Asked by: Julian Lewis (Conservative - New Forest East)
Question to the Ministry of Defence:
To ask the Secretary of State for Defence, whether his Department continues to apply the criteria introduced following the 2016 publication of the Defence Committee report (HC567) calling for restrictions on the prescribing of the antimalarial drug Lariam (Mefloquine) to Service personnel; if he will arrange for a consolidated table to be published of the twice-yearly data, subsequently compiled, showing the (a) number of individuals prescribed Lariam in each six-month period since such data began to be released, (b) percentages of those individuals prescribed Lariam who (i) did and (ii) did not receive face-to-face assessments, prior to the issuing of the prescriptions during each six-month period, and (c) totals of other antimalarials prescribed to Service personnel during each six-month period; whether it is his policy that the use of Lariam on a scale greater than that since 2016 should be permitted in future; and whether he accepts the original recommendation by the Defence Committee that Lariam should be designated as a drug of last resort, to be prescribed to Service personnel only (A) if an individual is unable to tolerate any of the available alternatives; (B) after a face-to-face individual risk assessment; and (C) after he or she has been made aware of the available alternatives and given the choice between such alternatives and Lariam; and whether his Department has an evidential basis for challenging evidence of serious side effects previously caused to some Service personnel when Lariam was widely dispensed within the Armed Forces.
Answered by Leo Docherty - Minister of State (Ministry of Defence) (Minister for the Armed Forces)
The Ministry of Defence (MOD) revised its malaria prevention policy in response to the Defence Select Committee Inquiry. As a result, it remains the policy that mefloquine only be prescribed to Service personnel by a doctor, after a face-to-face malaria health risk assessment and alternatives to mefloquine have been identified as unsuitable. There are no plans for this policy to change in the future.
The Government publishes official statistics every six months on Mefloquine Prescribing in UK Armed Forces. All future official statistics will include the supplementary table requested.
It is admitted, on the balance of probabilities, that as a prophylactic mefloquine can cause a range of minor to moderate psychiatric symptoms in certain individuals for a limited period of time. The causal relation between mefloquine and severe or long-term symptoms has not been shown. Whether it has caused any symptoms in individual cases will be a matter for expert evidence.
The issue of longer-term sequelae is currently being litigated and the MOD has the support of eminent experts in the fields of psychiatry, neuro-psychiatry, epidemiology, neurotoxicology and psychopharmacology whose evidence is privileged and will be disclosed in due course within the litigation. Their evidence is consistent in its conclusion that there is insufficient evidence to establish a link between taking mefloquine and long-term psychiatric illness or neurological damage.
Asked by: Julian Lewis (Conservative - New Forest East)
Question to the Ministry of Defence:
To ask the Secretary of State for Defence, what the rules are on dismissal of Service personnel for a single offence of drug abuse; if he will list the criteria for allowing a second chance before dismissal; whether there is a consistent policy on dismissal for a first offence across all (a) units and (b) Services; what provision is made for personnel summarily dismissed to access a standardised, monitored and evaluated care pathway giving the individual time to find alternative (i) accommodation and (ii) employment; and if he will make a statement.
Answered by Leo Docherty - Minister of State (Ministry of Defence) (Minister for the Armed Forces)
The Ministry of Defence (MOD) deems substance misuse within the Armed Forces unacceptable. It threatens the efficiency and discipline of the Services, where individual responsibility and teamwork are essential to operate highly technical, expensive, and potentially lethal equipment. The Services campaign against substance misuse and have a comprehensive education programme to inform personnel of the dangers and consequences of substance misuse, including dismissal. This is complemented by the Compulsory Drug Testing programme that reinforces our stance that substance misuse is not be tolerated.
A standard tri-Service policy governing the handling of substance misuse is in place across the Armed Forces via Joint Service Publication (JSP) 835: Alcohol and Substance Misuse and Testing: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/425401/20131101-JSP_835-V2_0-U.pdf
Personnel who misuse substances will be removed from the Services by disciplinary or administrative means following a single offence, except in exceptional circumstances where it is determined that the retention of an individual is desirable and achievable. There are no plans to change the current zero tolerance policy.
Personnel dismissed from Service for substance misuse are able to access pastoral and welfare support via their unit and retain access to their Service accommodation up to the point of dismissal. Unless there are individual circumstances which may mean the individual becomes a burden on the state once they are discharged, dismissal is swift. If an individual has particular health needs, including mental health needs, the process can be slowed to ensure smooth transition into NHS care. Access to Defence Transition Services, which provides tailored advice and support, is also retained following dismissal.