Oral Answers to Questions

Madeleine Moon Excerpts

Monday 13th March 2017 Commons Chamber

[Harriett Baldwin]

Listing the 23 that do not spend 2% would take too long, but I reassure my hon. Friend that the five that do meet the target are the United States, the UK, Poland, Greece and Estonia. I am sure he can deduce from that the absentees.

[Mrs Madeleine Moon (Bridgend) (Lab)]

23. Germany currently spends 1.23% of GDP—€36 billion —on defence and to spend 2% it would need almost to double that, to €60 billion. Does the Minister appreciate that a rearmed Germany would give concern not only to some of its neighbours, but to Russia, thus potentially increasing the difficulties we face with tensions on the Russian border?

[Harriett Baldwin]

With the greatest respect, we think it is incredibly important that all NATO members, who share joint responsibility for the defence of the alliance, committed at the NATO conference in Wales in 2014 to spend 2% of GDP. We welcome the fact that eight further countries are now on a clear trajectory to meet that target, and Ministers from across all Departments continue to have discussions to encourage them to reach it.

Oral Answers to Questions

Madeleine Moon Excerpts

Monday 30th January 2017 Commons Chamber

[Sir Michael Fallon]

The expenditure that NATO classifies as meeting or not meeting the 2% is something for NATO to judge against its own guidelines. I note that our own Defence Committee commended the Government’s commitment to UK defence and found that our accounting criteria fell firmly within existing NATO guidelines, but ultimately, as I have said, this is a matter for NATO to judge.

[Mrs Madeleine Moon (Bridgend) (Lab)]

Since the Wales summit, 22 NATO countries have increased their defence spending in real terms, and 20 of them have increased it as a percentage of GDP. The number of allies spending 20% of their overall defence expenditure on equipment modernisation has also risen from eight to 10. Is the real risk to NATO not, in fact, defence spending, but a move away from transatlantic solidarity, which the present President is in danger of taking forward?

[Sir Michael Fallon]

Of course we welcome the increases in defence spending that have taken place—the baton is moving in the right direction—but I hope the hon. Lady agrees that a number of countries, including some that are quite wealthy, are still a long way from meeting the 2% target, and, in some cases, the 20% target as well. As for her latter point, I agree with her: this is a north Atlantic alliance, and it is extremely important for all of us to continue to assure the United States that that alliance is as much in the interests of the United States as it is in our interests here in Europe.

Oral Answers to Questions

Madeleine Moon Excerpts

Monday 12th December 2016 Commons Chamber

[Mrs Madeleine Moon (Bridgend) (Lab)]

The Israeli and US navies have recently been attacked with anti-ship missiles by Hezbollah and the Houthis. Is it not time to look again at the River-class offshore patrol vehicles and the Type 31 frigate to ensure that they have ASAM capability?

[Harriett Baldwin]

It is important that the Royal Navy continually assesses the capabilities with which ships are fitted. I cannot go into some sensitive details at the Dispatch Box owing to operational requirements.

Oral Answers to Questions

Madeleine Moon Excerpts

Monday 7th November 2016 Commons Chamber

[Sir Michael Fallon]

I am very happy to undertake to look into that particular matter, but our emphasis, as I am sure my hon. Friend would agree, must be on the 200 or 300 British citizens who have gone to Iraq and Syria to fight for Daesh and pose a potential threat to this country, and who may well have committed criminal acts in fighting alongside Daesh. They are the people who need to be investigated first.

[Mrs Madeleine Moon (Bridgend) (Lab)]

T3. The hon. Member for Gower (Byron Davies) and I have been campaigning to bring opportunities to air cadets in Wales to experience gliding in Wales. We were promised at a meeting in the Ministry of Defence last week that a decision was pending. Is it good news or bad news?

[The Parliamentary Under-Secretary of State for Defence (Mark Lancaster)]

It is good news. The hon. Lady and my hon. Friend the Member for Gower (Byron Davies) have been absolute champions when it comes to pursuing the opportunity for cadets in Wales to glide in Wales, so I am pleased to announce that I will facilitate summer gliding camps at St Athan on a trial basis next summer, with a view to continuing them in future.

Defence Expenditure

Madeleine Moon Excerpts

Thursday 27th October 2016 Westminster Hall

[Mrs Madeleine Moon (Bridgend) (Lab)]

I will not delay everyone for long. Although the Committee found that the Government’s accounting criteria fell firmly within the NATO guidelines, we also found that those criteria had been amended to include several significant items that had not previously been included when the UK calculated its defence expenditure. That is the nub of the issue that we must address. The Committee is concerned that the inclusion of such items, which were critical in attaining the 2%, could undermine the promises in the SDSR of new money for defence.

During our inquiry, there was considerable discussion of the 2% as an indicator of Britain’s political willingness. Witnesses said that

“2% is good politically”

and not to meet the 2%

“would have been damaging to our reputation politically.”

The 2% was said to have

“a…powerful symbolic meaning”.

The UK has made great play of that 2% as demonstrating its commitment to collective defence in NATO, but the inclusion of items that had not previously been included, such as pensions, has not gone unnoticed—with considerable contempt—across the alliance. As well as being a member of the Defence Committee, I represent the UK on the NATO Parliamentary Assembly, and I have found that other countries, when talking about their expenditure and accepting that it does not reach 2%, take great delight in pointing out that their figures do not include pensions, as they have no wish to use creative accounting to bolster their spending. That is divisive within NATO and damages our credibility and capability to defend our shores and those of our allies.

Our report highlighted that 2% should be a minimum, not a target, and certainly should not be seen as an indicator of capability or capacity, or give a false glow of competency and readiness. The report also urged the Government to provide a calculation of what defence expenditure would be if we left out the new items such as pensions and used the same items as we had under the 2010 accounting rules. We still await those figures.

A perfect storm is building of cuts to personnel, cuts to training, problems in procurement and gaps in capability. With the 2%, there is a disparity between our procurement aspirations and their affordability—and our capacity to deal with major defence equipment deficiencies, such as the engines for the Type 45 destroyers and the delays in replacing the Type 23 frigates and logistics supply ships. I have a major concern in particular about the Royal Navy’s capacity and capability. If we went back to realistic accounting, perhaps we would be able to deal with those issues.

I do not want to take too much time, because I know that colleagues want to speak, but I must emphasise that in our report, the Committee expressed concern that the UK must not become a hollow force. Sadly, despite the great commitment and bravery of our personnel and their amazing “make do and mend” ingenuity, I fear that we are hiding our vulnerability behind the cardboard shield of 2%.

Lariam

Madeleine Moon Excerpts

Thursday 27th October 2016 Westminster Hall

[Mrs Madeleine Moon (Bridgend) (Lab)]

I beg to move,

That this House has considered the Fourth Report from the Defence Committee of Session 2015-16, An acceptable risk? The use of Lariam for military personnel, HC 567, and the Government response, HC 648.

Before I turn to the overview of the report and the conclusions of the Select Committee on Defence, I want to put on record our thanks to those who gave us the impetus to investigate the issue and contributed their knowledge and their time. I apologise if I leave anyone out. Our thanks go to Trixie Foster and the retired Colonel Andrew Marriott for their persistence in raising the issue and co-ordinating a detailed submission; to defence correspondents who took the matter up; and to Forces TV whose work brought in more evidence. I thank the Library for its research and our Clerks, who do a magnificent job, as well as the witnesses who appeared at our three evidence sessions, including from the drug’s manufacturer, Roche.

I would also like to put on record my personal thanks to the Committee for agreeing to pursue the issue for the sake of the approximately 25% to 35% of personnel who have taken Lariam who have been directly affected. The Committee was determined to ensure that the Ministry of Defence would examine the damage to lives and the failure of the duty of care, and to make the necessary recommendations to protect our armed forces personnel in the future.

Lariam is one of several antimalarial drugs that the MOD uses to protect military personnel against malaria. None of the alternatives is without its problems, but Lariam has been the subject of concern for a long time. The inquiry set out to establish a clear picture of the impact of its use in the UK armed forces. I think it is fair to say that the Committee was shocked and surprised by what we found. I will leave others to go into details, as it is my role to give an overview of our principal conclusions and recommendations.

From the evidence we received from individuals and the statistics that the MOD provided, we were shocked that Lariam is still being used so often despite the well-known problems. We were told by the drug’s manufacturer that the MOD accounts for one fifth of all its UK sales. At a minimum, 17,368 personnel were prescribed the drug between 2007 and 2015. There may well be more, but one of our findings was the haphazard nature of MOD medical record keeping. Note to the Minister: it was particularly unhelpful when the MOD published its first 10-page statistical bulletin on Lariam on the day we took evidence from the Minister.

The MOD receives advice from the Advisory Committee on Malarial Prevention alongside the advice from the manufacturer. Roche is clear in its guidance that every individual who is prescribed Lariam should undergo an assessment with a medical professional to identify any contra-indications that might make them more susceptible to side effects. We questioned whether the ACMP’s advice was appropriate. It was clear to us that the general advice that it offered was not tailored to the specific needs and circumstances of the military. It fell short and put military personnel at risk. We concluded that the MOD should work with the ACMP to develop specific guidelines, similar to the US so-called “Yellow Book”.

[Douglas Chapman (Dunfermline and West Fife) (SNP)]

Is the hon. Lady now confident that the MOD will be able to deliver on the duty of care and the commitment to proper prescribing of Lariam, especially when a large number of troops are leaving at the same time?

[Mrs Moon]

If I am perfectly honest, no. I think that the medical care that is offered continues to fall short, but I hope that the Committee will be able to address the issue again in future and ask for further updates. Of course, we have the opportunity to hear from the Minister today what further progress has been made.

Alongside our findings about the ACMP, we looked at whether Lariam was appropriate to where personnel were sent and the work that they do. The Minister and the Surgeon General told us that geographical location was a consideration in prescribing Lariam. By contrast, other witnesses made it clear that there is nowhere where Lariam should be the preferred drug, particularly given that there is increasing resistance to it and there are alternatives available. Geography aside, and linked to our earlier concerns about the ACMP advice, we sought to clarify whether Lariam, given the known side effects, was appropriate at all in a military setting. A military deployment is a world away from a tourist sightseeing or sitting by a pool. The physical and mental strain of being deployed in stressful situations does not need to be exacerbated by the severe side effects that Lariam can induce.

Dr Nevin gave evidence of an alarming potential negative impact on military performance and operations. There were cases of service personnel experiencing

“episodes of panic resulting in abnormal behaviour”

and incidents of servicemen becoming confused and being found “wandering aimlessly”. There were incidents of tension and anger, episodes of severe mental and physical exhaustion and nausea, lapses of concentration and episodes of short-term memory loss, ill temper, dangerous driving, confusion and suicide ideation. That is a grim picture of medically induced problems for military personnel on deployment.

We explored whether other nations gave Lariam to their armed forces. Our research uncovered a mixed picture, but a tendency towards either no longer using Lariam at all or using it only as a drug of last resort. That all added weight to our recommendation that greater clarity is needed in determining when to use Lariam, and that attention should be paid to whether it is appropriate for military personnel.

At the heart of our inquiry was the question whether the MOD was fulfilling its duty of care by following the clear guidance on prescribing Lariam. Did every individual undergo the Roche-required individual medical assessment prior to deployment? Was it realistic to think that the MOD could ensure that that happened, particularly for a large-scale, short-notice deployment? Alarmingly, there was evidence that individual assessments were not happening. Lariam was included in pre-deployment kit; it was handed out on parade; or the MOD relied on an assessment of medical records only for prescription. We felt that that was a fundamental failure in duty of care. We concluded that, aside from the need to consider the practicalities of arranging assessments, prescribing Lariam should only ever be a last resort bounded by strict conditions. Linked to that, we uncovered concerns about non-reporting of contra-indications; military personnel appeared unwilling to admit to conditions such as a previous history of depression, because of fear of a negative impact on their career. That underlines even further the need for individual assessments.

Several witnesses reported that personnel were so concerned by the reputation of Lariam that they discarded their medication and were potentially left with no antimalarial protection at all. That came even from the very top. I believe Lord Dannatt has announced that he refused to take Lariam and would throw it away. We were deeply disturbed by that and recommended that the MOD should monitor compliance rates.

[Bob Stewart (Beckenham) (Con)]

I recall that evidence that came to us, as hearsay, from Lord Dannatt. It really shocks me that he was Chief of the General Staff and felt that way and did not take action. I think that the Committee felt that too.

[Mrs Moon]

We most certainly did; but that also shows the inertia in the Ministry of Defence. We heard from many personnel—either individually or as a Committee—at different ranks within the MOD. The matter was not something that was not known about, but it was not being tackled or recognised as a major problem for serving personnel.

Finally, and most tragically, we heard from many individuals who suffered severe long-term effects from taking Lariam. Long after leaving the military, they are still suffering such things as mental trauma, vivid dreams and suicide ideation. That is totally unacceptable. We sought to establish what support was on offer for them from the MOD as it became clear that arrangements were somewhat fragmented. We recommended the establishment of a single point of contact, which we felt was particularly important for veterans, some of whom have experienced mental health problems for years.

Having seen what happened in the previous debate, when the vice-chair of the Committee could not be called to speak owing to time restrictions, I shall now leave it to my colleagues to expand further on the report and evidence. We look forward to hearing from the Minister that further progress has been made.

--- Later in debate ---

[Johnny Mercer]

I thank my hon. Friend, loosely speaking, for raising that point. He gets to the crux of the problem. Essentially in the military, we go on medical advice. None of us are scientists or doctors. If we get into the real detail of the issue, it is on that point that we get to the nub of what has gone wrong.

[Mrs Moon]

Does the hon. Gentleman agree that the problem was that there was no medical advice? Often, a sergeant major would just walk down the ranks, saying, “Take these.” There was no assessment—nothing. It was just, “This is what we have in the stores. You take it.” There were no warnings about the side effects or about reporting them. That was, and remains, the failure.

[Johnny Mercer]

I absolutely agree that the single point of failure was that we had a drug that, like any drug—even paracetamol or Anadin—should be used within the guidelines set down by the manufacturer, but instead of people being given it carefully, in a medical fashion, with individual risk assessments as stipulated by Roche, Lariam was just handed out on parade. Clearly, that is not the way to do business. The hon. Lady is right. I am glad that we have identified that practice, and I believe that we have put a stop to it. That is a good thing to have come out of the report.

We now need to ensure that we look after those who come forward. There are conversations about compensation and things like that—I understand that that is the way of the world—but that is never the intent behind inquiries such as this. I am interested in looking after those who are going through the process. We must get those who come forward some sort of treatment. We must provide some point of contact that is not just known by me, other MPs and those within Main Building. Everybody should know where they can go to get help if they feel they have been affected, and we need to show them a clear pathway.

Ultimately, we need to pay people an interest and accept that something has gone wrong. There is a slight issue within the Department—I know that everybody, including the Minister, knows this—with accepting evidence of a problem. If I have seen that in my experience as a lowly Member of Parliament, I can only imagine what it is like for families who have an issue with the Ministry of Defence to come forward. I bring that point to people’s attention and ask that we never ignore evidence of problems. We all know what soldiers are like. They are fantastic people, although if they are not moaning, something is not right, but we need to be slightly smarter and understand what they are saying so that we can identify problems before they become as big a problem as Lariam.

--- Later in debate ---

[Fabian Hamilton]

My apologies for that. I obviously did not write my notes correctly. I am sorry if I misquoted the right hon. Gentleman.

As we discussed in the previous debate, we have a duty to ensure that people who put their lives on the line for the defence of this country, like hon. Members in this Chamber who have done so, do so in the knowledge that those who ask them to do it and who send them to dangerous places are looking after their interests.

We know that Lariam is the brand name of mefloquine and that it is used to treat malaria. It is most commonly administered as a prophylaxis, but the history of side effects, the evidence we have received and the evidence in the Defence Committee’s report make it clear that it is not necessarily the most appropriate prophylactic medication. I am glad we have made it clear that we do not blame the manufacturer, Roche, for the misuse of its drug. It is clearly an issue for the Army itself and we want the Army to get it right. That is why the Committee’s report was written in the first place. I myself have taken chloroquine and proguanil; I suffered some side effects, but nothing like those that have been recorded for Lariam.

We know that many countries’ military forces have used Lariam in the past, but that it is becoming increasingly uncommon because of its side effects. Some 17,000 British military personnel were prescribed Lariam between April 2007 and March 2015, and the reports of those side effects meant that many of them have discarded their Lariam tablets instead of using them. That makes them far more susceptible to malaria, which is extremely dangerous—as the hon. Member for Stafford said, it has killed 438,000 people in the last 12 months.

The summary of the Defence Committee report says:

“The evidence we received highlighted some severe examples of the possible side-effects of Lariam in a military setting. While they may be in the minority, we do not believe that the risk and severity of these side-effects are acceptable for our military personnel on operations overseas.”

When the Minister responds to the debate—I apologise that I will not be present to hear him—will he care to tell us about the handing out of Lariam to military personnel in future in the light of the report and the evidence contained within it?

In preparing for this debate, I sought the advice of a specialist—he has asked not to be named—who works at the London School of Hygiene & Tropical Medicine. His view was quite interesting. He made the point that Lariam is a cheaper medication than some antimalarials, and that it is very effective. That could be one reason why the MOD is maintaining its support for Lariam in the face of media controversy, the Defence Committee report and, of course, resistance from many military personnel. The specialist said that it is a good drug. He even gave it to his spouse when they went to west Africa a few years ago. He reported that she had had the most vivid and crazy dreams. Like most drugs, it is not good for some people, but it is good for others.

One thing in favour of Lariam is that it is administered once a week. Many other antimalarials are administered once a day. For someone in a military setting who is in a conflict situation, or who has been deployed in a remote area, it being a once-a-week drug will have a huge benefit for those administering it and those having to take it. A once-a-week dosage also increases the chances of compliance and of people actually taking the medication when they need to take it.

The specialist I mentioned noted that the number of tests on the effects of Lariam on Army personnel were small and were not done in an adequately controlled situation. I do not know whether my hon. Friend the Member for Bridgend would agree with that, given the evidence taken by the Select Committee, but there needs to be far more testing. There needs to be a much greater database of evidence to prove conclusively that so many people will not tolerate Lariam and that it should perhaps be replaced by other drugs, depending on geolocation and the individual assessment of military personnel.

[Mrs Moon]

Is my hon. Friend aware that there have been episodes in which serving personnel have murdered individuals, and in which they have deliberately carried out inappropriate acts, all because they were under the influence of Lariam? That is part of the record that the Committee looked at.

[Fabian Hamilton]

Yes, I was aware of that, but I am not aware of the details. I have heard anecdotal evidence, but it is important to hear about the actual cases and evidence.

I know that other Members wish to speak, and of course the Minister must respond, so I shall conclude. Paragraph 97 in the conclusion of the Defence Committee report states:

“The Ministry of Defence has a duty of care to protect military personnel on operations overseas. It includes ensuring that they are adequately inoculated against disease. This will never be without the risk of detrimental side-effects, and we understand that the MoD must balance those risks against the health of our Armed Forces. However, in the case of malaria, we conclude that the MoD’s current policy has got that balance wrong.”

I hope the Minister addresses that point in his response.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Defence (Mark Lancaster)]

It is a pleasure to serve under your chairmanship, Mr Rosindell.

We seem to have had something of a flurry of detailed questions towards the end of the debate, giving me little opportunity to address many of them in the nine minutes I have to respond to the debate. I will do my best, but at the start I simply commit to writing to any hon. Member whose question I do not manage to answer during that time.

Of course, I begin by taking this opportunity to thank the Defence Committee for its very thorough report on the use of mefloquine by service personnel, and I also thank the hon. Members who have spoken today, from the opening contribution by the hon. Member for Bridgend (Mrs Moon) onwards. I will address many of the points that were made as I go through, but on a specific point that she made, I absolutely regret the publication of the statistics on the day of the Committee hearing. However, she may not be aware that it is absolutely right that Ministers have no control over the collection or publication of statistics; it would be wrong if we did. So it was genuinely an unfortunate coincidence, and it would have been even worse if the statistics had been published the day afterwards.

I thank my hon. Friend the Member for Plymouth, Moor View (Johnny Mercer) for his passionate contribution, not least because every time he speaks in this House he seems to suggest that I should be promoted—so I thank him very much indeed. I also thank my hon. Friend the Member for Stafford (Jeremy Lefroy), who gave an incredibly incisive personal account; it really was very powerful. Of course, I also thank my right hon. Friend the Member for New Forest East (Dr Lewis), who asked a number of questions, which I will endeavour to answer during my response to the debate.

We had other good contributions from the hon. Members for Leeds North East (Fabian Hamilton), who has had to leave us, for Glasgow North (Patrick Grady), and for East Renfrewshire (Kirsten Oswald). I will endeavour to address all the points that they made in due course.

The Government have considered our conclusions carefully, and I will outline the positive steps that the Ministry of Defence is taking to address the Committee’s recommendations. Before I do so, I want to nail one issue that floated around towards the end of the debate—that Lariam is somehow the MOD’s drug of first choice, and that cost is a factor in its use. According to the “British National Formulary” of March 2015, Lariam, at £14.53 for an eight-week supply, is more expensive than Paludrine/Avloclor, less expensive than Malarone but more expensive than doxycycline. So cost is not a factor, and we would never prescribe on the basis of cost alone.

Equally, mefloquine currently constitutes only 1.2% of all the antimalarial tablets held by the MOD, and in terms of doses for a six-month deployment—of course, doses for different drugs are given at different rates—it accounts for just 14% of the stock. So 86% of our stock is not Lariam. That hardly represents a reliance on Lariam or evidence that it is being used as a drug of first choice.

[Mrs Moon]

I am delighted to hear about the low take-up of Lariam by the Ministry of Defence now. Does the Minister have the figures for what the take-up was in the past?

[Mark Lancaster]

Those figures give the current status, but I believe that the figures for the last eight years, which is as far as we go back, are similar. However, I am happy to write to the hon. Lady to give the exact figures. Of course, much of this debate is about how we move forward, as opposed to what we have done in the past, and I hope to demonstrate in my response over the next five and a half minutes that the steps we are taking are very positive.

It is important for me to state that we take the health and wellbeing of our personnel extremely seriously and acknowledge the duty of care to provide the best possible support to them. Malaria is a deadly disease, and we must protect our deployed personnel from it. The most effective way to do so is through the use of antimalarial drugs. However, as we have established, no antimalarial drug is 100% effective and risk-free. Indeed, all medications have the potential to cause side effects and adverse reactions in a small number of people. That is why the MOD needs to use a range of prevention drugs to protect our personnel and ensure that the treatment provided is the most effective for each individual. I should emphasise that despite tens of thousands of service personnel deploying to malaria-risk areas, no serviceman or woman has died from malaria resulting from an operational deployment since 1992, and cases of severe malaria are rare in the armed forces.

I turn to the two main recommendations of the Committee’s report. The first was that the MOD works with the Advisory Committee on Malaria Prevention to develop guidelines on mefloquine and other antimalarials, specifically regarding their use by military personnel. The MOD has always kept its malaria prevention policy under constant review, and I can confirm that a recently revised malaria prevention policy has been passed to the ACMP for its consideration.

The revised policy is based on three elements. In the first instance, at around the time when individuals complete initial training they will undergo a face-to-face consultation with a medical professional, to identify any adverse reactions to the five most commonly used antimalarial drugs. Secondly, after posting into a deployable role, armed forces personnel will undertake a generic face-to-face travel health risk assessment, again with a medical professional. Finally, once individuals are advised that they are likely to deploy, they will undertake a deployment-specific face-to-face travel health risk assessment.

The results of those assessments will be recorded in the patient’s electronic health record. Although the need for a risk assessment is not new—defence policy since 2004 has been clear on the requirement for such assessments—monitoring will now be better aided by an electronic records system. In answer to a question put by my right hon. Friend the Member for New Forest East, perhaps I can say that if the actions that he described need to be taken, in extremis, before an emergency deployment, they will be based on those three thorough, face-to-face, comprehensive interviews, as recorded in the electronic record.

On that point, I reiterate what I said when I gave evidence to the Committee. I recognise that anecdotal evidence submitted to the Committee suggests that, in a small number of cases, some people believe that their individual risk assessments did not take place in the past. I hope that the new system will prevent that situation from recurring. I encourage anyone who has concerns about the issue to come forward, in confidence, as there are established processes by which current and former members of the armed forces can be referred to medical staff to have such concerns investigated.

That leads me to the second main recommendation of the Committee’s report, namely that the MOD should establish a single point of contact for those who are worried about their experience of mefloquine. I am pleased to report that the mefloquine single point of contact has been set up and publicised widely through the chain of command, veterans’ organisations, military publications and GPs. As I sat here listening to the debate, I googled the advice about that single point of contact, and there it was on the gov.uk website. It was launched last month and is easily accessible. It is a confidential service for people to make contact by phone and email, and it is supported by other information on the Government website, as I have just said. Depending on their circumstances, individuals are directed to a range of information and services available to help them. That includes how service personnel and veterans can find out whether they have been prescribed mefloquine in the past. My right hon. Friend the Member for New Forest East has raised concerns about the quality of information being given on the helpline. I am more than happy to go and examine that, and I will write to the Committee with details as to exactly what advice is being given.

Again, I encourage anyone who is concerned about their experience of mefloquine and who has not yet gone to the single point of contact, including those who believe that their risk assessment did not take place, to contact the single point of contact or speak to their GP.

In addition to those two main recommendations, the MOD will conduct a prospective audit of returning travellers, to assess the impact of the new policy. That will be for any antimalarial drug that has been taken. The MOD will also continue to undertake post-deployment surveys, to enhance its understanding of compliance with the revised policy.

The Government informed the Committee that the MOD would undertake further research into the impact of the adverse effects of antimalarial drugs on the performance of military personnel. A research proposal is currently being considered by the MOD’s research ethics committee. The research will be in the form of a retrospective survey of soldiers deployed on exercise in Kenya who have been prescribed one of three antimalarial drugs. A questionnaire will seek information about risk assessments, individuals’ compliance with prescriptions, the incidence and prevalence of side effects of the drugs, and the impact of those side effects on functional effectiveness.

If there are any other questions, I will endeavour to write to hon. Members about them.

Question put and agreed to.

Resolved,

That this House has considered the Fourth Report from the Defence Committee of Session 2015-16, An acceptable risk? The use of Lariam for military personnel, HC 567, and the Government response, HC 648.

Ministry of Defence Future Accommodation Model

Madeleine Moon Excerpts

Wednesday 19th October 2016 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

Will the hon. Lady give way?

[Mrs Madeleine Moon (in the Chair)]

Order. The hon. Gentleman has not been present to hear the whole speech.

[Jim Shannon]

I was chairing another meeting. I have come straight from it, Madam Chair.

[Mrs Madeleine Moon (in the Chair)]

It is generally accepted that interventions should be from Members who are present for the whole speech. Is the hon. Lady happy to give way?

[Mrs Trevelyan]

I am going to run out of time, am I not?

[Mrs Madeleine Moon (in the Chair)]

It is up to the hon. Lady.

[Jim Shannon]

Just very quickly.

Oral Answers to Questions

Madeleine Moon Excerpts

Monday 12th September 2016 Commons Chamber

[Harriett Baldwin]

Yes, in March this year we reduced the profit rate on single-source contracts from 10.6% to 8.95%. The regulator will then recommend a rate for 2017, which we will consider carefully, along with its recommendation on multiple profit rates.

[Mrs Madeleine Moon (Bridgend) (Lab)]

What steps will the Minister take to ensure that, where single-source contracting is placed abroad with, say, American companies, there are appropriate levels of set-aside, so that apprenticeships and the seed-corning for future capability in British defence companies are protected and facilitated?

[Harriett Baldwin]

The hon. Lady will be aware that that is an ongoing subject of discussion, and of the commitment that General Dynamics has made in Wales in the part of the world she represents to create 250 jobs in the supply chain for the Ajax vehicles.

--- Later in debate ---

[Mrs Madeleine Moon (Bridgend) (Lab)]

The British Royal Navy is now smaller than the flotilla that we sent to take back the Falkland Islands. When will we have a date for Type 45 destroyer engine repairs and replacements, which are desperately needed, so that we can at least maintain the 19 ships of the line that we currently have?

[Michael Fallon]

I hope that the hon. Lady, who knows a lot about this, is not confusing number with quality or power. The ships we are now deploying—the aircraft carriers, the Type 45 destroyers and the forthcoming Type 26 frigates—are of course much more powerful than the ships that sailed to liberate the Falkland Islands. I know she will join me in welcoming the new missions of the two Type 45s, HMS Diamond and HMS Daring, which sailed in the past few weeks.

Report of the Iraq Inquiry

Madeleine Moon Excerpts

Thursday 14th July 2016 Commons Chamber

[Johnny Mercer (Plymouth, Moor View) (Con)]

Thank you, Mr Speaker, for this opportunity to speak in the debate. The Chilcot report, published last week, made sobering reading. Many things have been said already on the issue—I shall not repeat them—and the chief protagonists at the time have received, in my view, fair criticism. I am in the fortunate position of both having been in the Army at the time of the Iraq war and now being a Member of this place. I did not serve in combat in Iraq; my theatre was another unpopular war, in Afghanistan.

At the time of the Iraq invasion, the Army was a strange place to be, particularly if you were just beginning your career. It is difficult to be positive about a mission when over 1 million people march against your deployment just before you go. But it is testament to the character and professionalism of the UK armed forces that the initial operation was the success that it was, despite cruel losses—including from my own regiment on 23 March 2003, when Ian Seymour, Les Hehir and Welly Evans of 29 Commando were killed during the insertion into southern Iraq.

However, what happened following the initial operation in that country and for the following seven years—indeed, perhaps right up to today—has been a tragedy for Iraq. I visited the country last autumn and met the President. It remains a place of extreme violence, heavy corruption and deep division. It was a challenge to return from a visit to Baghdad with much of a sense of optimism, although recent changes in the Iraqi security forces, and the international coalition’s mammoth efforts in the fight against Daesh, give real cause for hope, and I want to pay tribute to all UK forces engaged in that fight today.

How did we get to this point? I absolutely understand the public rage. The actions of some of those at the top of Government at the time—and yes, at the top of the military—were negligent. I am concerned, however, that the public’s fixation on Tony Blair could make us miss some of the learning points that must be taken from Sir John’s comprehensive work. Those learning points are the whole point of this process. It was encouraging to hear the Prime Minister who left office yesterday say that it would be impossible for these events to happen again today because of the structures he and his team had put in place, and I commend him and the Secretary of State for Defence for that.

However, there is a deeper issue here—one of basic moral courage—that I have found most distressing. In the military, that moral courage can be a rarer and therefore more treasured commodity in an organisation configured to imbue and nurture physical courage in the face of the enemy. That ability to stand up for your men in the face of a seemingly unstoppable sequence of events, and to speak truth to power, is an integral part of the military’s duty to this nation. We drill it into our subordinates and we preach it to anyone who will listen. So where was that courage in the build-up to this disastrous war?

It is inconceivable to me to allow a political Administration in this country to hamper preparations for war because they did not politically want to be seen to be making those preparations. It is inconceivable to me to allow soldiers out of patrol bases and into contact with the enemy without body armour, not as a tactical decision or a result of enemy action against a supply route, but simply because of bad planning. It is inconceivable to me continually to allow patrolling in Snatch Land Rovers when they were known to provide no protection whatever to our men and women against a well known and obvious threat from improvised explosive devices. But those things happened, and they directly cost UK military lives. These lessons must not be missed amid the almost visceral fixation of hatred on Tony Blair, lest we do a further disservice to our men and women who serve.

The Prime Minster does not make tactical decisions. She does not plan logistics; she is advised by those who do. I cannot in all honesty conceive of a time when I, as a very junior and insignificant commander in another unpopular war in Afghanistan, would ever have sanctioned an operation knowing that it lacked the equipment required to protect my men from a threat that I clearly knew about, because I was not prepared to say no. I find it hard, as do many of my cohort, to understand why that was sanctioned, yet it was.

We as a military betrayed the individuals who lost their life in this conflict as a direct result of equipment shortages. That is the point that really sticks in the craw. The political arguments and the strategic comings and goings will be debated ad infinitum, as they must be, to ensure that we do not make the same mistakes again, but the military and tactical lessons must also be learned. What happened in Iraq had a profound effect on my whole generation of junior commanders in the military. We grew up with a deep sense of distrust in our superiors as a result of their actions, or lack thereof, during the Iraq war. That affected many of us at a formative stage in our career.

Finally, I want to speak strongly against the idea that the lives of British servicemen and women were somehow wasted in this war, or that they died for nothing. I simply cannot reconcile it with my not insignificant personal experience of commanding men in combat that lives lost in the pursuit of protecting the freedoms and privileges that we enjoy in this country were lost in vain. For the families, many of whom I know intimately, nothing—no mission, no cause—can be worth losing a loved one. As a soldier, however, I feel that I must represent the intimate conversations we shared, and the deep motivations that we fell back on to get through yet another day in the sweat, heat, blood and dust of these recent wars. We soldiers are drawn from all backgrounds, races, religions, colours and creeds. We all have different views—usually much more informed than anyone gives us credit for, and no doubt crafted by our own personal experiences—but we wear one uniform, with one Union Jack on our sleeve. We sign up to the same core value of protecting this nation, in exactly the same tradition of immense sacrifices as our forefathers, who wore the same cap badges and were under the same flag.

The truth is that, when a soldier leaves his patrol base in the morning, he is not thinking about how his particular contribution that day will help to advance the cause of Iraq’s future prosperity or Afghanistan’s place in the world. He is not thinking about whether we should have believed the dossier about weapons of mass destruction or whether he is going to stumble upon Osama’s house in downtown Sangin. He is thinking of calling his wife later, of covering his arcs and of trying not to blink in case he misses something. He is making sure he has some spare batteries for his radio. He is more frightened of letting his mates down than he is of the enemy. He is more focused on doing his section, his platoon, or his battalion proud than whether he should be there in the first place. In those endeavours he is showing that courage, that fortitude, that resilience, that commitment, that discipline and that humanity that we all aspire to on the most revealing stage of all: warfare, where norms do not exist and brutality and raw human emotion are everywhere.

We aspire to those things because they are good, because they are noble, because they are to be desired, and young men and women made sacrifices demonstrating such qualities, which those of us who witnessed it and were lucky enough to return refuse to remember as futile. They did make a difference. They saved comrades’ lives through their bravery. They shielded civilians from a brutal enemy intent on showing the very worst of humanity. They improved individual communities and made them safer and better—perhaps not on an overall strategic level, but it was not all a waste. That courage, that resilience, that discipline, that commitment, they are what we must remember from these conflicts. They cannot and must never be forgotten, for that would be an even greater betrayal than the ones laid out in the report. The lives were not wasted; they were engaged in noble pursuits in the generational struggle of our lifetime.

In conclusion, let us learn these painful lessons. Let us not fixate on Tony Blair—he is yesterday’s man. Let us not commit to things that we cannot fulfil and pass the buck to the lower end of the command chains.

[Mrs Madeleine Moon (Bridgend) (Lab)]

I thank the hon. Gentleman for giving way and for his powerful speech. One thing that has always worried me about the Iraq war debate is the idea of the military as victims who were forced to go to fight when they in fact were trained and wanted to do so. What they did not want, however, was bad equipment, and they do not want bad equipment today. Does it not behove this House and its Members to be much more interested on a daily basis in what we are providing service personnel with, rather than just focusing on past decisions?

--- Later in debate ---

[Mrs Madeleine Moon (Bridgend) (Lab)]

A number of people have said today that the 2003 decision casts a long shadow, and indeed it does. There has been much talk about lessons learned and lessons needing to be learned, but I fear that this is largely about: “I was right and others were wrong”. There is a slightly self-righteous tone when people talk about where they stood on the vote in 2003 that I feel will not help us to make the decisions facing us, which are as serious, dangerous and consequential as any.

I was not in the House in 2003; I did not come in until 2005. At the time, I was one of those marching up and down and saying no to war. When I came in, I never in my wildest dreams thought that I would spend most of my time on defence matters, but I came into the Chamber one day and noticed a group of middle-aged men talking to another group of middle-aged men across the Chamber on perhaps one of the most important subjects facing the country. I thought, “I’m not having this”, and I went out of my way to teach myself defence. I have to say that that is necessary—unless someone has been in the armed forces, they have to go out and learn, find out how decisions are made, what equipment to use, how on earth a decision to go to war is implemented and how it is carried through. It is not enough to be a Member of Parliament and think that defence is something that can be dipped into. Sadly, too many right hon. and hon. Members think it is.

I do not feel that people have the right to criticise unless they have looked and questioned: what equipment are our people going to war with; how many of them are there; what is going to happen when the number of personnel we want to send is balanced against the number of personnel that can be met? We made a disastrous decision when we sent our people to Helmand, but nobody questioned it. We are not having a big two-day debate about that disaster. How many hon. Members have bothered to read any of the Defence Committee reports on anything? Quite honestly, I wonder how many Members have read the strategic defence and security review. How many Members have been worried and concerned at the paring back over and again of our armed forces? How many have been concerned about the cuts to the platforms that our armed forces will be able to utilise?

It is all very well to go back to 2003 and beat our breasts. It is all very well to spend seven years. Since I have been a Member, I have taken three decisions on going to war—and I spent a lot of time on all three of them. Libya was as great a disaster as Iraq. I spent a lot of time asking whether it was about regime change, and I was told, “No, it is not about regime change.” I do not believe that to be true—I think it was always about regime change. I asked what we were going to do about post-conflict reconstruction, because it was the big lesson from Iraq, and I was told, “We are not putting boots on the ground, so it isn’t an issue for us.”

[Bob Stewart]

The hon. Lady knows that I have deep respect for her, which will continue. I seem to recall, however, that we had little choice but to intervene in Libya, and I voted for it because I was terrified that people would be killed.

[Mrs Moon]

I thank the hon. Gentleman for that most helpful intervention, because it takes us back to the exact same issue that people faced when dealing with Saddam Hussein. He led people down a track that really made intervention almost inevitable. He ignored all the UN missions and he was obstructive many times to the people who went in to look for weapons.

I am not sure whether the hon. Gentleman was with us on the visit, but when we met a group of tribal elders in a room in Iraq, they told us that the last time they had been in it, they had been called there by Saddam to hear a report about the changes he was introducing to the health service in Iraq. Someone had stood up at that meeting and said not that he disagreed with it, not that he thought Saddam was wrong, but that a small change might make it slightly better. The man was marched out of the room and shot at the front door of the building. That is the world that we were trying to understand.

On that occasion, too, I asked why on earth Saddam did not simply say, “I have given up the weapons of mass destruction; I do not have any. I got rid of the chemical weapons; I do not have any.” I asked why he did not just step forward and say that. I was told, “Because he was more afraid of his own people than he was of you, so he had to convince not you but his own people that he had those weapons.” That, I was told, was why he kept that myth going—not for us, not because he was afraid of our invasion, but because he was afraid of his own people if they thought he showed any weakness.

The situation was exactly the same in Libya. Gaddafi made it impossible for hon. Members to feel that we could sit back and let him say, “I am going to slaughter those people in Benghazi,” which is what he said he was going to do. We acted, but look at the consequences. In seven years’ time, are people going to stand up and criticise us for that vote? Are they going to say self-righteously, “How dare you? You did not do enough on post-conflict reconstruction.” No, we did not; and, yes, it is a mess. There are so many lessons that we have to learn.

I have been to Iraq and to Afghanistan. As a member of the Defence Committee, I believe that if we send our personnel there, we have a responsibility to go ourselves, to see for ourselves and to talk to people on the frontline and ask them, “Have you got the right kit? Have you got the right equipment? Are you being looked after all right? What do we in Parliament need to change? Tell us and we will be your voice.” Those are the lessons we have to learn.

We need to be more robust in our understanding of defence. We have to be more responsible in understanding the tasks and the responsibilities we place in front of our armed forces. We do not want to be sitting here pontificating about whether Tony Blair was a liar, or whether a jolly big “but” continued underneath the sentence when he said:

“I will be with you, whatever.”

I want us to look much more at what we have learned and what we are going to do in the future. I doubt whether many Members have read it, but the Defence Committee recently put out a report about Russia—be afraid, be very afraid, because that is coming down the track.

[Martin Docherty-Hughes]

I may disagree with certain elements of the hon. Lady’s speech, but does she agree that one of the problems during the period was that many of the major partners of the United Nations, including the Russian Federation, did not want to play their part?

[Mrs Moon]

I look at the Russians in Syria. I look at what the Russians did in Afghanistan. Do I want to stand alongside them? I have my standards. The hon. Gentleman may have different standards, but I am not for the barrel bombing of civilians, which the Russians think perfectly acceptable.

I am not someone who will be happy about coming to the House and just saying, “We made mistakes in Iraq.” We made mistakes in Libya. In fact, we have made mistakes in every war in which this country has been involved. What I would like to know—I am glad that the Secretary of State is present—is whether the historical analysis team that used to be in the Ministry of Defence and that analysed and taught the lessons learnt to military personnel will be reinstated, because that would have more impact than anything else that we are discussing here. That is what we need: we need our personnel to know the lessons that will be learned.

What about the South China sea? We have 19 ships. Those who are worried about Iraq should worry about the South China sea. Please let us be realistic, because the world is looking and laughing at our tearing ourselves apart. I want a confident Britain. I want a secure Britain. I want a Britain that is not afraid of making difficult decisions, a Britain that is not afraid of sticking its hand into a wasps’ nest and a Britain that is well equipped and well trained but will take on its responsibilities in the world. We will look at our mistakes and we will learn, but we will not waste our time casting rude and offensive remarks at people who lead us.

Oral Answers to Questions

Madeleine Moon Excerpts

Monday 27th June 2016 Commons Chamber

[Mark Lancaster]

I shall of course be delighted to look at the case and may I suggest that we meet?

[Mrs Madeleine Moon (Bridgend) (Lab)]

What percentage of the P-8 contracts will be offset to British companies and what maintenance work will take place in the UK? Will the Minister confirm that the sonobuoys and missiles will be procured from British companies?

[Mr Dunne]

The P-8 contract has not yet been let. We announced at the time our intention to procure P-8, and some $4.5 million per aircraft is UK-sourced. The support contracts will be let in due course.