EXECUTIVE SUMMARY

1.1     The principal focus of the Inquiry is the health status of the children of personnel who served in an official capacity in Vietnam during 1964 - 1972 and of those Naval personnel involved in supporting the British atmospheric tests at Christmas and Malden Islands during 1957 - 1958. Although the two scenarios have little in common, one chemical the other radiological, there have been long standing concerns among some veterans that they may have suffered exposures that could be responsible for the medical problems of their children.

1.2    In our preliminary research we realised that in the short time available, the relatively small number of people involved and the relative infrequency of the conditions under investigation, it would not be possible to undertake a reliable scientific study. A large amount of data relating to radiation has been derived from well documented, direct and measured exposure to nuclear weapons and other sources. The data for Agent Orange in Vietnam, however, has been taken from studies of indirect exposure and is complicated by herbicides and insecticides being present in the environment as well.

1.3    In order to ascertain whether any exposure to defoliants, herbicides and insecticides and nuclear radiation had been responsible for health problems in the children of veterans, we:

1. Undertook a survey of those military and civilian personnel who served in Vietnam and Operation Grapple l in order to identify their children who wished to provide us with details of their medical conditions;

2. Examined records of the exposure environment and safety provisions in place at the time to determine their adequacy and whether any exposure might have occurred;

3. Consulted scientific and medical experts;

4. Reviewed epidemiological evidence and assessments, and the conclusions of previous studies including those done in New Zealand and elsewhere; and

5. Discussed the concerns directly with veterans and their representatives, and examined the testimonials and documentation they provided;

1.4    In determining appropriate measures to assist those affected, we also took account of the status of Service men and women and the provisions of the War Pensions Act 1954.

1.5    Using these various approaches and different forms of analysis, our investigations do not convincingly demonstrate any causal connection between exposures to service personnel and health effects in their children. It is not possible to say with absolute certainty that those involved were never exposed to significant levels of radiation or chemical agents although the weight of evidence suggests this to be the case. In the case of radiation during Operation Grapple and chemical agents in Vietnam, we cannot give a categorical assurance that there is no linkage to the effects in the children. Furthermore, the information available did not allow us to decide whether the incidence of health problems amongst veterans' children was any different to what occurs in the general population of New Zealand.

1.6    The Committee accepted the following categories of association adopted by the US Institute of Medicine:

1. "sufficient evidence of an association";

2. "limited/suggestive evidence of an association";

3. "inadequate/insufficient evidence of an association"; and

4. "limited/suggestive evidence of no association".

1.7    We believe that the first and second categories should be accepted by Government as sufficient grounds to qualify for medical treatment and social care similar to the non means tested provisions of the War Pensions Act 1954.

1.8    With the possible exception of spina bifida, categorised as "limited/suggestive evidence of an association", the current state of science and medical knowledge does not point to a link between exposure of Service personnel to nuclear radiation and to defoliants, herbicides and pesticides and the health of their children. All other conditions relating to the children of Vietnam veterans fell into the category of " inadequate/insufficient evidence of an association", while those pertaining to the children of Operation Grapple veterans were categorised as "limited/suggestive evidence of no association".

1.9    Nevertheless, the Committee is aware of the children's perception that they have been harmed by a parent's service either in Vietnam or in Operation Grapple. Despite strong evidence to the contrary, a scientific analysis cannot give a categorical assurance which will dispel that belief. Veterans and their families have a particular status in New Zealand and the Government has a duty to look after them, particularly given the liberal philosophy underpinning the War Pensions Act. We are recommending that the Government address the medical and social needs of the children by funding and providing a package of services through the Office of Veterans Affairs for case management, family counselling and genetic counselling where appropriate.

1.10    We recommend that:

1. Children of Vietnam and Operation Grapple veterans whose present or future condition, as a result of their parent's exposure to chemicals or radiation during service, falls into the epidemiological categories of "sufficient evidence of association" or "limited/suggestive evidence of an association", be provided with non means tested medical treatment and social care.

2. A programme of special assistance involving case management, family counselling and genetic counselling, be established for the children of Operation Grapple and Vietnam veterans.

3. The proposed Office of Veterans' Affairs be responsible for:
   1. The management of the special assistance programme;

   2. The development and monitoring of the Register of Operation Grapple and Vietnam veterans' children;

   3. The establishment of a research capability to provide information on the health of veterans' children;

   4. The provision of information and training for health professionals and others who work with the children of veterans;

   5. Adoption of a case management approach to veterans' children.

1.11    We recommend that funding to support these recommendations be provided by appropriation and administered by the Office of Veterans' Affairs.

INTRODUCTION

2.1    Following the 'Vietnam Remembered" commemoration in 1998, Cabinet directed that an inquiry be undertaken into the health status of children of New Zealanders who served in Vietnam and may have been exposed to chemical defoliants, or who participated in observations of nuclear testing in the Pacific in the late1950s and may have been exposed to nuclear radiation.

2.2    The principal focus of the inquiry was to be the children of veterans and any civilians who served in official capacities in either situation. Although the two situations had little in common, one being chemical and the other radiological, there had been long-standing concerns among some former servicemen who had served in one theatre or the other that they may have suffered exposures responsible for medical problems in their children.

TERMS OF REFERENCE

3.1    At its meeting on 27 July 1998, the Cabinet set the Terms of Reference for the Inquiry into the Health Status of Children of Vietnam and Operation Grapple veterans as follows:

"Under the chair of Sir Paul Reeves, and comprising representatives of the Department of Social Welfare (War Pensions), the Department of the Prime Minister and Cabinet, the Ministry of Health, and the New Zealand Defence Forces, the Advisory Committee will undertake an Inquiry into the health status of children of New Zealanders who served in Vietnam in an official capacity, or who were involved in support for allied atmospheric nuclear testing in the Pacific.

The purpose of the Inquiry is to ascertain whether any exposure to defoliants or nuclear radiation has been responsible for health problems in the children of those who served and, if so, to recommend appropriate measures to assist those affected.

The inquiry will be based on a survey of all Service personnel and civilians who served in an official capacity who were deployed in Vietnam in the years 1964-1972, and all navy personnel involved in supporting the British atmospheric tests and Christmas and Malden Islands in the period 1957 - 1958. On the basis of the survey data, and drawing on experience elsewhere and the findings of studies undertaken in other countries, the Advisory Committee should scope the extent, if any, of the problem and recommend appropriate options for Government to consider to assist with medical and social care.

In particular, the Advisory Committee should:

1. identify those exposed;

2. determine the number of children possibly affected;

3. analyse information and research on similar studies elsewhere and decide their relevance to the New Zealand situation;

4. validate each case and define disability measures ; and

5. develop options for medical and social care for Government consideration.

3.2    The Cabinet determined that the composition of the Advisory Committee would be:

1. Sir Paul Reeves, GCMG, GCVO, QSO, CF, (Chair);

2. Margaret Faulkner QSM, War Pensions, Department of Social Welfare;

3. Patrick Helm, Department of the Prime Minister and Cabinet;

4. Dr Colin Feek, Ministry of Health; and

5. Lt Gen A.L. Birks, CB, OBE, Chief of Defence Force.