Tom Parlon (Laois-Offaly, Progressive Democrats)

I am happy to join my colleagues in acknowledging the pain and suffering that has been inflicted on a large number of our citizens as a result of hepatitis C and HIV infection and the involvement of the State and others in the administration within the State of infected blood products. This is an emotive issue and many speakers have been very fair in dealing with the it and have tried not to raise emotion levels any higher. What we need to do today is seek a reasonable solution and what the Bill offers is a major breakthrough in terms of where we are coming from. If there are shortcomings, certainly they should be raised here and we will try to deal with them by way of amendments.

Most Deputies have referred to the good faith of the Tánaiste and Minister for Health and Children, which is not in question, although some have inferred otherwise. She must take all of the advice that is available to her, whether it be from the Office of the Chief State Solicitors, the Office of the Attorney General or elsewhere.

Three forms of support will be put in place for infected persons as a result of the enactment of the Bill. The first, which is quite important, is compensation. Clearly, as many Deputies have already said, compensation in monetary terms can never set right the wrong that has been done. On the other hand, as the old saying has it, "money makes the mare go". Compensation is important in terms of supporting people going forward. To date awards have been made to approximately 2,200 people. The tribunal was put on a statutory footing in 1997. It allowed people to make claims for compensation in a non-adversarial fashion. Claimants could also appeal to the High Court. Persons infected, their spouses, partners and next of kin have been presenting their claims to the tribunal since its establishment. The total cost of the tribunal at the end of 2005 was over €600 million, which included legal fees, administration costs and so forth. From that total, the cost of awards was approximately €580 million, which is a substantial amount of money.

The second support that will be available on enactment of the Bill is the special health card, the Health (Amendment) Act card, which will entitle the holder to a range of health care services free of charge. Having met a number of the sufferers, I know it is important for them not to have any financial exposure from dealing with the health service going forward. Health care costs under the Health (Amendment) Act are approximately €15 million per annum.

The expert group on hepatitis C, which is chaired by the Department's chief medical officer, includes a representative of the leading liver consultants and a member of Positive Action. The group agreed in 1998 that eligibility for the card should be on the basis of a positive diagnostic test for hepatitis C. This is an issue that has been discussed at great length, in terms of the ELISA test, its suitability and advances made in that test in recent years.

The Department is preparing a detailed guide to the services available under the card, which include hospital care, primary care, home support and a new nursing home scheme, which is being piloted in the eastern part of the country this year. The representative groups have been involved in shaping the development of these new services and it is important that they meet the needs that exist.

The third support to be put in place with the enactment of this Bill is the life assurance scheme, which is expected to cost approximately €90 million over its lifetime. It is expected to run for at least 30 years. Several speakers referred to the fact that people were having difficulty with travel insurance, life assurance and so forth. That was a major difficulty but under the new scheme, the State will pay the additional risk premium where the life assurer is willing to provide cover, subject to an additional premium, or will assume the risk on the life cover where the assurer is not willing to provide cover. When the Bill is enacted, the assurance scheme will bring major peace of mind to the people who were previously having difficulty obtaining cover. Most people take it for granted that they will get life assurance and travel insurance cover. In this case, the State is underwriting the cover, which will give much solace to the people involved.

The tragic episodes of infection of blood and blood products took place in 1977 and again between 1991 and 1994. Since then, every effort has been made by the State to make recompense to the victims of that terrible scandal. A multi-million pound investment was approved in the late 1990s to support the reorganisation and redevelopment of the Irish Blood Transfusion Service to make sure such a tragic eventuality, with all of its terrible consequences, would not happen again. The primary objective was to ensure the Irish Blood Transfusion Service was resourced to provide a transfusion service in line with best international standards.

Significant additional resources were made available to the IBTS to support various programmes, including the provision of a new national headquarters, the development of a new components processing laboratory and other improvements at the Cork centre, the implementation of a new IT system, the introduction of new technologies such as PCR testing and other services to improve the safety of the blood supply. Additional senior staff appointments were also made, which have resulted in the establishment of new personnel and finance departments. Clearly the State has had a major involvement, and made a significant investment, in the upgrading of the blood transfusion service to ensure such an eventuality never happens again and that the service complies with international best practice.

The Irish Blood Transfusion Service has introduced major new testing programmes in advance of most other international transfusion services. It continuously monitors international developments, such as guarding against emerging threats, for example, variant CJD. All of these developments will undoubtedly contribute to a modern, safe and efficient blood transfusion service to meet the demands and challenges of the 21st century.

Since the introduction of regulations to transpose the European directive on quality and safety of blood products, the activities of blood banks and blood establishments must be authorised by the Irish Medicines Board. Strict standards must be in place with regard to the collection, testing, processing, storage and distribution of human blood and blood products. Penalties are imposed on facilities that do not comply with the regulations. Not only has the State invested enormous resources in this area, it is also observing very strict regulations and imposing penalties where those regulations are not being adhered to. Significant funding has been allocated to ensure compliance with statutory requirements and I am confident this will result in improved hospital systems and traceability in terms of the blood transfusion chain. Many people on all sides of the House have offered their sympathy and support to the victims of infected blood and blood products, and I know that sympathy is not much use, it is action that is needed. The Bill that we are endorsing in the House today will certainly strengthen and enhance the services available to those with hepatitis C and HIV. All the representative groups have been very busy over the years, particularly in lobbying over the past 48 hours and articulating genuine concerns. Positive Action, Transfusion Positive, the Irish Haemophilia Society and the Irish Kidney Association have attended the House to lobby individuals from all sides with great enthusiasm and genuine depth of feeling. They have worked relentlessly with State officials from the HSE and the Department of Health and Children, putting in massive efforts regarding the difficulties that they have highlighted.

The State funds the representative organisations to the tune of approximately €1.5 million, and that is certainly a help. However, regarding the individual efforts made, the voluntary time and money expended would certainly dwarf that. There has been a spirit of co-operation in the House towards the representative groups with the aim that services might continue to be enhanced and developed. I am certainly extremely happy to give the Bill my full support and I look forward to its passage into law.

The much-needed insurance scheme can now be established to ensure that products for those with hepatitis C and HIV will be provided for them. This is the first scheme of its kind in the world, and I congratulate the Tánaiste on the major efforts she has made to establish it. She has once again shown how determined she is to reform the health service and this area in particular, which has blighted those infected for some years.

I will refer once again to the main provisions of the Hepatitis C Compensation Tribunal (Amendment) Bill 2006. Section 1 amends the definition of hepatitis C diagnosis in the Hepatitis C Compensation Tribunal Acts 1997 and 2002 to exclude those who do not test positive for hepatitis C from applying for compensation. Following enactment, this section will come into effect on 20 June 2006. Importantly, applications already lodged with the compensation tribunal will not be affected. No one who has made a claim over the past ten years will be affected by enactment of this law.

Section 2 amends the Hepatitis C Compensation Tribunal Acts 1997 and 2002 to exclude future compensation for the spouses and partners of persons where the diagnosis of hepatitis C or HIV had been made before the relationship commenced. That section will come into effect upon enactment.

Sections 3 and 4 establish a scheme to address the insurance difficulties experienced by persons infected with hepatitis C or HIV through the administration within the State of blood and blood products. The commencement date of those sections will be set by regulation. Certain benefits under the scheme will only be available for a 12-month period after the commencement date, and it will be necessary for the scheme administrator to be in place, application forms drafted, explanatory material printed and terms and conditions of the scheme published before its commencement. The details of this Bill are extremely important and I can understand the fears of those who have misread or misconstrued them, or failed to take them fully on board. All eventualities are covered.

Section 6 amends the Health (Amendment) Act 1996, which provides for a range of free health care services for injured persons to include the same definition of hepatitis C diagnosis as contained in the above amendments, that is, section 1 of the Hepatitis C Compensation Tribunal Acts 1997 and 2002. Upon enactment, this section will come into effect on 20 June 2006. Applications seeking to establish entitlement to relevant health care services lodged with the HSE before that date will not be affected. That element is also very important.

Approximately 20,000 infected or potentially infected vials of anti-D were distributed in the two periods between 1977 and 1979 and, unfortunately, between 1991 and 1994. Taking into account multiple applications to single individuals and the approximately 1,000 women who tested positive for the virus or antibodies, there are approximately 15,200 individuals who have never tested positive for either the virus or antibodies.

Under the existing Acts, diagnosis of hepatitis C is not defined. That has led to one High Court case and nine tribunal cases where compensation was paid to persons who did not pass the diagnostic test. The estimated cost of compensation, including the reparations fund and legal fees per person for general damages claims is in the order of €225,000, while the cost of special damages claims by eligible persons could add an indeterminate amount. The average cost of the ten cases referred to above in respect of which victims received High Court or tribunal awards is €275,000, excluding legal fees.

The 2002 Act allows spouses or partners to claim for loss of consortium, including but not confined to the impairment of the couple's sexual relationship. That was intended to compensate the spouse or partner who had entered into a relationship with the primary victim before either party knew of the hepatitis C diagnosis and whose relationship was adversely affected by it. The High Court has since made awards on appeal to persons whose relationships were formed after the date of diagnosis. The proposed amendment will clarify the position in that regard and will confine compensation, from the date of publication of the Bill, to persons whose relationships started before diagnosis, even where claims have already been lodged with the compensation tribunal.

The following are details of the infectious or potentially infectious anti-D vials issued and the maximum number of recipients at risk for the two risk periods. From April 1977 to October 1978, an estimated 12,460 doses of anti-D were produced, of which 4,026 vials were infected or potentially infected with the hepatitis C virus, HCV. Allowing for the administration of multiple batches to single individuals, a maximum of 3,959 individuals were at risk. From 1991 to 1994, an estimated 26,766 doses of anti-D were produced and 17,545 vials were infected or potentially infected with HCV. Of those, at least 1,208 were recalled by the Irish Blood Transfusion Service. In summary, 16,337 vials infected or potentially infected with HCV were issued in the period. Once again allowing for the administration of multiple batches to single individuals, a maximum of 12,250 recipients were found to be at risk. The total number at risk over the two periods from 1977 to 1979 and 1991 to 1994 was 16,209.

The annual reports of the compensation tribunal's awards contain a certain amount of high level information on awards, including their number and size. Owing to the diversity of claims, ranging from persons with severe liver damage to relatives burdened by loss of consortium, loss of society, mental stress or funeral expenses, the average award calculated by dividing the total number of claims by the total amount awarded is of limited use. The annual total cost of awards is set out in the tables and I will give Members that information. Last year the tribunal produced a table of cases where awards were made without ELISA tests. In a small number of cases, the claimants had evidence of suffering acute jaundice and it is important to stress that such cases will continue to attract compensation. They will remain entitled to compensation under the amended legislation. There is no information as to what influenced the tribunal to make awards in the other cases. Hepatitis C appeals in the High Court in 2004 were held in camera at the appellants' request. It is a matter of public record that one case in 2004 involved a person who did not test positive and appealed the refusal of the tribunal to award compensation and won.

I am happy to speak on this issue, give my full support to the Bill and look forward to its enactment and the establishment of a much-needed insurance scheme without undue delay.

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