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Although he bears few physical scars, Simmons is certainly suffering now. In the aftermath of the attack he could not bear to be alone. He started drinking heavily and lost his job. He has nightmares and wakes up drenched in sweat. “My dreams are all about war and conflict now,” he says. “I am a soldier in them and bullets are flying around. My friends and family are in them and I am trying to help them. I don’t have happy-go-lucky dreams any more.”

Simmons is one of the forgotten victims of July 7. Having lost no limbs, he attends no rehabilitation clinic. When he was taken to the Royal London hospital in the aftermath, a social worker spoke to him, but he has not been contacted by any trauma specialist. Police visited him a few weeks later to take a statement; but for that house call he has been left entirely alone. He is one of many hundreds who have fallen through the net.

In addition to the 52 lives lost and 100 serious injuries, another 150 passengers or so suffered smoke inhalation. Long after the soot has cleared from their lungs, however, they and many hundreds like them are experiencing the long-term effects of flashbacks, anxiety attacks and trauma.

Some of the victims trying to make sense of that day were children. Jack Linton, from Hockley in Essex, was 14 at the time of the blast. A schoolboy, he was on the third day of a work experience placement when he was caught up in the blast on the Circle line. He thinks it may be years before the horrifying memories are expunged.

“When I close my eyes I can still picture what I saw that morning — I remember the smoke, the flames and the dead and injured. My ears were hurting because of the blast and I used my tie to cover my mouth to stop me breathing in smoke. As we stumbled out of the carriage there were three or four bodies on the track. I was crying a lot because I was frightened — I had really thought I was going to die and would never see my family and friends again. I still wake up at night thinking about what I saw.”

After mounting criticism about the lack of financial assistance for victims, the Criminal Injuries Compensation Authority has pledged to approve the first handouts by Wednesday. Victims will be entitled to a fixed payout for their injuries and compensation for loss of earnings up to £500,000. The London Bombings Relief Charitable Fund (LBRCF), set up by Ken Livingstone, the London mayor, has raised £9m and has already paid out £1m among the families of the dead and injured.

Survivors such as Simmons, who has not worked since the attacks, will also be entitled to payouts.

The size of this group is, however, unknown. Gerald Oppenheim, chair of the LBRCF, said last week: “We are now offering help to those who were medically certified as unfit for four weeks or more. Exactly how many are in this position we don’t know.”

The survivors describe an apparently haphazard system of monitoring and follow-up treatment. Many say they have not been offered any counselling or support since the attacks. Like Simmons, they are confused and isolated as a result of what they experienced.

According to Leslie Carrick-Smith, a forensic psychologist who treats post-traumatic stress disorder (PTSD), confusion and isolation are symptomatic of the syndrome. Even for those without severe injuries, their emotional reaction can be very disabling, he adds: “What can also happen is flashbacks. They don’t have to be pictures, they can be images, sounds or smells. We call it intrusive recall. That can happen in the daytime or through dreams and nightmares. Then there is avoidance. This can be avoiding wanting to talk about it, answering correspondence, the place where it happened, the Tube, central London and even wide open spaces.”

There is often a shift in personality. “People may find they can’t take pleasure in things any more. They are becoming distanced from people, unable to express loving feelings or enjoy nice things. They may also feel there is no real future, that it has been foreshortened. Then there is over-arousal, blazing outbursts of temper, disturbed sleep patterns, poor concentration, lousy memory and physiological reaction, such as stomach churning and cold sweats.”

Not everyone, however, benefits from PTSD treatment. For some, reliving the events with a therapist can re-traumatise them if the pace is too fast. Others may be helped simply by forging links with fellow survivors.