Dáil debates

Tuesday, 17 February 2004

Adjournment Debate.

Hepatitis C Incidence.

10:00 pm

Photo of Olivia MitchellOlivia Mitchell (Dublin South, Fine Gael)
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I am raising one aspect of the ten-year blood scandal saga, which is as scandalous as any of the others with which we are familiar. It is the failure to inform some blood donors that they had tested positive for hepatitis C, which precluded them from protecting other members of their family and loved ones, and from seeking treatment in a timely manner. In other words people with a highly infectious disease were stopped from seeking treatment, which could have prevented their illness from deteriorating and also protecting members of their family.

Although this was known for some time it was not until Donor L initiated court action that the full implications of this scandal became known and were widely discussed. At that time it became clear that Donor L was not the only one involved and there were possibly another 27 people who had not been informed. Both Positive Action and Transfusion Positive expressed concern that there were many cases of people who had not been informed. This among other matters prompted the Minister into promising an inquiry into this aspect, which is just one part of the long-running blood scandal.

For reasons, the details of which are far too arcane for me to cover in the short time available to me, no inquiry took place. At least one reason for this was that interests within the BTSB, the body to be examined and investigated, did not want it for a variety of reasons. I do not even understand why it was consulted or asked and it is beyond understanding as to why the Minister succumbed to its wishes. The only explanation is that there is an unhealthy overlap between the Minister's electoral interests, the Southern Health Board and the board of the Irish Blood Transfusion Service, and that this conflicts with the public interest. I would be interested to hear if the Minister has another reason for the failure to establish this inquiry.

The information made available to my colleague, Deputy Hogan, under the Freedom of Information Act gives cause for serious concern in this regard and also in regard to other matters which should form the subject matter of an inquiry. For instance why did both the BTSB and the expert group it set up to investigate the sites where blood testing should occur change their minds in favour of dual site testing to include Cork rather than the original decision which was single site testing in Dublin, which is more in line with international best evidence and experience. This is particularly surprising given the extremely poor record of the BTSB in any form of recording and communicating of information with others and even within the board itself. The Cork dimension seems to have constrained the Minister and resulted in a less than optimal solution from the public point of view.

This is no longer a matter the Minister can let slide. I am not calling for a tribunal like any of the other tribunals we have had in the past into financial scandals, bribery or corruption. These are matters that can wait some months without impacting the public or the public interest. However, this is a matter on which the clock may be ticking in a real way for some people. People may have been infected who have not been informed and this must be investigated. While the Minister considered this matter sufficiently serious to order an inquiry, he has allowed it to be delayed for whatever reason.

I understand the Minister is now suggesting this matter might now be better investigated after the Commissions of Investigation Bill has been processed through the Houses of the Oireachtas. This is rubbish. It is totally unacceptable to postpone an inquiry, which may be a matter of life and death for some people, to wait for a Bill that has not even been read once in the House. It represents yet another unacceptable delaying tactic.

I am aware of the seriousness of this allegation: it is criminal to delay any further. The Minister must establish an independent inquiry now regardless of whose toes he steps on. He owes it to those who have been damaged over the years by the omissions, actions or inactions of those who have managed or mismanaged the blood supply on behalf of the State. He also owes it to those who will give or receive blood tomorrow or who will need it in the future and to those who will depend on the existence of a stable, efficient, well-managed and well-resourced blood supply and a service in which we can all have confidence. While the inquiry is outstanding no such confidence can exist in the blood supply.

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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The Finlay tribunal, which reported in 1997, noted that between November 1991 and December 1993, donors in the Munster region who tested positive for hepatitis C were not immediately informed of their test results. One of these donors, known to the tribunal as Donor L, gave evidence that he had made blood donations regularly between 1986 and July 1993. He expressed considerable distress and anger that he had tested positive to HCV antibodies in December 1991 and that from then until November 1993, despite making donations on a number of occasions, he was at no time informed that they were being used for the purpose of testing only, nor was he informed that any form of positive test had arisen.

It is important to note that the Munster director of the IBTS gave evidence to the Finlay tribunal that the HCV screening available in 1991 was insufficiently precise to warrant the risk of upsetting a donor who was tested in the ordinary way, as was Donor L, by informing him of a positive result. She felt that the best course to adopt was to continue screening his blood on a regular basis by sending him an ordinary donor's notification card from time to time to see whether the apparent reaction would vary and also in the expectation that confirmatory testing of a more certain kind would become available very soon. She denied that this occurred inadvertently or through want of care. It was, she said, a conscious decision which she made with great difficulty concerning the position of donors who screened positive on the introduction of the test in October 1991. This was apparently implemented as a general policy and not merely in one case.

In 2000 my Department was advised by the Chief State Solicitor that Donor L had initiated proceedings in the High Court seeking damages arising from the delay in notifying him of his infection with hepatitis C. I have been cited, as Minister for Health and Children, as one of the respondents in that action. As part of the preparations for this, my Department made detailed inquiries of the IBTS, in particular seeking information on the number of other donors who had been treated in a similar fashion. It also brought the matter to the attention of Transfusion Positive and Positive Action, the main support groups representing persons infected with hepatitis C through infected anti-D or blood transfusions, to determine what action needed to be taken to promote the interests of the donors concerned. I and my officials had a number of meetings with the two groups and the IBTS during 2002. Arising from these discussions, the IBTS agreed to contact the donors regarding the delay in notification. This was done in August and September 2002 and appropriate counselling and other supports were offered to all.

The IBTS wrote to 30 donors in total. A total of 17 donors responded to the written communication from the IBTS — 11 by telephone, two by letter and four through their solicitors. In general, donors called to request access to the information held on file about their cases and they did not discuss any concerns in detail. Some donors were upset at having the matter reopened. A number of donors requested that the information be provided to their solicitors and this has been done. Following discussions between my Department and the support groups, it was agreed initially to establish an independent investigation of donor notification procedures, to be undertaken by senior counsel, in a non-statutory format, assisted by relevant experts. The board of the IBTS, however, considered that the matter should be subject to a judicial inquiry — again, on further investigation, of a non-statutory kind. Subsequently, the support groups indicated that the matter required the establishment of a tribunal of inquiry. The Deputy said earlier that she does not believe a tribunal is the correct response.

I have already informed the groups that the Commissions of Investigation Bill, when enacted, will provide an appropriate mechanism for such an investigation.

Photo of Olivia MitchellOlivia Mitchell (Dublin South, Fine Gael)
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On a point of information, I did not say that.

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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I thought the Deputy had said that earlier.

Photo of Olivia MitchellOlivia Mitchell (Dublin South, Fine Gael)
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No, I said it was not appropriate to wait until the commission——

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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She also said she did not want a tribunal of inquiry as such.

Photo of Olivia MitchellOlivia Mitchell (Dublin South, Fine Gael)
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No. The Minister imagined it — he hoped I said it, but I did not.

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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I certainly did not hope that.

Photo of Olivia MitchellOlivia Mitchell (Dublin South, Fine Gael)
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I definitely did not say it.

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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I thought the Deputy said it. I will check the record.

Photo of Olivia MitchellOlivia Mitchell (Dublin South, Fine Gael)
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I was here looking for a tribunal of inquiry. That is the purpose of this discussion.

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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Originally, the groups agreed on a non-statutory inquiry undertaken by a senior counsel.

Photo of Olivia MitchellOlivia Mitchell (Dublin South, Fine Gael)
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I understand that.

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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Then the IBTS issued a public statement to the effect that there should be a judicial inquiry, albeit non-statutory.

Photo of Olivia MitchellOlivia Mitchell (Dublin South, Fine Gael)
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They got nothing.

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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We then indicated that we would await the Commissions of Investigation Bill to provide an appropriate mechanism for such an investigation. In the interim there was another major——

Photo of Olivia MitchellOlivia Mitchell (Dublin South, Fine Gael)
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How can the Minister justify that? People are being kept uninformed while the Minister waits for a Bill.

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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They are informed.

Photo of Olivia MitchellOlivia Mitchell (Dublin South, Fine Gael)
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There may be others. The Minister does not know.

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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That is a matter——

Photo of Olivia MitchellOlivia Mitchell (Dublin South, Fine Gael)
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That is a matter for the inquiry.

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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It is envisaged that the legislation will provide for compellability of witnesses and hearings in public if necessary. The Department of Justice, Equality and Law Reform has confirmed that the Commissions of Investigation Bill is one of its top priorities for enactment in the coming months. As soon as the legislative framework is in place, I will seek Government approval to proceed with the investigation. I reject the unfair suggestion that some electoral interest is involved. There is none.

Photo of Olivia MitchellOlivia Mitchell (Dublin South, Fine Gael)
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There is no other explanation.