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The Guardian - UK
The Guardian - UK
National
Haroon Siddique Legal affairs correspondent

What is the NHS contaminated blood scandal and how did it happen?

Demonstrators hold a large placard reading 'Dying for justice' outside a building in London
People demonstrate in London as Rishi Sunak is questioned by the inflected blood inquiry in July 2023. Photograph: Justin Tallis/AFP/Getty

The final report of the infected blood inquiry will be published on 20 May, almost six years after it started. Here is the background to the scandal the inquiry was set up to investigate.

What is the contaminated blood scandal?

From 1970 to the 1990s, people treated by the NHS in the UK were exposed to tainted blood through transfusions, including during complications in childbirth, or, in the case of haemophiliacs, given contaminated “factor VIII” blood products imported from the US. The inquiry has previously estimated that more than 30,000 people were infected with HIV, hepatitis C or – in the case of 1,250 haemophiliacs – both. Most hep C infections (26,800) were in transfusion recipients. Those infected with HIV included 380 children. An estimated 2,900 people had died as a result of infection by the end of 2019.

How did this happen?

People were infected through blood transfusions because donated blood was not screened for HIV until 1986 and not tested for Hepatitis C until 1991.

Blood products for haemophiliacs were imported from the US where people were paid to donate blood, which led to people at high risk of infection donating, such as drug addicts and prison inmates. Again, the blood was not screened. Donations were mixed together, which increased the chances that any virus would contaminate many batches of factor concentrate.

Were the authorities too slow to act?

There is plenty of evidence, much of it heard during the inquiry, that there were ample warnings about the dangers posed by the lack of screening and the importation of products from the US before action was taken to combat the risk.

In 1974, the World Health Organization (WHO) warned Britain not to import blood from countries with a high prevalence of hepatitis, such as the US. A warning of the risk of contracting HIV from blood products was issued in 1982 and the following year the Lancet and WHO said haemophiliacs should be told about the dangers.

There were also warnings communicated directly to the government, including a letter sent by Dr Spence Galbraith, of the Public Health Laboratory Service, to the Department of Health in 1983, which said: “I have reviewed the literature and come to the conclusion that all blood products made from blood donated in the US after 1978 should be withdrawn from use until the risk of Aids transmission by these products has been clarified.” The advice was never taken.

In an interim report, the inquiry chair, Sir Brian Langstaff, said “wrongs were done at individual, collective and systemic levels”.

Has anyone received compensation?

Before the inquiry began there had only been ex gratia payments made through several different schemes and trusts, the first of which was established in 1987. In 2017, the same year the inquiry was set up, they were replaced by new support schemes for each of the four home nations. In 2022, the government agreed to pay £100,000 each in interim compensation to people who were infected and bereaved partners registered under the support schemes after a recommendation made by Langstaff.

The following year, Langstaff said that parents and children who suffered bereavements as a result of the infected blood scandal should also receive £100,000 interim compensation payments. He also said that the compensation scheme, which would determine the total amount each person would ultimately receive, should be set up as soon as possible, rather than waiting for the inquiry’s final report. However, neither of those recommendations have been put in place, with the government maintaining it will consider them only after the final report is published, to the anger of campaigners.

Who gave evidence at the inquiry?

The inquiry heard moving testimony from infected and affected people as well as donors. Clinicians, civil servants and politicians also gave evidence, with the latter often irking the audience. John Major said those affected had “incredibly bad luck”, Ken Clarke called some of the questioning “pretty pointless”, while Rishi Sunak was heckled as he defended the failure to set up a compensation scheme, as directed by Langstaff. By contrast, Andy Burnham, the former health secretary, now mayor of Manchester, was applauded when he suggested there may be a case for charges of corporate manslaughter.

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