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Gulf War Illnesses

My Lords, I congratulate the noble Lord, Lord Morris of Manchester, on securing this important debate. No one has done more than he has over the years to obtain some satisfaction for the veterans of the first Gulf War who are now suffering from Gulf War syndrome, a label which, ultimately, the Ministry of Defence accepted as being a correct umbrella term. However, if we accept the findings of the massive new report which is now before us, we can instead refer simply to ““Gulf War illness””. There is an interesting passage in the report at page 41, where the authors of the report discuss what we mean when we talk of Gulf War syndrome as being unique. They accept that the consistent pattern of symptoms from which veterans are now suffering would fall well within most definitions of what is meant by ““syndrome””, but say it is easier and simpler to refer to Gulf War illness. I am certainly happy with that and I imagine that the veterans will be happy too. However, I am not so happy with an answer given by the noble Lord, Lord Tunnicliffe, on 9 December 2008, to a Question asked by the noble Lord, Lord Morris. He said at column 258 of Hansard that there is—and I paraphrase—no justification for treating Gulf War veterans differently from others from other operations who have the same conditions. I have difficulty with that answer for this reason: the one thing on which everyone is agreed is that there has been no similar widespread and unexplained symptomatic illness identified in any other war zone, either before the Gulf War or since. That finding is made quite clearly on page 1 of the report. So, in that sense at any rate, Gulf War illness or syndrome—whatever you call it—is, indeed, unique. I hope that when the Minister comes to reply she will at least accept that. I turn now to the more important issue of causation. When Dr Norman Jones, Sir Michael Davies and I wrote our report in November 2004, there were a number of different possible causes. A medical appendix, written by Dr Norman Jones, was attached to the report, and in part 2 of that appendix he listed no fewer than nine possible causes of the illness, either alone or in combination. But although there were nine possible causes in all, there were three front-runners to which I shall refer. The first was the multiple vaccinations to which it was said by the Ministry of Defence that the men had given their informed consent, whatever that may have meant. So the first possible cause was what came to be known as the cocktail of injections which the men were given before going to Iraq. Secondly, there were the organophosphate pesticides used to spray the tents in which they were living when they got to Iraq. For many years the Ministry of Defence denied that OP sprays had been used at all, except in the case of one single tent. But eventually, on 10 December 1996, Mr Soames admitted that Parliament had indeed been misled. Thirdly, there were the nerve agent pre-treatment sets, or NAPS tablets as they were known for short, which the men were required to take in the event of a threatened gas attack. They had never been used before by our forces or the American forces on anything like the same scale. The medical appendix deals with each of these causes in some detail and we owe a great debt of gratitude to Dr Norman Jones, who wrote it. He also dealt with the other possible causes, such as depleted uranium shells which were used for knocking out the Iraqi tanks. In the body of our report we did not reach any conclusion as to which of these actually caused the illness. It would have been ridiculous for us to attempt to do so because there was still much research to be done. Causation was an issue, as we saw it, on which the jury was still out. Stephen Irwin QC took the same view when he advised in March 2003 that legal proceedings against the Ministry of Defence would be unlikely to succeed, for without reliable evidence as to cause of illness, it would be difficult to establish negligence as the basis of the cause of action. We are now six years on and a prodigious amount of money has been spent—said to be $300 million in the United States on research and £9 million in this country. As a result of all that research, we now have a much clearer picture, and that is why this report which we now have is so important. It has provided us with the evidence which we have always needed. The committee which prepared the report under the chairmanship of Mr James Binns was appointed by Congress in 2002. It published an interim report in 2004 and the final report, which we now have before us, in November 2008. As the noble Lord, Lord Morris, said, the committee has reviewed 1,840 scientific papers listed alphabetically at the end of the report. I am told by Dr Norman Jones that the great majority of these papers have been published in peer-reviewed journals. The committee has gone through all the possible causes in the greatest detail and concluded that only two remain which have been consistently identified by all the evidence—NAPS tablets and OP pesticides. Together, as they say, these causes make a compelling case as the causative factors involved. True, other factors cannot be absolutely ruled out, but there is little or no evidence to support them. In his Answer on 9 December the noble Lord, Lord Tunnicliffe, said that the Government would need time to consider the report—no one would quarrel with that—but he went on to say that it would have to be peer-reviewed. Why? The report we now have is not a piece of original research; it purports to be a report of findings based on the research of others, and that it is indeed what it is. It is a report of findings by a committee of medical scientists, all of whom, according to Dr Norman Jones, are leaders in their fields. What more do we need? In our report in 2004—modest when compared with the report we now have—we said that on causation the jury was still out. I suggest that the jury has now returned and that the verdict is to be found in the Binns report. If that report needs peer review, then peer review will never cease. After six years the Binns committee has brought its labours to an end; what conceivable purpose could be served by asking the MRC or indeed any other body to go through the evidence all over again—all 1,840 papers of it? It is surely not suggested that Gulf War illness on this side of the Atlantic is any different from Gulf War illness on the other side. I ask the Minister to accept on the basis of the Binns report that the probable causes of Gulf War illness are the two that have been identified by the committee. We cannot be certain, of course. Little in life is certain, and even less in litigation. But probability, the civil standard of proof, is enough now to enable us to deal justly—and, I hope, generously—with the veterans suffering from Gulf War illness. Where, then, does that lead us? The Government have already apologised for the way the veterans suffering from Gulf War illness have been treated, but say that the veterans are now receiving pensions to which they are entitled and, so far as compensation is concerned, that is the end of the story. That is not an end to it, however. The war pension scheme entitles the veterans to a pension for injuries attributable to their service. But the peculiarity of the present case is that the injuries received by the veterans are not attributable to enemy fire, accident or anything of that kind; they are attributable to the NAPS tablets with which they were issued by the MoD and to the OP sprays, supplied by the MoD, with which their tents were sprayed. No government department likes to create a precedent—