Liam Twomey (Wexford, Fine Gael)

The Tánaiste will ram the Bill through the House but it will leave a bad taste for many people watching our proceedings. I asked the Tánaiste several questions yesterday, some of which she has partially answered. Some of her reply, which leaves us more confused than ever, should have been part of her Second Stage speech. For example, yesterday, when I questioned whether the ELISA test was good enough on its own, the Tánaiste came back after six hours with the RIBA test and the PCR test. I am not an expert on treating hepatitis C but I understand it better than most. These other tests also have problems. The Tánaiste should provide more information to the House with regard to the tests so we can be satisfied with what is happening.

The Tánaiste referred to the KL case in her closing argument, when she suggested that fatigue and depression was all the person suffered from. No consultant would support a court case for a person who suggested hepatitis C was the problem if the only symptoms that person complained of were fatigue and depression. One in ten patients seen in any GP's surgery suffers from fatigue and depression. No consultant would stand over that.

The Tánaiste needs to explain further with regard to the restrictions being introduced, which would be fair to the House as well as to the groups being represented by us today. In essence, we are trying to represent the men, women and children affected because the Tánaiste did not enter serious negotiations with them. The Tánaiste must explain this matter because we oppose the Bill purely on the basis of the tests.

We explained yesterday to the Tánaiste how the ELISA test might go wrong. It is important that I should address some of the other points raised by the Tánaiste. With regard to the PCR test, a recent report states:

Several problems exist in the clinical application of HCV RNA testing by PCR. First, there is a high degree of variability in laboratory performance such that specimens may not provide the same result if retested. In a survey of 31 European laboratories performing HCV PCR, only five were able to correctly identify all positive and negative specimens in a standardised test panel.

On the same issue, the report states:

Other factors which may contribute to variability include specimen storage conditions, the design of amplification primers, variability of biochemical reactions, DNA product contamination, and the efficiency of postamplification detection systems. As noted above, there are a variety of reasons why HCV RNA tests might yield false negative results in patients who are anti-HCV-positive.

Difficulties therefore arise with the tests proposed in the legislation. If we had time to discuss this matter in full and receive expert medical advice similar to that obtained by the Tánaiste, it might be possible to cover every potential case and perhaps the Opposition would be convinced of the merits of the Government's case. It is, however, too much to expect Deputies to take on board the information we have been given and vote on the Bill within an hour.

The Tánaiste is treating the groups in question disgracefully. Regardless of whether her intentions are good, it is wrong from a legal and medical point of view to ram through the amendments. Her approach will inevitably create further problems. While the legislation may be signed into law or may survive a challenge in the Supreme Court, the manner in which the Tánaiste has dealt with this issue will leave a bad taste in the mouths of victims. If this is the way she proposes to do business on such a serious issue, it will also leave a sour taste in the mouths of Opposition Deputies.

The Tánaiste has not answered a series of questions Deputies asked yesterday on the other blood test provided for in the legislation, namely, the alamine aminotransferase test or ALT. In the event that, God forbid, others are infected by hepatitis C in future, under the legislation they will have one opportunity to present themselves. This is a disgraceful and ridiculous provision. If a woman who receives anti-D contracts hepatitis for any reason — she may not even be aware that she has the condition — she will have only one opportunity to obtain a diagnosis. As I stated yesterday, if the Tánaiste persists with the highly restrictive approach taken in the legislation, every woman who receives anti-D should at least be offered an alamine aminotransferase test 16 weeks after receiving the product.

Deputies said more than enough on the Bill yesterday and gave the Tánaiste ample opportunity to respond. She should suspend the vote on the Bill to give Deputies an opportunity to study the expert legal opinion she has received. Rushing the Bill through the House against the wishes of the Members is not the right way to treat the House.

I can understand documentation on PCRs, ELISA tests and RIBA tests, but many Deputies do not understand the meaning or significance of these tests and are unaware that many such tests are geared towards diagnosing an illness so that it can be treated immediately, rather than determining whether a person has had the illness in the past. These are the issues comprehended by the terms "false negatives" and "false positives". The Tánaiste's medical adviser will inform her about these matters and the least she could do, on being so informed, is to prepare a briefing document for Deputies, many of whom, on both sides, will vote on this legislation without fully understanding what they are voting for or against.

The Tánaiste is asking us to vote in favour of deciding, on the basis of three blood tests, whether a person was infected by State blood products without providing an explanatory memorandum on the specificity of the blood tests in question. I could read some of the data available on their specificity which show that they may not work in some cases, including some of the circumstances in which it is proposed to use them. It is wrong and surprising that the Tánaiste has failed to explain these matters to the House.

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