Nicola Sturgeon
Cabinet Secretary for Health and Wellbeing
Statement on Hepatitis C and HIV
Scottish Parliament
April 23, 2008
Almost exactly two years ago - on 18 April 2006 - the Scottish Parliament's Health Committee called for a public inquiry into the infection of people with Hepatitis C through NHS treatment.
That call was rejected by the previous administration.
The SNP manifesto for last year's Scottish election promised to right that wrong and establish an inquiry.
Presiding officer, I can confirm that the Scottish Government will honour that commitment.
I am pleased to announce today, under section 28 of the Inquiries Act 2005, a judicially-led public inquiry into the transmission of Hepatitis C from blood and blood products to NHS patients in Scotland.
Presiding officer, although much of the public debate around this issue has centred on Hepatitis C, many people also contracted HIV from NHS treatment with blood and blood products. As it would be very difficult to separate the circumstances in which Hepatitis C and HIV were transmitted, I have decided that the inquiry will also investigate the transmission of HIV.
In my statement today I will set out the background to this issue, the reasons for my decision and the timing of my announcement. I will also confirm who will chair the inquiry, the issues that will be examined by it and what will happen next.
Presiding Officer,
Many people in Scotland have suffered or died as a result of the transmission of Hepatitis C and HIV through NHS treatment. Nothing will ever compensate them or their families for that. However they do deserve answers to the complex questions that surround their or their loved one's infection with Hepatitis C or HIV as a result of NHS treatment with blood and blood products prior to the introduction of a test in 1991.
The transmission of Hepatitis C and HIV through blood and blood products is a tragedy that has blighted the lives of many people in Scotland. That is why we are committed to a thorough inquiry to get to the bottom of what happened. We owe an explanation to patients and the public of what took place. We are determined to provide that.
Presiding officer, at this stage I want to pay tribute to all those who have campaigned over many years for an inquiry.
The haemophilia community, most notably the Scottish Haemophilia Forum, and other patient groups and individuals have worked tirelessly for more than 15 years and in the face of opposition from previous Scottish administrations, to raise awareness and to keep this issue on the political agenda.
I hope that they feel today that their efforts have at last paid off and that they are now a significant step closer to the answers that they deserve.
I also want to pay tribute to the Health Committee. On several occasions since 1999, it has considered petitions and heard evidence on this matter.
It was, of course, the Health Committee that was instrumental in persuading the, then, Scottish Executive to agree financial assistance to Hepatitis C suffers through the Skipton Fund - something that it had resisted for some time. The current Scottish Government, when in opposition, fully supported the Hepatitis C ex gratia payment scheme, and I am pleased to report that it has benefited hundreds of Scottish sufferers - to the tune of £14 million - since it was introduced in 2004.
In announcing a public inquiry today, I recognise that the events in question took place many years ago, when knowledge about blood-borne viral infections was much more limited and the science involved was not as advanced as it is now.
However, records show that at the time there were indications that an unidentified virus that affected blood supplies did exist, and there was a scientific debate about its importance and what precautions should be taken. An important role of the inquiry will be to look at whether all that could be done was done, based on the epidemiological and scientific knowledge available at the time, to protect the public.
I also recognise that many of the key documents involved have been released into the public domain and that there have been a number of previous inquiries and investigations into this issue, including the look-back exercise between 1995 and 1997 and the investigation into the introduction of heat treatment for blood and blood products in 2000. These inquiries have provided some valuable information and advice, but were carried out by Government and, therefore, lacked independence.
In other words, we have not yet had an investigation with the credibility and authority that a full Scottish public inquiry will bring.
That is why, on 16 August 2007, at a meeting with representatives of the haemophilia community, I confirmed that the Scottish Government would honour our commitment to hold an inquiry. At that time it was my intention to await publication of the report of the private independent inquiry in England currently being conducted by Lord Archer of Sandwell QC. I understand that Lord Archer is in the final stages of completing his report and that this will now be published early in the summer.
However, on 5th February 2008, Lord Mackay of Drumadoon published his Opinion that the decision of the former Lord Advocate not to hold a Fatal Accident Inquiry into the deaths of the Rev. David Black and Mrs Eileen O'Hara was incompatible with Article 2 of the European Convention of Human Rights.
Lord Mackay also held that both the Lord Advocate and Scottish Ministers have statutory powers under which they could set up public inquiries into the deaths of the Rev. Black and Mrs O'Hara and that such inquiries would satisfy the Convention rights of the deceased.
Following careful discussion, the Lord Advocate, the head of the system of deaths investigation in Scotland, and I decided not to appeal against Lord Mackay's determination. We also decided that progress towards establishing an inquiry need not await the outcome of the Archer Inquiry and concluded that we should proceed to hold a Scottish public inquiry under section 28 of the Inquiries Act 2005.
Presiding Officer, I am pleased to announce today that the Right Honourable Lady Cosgrove has been appointed to act as Chair of the Inquiry. We are privileged to have a person of Lady Cosgrove's calibre to conduct this inquiry. Lady Cosgrove is a distinguished former judge and sheriff. She will bring her wealth of knowledge and experience to the task, and I am sure that I speak for the whole Parliament in expressing my gratitude to her for agreeing to undertake this important review.
I can confirm that there will be no other appointments to the inquiry Panel. The Chair will have a critical and pivotal role in determining the framework of the inquiry, which will be inquisitorial rather than adversarial. The inquiry will have the capacity and resources to carry forward a thorough investigation of the issues.
Presiding Officer, let me now turn to the issues that will be examined by the Inquiry.
The final terms of reference will, of course, be announced in due course, following further discussions and agreement with Lady Cosgrove.
However, I can confirm that the inquiry will have a remit to investigate the deaths of Rev. David Black and Mrs Eileen O'Hara and will address the terms of paragraph 125 of Lord Mackay's judgement that:
"any practical and effective investigations of the facts, of the nature required by Article 2, must be capable of addressing when each Mrs. O'Hara and Rev. Black became infected with the Hepatitis C virus and whether any steps could have been taken by the Scottish National Blood Transfusion Service or by other individuals and public authorities involved in the NHS in Scotland that might have prevented such infection occurring ".
The inquiry terms of reference will ensure that the inquiry is compliant with Article 2 of the Convention in relation to those deaths and any other deaths which have occurred as a result of the deceased having become infected by the Hepatitis C virus, where given the particular facts and circumstances in relation to the death an Article 2 compliant inquiry should be held.
In addition the terms of reference will allow for an in depth inquiry into the circumstances of the transmission of Hepatitis C and HIV from NHS treatment with blood and blood products and the consequences of the transmission of each of those viruses for the patients affected.
Parliament should of course be aware that, under the terms of the Inquiries Act, there is provision for adaptation or changes to the remit as the inquiry progresses should that prove to be necessary and appropriate.
As I have already said, I acknowledge that there is already considerable information about these matters in the public domain.
The job of the inquiry will be to scrutinise that evidence methodically in its efforts to establish the facts, in what is a complex issue with numerous strands.
For example, the inquiry may choose to look at:
- The sources of blood and blood products used by the NHS in Scotland at the time
- The demand for blood products, including factor Eight for haemophiliacs, and the steps taken to achieve self-sufficiency
- The introduction of heat treatment for blood and blood products and whether this could have taken place earlier
- The introduction of effective screening of blood donations for the Hepatitis C and HIV viruses and whether relevant tests were put in place as quickly as was possible
- The Scottish National Blood Transfusion Service's practices at the time
However, I give these only as examples of what the inquiry may look at and to emphasize that there will be many difficult matters to consider. It will be for Lady Cosgrove to develop the shape of the inquiry once the terms of reference have been agreed.
However, there is no doubt that the people affected, and their families, deserve nothing less than answers to these questions. If they are to achieve any sort of closure, we need to get to the bottom of what has been one of the most tragic episodes in NHS Scotland in the provision of treatment with blood and blood products.
Presiding Officer,
Let me now comment briefly on next steps.
The Scottish Government will release all relevant papers to the inquiry team as quickly as possible. I am sure that all members appreciate that this inquiry will be looking at a complex set of issues which took place a long time in the past and will therefore need to take time to gather and absorb background papers before starting to take evidence.
In the meantime, officials are taking steps to put an appropriately resourced inquiry team in place, locate appropriate premises and secure IT support.
While a location has yet to be decided, we will ensure that the venue is fully accessible by public transport and for those with restricted mobility. We will also provide appropriate access to information to those who may give evidence in due course to the inquiry.
Presiding Officer,
In making this announcement today, I hope that members will agree that it is a fitting response to the concerns of those who have campaigned long and hard for over many years for an effective public inquiry into these issues.
No one can undo the pain and suffering of those affected. But they do have a right to a deeper explanation of how Hepatitis C and HIV came to be transmitted through NHS treatment in Scotland and an assurance that where there are lessons for the future, these have been learned.
I hope the inquiry that I am announcing today gives them both.