Bad blood: issues of compensation

In February 2009, Lord Archer of Sandwell’s Independent Public Inquiry Report on NHS Supplied Contaminated Blood and Blood Products was finally released. The inquiry was prompted in response to the knowledge that, throughout the 1970s and 1980s, many UK haemophilia sufferers were treated with contaminated blood products which carried what later came to be known as hepatitis C virus, (HCV) resulting in 4,670 patients becoming infected. Between 1983 and the early 1990s 1,200 patients were infected with human immunodeficiency virus (HIV), also via blood products. By the mid 1970s, however, it was known in medical circles that blood products carried a danger of infection with hepatitis and that commercially manufactured products from the USA were particularly suspect. By the mid- 1980s there were warnings of a similar situation in respect of HIV. But the products continued to be imported and used, often with tragic consequences, although some reports have since suggested that this might have been avoided had the UK achieved selfsufficiency in blood products – a policy the Government initiated in 1975. To date, these infections have caused at least 1,757 deaths in the haemophilia community, with many more now terminally ill as a result of what Lord (Robert) Winston has described as “the worst treatment disaster in the history of the NHS”. Not withstanding improvements in treatment for both viruses, only 2,552 patients with hepatitis C and just 361 with HIV are still alive.

Human tragedy

The terms of reference of the Archer Report, which was funded entirely by donations and received no Government support, were to investigate the circumstances surrounding the supply to patients of contaminated NHS blood and blood products. In particular, the consequences of this to the haemophilia community and other victims afflicted by blood-borne viruses were investigated, as well as suggesting what further steps need to be addressed in relation to their problems and needs. In reaching his conclusions, which heard evidence from patients, bereaved dependants, former Health Ministers and other witnesses, Lord Archer described the infection of thousands of haemophiliacs with HCV and HIV as “a horrific human tragedy”, adding: “subsequent events have done little to alleviate the hurt of the victims or their families.” The Archer report criticised the fact that commercial priorities had been placed before public health interests and was also dismayed at the time taken by governmental and scientific agencies to become fully alert to the dangers of HCV and HIV infections, particularly in relation to high-risk blood products from overseas, and by the slow progress towards achieving self-sufficiency in blood products in England and Wales. Archer’s main recommendations in his report were that: • A committee should be established with patient representation onboard to advise Government on the management of haemophilia in the UK to address their medical, financial and other needs. • This committee should also have responsibility for the selection, procurement and delivery of the best therapies currently available. • Infected individuals should be issued with cards entitling the holder to benefits not freely available under the NHS, including free-of-charge prescription drugs, GP visits, counselling, physiotherapy and home nursing/support services. • Compensation in the form of direct financial relief should be provided to sufferers and families, which should be at least as generous as that which operates in Ireland. • A full “look-back” exercise should be carried out