Health: Contaminated Blood Products — Debate

Part of the debate – in the House of Lords at 1:18 pm on 23rd April 2009.

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Photo of Baroness Thornton Baroness Thornton Government Whip, Baroness in Waiting (HM Household) (Whip) 1:18 pm, 23rd April 2009

My Lords, I begin, as have all other noble Lords, by paying tribute to my noble friend Lord Morris of Manchester, a fellow corporator, for his dedicated and tireless work over many years on behalf of haemophilia patients and their families. It was he who initiated the inquiry chaired by my noble and learned friend Lord Archer of Sandwell, to whom, together with Dr Norman Jones, Judith Willetts and my noble friend Lord Turnbull, we owe a debt of gratitude for their well considered report. The Government acknowledge its importance and value to those who have suffered as a result of the very treatments which should have transformed their lives for the better. There is no doubt that the tragic consequences of these treatments have seriously impaired the lives of many people and those of their families, as outlined by noble Lords, and I appreciate and commend that many noble Lords wish to take every opportunity to seek further steps to remedy this situation.

The Government take the report of my noble and learned friend Lord Archer very seriously. I have now read the report and its recommendations twice and I was struck again this past week by its reasoned and passionate tone; it manages to incorporate both. As noble Lords know, the Government are giving careful consideration to all the recommendations. However, in light of this, it would be premature of me to address today the recommendations in any detail while my right honourable friend the Secretary of State for Health was still considering the implications in the round. I would dearly have loved to be able to give your Lordships further enlightenment on the Government's view of the detail but I am not in a position to do so. In answer to the point made by the noble Baroness, Lady Morris, I am pushing hard, shall we say, in terms of the next stage of the Health Bill.

Before returning to some of the salient points of my noble and learned friend's report, I should say to your Lordships' House that we fully acknowledge the pain and suffering—physical, psychological and economic—that has afflicted so many people and which has permeated the lives of the friends and families of those affected. As the noble Baroness, Lady Campbell, eloquently described, the wives, husbands, partners and friends have had to, and still do, take care of their loved ones and support other family members.

Many Members of past Governments have expressed their regret for what happened. Perhaps I may I say on behalf of this Government how deeply sorry we are for what happened. We acknowledge that these serious infections, which were acquired as a result of NHS treatment some two or more decades ago, have struck a particularly cruel blow to patients suffering from haemophilia and other bleeding disorders, who saw treatment with clotting factor concentrates as giving hope of a much improved and possibly near normal life.

Legal proceedings were initiated and concluded several years ago and successive Governments have established three schemes to provide financial relief to those affected. In the light of the recommendations made by the Archer report and remarks made by, for example, the noble Baroness, Lady Barker, I should say that the whole issue of financial relief is being considered as part of the Government's consideration of the report. I assure your Lordships that that is happening but I cannot tell you what the outcome will be. While Governments have taken steps to provide financial relief, the contribution of the Haemophilia Society in supporting these patients and their families cannot be overstated. I pay tribute to the work of the society and its officers, past and present, and to those members who have worked tirelessly in support of the society's aims. I know that my noble friend is concerned about the funding position of the Haemophilia Society and that this is a matter for ongoing discussion with the department.

Understandably, haemophilia patients, together with their clinicians, initially welcomed a product which improved their quality of life so greatly. As my noble and learned friend observes in his report on page 26, it was recognised at an early stage that there was some risk of infection associated with blood products, but the balance of the risk assessment was in favour of continuing to provide access to clotting factor concentrates derived from US plasma obtained from high-risk donors. With the benefit of hindsight, we now recognise the tragic consequences of the decisions about treatment that were made in good faith and with every intention to improve the quality of life. We must remember, though, that even if this country could have met its own need for the supply and processing of plasma, the risk could not have been completely eliminated. The seriousness of chronic hepatitis C infection only became apparent after full characterisation of the virus in 1989, a problem not unique to the UK.

As noble Lords know, our ability now to make properly informed assessments of the relevant events and decisions taken throughout the period in question—the 15 years from 1970 to 1985—is limited by the incompleteness of the documentary record, for which this and former Governments have apologised. The noble Baroness, Lady Barker, made some very pertinent points about record keeping. The Department of Health has acknowledged that it fell well short of expected standards of records management—a number of documents that it held were misplaced or destroyed in error—but considerable efforts have been made to identify and release all documents that can now be traced. Following an internal audit, the department reviewed all its remaining documents from the period in question and has now published over 5,000 documents, comprising more than 20,000 pages, on its website. These include documents that were withheld from the court in 1990. I am pleased that my noble and learned friend's report stated that,

"we have discovered no evidence of malicious destruction of relevant records".

The department remains committed to publishing, in line with the Freedom of Information Act, any further relevant documents from these years. That is why it has reviewed the 35 remaining documents and I am pleased to report to the House that there are now only nine documents outstanding, and these contain personalised information within the terms of the Freedom of Information Act. We will also provide assistance to the official inquiry in Scotland under Lord Penrose, beginning with a list of all relevant files held by the department.

Turning to the question of the inadequacy of information given to some patients by their clinicians, I deeply regret that this occurred. It is a reflection of the accepted norms of clinical practice at that time. That is not an excuse but we need to recognise that we live in different times. The medical profession now takes a different approach to the assessment of relative risks and the communication of those risks to patients.

Human blood and the products derived from it can never be completely safe. I should say to my noble friend Lord Rooker that great strides have been made. There have been great improvements in safety since the 1980s, and European-wide standards are now mandatory for the safety and quality of blood and blood components used within the European Union. Multiple layers of safeguards are in place to protect against the transmission of blood-borne infection.

Products derived from blood, such as clotting factors, are medicinal products and are required to meet the strict criteria of European medicines regulation. The risk to haemophiliacs from transmission of blood-borne infection has further been significantly reduced through the introduction, for all those patients for whom they are suitable, of synthetic products not derived from human blood. This represents a major advance in safer treatment for many patients.

The threat posed by variant CJD, which has been mentioned by many noble Lords, is currently uncertain. Risk estimates are refined as new knowledge emerges, but there is still much that we do not yet understand about the transmission of this disease. We have implemented a series of precautionary measures over the past decade to protect the blood supply and we continue to monitor this area very closely in conjunction with our expert advisory committees. I know there is much interest in the introduction of a blood test but it is crucially important that any such test is properly validated.

In response to the question of my noble friend Lord Morris, I should say that studies show that the composition of blood changes as a consequence of filtration. Therefore NHS Blood and Transplant and the Department of Health require that all prion filters undergo appropriate quality and safety trials. None of the filters currently available has yet completed the necessary safety and efficacy trials. Once they have, the Department of Health will seek independent expert advice from the Advisory Committee on the Safety of Blood, Tissues and Organs in deciding whether to introduce prion filtration. I will keep the House informed of progress on that matter.

We are certainly not complacent on this issue. As scientific knowledge progresses and new technologies are developed, our independent expert scientific Advisory Committee on the Safety of Blood, Tissues and Organs continues the task of assessing options for making blood even safer, taking account of up-to-date, validated scientific evidence and its potential impact on supply and cost-effectiveness. Further, we continue to support the NHS through the National Blood Transfusion Committee and others to embed best practice so that blood is used only when clinically necessary. Current initiatives on the better use of blood are having a positive impact in clinical practice.

I turn now to some of the specific points raised by noble Lords. My noble friend Lord Morris asked, as did other noble Lords, why a Minister or an official did not give public evidence to the Archer inquiry. Apart from the fact that no one in the department has any direct knowledge of this, the department agreed that the evidence it held was documentary, which is why over 5,000 documents were released and copied to the noble and learned Lord for his inquiry. I appreciate that that may not completely satisfy noble Lords on this matter, but I also make the point that, as several noble Lords have indicated, this is the beginning of a process of accountability for the Government on this important matter, and I do not doubt that we will have several opportunities to discuss it and take it forward.

My noble friend Lord Morris and the noble Lord, Lord Thomas of Gresford, raised the issue of Crown immunity, which applied at the time. Following the Burton judgment of 2001, there is strict liability under the Consumer Protection Act for the supply of any defective products. The noble Lord also raised the issue of why the department gave no explanation for the loss of documents. I have given the best explanation that we can: some documents were lost. We have carried out an audit and we have released all the documents that have been retrieved. We have retrieved documents that we thought were lost and made them available. We have apologised for the fact that in the past we fell short of the standards that one would expect.

My noble friend Lord Rooker raised the issue of full disclosure. I make the point that the Government have gone further than any other in making information available on this. We are committed to releasing all the relevant information that we hold from 1970 to 1985, when the safeguards for blood products were in place. As I say, 5,000 documents were released and we have every intention of co-operating with the Penrose inquiry.

My noble friend put his finger on the ethical matter in this debate. My noble friend Lord Morris and those who are championing the Archer report will be pleased that they have my noble friend Lord Rooker as a champion in this issue; I have no doubt that his trenchant comments will have a desired effect in the right places, because he has made them.

I looked at the list of speakers today and thought, "Oh my goodness—here are all these noble colleagues who have such vast experience in these matters". If I were looking for people to support me in a campaign, this list of speakers would pretty much be it. My noble friend Lord Corbett made a passionate and pointed speech. We acknowledge that the point he made is one of the key recommendations of the Archer report and, although I cannot say anything specific about this, I know that it is one of the matters that the Minister is considering.

The noble Baroness, Lady Barker, raised the current system of domestic surveillance for infectious agents. We have made considerable investment in disease surveillance systems and continue to look at how they may be further improved. I would like to come back to her about this, because I remember that in the discussion we had previously on this issue there was significantly more detail about it, including the international work.

The noble Baroness also raised the issue of testing people other than haemophiliacs who received blood transfusions during the 1970s and 1980s. We are currently funding a national public awareness campaign to encourage people who may have been exposed to risks for hepatitis C factors, including blood transfusions, to consult their GPs and discuss having tests done.

The noble Baroness, Lady Campbell of Surbiton, raised various issues that I hope I have addressed. She mentioned the amendment to the Health Bill. I believe that that has already been tabled, so I will limit myself to saying that we are going to revisit this issue and that there will be further discussion at the next stage of the Bill. I have no doubt that many of these remarks will be made again at that time, and I hope I will have a more detailed answer then.

I have listened carefully to the moving, wise and considered contributions that noble Lords have made to this debate, and I am grateful to my noble friend Lord Morris for securing it. As my noble friends Lord Rooker and Lord Corbett have said, this is the beginning of this discussion. It remains for me to reaffirm the Government's commitment to consider carefully all the recommendations put forward by my noble and learned friend Lord Archer, and to say again to those affected how sorry we are and how much we regret the events that resulted in the tragic outcomes for their families.