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It has been called the worst treatment disaster in the history of the NHS. But the scandal that saw 30,000 people in Britain infected with contaminated blood, of whom around 3,000 have died, was much more than that. As a damning public inquiry report now concludes, it was a failure of the British state, on multiple levels, for decades. It was a calamity that could largely have been avoided. And it was made worse by a “subtle, omnipresent and chilling cover-up by the health service, public administration and government.
After decades of suffering, the tens of thousands of people affected have received some closure thanks to the publication of Sir Brian Langstaff’s book. reportand an apology from Prime Minister Rishi Sunak on behalf of successive governments. Now several more things must happen, all of them complex. The government must launch a proper compensation scheme as it failed to do so even after Langstaff called for it in an interim report last year. The culture in the health service must change further to put patient safety above all else. Reforms recommended by Langstaff must also be implemented to end the culture of “being on the defensive” in government departments.
Britain was among at least a dozen countries that suffered infections with HIV, hepatitis C and other viruses from contaminated blood through transfusions or blood products used to treat diseases such as hemophilia from the 1970s to the early 1990s. Where it differs from most peer group countries is the length of time it takes to provide accountability and adequate reward, and the lengths to which the system went to prevent this.
The Langstaff Report. found Health officials failed to ensure rigorous screening of blood donors to exclude higher-risk donors, such as prisoners, or to block products from the United States and Austria made from high-risk donations. Patients were knowingly exposed to unacceptable risks. It is disgusting that doctors conducted research using products on patients, including children, without obtaining consent or informing them of the risks.
These failures were then compounded by “institutional defensiveness.” Ministers, advised by civil servants, repeatedly wrongly told infected patients that they had received the “best available treatment”, that their infections had been undetected and that blood tests had been introduced as soon as possible. The documents were lost or destroyed. Successive governments refused to conduct an investigation.
Surely part of the reason is that the iconic publicly funded program National Health Service played a central role, opening the State to potentially enormous compensation costs. As was also seen with subpostmasters unfairly prosecuted by the Post Office, the UK establishment has an instinct to close ranks when accused of failures.
Other countries made efforts much earlier to address what went wrong and compensate victims. Canada, Ireland, Japan and Denmark took action in the early 1990s. Some also attempted to hold individuals and blood products companies accountable. In 1999, France charged former Prime Minister Laurent Fabius and two former ministers with involuntary manslaughter in its tainted blood scandal, although only one former health minister was found guilty. In the United States, facing lawsuits from hemophiliacs, several pharmaceutical companies paid settlements.
In Britain, some key people who could have been held responsible are now dead. Repeated delays in risk reduction and confronting errors have increased the number of infections and deaths, and driven financial costs much higher. The government is now expected to establish a compensation plan that costs up to £10 billion — enough to have a material impact on public finances, affecting the entire society. But the highest price, by far, has been paid by the victims of this terrible episode.