Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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Question 2: To ask the Minister for Health if he will use his powers under the Hepatitis C Compensation Tribunal Act 1997 to make available the measures provided for the majority who have tested positive, to the small number of women who received blood products from contaminated batches of anti-d in the 1977-79 and 1991-1994 periods but who are testing negative while experiencing severe health problems consistent with testing positive [24409/12]

James Reilly (Dublin North, Fine Gael)
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The Health (Amendment) Act, HAA, card is given to men, women and children who contracted hepatitis C from the administration within the State of blood or blood products. Under the Health (Amendment) Act 1996 the entitlement of an individual to an HAA card and to related services is decided by the chief executive officer of the Health Service Executive. The latter is bound by the definition of eligibility in the Hepatitis C Compensation Tribunal (Amendment) Act 2006, which requires a positive diagnostic test for applications received by the tribunal after the specified date of 20 June 2006.

A great deal of consideration has been given to the issue of recipients of anti-D who have neither tested positive for hepatitis C nor had a positive tribunal decision in their favour. A number of women who have tested negative for hepatitis C have experienced a variety of symptoms. However, there is no scientific proof that these symptoms are specific evidence of hepatitis C infection. In fact, some symptoms of hepatitis C, such as fatigue, fibromyalgia and depression, are common conditions that occur in the general population or are also associated with other illnesses. It is estimated that up to 16,000 women in Ireland were exposed to potentially infectious batches of anti-D and that approximately 1,000 of these were infected with hepatitis C. Extending eligibility for HAA cards to those who have tested negative for hepatitis C would have significant implications for the scheme overall.

I am sympathetic to the women in question. However, taking account of international practice and the rationale which led to the passing of the 2006 Act, I am satisfied that the present arrangements are reasonable in the circumstances.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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I understand that the cohort of women described in my question is 15 in number, two of whom are currently seriously ill. I take this opportunity to send my best wishes to them and their families at this very difficult time. The women who make up this tiny minority are very disappointed to have been excluded from the measures provided for the majority who have tested positive, including access to Health (Amendment) Act cards. I strongly urge the Minister to revisit the matter. Section 9 of the Hepatitis C Compensation Tribunal Act 1997 states:

The Minister may, with the consent of the Minister for Finance, by regulations extend the class or classes of persons who may make a claim for compensation before the Tribunal.

This provision provides the Minister with the means to address a long-standing injustice. Given the small number of women involved, where there is a will there must be a way.

Second, funding for the organisations representing the women concerned, both those who have tested positive and those experiencing illness but not testing positive, has been reduced. These bodies were the subject of some very unfair media coverage in recent times, even though their expenditure was in all cases prior-approved by the Department. Will the Minister acknowledge that? I understand he has already met with one of the organisations, Transfusion Positive, on this issue. Will he undertake to meet with representatives of Positive Action as well?

James Reilly (Dublin North, Fine Gael)
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I too send my best wishes to anybody who is acutely ill at this time. I realise the difficulties attaching to this issue and am sympathetic to the plight of those involved. However, as I said in my reply, in the absence of some other method of defining the cause of illness, it is very difficult, under the legislation, to deal with the cases outlined. The Deputy observed that a very small number of women fall into this category, but the symptoms outlined are so prevalent with many other conditions that it would be difficult to confine any measure in this regard to the cohort we are discussing. Having said that, I am certainly prepared to review the matter with a view to finding some definable way of addressing it to everybody's satisfaction.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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I have a note before me, which I will pass on to the Minister, setting out the most up-to-date medical information relevant to this case. The absence of serological markers for hepatitis C does not exclude the distinct probability that an individual was exposed to virus-contaminated anti-D immunoglobulin. There is very good evidence that some individuals, when exposed to the hepatitis C virus, have an acute resolving infection that can leave the previously infected person with none of the usual diagnostic metrics of the past infection, such as seropositivity. In regard to the patients we are discussing, the case of donor Y has been described as the clearest example of this progression within the context of the natural history of hepatitis C infection. The details are outlined in the report of the expert group on the Blood Transfusion Service Board of January 1995, pages 29 and 30. The report states that a large volume of plasma was collected from donor Y in 1989. This plasma was found in retrospective testing in 1994 to be positive for the hepatitis C virus, yet donor Y was independently tested by the then BTSB for evidence of hepatitis C viral infection and tested negative under the third-generation ELISA test.

These facts provide a means for the Minister to progress this matter. I do not doubt for one moment that it is his personal wish to do so. As such, I hope that what I have recounted today gives him the formula and wherewithal to proceed. To reiterate, we are speaking about a very small number of women who desperately need our help.

James Reilly (Dublin North, Fine Gael)
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I thank the Deputy for his comments. I will certainly undertake to consult again on this matter. There are specialists particularly proficient in this area who would be of assistance to us. I do not mean this as a defence, but the Attorney General must be consulted in this matter lest it create a precedent which might cause problems. The primary objective must be to support any woman who was infected by or has suffered as a result of receiving infected blood. My goal is to do so within the parameters and strictures under which I must operate. If we can manage it, we will certainly act on this. The Deputy said that where there is a will there is a way. There is a great deal of willingness on this side of the House if we can find a way.

Joan Collins (Dublin South Central, People Before Profit Alliance)
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Question 3: To ask the Minister for Health the reason holders of the HAA cards under the Health Amendment Act 1996 are being denied access to boceprevir (Victrelis) and Telaprivir; if he will reiterate the obligations this State has to citizens who contracted Hepatitis C through the Blood Transfusion Service Board, especially in relation to access to drugs that increases their quality of life. [24411/12]

James Reilly (Dublin North, Fine Gael)
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I am pleased to confirm that a decision has been made to make boceprevir, marketed as Victrelis, and telaprevir, marketed as Incivo, which are hepatitis C protease inhibitor drugs, available within the hospital system for the treatment of hepatitis C. The new treatments have been found to be effective in treating adult patients with hepatitis C genotype 1 infection who have compensated liver disease and are previously untreated or who have failed previous therapy. The use of these drugs requires a detailed programme of treatment and monitoring of progress. The HSE is putting in place the protocols and structures to allow treatment to begin as soon as possible. Anyone who meets the criteria under the protocols will have access to these new treatments.

Joan Collins (Dublin South Central, People Before Profit Alliance)
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I welcome the Minister's reply. There was an intake of breath by members of Positive Action and other organisations representing people infected by hepatitis C when it was indicated that there might not be access to these treatments. The situation has clearly moved on since then. Can the Minister indicate how soon treatment programmes will be initiated and what the associated protocols will be? Positive Action, Transfusion Ireland and other survivors will welcome this news.

James Reilly (Dublin North, Fine Gael)
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I have discussed this issue with Dr. Barry White, national director of clinical strategy and programmes with the Health Service Executive. He is very much involved in this area as somebody who treats patients with haemophilia, many of whom contracted hepatitis C through contaminated blood products. There are medical protocols around this, which I will not go into, because there is a possibility of serious side effects associated with the treatment. For instance, the administration of these medicines to patients who are hepatitis C negative would not be considered justified in terms of the down side that can possibly occur.

Joan Collins (Dublin South Central, People Before Profit Alliance)
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As far as I am aware, some members of Positive Action embarked on the new treatment some months ago and are ready to move. Will the Minister ensure those who have embarked on the programme can move quickly? They were supposed to start the 48 week process in January and then in February. Is the Minister saying those who are on the programme can move quickly to the long-term treatment needed? As he said, the new treatment is fantastic for persons who have been affected by hepatitis C.

I reiterate what my colleague said. There have been requests from Positive Action to meet the Minister to discuss a number of issues that have arisen. I would appreciate it if this meeting could be arranged as soon as possible.

James Reilly (Dublin North, Fine Gael)
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Those who have been assessed and are on the drug will progress quickly, while others must go through the process to ensure they are suitable.

With regard to meeting Transfusion Positive-----

Joan Collins (Dublin South Central, People Before Profit Alliance)
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Positive Action.

James Reilly (Dublin North, Fine Gael)
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I am sorry. I have met Transfusion Positive and have no problem meeting representatives of Positive Action.