A former Newcastle University student given hepatitis C through NHS blood has told an inquiry he wants to see three key improvements to how the NHS works.
Andrew Bragg - who has previously told the Infected Blood Inquiry how his experience with the NHS makes him doubt its commitment to learn from mistakes - gave an oral closing statement this week. Mr Bragg, a Newcastle University graduate and chemical engineer who worked for ICI in the North East, suffered a motorcycle crash in Norway in 1986 following his graduation.
He underwent extensive surgery in Norway, but following further procedures in the UK - in Blackburn and Liverpool - he contracted hepatitis C from a blood transfusion. He was not diagnosed for more than a decade.
Mr Bragg has suffered numerous serious illnesses since then, including repeatedly become ill with sepsis due to his weakened immune system. That is a result of his hepatitis and the treatments he has received for it.
The Infected Blood Inquiry has spent the past five years investigating the circumstances of the wider contaminated blood scandal which has led to more than 2,000 deaths after innocent NHS patients were given blood transfusions or blood products tainted with viruses like hepatitis or HIV.
The Inquiry is now hearing closing submissions from those involved - and is set to report back this year. Mr Bragg has used his expertise from working in industry to make recommendations as to what Inquiry chair Sir Brian Langstaff might decide to include in his final report.
He said improvements to NHS accountability through better reporting systems for incidents which see - or could see - patients coming to harm and the establishment of a new agency to monitor healthcare safety issues. He also said he wanted to see a "joined up" way of monitoring hepatitis C patients like himself.
He told the Inquiry: "The NHS culture towards openness and reporting professionally appals me. The fact that the NHS can suppress whistleblowing, that they can bully, intimidate whistleblowing, that they can legally hamstring people to prevent them from expressing their concerns is extremely unprofessional, extremely unprofessional. "
Mr Bragg compared what he had seen to his own work in the private sector in the chemicals industry. He said: "We encourage our staff to be open, to report to us, to tell us, when things are going wrong because they are the people who see it happening.
"Organisations need to take responsibility. Things do go wrong, it is inevitable, but you have to own it, you have to recognise it and you have to deal with it."
Speaking about his first recommendation, Mr Bragg added: "My first recommendation is about creating a statutory responsibility for all employees in the NHS to form a report when serious injury or death has incurred which might have been preventable."
He added that at the moment, "there is very little reporting about right now, there is very little reporting into what happens in the NHS". He also cited research from the London School of Tropical Medicine suggesting "about 10% of patients suffer harm and about five per cent of deaths are avoidable".
He added: "If what happened to us in terms of hepatitis C and HIV had been reported as an error and a mistake and it was in the public domain and there had been investigations to try and - we wouldn't be here now, they would have dealt with this years ago. But they didn't do that, they didn't publish the numbers, they hid it, they obscured it, they destroyed the data.
"That's not an open and transparent organisation."
He added he wanted to see a "new organisation" created within Government, with a "responsibility to collect this information, to investigate incidents and make sure that effective action has been taken".
Mr Bragg said his final proposal, relating to hepatitis, was "a bit more personal". He said: "Having an effective, joined up way of monitoring people who have suffered from hepatitis C. My experience was that I got diagnosed and put on the shelf for a couple of years. I got the treatment .I had three negative PCRs and I was discharged from the regional liver unit. No interest."
Mr Bragg's submission on Tuesday followed that of Steven Snowden KC, on behalf of a number of other core participants in the Inquiry. Mr Snowden had asked the Department of Health and Social Care's legal team to deal with a number of questions relating to its "candour" and also said the DHSC's attitude to campaigners during the inquiry - and before - had been a "combination of the two words 'patronising' and 'condescending'."
Eleanor Grey KC, representing the DHSC on Wednesday, said: "It was submitted that the department should have set out in its submissions, a corporate case on what had gone wrong, and that the absence of such a case or evidence of learning, represented a lack of candour or good faith on the part of the department. He suggested that I should today or perhaps suggested in closing within three weeks, set out the department's response, in all but name a case, on a number of issues."
She added: "There is not one model of how to participate in or how to respond to an inquiry. And as a result, I'm not going to offer answers to the six or so questions who challenged me to respond to the submissions that you heard yesterday."
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