Peter Kelly (Longford-Roscommon, Fianna Fail)

There is no doubt that what happened regarding hepatitis C is the greatest public health tragedy since the foundation of the State. Large numbers of persons were infected with an incurable disease which has changed their lives and prospects as well as their family and work relationships. No monetary support or compensation can ever undo the damage. However, we as legislators must do what we can to make life easier for the victims. I offer my sincere sympathies to the families affected. It was an absolute disaster.

This House has already enacted two Acts to deal with this tragedy, the Hepatitis C Compensation Tribunal Acts 1997 and 2002. This Bill seeks to establish a statutory scheme to address insurance difficulties experienced by persons infected with hepatitis C and HIV through the administration within the State of blood and blood products. It is a vital measure designed to give further support to people diagnosed with hepatitis C and HIV as a result of the administration of contaminated blood products.

The consultative council on hepatitis C is the statutory body established to advise the Minister on all aspects of hepatitis C. Millions of people all over the world have this virus infection and most people with hepatitis C live as long as anyone else. Many never develop serious problems but some will need active treatment at some stage of the illness. A small number of people with hepatitis C have progressive liver disease that does not respond to existing treatments. However, doctors are making real progress in finding better treatments. Nonetheless, since 1997 it has been obvious that the inability of those infected to buy life assurance or mortgage protection policies is further compounding the damage they had already suffered. These people have suffered enough. On the enactment of the Bill, three types of recompense will operate. To date, the Hepatitis C and HIV Compensation Tribunal awarded more than €660 million to approximately 2,000 people. Of these, approximately 1,000 were anti-D recipients and approximately 700 were transfusion recipients, renal patients or persons with haemophilia. The remainder were secondary claimants or dependants entitled to claim under a range of headings including "loss of consortium", "loss of society" and "carer's expenses".

Those who contracted hepatitis C through the administration within the State of blood or blood products are entitled to a special card under the Health (Amendment) Act 1996. This is termed the "HAA card". HAA cardholders are entitled to avail of a range of services and products without charge including general practitioner services, prescribed drugs, medicines and appliances, dental services, ophthalmic services, home support, home nursing, counselling services, physiotherapy, chiropody and podiatry. The Bill adds life assurance support to the entitlements of cardholders which will cost an estimated €90 million to provide over the life of the scheme. I applaud the Government on the introduction of a life assurance scheme which no other country has put in place. The Bill demonstrates the State's commitment to working with the victims of infection to provide every possible support. The scheme will cover the insurance risk of more than 1,700 people who are entitled to avail of assurance products, irrespective of any other medical condition, on payment of the standard premium paid by an uninfected person of the same age and gender.

To ensure a consistent approach to all three supports, Government agreed to define hepatitis C diagnosis in the Hepatitis C Compensation Tribunal Acts 1997 and 2002 and the Health (Amendment) Act 1996 in accordance with the scientific ELISA test. Alternatively, if a person has displayed symptoms of acute infection with jaundice up to 16 weeks after the administration of an infective agent, the resultant infection also comes under the terms of the Act. While the ELISA test has had its doubters, the Tánaiste pointed out this morning that there has been significant progress in its development. A similar scientific test definition for hepatitis C diagnosis is used in other jurisdictions where compensation schemes operate including the United Kingdom and Canada. The sections of the Bill setting out the definition of a diagnosis will not affect claims already made to the compensation tribunal. Symptoms linked with hepatitis C include tiredness, aches, pains and depression, some of which are common to a number of conditions not associated with the disease. To ensure the support schemes operate in a fair and equitable manner and that those determining eligibility use clear consistent criteria, it has been decided that diagnosis will be determined by means of an internationally accepted test. We should remember that the expert group on hepatitis C, chaired by the Department's chief medical officer and including leading liver consultants and a member of Positive Action, agreed in 1998 that eligibility for the Health (Amendment) Act card should be based on a positive diagnostic test for hepatitis C.

The objective of the scheme set out in the Bill is to provide reasonable access to the insurance market, within certain limitations, to those for whom the cost is prohibitive or cover is unavailable. From its inception, the consultative council on hepatitis C highlighted the obstacles people encountered in obtaining insurance cover. The Department of Health and Children sought advice from life assurance experts on the feasibility of developing an insurance scheme, the parameters of which were established in a subsequent phase of work. In devising the draft scheme, officials worked closely with the representative groups to agree its provisions. On foot of representations by the Irish Haemophilia Society, it was agreed that the small number of persons infected with HIV only would also be eligible for support under the scheme. Most persons with haemophilia who are infected with HIV also have hepatitis C.

For insurance purposes, persons with hepatitis C and, or, HIV fall into two categories. While those in the first category can obtain insurance, it is only on payment of increased premiums. Those in the second category are deemed by the insurance industry to be uninsurable. The Bill provides that the State will pay the additional risk premium where a life assurer is willing to provide cover subject to an additional premium or assume the risk of the life cover where an assurer is unwilling to provide cover to an applicant. In each case, the person requiring insurance will pay the average basic premium an uninfected person of the same age or gender would pay. The scheme will be administered by the Health Service Executive and made available in respect of all standard life assurance policies offered by those life companies authorised to transact life assurance business in Ireland that choose to take part. The scheme, which will be administered under the aegis of the Health Service Executive, will be available in respect of all standard life assurance policies offered by life companies which are authorised to transact life assurance business in Ireland and who choose to take part in it. Life assurers who wish to take part in the scheme will enter into an agreement to abide by the rules of the scheme, which will also provide for appeal in the event of a dispute.

The parameters of the scheme mean life assurance with maximum cover of €400,000, or seven times the earned income of the eligible participant or his or her partner, or both, in respect of the tax year in which the proposal is submitted and up to a maximum of €500,000, will be available to the age of 75. These sums will be indexed to keep pace with the consumer price index.

Also being provided up to the age of 75 is mortgage protection cover on purchasing, changing or improving a primary residence, up to an overall maximum of the average house price in Dublin plus 25% or €375,000, indexed in accordance with the TSB/ESRI Dublin house price index.

For an initial period of 12 months from the commencement date or, if later, three years from the date hepatitis C or HIV is diagnosed, all persons with hepatitis C or HIV will be entitled to apply for cover under the scheme. After that, a waiting period will apply, during which full cover may be phased in over two years for the under-50s and three years for over-50s.

In order to ensure equity there will be an open period for young people, who are not ready to avail of insurance or mortgage protection at this time, until the date of their 30th birthday.

The maximum age of entry into the scheme will be 65 and the age at which cover will cease will be 75. However, persons aged up to 75 will be able to take out insurance cover in the first year of operation of the scheme.

On the question of consortium, the Bill proposes to clarify that compensation will be awarded to spouses and partners of persons where the relationship had commenced before diagnosis of hepatitis C or HIV. New partners or spouses of infected persons who knowingly entered relationships after the diagnosis of hepatitis C will be unable to claim damages for loss of consortium. However, other headings of claim for compensation by persons in this category, suchas loss of earnings, loss of society and post-traumatic stress, will not be affected by the amendment.

We must acknowledge in the strongest possible terms that the infection of people with contaminated blood products was catastrophic for them. No monetary support or compensation can ever repair the damage done. However, Ireland is doing more for victims than other countries in similar circumstances.

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