debriefing and rehabilitation, more particularly for reservists, after the conflict.

Within weeks of the conflict ending, US and UK veterans began reporting illnesses. An early trickle soon became a stream. Here it now exceeds 5,000; in the United States it has risen to 110,000. The number of war pension claims here is over 4,000.

The initial MoD reaction to claimants was to say it was "open-minded" about them; but veterans say they were treated with disbelief and even cynicism. The department was slow to set up the Medical Assessment Programme (MAP), which became a fully established unit only in 1994; and there were constant official denials of any specifically "Gulf War" health problems. The use of organophosphates was denied as was the exposure of British troops to fall-out from US bombing of an Iraqi arms dump in Khamisyah where chemical weapons were stored. This latter denial was made by Ministers in Answers to Parliamentary Questions I tabled in another place, to assist the Royal British Legion's Gulf War group.

It was this group that led to veterans' cases first being put direct to all Members of Parliament. Its effect—strengthened by pressure from the Defence Select Committee—brought admissions that there were specifically "Gulf War" health problems to address. MAP was placed on a full-time footing and epidemiological studies were initiated.

The UK's most significant study, however, has been that funded by the US Presidential Committee and led by Professor Simon Wessley of King's College, London. He compared the health of veterans deployed in the conflict with control groups deployed to Bosnia or who stayed at home. The study reported in 1999 that Gulf veterans had a higher incidence of ill-health. The study is ongoing and has significant credibility both in the UK and the US.

A similar study funded by the Ministry of Defence and conducted by Professor Nicola Cherry of Manchester University is believed to have reached similar conclusions to the Wessley study.

My Lords, veterans and their families strongly resent the implication of being told to accept that, where mistakes were made, they were not deliberate. They know as well as anyone in Whitehall that decisions about protective measures often have to be made on a "needs must" basis. But they will never accept that the victims of mistaken decisions alone should be left to cope with their consequences. They rightly insist that the nation, not the individual, should meet the cost of such decisions.

Moreover, claims that extra-statutory compensation is not paid by the state unless negligence is proven are simply not true. What about the Vaccine Damage Payments Scheme and the Macfarlane Fund for people infected with HIV by contaminated NHS blood products? Again, what about the decision in 1974, by the then Minister for War Pensions, to treat as war-attributable the death of anyone who, having served in a theatre of war where gas was used, died of a cardiothoracic illness? I speak as the Minister who took that decision 27 years ago.

As the cases of Major Ian Hill and other needful UK veterans demonstrate, care for them needs urgently to be improved. When veterans have been assessed by MAP, continuing care is provided by the NHS. That care is patchy, occasionally unsatisfactory and hampered by poor medical records for the Gulf War period; cynicism about Gulf War illnesses among some GPs and inadequate knowledge of symptoms; lack of any priority for hospital treatment, made worse by the closure of service hospitals; and lack of any continuous health monitoring of Gulf veterans by the MoD.

I return briefly to depleted uranium. The mass media across the world headlined day by day over recent weeks Britain's growing isolation as the list of countries screening for adverse health effects from its use rapidly grew. Then came John Spellar's announcement last Monday of what The Times headlined as
"Downing Street's retreat on depleted uranium risk."
The paper reported a "morning of confusion" at the MoD. The Defence Secretary, it said, intended to make a statement two days later but pressure from No 10 required an announcement forthwith:
"Downing Street intervened"
said The Times,
"after Tony Blair's advisers cautioned that the Government could not wait another 48 hours".
DU shells were heavily deployed in Bosnia and Kosovo; but so were they in the Gulf. Yet Gulf veterans appeared to be excluded from screening by last Monday's announcement. It will be widely seen as incomprehensible and deplorable if they are in fact excluded and I hope that my noble friend can make it plain now that this will not happen. If it does, feeling among Gulf veterans will be further inflamed. But even today they are already saying that:
"the MoD's vacillation is reminiscent of such denials as the use of organophosphates".
It was strong feeling among veterans that led The Royal British Legion's annual conference in 1998 unanimously to call on the Prime Minister for a public inquiry into the handling of Gulf War illnesses. Over 16 months went by before a response came from the MoD in which John Spellar rejected an inquiry. Yet it had been emphasised to the Prime Minister that the Legion wanted the inquiry to go wider than the responsibilities of the MoD or of any other single department.

The rejection was deeply unfortunate. For ultimately there will have to be an independent and wide-ranging inquiry, not only in fairness to those afflicted but to restore public confidence and demonstrate that our Armed Forces will be fully protected in future deployments. In my view, any further delay can only postpone, not frustrate, the securing of an inquiry.

Too many families are bereaved for an inquiry to be indefinitely delayed. They crave the truth about their bereavement too strongly to allow any even possibly revealing stone to remain unturned. And public support for them is too strong for anyone to stop right being done.

The inquiry will help to end speculation, establish facts and answer questions by parliamentarians that have long gone unanswered. Most of all veterans and their dependants will be assured that they are not being treated as "yesterday's people".

My Lords, that should not be too much to ask on this 10th anniversary for those who served our country with such distinction and gallantry in the Gulf War.

8.40 p.m.

My Lords, other noble Lords speaking in this debate know far more than I do about the long and complex saga of the Gulf War veterans and the illnesses to which they have been subject. There has been extensive publicity in the past week about the reported existence of an MoD report of March 1997 warning that soldiers who recovered or worked upon destroyed tanks,

"should be warned that inhalation of uranium dust carries a longterm risk to health. They should be counselled appropriately. They should wear protective clothing if working on such vehicles in the Gulf".
The MoD confirmed that a signal was sent but publicly acknowledged that it did not reach the appropriate people. It has also been reported that a US report of 1992 reached similar conclusions on the potential threat to health from depleted uranium.

I wholeheartedly agree with the statement made by the Minister in another place that,
"DU ammunition has represented a battle-winning military capability and that therefore it will remain part of our arsenal for the foreseeable future because when this country commits our forces to conflict, we fight to win. Our troops need the best available equipment to enable them to do that. To deny them a legitimate capability would be quite wrong".
We do indeed have to remember that if we send our troops into war we must give them the best available weapons. However, Mr Spellar said in the same statement that,
"alternative methods are not as effective".
I find that difficult to square with reports that the Americans, recognising the dangerous nature of the depleted uranium, are replacing it with tungsten, and that the Royal Navy, which has bought these weapons from the Americans, is therefore phasing out its own Phalanx weapon. I hope that there will be no delay in replacing them also with the tungsten variant, since this does seem an acceptable alternative, and that this will not be at the expense of some other equally vital defence expenditure. The Treasury must meet any increase in the bill to equip our Navy safely as well as effectively in the light of this new development.

But while we have an undoubted duty to equip our forces with what they need to be an effective fighting force, we have an equally paramount duty to protect them from any danger which need not be incurred. If healthy men and women are ready to go into battle, we must be equally ready to equip them to take proper precautions against threats to their health which could arise from that service. If we fail to do that, and more and more evidence is emerging to suggest that there have been failures in that regard, we must do everything possible—and I do not make this as a party point, since all governments since the Gulf War have failed in their duty to the forces in this matter—to rectify the damage to human lives which has arisen not from enemy action but from our own obstinate refusal to concede that there is danger. We must recognise fully that the Gulf War veterans, like the former PoWs in Japanese hands whose rights have at long last been recognised to some degree, went to war for us hale and healthy men and returned sick men.

I honour this Government for recognising that the issue of the Gulf War veterans' illnesses should be dealt with openly and sympathetically. I quote the Minister's words in a recent Gulf War newsletter. But openness is just what there has not been. I also welcomed the setting up of the MoD's Gulf War Veterans Illnesses Unit when it was created by the previous government in February 1997 as a result of long, patient and unremitting pressure from the noble Countess, Lady Mar, above all others. But more and more men have been dying in this group in the 10 years since the Gulf War, some, as we have been told most movingly by the noble Lord, Lord Morris of Manchester, by their own hand, and it is simply not good enough for the MoD to continue to await the outcome of a long series of academic and other research projects to determine whether or not there is such a thing as a Gulf War syndrome and to refuse to take any real action unless and until they have the results of the research. That will take years. Meanwhile both the men and their desperately unhappy families are left without help.

What is the point of a Gulf War unit if the MoD and the pensions agency can continue to offer such contradictory advice to men and their dependants who are sick and in need? There has been total confusion, for instance, over the advice received by the former TA Reservists who served in the Gulf on the operation of the attributable benefits reservists scheme. Why were they told in writing before they went to the Gulf that they would be treated on exactly the same footing as regular soldiers only to learn later that this written statement had no legal standing? The Government, in their reply to the Defence Committee's report on 11th May 2000, said—and I quote this from the Gulf Update—that,
"The government believes that the current financial provisions are the most appropriate way of compensating Gulf War veterans—they are able to apply for attributable benefits for reservists".
How, in this joined-up government, was it possible, therefore, for the claimants to be told the week before Christmas—very nice timing—that they had no entitlement to this benefit? I wonder how many forms they completed and over what period before they heard that constructive reply to their problems? What does the MoD intend to do to ensure that hopes are not raised and then dashed by hopelessly contradictory advice?

I believe that I first spoke in support of the efforts of my noble friend Lady Mar, and later in support of the noble Lord whom I shall also claim as a friend, Lord Morris of Manchester, and not least in support of the men themselves six or seven years ago. It beggars belief that we and the country can cheerfully send healthy men to war and then spend years denying in effect responsibility for the state in which they return, fobbing them off with endless research, especially when it now seems that an American report gave support to their case, that in 1997 there was a medical report from our own MoD and, to judge from The Times today, there were warnings long before from the Atomic Energy Authority.

We must not treat this issue as a party political football. If we take the defence of the realm seriously, as I am sure we all do, we must surely recognise that no amount of excellent weaponry can replace the will of our men and women to put their lives at risk for the country's sake. I do not believe, however, that that will long continue if they and their families see what happens to those who come back as sick men. In reply to a Written Question in May 1998, I received from the War Pensions Agency a letter which, having stated that so far extensive international research had failed to identify a specific Gulf War syndrome, went on to say that,
"it is however acknowledged that illness has occurred in relation to Gulf service".
That is the nub of the matter. A significant number of claimants went out as healthy men and returned as sick men. They deserve better than the treatment they have so far received. I know that the Minister and, I have little doubt, her colleagues too care about this issue, but the question is what is going to be done now—not next year, or the year after, or when we have the results of further research. A great deal of money is being found for many worthy objectives just now, and I do not grudge money for education, the NHS or, certainly, pensioners. But I do suggest that there must be money, too, for this relatively small group of people who have deserved so much from us. This is a question of human dignity as much as anything.

8.49 p.m.

My Lords, I declare an interest as patron of the Gulf Veterans' Association. Once again I am indebted to the noble Lord, Lord Morris of Manchester, for returning to this topic. As he said, we are now approaching the 10th anniversary of the beginning of what was known as the air war in what must be the environmentally dirtiest war ever fought.

As noble Lords know well, the noble Lord, Lord Morris, and I, together with some other Members of your Lordships' House and those in another place, have been asking questions about the many factors which may have contributed to the ill health reported by Gulf War veterans for at least six years. Many ofthe responses I have received in that period have been at least unhelpful and have often been misleading. Whether or not this has been deliberate I leave for others to judge. It matters not which party is in government, the answers are similar and ministerial pronouncements, while they may be couched in slightly different language, all mean the same thing.

The question of the effects of depleted uranium munitions will, naturally, be today in the forefront of our minds. In last night's news, the Secretary of State for Defence was repeating the MoD mantra that,
"there is no scientific evidence that DU causes ill health".
He said that if there is a problem, it is a very minor one and that the risks to our troops are outweighed by the protection that the use of DU gives against enemy tanks. He and his colleagues have also said that the possible damaging effects on health from exposure to DU have been known for anything from 10 to 40 years. Which is it? Is DU safe or not?

Perhaps most important in this context is the ministerial statement to the effect that our troops have always been aware of the dangers and have taken the necessary precautions. That "always" seems to imply that British troops serving in the Gulf were advised of the dangers and that if they are found to have DU in their systems, it is their fault. Where have I heard that before? It is a disingenuous statement. There is a surfeit of evidence to show that British troops in the Gulf were not made aware of the risks. I have been told of coach parties organised for our troops to view the remnants of Iraqi tanks when hostilities ceased. I have photographs of members of Her Majesty's Armed Forces in T-shirts and shorts clambering over tanks that had clearly been disabled by DU weapons. It is known that the radioactive constituent of DU can be found in dust. The inference that our troops were not exposed to any dust under desert conditions with hundreds of military vehicles passing through contaminated areas is nothing less than idiotic.

I understand that today the MoD has offered to examine any Gulf veteran who has symptoms of DU poisoning. The veterans do not know what those symptoms are, unless they involve overt cancers. Will the Minister arrange for the two veterans' organisations to be informed of the symptoms so that they can tell their members?

In the desire to find a universal illness with a universal solution, there would appear to be a measure of acceptance of post traumatic stress disorder as a diagnosis for the ills of the Gulf veterans. That is not corroborated by the epidemiological study conducted by researchers from King's College Hospital. Ministerial statements invite me to repeat Toyber's dictum:
"The absence of evidence is not evidence of absence".
If you do not look, you will not find, and, lo and behold, there is no problem. The Government have singularly failed to conduct new clinical research. Epidemiological studies and literature reviews are not new science.

In fact, there is not an absence of evidence. Many medical researchers—some in the UK, but most in the USA—practising in a number of different fields have demonstrated organic causes for the illnesses of Gulf veterans whom they have examined. Those researchers do not have access to government funding and, of necessity, their sample populations must be small. Instead of stimulating scientific curiosity and encouraging those who hold government purse strings to sanction further research, the findings of those individual researchers are trivialised and attempts are made to discredit the men and women doing the work.

I have thought long and hard about why that is. One difficulty arises from the apparent variety of signs and symptoms that the veterans present. Conventional medicine is currently divided into specialities. That means that patients are examined by a number of different consultants and are treated symptomatically. I am told that it is rare for a full history to be obtained from a patient. There seems to be an extraordinary absence of natural curiosity from clinicians about causation. As a result, not all the information is gathered. If any solution is to be found to the ills that the Gulf veterans are suffering, there is a need to look at patients as a single body and mind, not as a series of fragmented parts, and to look at all the various medications and toxins to which they were exposed. I understand that in their training, doctors are told to listen to the patient and the patient will tell them the diagnosis. They have obviously not done so in this case.

Only yesterday it was revealed that US Government-funded research had found that pesticides used in the Gulf were not the cause of illness among Gulf veterans. Tell us something new. In the past, individual vaccines and NAPS tablets have been singled out and given a clean bill of health. That is not the way to tackle the problems faced by the Gulf veterans. I have always contended that there is not a Gulf War syndrome. That was an invention of the press. There are Gulf War illnesses. It has always been clear that there are variations in the reported symptoms, although there are underlying symptoms that are common to many illnesses. Not all the veterans had the same vaccination programme. There were significant variations in the frequency with which they took their NAPS tablets. Some were billeted in the desert, where their camps and equipment were sprayed frequently with an assortment of pesticides. Others were lodged in permanent housing that did not need the sprays. Some were exposed to fumes from oil well fires and others crawled on tanks that had been struck by DU munitions. In addition, they had to adjust to changes in their physical environment and diet. They would have been physically and emotionally stressed. The veterans have been exposed to several of those factors, if not all of them.

There is a large body of scientific evidence that demonstrates the interdependence of all the systems and organs of the human body. There is also evidence that some individuals are better able than others to cope with toxic exposure, for a variety of reasons, such as age, gender, nutritional status or genetic make-up. It is too late for more than 500 Gulf War veterans, but it may not be too late for many more who are currently suffering from unpleasant and disabling illnesses. As the noble Lords who have already spoken have said, we must do something about those people.

Since the departure of Group Captain—later Wing Commander—Coker from the medical assessment programme, there has been little trust or credibility placed in those who have run it. The current director, Professor Lee, has apparently said that he sees only the "well sick", that he is there to assess and reassure veterans and that he is not responsible to either the MoD or the Gulf veterans illness unit. Yet he told one of the Gulf veterans last November that he is a medical expert for the MoD and appears for the Ministry in medico-legal cases. Is that true? If so, in how many cases has Professor Lee appeared on behalf of the MoD? Is he to give evidence on behalf of the MoD if any of the Gulf veterans' cases reach the courts? Is it ethical for a medical practitioner who is in charge of such patients to place himself in a position in which it is apparent that his patients' interests are not paramount?

Why has there been so much procrastination? Why have Ministers from successive governments voiced sympathy for the veterans, yet failed to obtain any substantive relief for their ills? With enormous reluctance and a careful study of the many, many answers to my questions, I am beginning to come to the conclusion that those who advise the Government have been aware for some time that the measures that were used to protect our troops in the Gulf were not without significant risks to the health of some of the members of Her Majesty's Armed Forces. There is no other explanation.

That stance of denial was adopted in response to the earliest parliamentary questions on the subject and has been steadfastly maintained until, as in the case of organophosphates, the evidence can no longer be resisted. Only a fool never changes his mind. These people have played a cruel and—dare I say it?—immoral game with the lives of men and women who were prepared to lay down their lives for the rest of us citizens of their country.

I shall end on a conciliatory note. I thank the Minister for arranging for Gulf War illness unit staff and Professor Lee to visit the hospital that I told her about. I hope that, in the absence of any other apparent effective treatment, proposals for treatment for the veterans at that hospital will be seriously considered.

8.58 p.m.

My Lords, I, too, am grateful to the noble Lord, Lord Morris of Manchester, for his Unstarred Question. Given the current media interest in the matter, it is surprising that more noble Lords have not put their names down to speak. The noble Lord posed his Question with his usual skill and vigour, so I shall not repeat all his very valid points. I remind the House that I have a peripheral interest.

I intend to cover two points: testing for depleted uranium and allergies. DU is necessary to defeat the armour of modern enemy armoured fighting vehicles. It is not used for training, as it is unnecessary or undesirable for technical reasons. It is not a mini-nuclear warhead and is only very slightly radioactive. It works solely by means of kinetic energy.

Ministers are adamant that uranium poisoning is not causing the problem. I am inclined to agree with them. Previously, DU testing would be undertaken at MoD expense only if clinically indicated. That was very convenient because generally the symptoms of DU poisoning have not been seen in Gulf War veterans. However, the absence of a medical indication for DU testing does not mean that there is an absence of a DU problem; for example, it may not be acting as a poison but as a catalyst for some undesirable effect. I believe that it should be eliminated as a problem. That could be achieved by a proper programme of testing with suitable controls. That would then insert a sense of reality into the debate about the use of DU ammunition.

Can the Minister confirm whether that is what her honourable friend Mr Spellar announced last week, or will the test merely be available haphazardly when requested by an ill veteran and without the proper control groups to ensure that meaningful results are obtained? It is hoped that the Minister will be able to enlighten us tonight by answering the question posed by the noble Lord, Lord Morris, about exactly who will be tested. The Minister nods her head.

Ministers rightly have made much of the epidemiological survey of Gulf veterans. I, too, was relieved to see the results and I am sure that the Minister will draw your Lordships' attention to them tonight. I have a slight anxiety that the survey concentrates on the death rate of veterans, which in some categories is better than that of the control group. However, as Gulf War illness has more to do with disablement than the death rate, is the Minister confident that the medical disability rate is no worse among the veterans than in the control group?

There has been speculation in the media that troops on operations spend much of their time clambering over knocked-out enemy armoured vehicles. So far as concerned Kosovo and despite the claims of the Minister at the time, there were in any case few knocked-out Serb armoured vehicles. But, more importantly, troops would be ordered specifically not to go near a knocked-out vehicle because of the threat from mines and booby traps. That was certainly my experience.

My second point concerns allergies. However, in making the point, I claim no special understanding or knowledge. It is a little unfortunate that, although we have a noble and gallant Lord with us tonight, we have no noble and eminent clinicians. Sadly, we know that the medical records of Operation Granby were poor, to say the least. We know that a veritable cocktail of vaccines and drugs were administered, but it is not known how they would have reacted with each other or in the presence of some other environmental pollutant. The noble Countess, Lady Mar, talked about some of those problems.

However, it seems to me that the symptoms are similar to those which involve allergies arid what is known as "multiple chemical sensitivity". I understand that there are two main types of allergic reaction. The immediate allergic reaction is the best known, although it does not appear to be the type which affects Gulf War veterans. Occasionally, that reaction can be dramatic and life threatening, as in bee and wasp stings and peanut allergy.

The other type is the masked allergic reaction. The symptoms are very similar to the type of chronic health problems that Gulf War veterans are experiencing: unusual and debilitating fatigue, headache, irritability, reduced mental alertness, muscle and joint pain, and respiratory and other problems. Such a variety of chronic symptoms have one possible common link: a damaged immune system. Given the cocktail of vaccines administered, all affecting the immune system, that is a very plausible scenario.

My understanding is that it is possible to unmask those allergies or chemical sensitivities by keeping the patient in a carefully controlled environment for a few days, free from any possible allergens. lf the symptoms disappear, there is probably an allergy problem. Once the problem has been identified, treatment procedures are available.

The Airedale Allergy Centre has had one ill Gulf War veteran—a staff sergeant who was treated, largely successfully, but privately at his own expense. Some noble Lords will recall the Starred Question in the House about the future of the Airedale Allergy Centre which was experiencing funding difficulties with the NHS. Having listened to the replies from the Minister the noble Lord, Lord Hunt, I believed that the centre's future was secure. However, apparently it has now been mothballed due to financial problems. I certainly did not recall him questioning the validity of the centre's work. There may be other, similar facilities available elsewhere in the world but they are certainly not common.

When the Minister replies to my suggestion, she may describe it as "interesting". If she does, it will be the first time that I have received that particular accolade.

When she returns to her office in Main Building, no doubt her sensible senior medical advisers will tell her to have nothing to do with any alternative medicine. However, the fact is that we do not know what Gulf War illness is or how to cure it, and we should explore every possibility for a solution.

In conclusion, your Lordships hold the Minister in high regard. Undoubtedly she will feel at least as, if not more, sympathetic to the Gulf War veterans as any other noble Lord. She will agree that it is indeed our duty to leave no stone unturned in the search for a solution. Among other things, we need a proper DU screening programme to eliminate the furore and widespread concern over DU ammunition and we need to check for masked allergies.

9.7 p.m.

My Lords, I, too, greatly welcome the well informed initiative of the noble Lord, Lord Morris of Manchester, on this matter. One of the troubles that underlies the whole problem is the fact that the phrase "Gulf War syndrome" means different things to different people and evokes quite different emotions depending on their different perceptions.

To those who served in the Gulf campaign and subsequently, for whatever reason, suffered seriously debilitating, sometimes fatal, illness as regards which they and/or their close relatives deserve the greatest sympathy from all sides of your Lordships' House, it provides a possible, perhaps probable, reason why those who have served have been so tragically struck down and it provides an opportunity in their deep distress to apportion blame and obtain redress.

However, to Whitehall officialdom—deeply apprehensive that such a condition, if established, could involve considerable financial compensation and set a precedent with untold ramifications to its already greatly over-stretched budget—that is seen as a contrived explanation. The various medical conditions are more likely to be attributable to the law of averages or the wheel of outrageous fortune than to anything that the patient experienced during or in the aftermath of combat in the Gulf War.

To old soldiers such as myself, there must be, when one considers what generations of fighting men have endured from the Crimea, through the Somme, Paschendale, Alamein and Burma, right up to the Falklands, some built-in irritation about the fact that the general and undoubted pressures, traumas and risks of combat should somehow be linked in a blanket and imprecise phrase to account for all subsequent ills and misfortunes, and thus become a means for those who had served their country to get back at the government who sent them to war.

On the other hand, like any other serviceman or woman, if, during or after the battle, those people incurred a medical or physical condition that was attributable to active service, let alone duty, they would be fully entitled not only to sympathy and understanding but a full and proper war disability pension that was appropriate to their condition.

Through all the verbal sparring that has been going on during the past few years because of the different perceptions and attitudes that I mentioned, one glaring question stands out above all others. Was the cocktail of inoculations—the veritable blitzkrieg of the immune system, as the noble Lord, Lord Morris of Manchester, so aptly described it—some of which had been given individually for many years but not, because of the urgency of time, given all at once, liable to cause, in some individuals, a harmful chemical or physiological reaction that would lead to a loss of future immunity? Presumably, no tests were done before inoculations. For that the Ministry of Defence could hardly be blamed, because of the urgent need to give all those entering the Gulf War zone comprehensive protection, including protection against nerve gas and anthrax. I hope that we can keep the stigma of negligence out of this argument. Once the whole question of so-called Gulf War syndrome was raised, that should have been done at once.

I was staggered, when I questioned the noble Lord, Lord Gilbert—then the Minister—many months ago, to hear him say that a comprehensive medical study of the whole question, including the medical histories of those who had subsequently so tragically suffered, would be undertaken, and that part of that approach would involve an analysis of the effects of dispensing all the inoculations at the same time. As I said, that should have been done at the outset, because it was by far the most likely common factor for inducing some subsequent indisposition, or worse.

So I put it to the Minister to tell us what the results of that particular test have been. It must by now have been carried out—if it has not been, that can only mean that the Ministry of Defence is not serious enough about getting at the truth. As I said, given the circumstances prevailing at the time, there may well have been no negligence on the part of the Ministry of Defence, nor any need to prove that. However, if those tests raise the suspicion that certain individuals could have been affected by that form of battle contamination, or by any other—such as the stuff that was used to spray camouflage nets or the uranium shells that we are currently hearing about and which were fired from aircraft cannon—will the Minister tell us whether the Ministry of Defence or the Ministry that is responsible for pensions intend, at this appropriate 10-year anniversary, to pay a proper disability pension to those who are suffering and who have suffered?

We keenly look forward to all that the Minister is now prepared to tell us on this very sensitive and emotive subject.

9.13 p.m.

My Lords, I add my tribute to the noble Lord, Lord Morris, who has, yet again, eloquently highlighted tonight the plight of Gulf War veterans. I also pay tribute to those noble Lords who made some extremely moving speeches in tonight's debate.

We last debated this subject in January 2000, when the noble Lord, Lord Morris, initiated the debate. The situation has radically altered since then. In a bewildering week of leaked documents, the credibility of the Ministry of Defence has, frankly, plummeted dramatically. Many people, including myself, have criticised the Ministry for its lack of urgency and care. However, there has been a severe loss of trust in the MoD since then. In fact, we are now in danger of having a catalogue of mistrust.

The key issue that has most recently been raised is that of depleted uranium and its effects. But there is clearly a long line of reports which gave warning of the dangers now revealed in the leaked documents. It appears that the MoD was clearly apprised of the dangers of depleted uranium. In particular the report by the Atomic Energy Authority nine years ago gave due warning of those dangers.

Have the Government revised their figures of the rounds fired in the Gulf War in the light of that paper, which was written at the time and claimed much higher figures? A 1993 US document from the Surgeon-General also gives the lie to the Government's attempts to minimise the dangers. It appears that there is an even earlier, 1990, document from the US which also makes clear the dangers of depleted uranium.

The facts are clear. It is well established that depleted uranium ammunition was used in the Gulf. It is clear that all necessary safety notices did not reach their destination in the Gulf. Does the MoD categorically deny that depleted uranium dust inhaled by troops taking part in the Gulf conflict may lead to lung cancer, bone cancer, kidney disease and chronic kidney damage, or even leukaemia, as its own scientists advised was the case in 1993?

A number of Gulf veterans tested in Canada have been found to contain high levels of depleted uranium. Does the Ministry deny that? The US Navy has withdrawn depleted uranium shells, as we heard from the noble Baroness, Lady Park, and substituted tungsten-tipped shells. Why cannot we withdraw those for military purposes? Is that not all a prompt to action by the Ministry? Above all, we need a comprehensive publication of all the advice that the Ministry of Defence received to date to enable us to evaluate for ourselves what that scientific evidence is.

On testing, following the Statement by the Armed Services Minister last week, can the Minister confirm what is being offered to Gulf veterans by way of tests for depleted uranium? Is it in accordance with the Government's response to Llew Smith MP's Question on 29th November, which said that only those who had paid for testing in Canada prior to August 1999 will be tested in London? Or is any Gulf veteran now entitled to be tested on request? The noble Earl, Lord Attlee, rightly raised the issues as to what those tests entail. What will they be? When will they start?

The Secretary of State stated on "Newsnight" last week that if Gulf veterans had any symptoms of illness they would be tested. Surely, as the noble Countess, Lady Mar, said, it is not good enough to wait until veterans show signs of illness before allowing them to be tested. Furthermore, there have been doubts about the quality of the Ministry of Defence screening. The Ministry needs to offer independent screening. That should be available for all Gulf War veterans on request. It should be available as soon as possible and well before the end of this year.

A further case of mistrust has been over government-funded research, not just that relating to depleted uranium. The research by Dr Nicola Cherry published in the Lancet last year purported to show that war veterans only had a marginally higher mortality rate than normal. But there are strong views that the selection of people was flawed; that they had, in effect, been picked by the Ministry of Defence. Perhaps the Minister can tell us what the methodology was of the Manchester research. Were the subjects selected by the Ministry of Defence?

A great deal of other scientific evidence has been raised. There was research by Professor Abou-Donia of the Duke University in the United States; research by Matthew Hotopf on vaccines; claims by Mr Bernie McPhilips about the effects of Gulf War illnesses on his children. Work has also been done on post-traumatic stress disorder. I shall be grateful if the Minister could adumbrate the research being done to evaluate some of those pieces of work.

Then we come to the legal actions. Perhaps the Minister can also tell us how many claims or notices of claims have been received so far from Gulf veterans. Will the Ministry now accept mediation rather than putting ex-servicemen through the full legal process? Or will the Ministry still insist on establishment of legal liability before agreeing to mediation? After all, why should veterans have to rely on that sort of legal action? Why should 1,800 veterans have to sue in those circumstances? The key questions are not so much causative as financial. The Defence Select Committee, in its conclusions in May last year, said that it might well be that the causes of Gulf War illnesses will never be found. We could spend another 10 years picking over the causes. We need, as the Select Committee said, to provide proper care, treatment and financial provision for those Gulf veterans.

Gulf veterans expressed complaints about treatment by the War Pensions Agency itself. Why is the Ministry insisting on legal liability before paying compensation? Why does it not pay compensation simply on the basis that those veterans have been in combat? After all, the Gulf was the largest mobilisation of troops since the Second World War. Do we continue expecting establishment of legal liability and doing more and more research? As a distinguished American involved with the Gulf War veterans in the US asked in September,
"Do we really give our veterans the benefit of the doubt? Or will we continue to study this until no doubts, and perhaps no veterans remain?".
In the light of recent events and the failure of the Ministry to come up with adequate compensation, I fully support the call by the Royal British Legion for a public inquiry into Gulf War illnesses. We are rapidly reaching the point where there is no public confidence in the ability or willingness of the MoD to get to grips with the issue or provide adequate care and compensation. It is a measure of the respect in which our Armed Forces are held that veteran campaigners and claimants have been so patient and tolerant of delays.

Ian Townsend, the Secretary General of the British Legion stated that,
"If a member of the public suffered from chronic fatigue, hair loss, severe bouts of depression or cancer, they would ask for and receive assessment, answers and treatment. But many veterans of the Gulf. the Balkans and Kosovo, who have risked their lives in combat for peacekeeping appear not to for various reasons".
That is a shocking statement. We must ask ourselves what effect all this will have on our troops and our ability to recruit for the future.

On the tenth anniversary of the end of the Gulf War, as the noble Lord, Morris, said, it is high time for the Ministry to re-evaluate its approach. Failing that, no member of the Armed Forces, who, after all, risked their lives on behalf of our country, can confidently say that the Ministry of Defence is acting in its interests. The Ministry has always said that it owes a debt of honour to those veterans. It is high time for that debt to be repaid properly.

9.21 p.m.

My Lords, the noble Lord, Lord Morris of Manchester, has shown considerable prescience in his timing of this Unstarred Question. It was, I have no doubt, scheduled to coincide with the tenth anniversary of the Gulf War. In fact it comes at a time when depleted uranium, and all it involves, has been hitting the headlines, as mentioned by many of your Lordships.

Depleted uranium has not hitherto generally been considered to have played a major part in the investigation and problems arising or not arising from conditions in the Gulf War. It is unfair to accuse this Government or the last of negligence in their attempts to discover the reasons why so many servicemen have suffered after having served in the Gulf, or, as it would now appear, in the Balkans. I use the phrase, "suffered after having served" because it is by no means clear that there is a degree of causality. Further, there would seem to be no real evidence that British servicemen are suffering after having served in the Balkans.

Both in this country and in the United States controls have been set up to compare the health of those who have served in the Gulf and the Balkans with servicemen who have not so served. It is fair to say that everything has been taken into consideration: the "cocktail of injections", chemical agents, nerve agents, oil well fires and the general conditions, particularly in the Gulf.

However, the helpful Gulf Update, published by the Government last month, does not mention depleted uranium. While the publicity given to the problems arising out of the use of depleted uranium may—I emphasise the word "may"—be excessive, there can be no doubt that it is a new factor which will have to be taken into consideration. Depleted uranium would seem to have caused few problems with regard to radiation and in its pre-use form it is unlikely to have any toxic effects. It is of course what happens inside an armoured vehicle after penetration that matters. A DU missile vaporises once inside, filling the interior with tiny lethal particles. Statistically, the risk of irradiation is small but soldiers, and civilians living in the combat area, cannot be blamed for concluding that DU is responsible if they become ill.

For that reason the current scare cannot be ignored. My honourable friend in another place, the shadow Secretary of State, has said that it is necessary now for the Government to make a clear statement about the position of depleted uranium, given all the evidence which has been coming out in dribs and drabs. The Minister, Mr Spellar, made a Statement last Tuesday in another place which was helpful so far as it went.

We need to be reminded of the comment made by Lord Wilson of Rievaulx that seven days is a long time in politics because in the past six days things have gone much further. Is it still the case that there is no evidence of unusual ill health among British peacekeepers in the Balkans? An honourable Member in another place pointed out that as in the Balkans there were not the problems of immunisation and environmental pollution, it should be easier to ascertain whether there is a definite link between DU and ill health. While much more DU was used in the Gulf—300 tonnes to 12 tonnes in the Balkans—it should not be impossible to draw conclusions about the problems of DU in the Gulf if there were none in the Balkans.

During the debate on the Statement last week, the Minister replied that the Government were awaiting an independent study that the Royal Society was conducting. I should be interested to know whether that is the same study which the noble and gallant Lord said he had been informed of by the noble Lord, Lord Gilbert. Does the noble Baroness, Lady Symons, know when the study will be completed? The current publicity on DU adds a new factor and it is difficult for the problems of the so-called "Gulf syndrome", which is almost certainly no such thing, finally to be solved until one major factor—that is, DU—can be eliminated or confirmed.

The Government must do more than just consider offering independent screening to veterans who may have come into contact with DU dust and who are seeking reassurance. The Government must also clarify the status of the March 1997 report on the problems of DU, which is said to be flawed. What also is the status of the BBC report which stated that half the British war veterans tested had abnormally high levels of DU in their bodies?

DU is only one of the factors which may have affected Gulf veterans. The Royal British Legion has done an immense amount of work to help veterans and it is with the greatest sadness that I echo the remarks of the noble Lord, Lord Morris, about the recent death of Major Hilary Jones who was a member of the RBL committee for as long as I can remember. That is the latest of the deaths reported among Gulf veterans but it is of course nothing like the first. The Lancet figure up to July last was 395.

In an article last July, the Lancet concluded that the excess mortality rate of Gulf veterans was not statistically significant, a point which was questioned by the noble Lord, Lord Clement-Jones. It also stated that the excess, compared with the comparison group of those who were not deployed, related largely to accidents rather than to disease. Nevertheless, the RBL has not been prepared to leave the matter there and I pay tribute to the noble Lord, Lord Morris, and to Colonel Terry English of the Royal British Legion for all their work, most recently for a most valuable visit to the United States in October. Their report shows that the United States has had as many problems as Britain, including failures in record keeping.

I also pay tribute to Lord Effingham. My noble friend Lord Attlee regretted that there were few speakers in today's debate. Lord Effingham, who is no longer with us following the changes to your Lordships' House, played a most valuable part in all the work on problems arising out of the Gulf war.

It is clear that the various programmes carried out in the United States do not always produce a single recommended course of action. After 10 years, the chief concern is inevitably to manage the limitation of veterans' illnesses rather than to determine the causes, although of course that may well be the same thing.

The American Institute of Medicine report regarded DU with pyridostigmine bromide, sarin gas and vaccines as the most obvious causes of illness, but that is not totally accepted by the Department of Defense. Nothing is certain. It is clear from the report of the RBL committee, which was well received by medical and political experts at a high level, that in the United States there is as much concern and as little real knowledge about the causes of the problem as here.

There can be no doubt that HM Government take the matter extremely seriously, but many questions remain unanswered which I hope the Minister will be able to answer. How does one persuade those who served in the Gulf and who are ill to report the matter when that may damage their career prospects either in the services or outside? How does one make it easy for someone who wants help to gain easy access to an expert? How does one train GPs to detect the symptoms of the various problems and refer their patients to someone who can help? How does one reduce the costs faced by those who look for help and may have to travel long distances to obtain it? These are not the only "hows"; there are many more.

An important step has been taken to answer these "hows" with the introduction of the MoD website in 1998. Among other things, that is linked to the US Gulflink site. I hope that the Ministry will look at ways in which it can further enhance the information provided on the Gulf illnesses website, including facilitating contact between veterans. Perhaps that would breed harmony between the various associations which, as I believe the noble Countess would admit, is not perfect at the moment.

The Ministry may also find it advantageous to make greater use of the medical assessment programme and its data. It might be pie in the sky, but it would be immensely helpful if all veterans could be seen to determine whether the symptoms demonstrated by patients were representative of the whole. All these matters will increase veterans' confidence in what is being done for them.

I hope that the Ministry now accepts that it should thoroughly review the way in which it provides medical assistance to Gulf veterans and take full account of their views. The Ministry has an obligation so to do. In the meantime, I again pay tribute to the noble Lord, Lord Morris, to whom we owe this debate, Colonel English and all at RBL and Professor Malcolm Hooper and all those who have done so much to help. Above all, their work is a memorial to Major Jones and other Gulf veterans who now suffer or have suffered, if not because of their service, at least after it.

9.33 p.m.

My Lords, I too am grateful to my noble friend Lord Morris of Manchester who once again has provided an opportunity to debate the Government's policy on Gulf veterans' illnesses. His interest in the subject is well known and respected. I believe that this evening we have had a valuable opportunity to take a broad, and in some senses deep, view about the problems which have arisen. I am grateful to all noble Lords who have spoken in tonight's debate. This debate is particularly timely in view of the Statement in another place last week by my colleague the Minister for the Armed Forces concerning depleted uranium, to which most noble Lords referred during their remarks this evening.

It is important not to overlook the vital work that continues into other aspects of Gulf veterans' illnesses, as most noble Lords recognise. Since our previous debate on this issue on 26th January last year a great deal has been achieved, and the next 12 months should see a substantial amount of new research material for us to assess. I stress that research is vital if we are to understand what has happened, help those who have suffered and mitigate any risks in future. Last May a team from Guy's, King's and St Thomas' Medical School published a paper on the hypothesis that multiple immunisations were associated with later self-reported ill health in Gulf veterans. More publications are expected from the team this year, including the results of clinical examination of 400 Gulf and other veterans who took part in the questionnaire-based Phase 1 of the study.

The King's College proposals for Phase 3 of their study have recently been approved by the Medical Research Council. Phase 3 will involve a longitudinal follow-up study of UK Gulf veterans to determine whether their overall health has or has not improved as time has passed.

In July last year a team from Manchester University reported the results of an MoD-funded study into mortality rates among Gulf veterans. The study found that over an eight year period from 1st April 1991 to 31st March 1999 out of a total cohort of 53,462 the number of deaths and the causes of death in the comparison group who did not deploy to the Gulf were similar to those recorded among Gulf veterans; that is, 452 deaths among Gulf veterans as compared with 439 in the control group. The Gulf cohort has experienced fewer disease-related deaths than the control group—156 compared to 190—but more deaths due to external causes, particularly road traffic accidents, some 289, compared to 239. That is something which the MoD is researching further. I can give my noble friend Lord Morris the latest figures on the sad deaths which have occurred. As at 31st December 2000, 477 Gulf veterans have died, but so also have 466 of the control group who did not go to the Gulf.

Another MoD-funded study, under Dr Patricia Doyle at the London School of Hygiene and Tropical Medicine, is examining the reproductive health of Gulf veterans and their partners and the health of their children. Results from the study are expected to be available later this year.

The programme of research initiated by the MoD to investigate the possible adverse health effects that might result from the combined administration of the Nerve Agent Pre-treatment Set tablets and vaccines used during the Gulf conflict is also making progress. That is the research referred to by the noble and gallant Lord, Lord Bramall. He will be disappointed when I tell him that the final results are not expected until 2003. But this is an enormously complicated study and in order to undertake it thoroughly that is the time needed by the medical experts.

In addition, the MoD has published three papers; the medical assessment programme passed the 3,000 patient mark; and over 2,500 GP information packs have now been sent out.

As the noble Lord, Lord Burnham, said, we are keeping veterans up to date with developments. The first edition of the Gulf Veterans' Illnesses Unit's newsletter came out just before Christmas and the website continues to be widely publicised and regularly updated.

In May last year the House of Commons Defence Committee published its report on the progress that the Government are making on the issue of Gulf veterans' illnesses. The Government believe that the observations made by the committee were well balanced and acknowledged the complexity of the central scientific issues. The report's recommendations were in the Government's response published by the Select Committee on 3rd August 2000. That response is wide-ranging and I commend it to your Lordships.

All noble Lords who have spoken today have referred to the possible health effects of depleted uranium and, in particular, the suggested link between exposure to depleted uranium and the illnesses being experienced by some Gulf veterans.

In answer to the point raised by the noble Lord, Lord Clement-Jones, in March 1999 the Ministry of Defence published a paper entitled Testing for the presence of depleted uranium in UK veterans of the Gulf conflict: The Current Position. It explains that, although it is possible that small quantities of DU dust may have been inhaled or ingested by some UK troops taking part in the Gulf conflict, we believe that the health risks, both radiological and toxic, to be small.

On 19th December 2000, the US Department of Defense published a second interim environmental exposure report on depleted uranium in the Gulf. That report concluded that the available evidence does not support claims that DU caused or is causing the illnesses that some Gulf veterans are experiencing. Indeed, the updated estimates indicate that exposures of the kind UK troops might have encountered—for example, working in or around tanks struck by DU—were far below any applicable US safety guidelines.

Depleted uranium is a very dense heavy metal. It results from the uranium enrichment process, and because the majority of the more radioactive isotopes are removed in the process, depleted uranium is about 40 per cent less radioactive than natural uranium. I remind the noble Lord, Lord Clement-Jones, that we have long recognised that on the battlefield depleted uranium debris might present a hazard from chemical toxicity, in the same way as any heavy metal such as lead might do so, and a low-level radiological hazard. The risk from chemical toxicity would arise from ingestion of the soluble depleted uranium oxides, and the radiological risk primarily from inhalation of the insoluble depleted uranium oxides. These risks arise from the dustcreated when DU strikes a hard target such as an armoured vehicle. I am told that it would be necessary for a depleted uranium fragment to be in continuous direct contact with the skin for 250 hours before any statutory UK radiation dose limit for exposure of the skin of employees aged 18 years or over would be exceeded. Even in a tank fully loaded with DU ammunition—DU ammunition before it is fired—over 1,500 hours' exposure would be required before any crew would receive a radiation dose above the UK limit.

Because of its density and metallurgic properties, depleted uranium is ideally suited as a kinetic energy penetrator for use in anti-armour munitions. The noble Baroness, Lady Park, rightly said that the munition provides a battle winning military capability. Alternative materials are not as effective at piercing the armour of main battle tanks. Therefore, depleted uranium will remain part of our arsenal for the foreseeable future because when this country commits our troops to conflict we fight to win. Our troops need the best available equipment to enable them to do that. To deny them that legitimate capability would be quite wrong.

The noble Baroness referred to reports in the weekend press about the UK and US withdrawing DU ammunition. It is not true that the ammunition is being withdrawn in that sense. It is true that it is being replaced by the Navy with tungsten ammunition. I assure the noble Baroness, Lady Park, that that is not because of concerns about safety. Rather it is because trials have shown that for this requirement—the Navy Vulcan Phalanx Close-In Weapons System—tungsten ammunition provides a longer range and a higher probability of bringing down its targets. The targets are missiles, not armour-plated vehicles. DU is needed and will still be needed to penetrate the armour of main battle tanks. When I saw those press reports, I, like the noble Baroness, thought that tungsten might be an answer about which someone had not fully briefed me. However, on being fully briefed, I am assured that it is being used for a quite different purpose from that which we are discussing here, which is the penetration of armour.

We have a two-pronged policy for testing Gulf veterans. We will test any veteran for body load of uranium if the need is clinically indicated. Of the 3,000 plus patients who have attended the MAP, only two patients have so far needed to be tested under these arrangements. Their results were normal. We have also offered to test independently for depleted uranium the 30 or so Gulf veterans whom we believe had tests performed in Canada. As was said by the noble Lord, Lord Burnham, there have been arguments about how this should be carried forward. I am sorry to say that not all our approaches on this matter have been positively received by the Gulf veterans'organisations. But we remain open on the protocols that we have sent them and we hope that there will be a positive reaction to them.

Last week the Government announced a new initiative to help to reassure our service personnel who have served in the Balkans. The initiative involves, in consultation with appropriate national bodies, identifying an additional voluntary screening programme for our service personnel and of course for civilians who served in the Balkans.

Details of the most appropriate form for this programme will have to be worked out, but I can assure my noble friend Lord Morris that unless independent scientific advice—I stress, independent scientific advice—is to the contrary, this programme will be equally applicable to Gulf veterans. I hope that that assurance will be of some comfort to him.

Furthermore, I can assure the noble Countess, Lady Mar, that the form of such a voluntary screening programme will be based on the best possible science and that we shall consult with the appropriate national bodies such as the United Kingdom National Screening Committee at the Department of Health and, of course, the Royal Society, which represents another valuable source of independent research on this issue. We hope to be able to complete those consultations by the end of March. I shall then be happy to discuss with any noble Lord who feels that important points need to be put forward on screening any point that he wishes to put forward on this subject. In specific response to a point raised by the noble Lord, Lord Burnham, we hope that the Royal Society working group will report early in the summer.

I hope that, in the short time available to me, I have been able to provide some reassurance to noble Lords as regards the way forward. I do not believe that any noble Lord should underestimate the importance that the Ministry of Defence attaches to the health of all our servicemen and women and to the health of all our veterans, as well as the importance we attach to the announcement we made last week. It is our business to be as open as we can, but to base all our conclusions on real scientific advice and, wherever possible, sound and solidly based research.

I hope that all noble Lords will know from experience that I remain happy to discuss any of these issues. I shall be delighted to discuss any points noble Lords wish to bring forward on the way in which the screening programme announced last week can be taken forward.

My Lords, before the noble Baroness sits down, what is the current position as regards the attributable reservists scheme?

My Lords, the answer to that point, which I have in my papers, is fairly lengthy. Perhaps the noble Baroness will indulge me. I shall write to her and place a copy of the letter in the Library of the House. I am also conscious of the fact that other detailed questions have been put to me, for example, the questions raised by the noble Countess, Lady Mar, on issues such as those on Professor Lee and other matters which I have noted in detail. I shall write to all noble Lords where I have been unable to reply in detail on any specific points.

My Lords, before the noble Baroness sits down, perhaps I may ask briefly whether she will say that the symptoms of DU poisoning are expected from the Gulf veterans; in other words, what is expected to be reported. They need to know because there is presently panic in the community.

My Lords, I am sure that the noble Countess knows that one of the most frustrating aspects of the illnesses reported by Gulf veterans is that there is no single stream of symptoms. I am sure that, were I by implication to exclude certain symptoms, the noble Countess would be the first to say that that was not right, fair or proper. The best thing that I can say to the noble Countess, Lady Mar, is that if individuals feel unwell and if they believe that they are suffering from illnesses caused through their service in the Gulf, then that should be looked at sympathetically. I shall certainly discuss this further with her if she would find that helpful.