The Parliamentary Under-Secretary of State for Health (Nicola Blackwood)
I congratulate the hon. Member for Kingston upon Hull North (Diana Johnson) and all the members of the all-party parliamentary group on haemophilia and contaminated blood on helping to secure this debate, and I thank the Backbench Business Committee for providing time for it. It has been a highly informed, very personal and moving debate, but it has also been non-partisan. I thank all Members from across the House for the constructive way in which they have approached the debate.
I would like to begin by formally adding my personal apology to all those who have been affected by these tragic circumstances and the impact that this has had on so many families. I thank all colleagues’ constituents for their bravery in allowing their personal circumstances to be shared in the House today. It brings this debate to exactly where it should be, reminding us all what we are trying to achieve through the process. The importance of that cannot be overstated. I wish I could refer to all the constituents who were mentioned today. I listed them, but that would take most of the debating time that we have today, so I say thank you to all those who allowed their stories to be told. That is exactly why the Government are introducing the reforms we have been debating today to existing support schemes, alongside a commitment within this spending review period of up to £125 million until 2020-21 for those affected, which will more than double the annual spend over the next five years.
At the beginning, however, we should be up front in recognising that nothing can make up for the suffering and loss these families have experienced, and no financial support can change what has happened to them. However, I hope all of those here today will recognise that the support provided is significantly more than any previous Administration have provided, and recognise how seriously the Government take this issue. I would like to join colleagues in paying tribute to the previous Prime Minister and to my predecessor, my hon. Friend the Member for Battersea (Jane Ellison), for all their work on the issue. I reiterate their statement that the aim of this support scheme is that no one will be worse off.
It is, as many colleagues have said, time for our reforms to bring an end to the tortured road that far too many of those affected have been down. It is time for a more comprehensive and accessible scheme that gives those affected their dignity back. However, as I hope is clear from the debate, not all the details are yet resolved. I hope to answer as many questions as I can today, but I am certain that the noble Lord Prior will be listening closely to the debate, and he will be in contact with all those here today to make sure we can resolve details that I cannot get to in the time available.
Let me turn to where we are. The reforms guarantee that all those who are chronically affected will, for the first time, receive a regular annual payment in recognition of what has happened to them. That includes all the 2,400 individuals with hepatitis C stage 1, who previously received no ongoing payment, but who will now expect to receive £3,500 a year.
Increases to existing annual payments have also been announced. These are not designed in themselves to guarantee a reasonable standard of living. The package needs to be considered in the context of the whole range of support that is available for the patient group, including support being exempt for the purposes of tax, and benefits being claimed by beneficiaries of the schemes, as the hon. Member for Glasgow South West (Chris Stephens) rightly mentioned.
I would like to address a couple of the issues raised by the hon. Member for Kingston upon Hull North about finances. We do expect to spend all the budget allocated to the scheme in the year, but the budget for the scheme does come within the Department of Health’s budget, not the Treasury budget, so if there is an underspend in any one year, the money will remain in the Department of Health. If any payments that should be made within that year fall into the next year, we can take that money forward.
I would also like to address the concerns that have been raised about the tendering for the scheme. The shadow Minister is, I am afraid, not quite correct that Capita and Atos have already bid to administer the scheme. The invitation to tender has not yet been issued, so no initial bids have been received so far. We intend to issue the invitation to tender shortly, and I am absolutely sure that, as the tender is being designed, the concerns that have been raised in the debate will be heard, and that the concerns about trust and the history of this situation will be well understood by all those involved in the design.
Diana Johnson
I am grateful to the Minister for clarifying the position around the tender, but could she confirm that the only organisations or businesses that have been invited in for conversations with the Department of Health were the two that have been mentioned by a number of hon. Members today? Is that correct or not?
Nicola Blackwood
I have had no meetings on this issue, because it is obviously not within my departmental brief. I am happy to try to find out about that issue, if the hon. Lady would like.
Nicola Blackwood
I would like to move on to some other issues because we are quite tight for time.
I would like to talk about the budget that has been allocated, because it has been mentioned on a number of occasions. The pressures on the health budget will come as no surprise to anyone here today—we had an animated debate about that just this week. I would like to assure everybody in the House that, even in the context of those pressures, we fought hard to protect the money for this scheme through tough budget negotiations so that we could fulfil commitments that were made and ensure that the concerns of those affected are addressed as far as possible.
In that context, I would like to talk in a little more detail about some of the concerns that have been raised today by colleagues. Colleagues have rightly raised the issue of support for the bereaved and those relying on discretionary payments. That is why we have introduced the one-off payment of £10,000 to bereaved partners or spouses of primary beneficiaries, where infection contributed to the primary beneficiary’s death, and in recognition of their relationship at the time of death.
Nicola Blackwood
I will in one second. I just want to respond to a point made by the hon. Member for Kingston upon Hull North about the certification of death. We understand that death certification may not state a direct contribution, so the policy that is to be published will recognise other ways to show a causal link between infection and death. We would like to make sure that issues around that are not a barrier to support under the scheme.
Jim McMahon
I thank the Minister for giving way on that point, which she has partly answered in her contribution. However, could we just get some clarity on cases where the death certificate is marked “unascertained” and on whether there will be more flexibility around that, providing that the hepatitis can be proven?
Nicola Blackwood
The hon. Gentleman makes an important point. Those are exactly the issues that are being wrestled with at the moment by the Department, and we are trying to resolve them.
We realise that the accessibility of the payment scheme for the bereaved, but also of the discretionary support scheme, will be important, as mentioned by the hon. Member for Glasgow South West and my hon. Friend the Member for Worthing West (Sir Peter Bottomley). I am not able to give the complete details of the discretionary scheme at the moment. In 2017-18, a new, single discretionary scheme will replace the three discretionary support schemes that are currently in place. It will have an increased budget, and it will be transparent and flexible so that it can support the beneficiaries who are most in need. However, until those details are fully worked out, it would not be fair for me to speculate on exactly what they will be. I want to reassure hon. Members, however, that until we are in a position to introduce that new system, the current discretionary payments will stay in place.
I would also like to reassure hon. Members that the policy of paying bereaved partners and spouses £10,000 will be published by the Department of Health, and it will be communicated to all major stakeholders, including the APPG, to ensure that we reach out to those who were bereaved a long time ago and make both these policies as accessible as possible.
We realise that these payments can never make up for the personal loss bereaved partners or spouses have experienced, but we are trying to make sure that the process is as smooth and effective as possible, with as few barriers as possible, so that individuals do not feel as though they are trying to jump through hoops.
Chris Stephens
On the point I made earlier, which was echoed by the hon. Member for Worthing West (Sir Peter Bottomley), will death certificates be dealt with in a very sympathetic fashion, so that someone’s death certificate will not say HIV or hepatitis C, although we will know through their medical records that that was the cause of death? Will the Government look at that?
Nicola Blackwood
The issue of death certificates is one that we are very alive to. It is one that the Department is trying to address, and I hope that we will be consulting closely with the relevant groups to make sure we deal with it in as sympathetic a manner as possible.
Ms Ritchie
Could the Minister comment on the points I made about the inactivity of the Northern Ireland Executive? Would it be possible for further phone calls to be made to the Minister for Health in Northern Ireland to accelerate the process and to enable payments and a scheme to be made available?
Nicola Blackwood
If the hon. Lady will have a little patience, I have an entire section on the devolved nations coming up. Before then, however, I would like to move on and speak a little about the other sections of the scheme. As well as the one-off payment to bereaved partners and spouses, the Government’s response to the consultation makes it clear that partners and spouses will be able to continue to access discretionary schemes on a means-tested basis. However, that is not the end of the story. My officials will continue to work with a reference group of experts on the details of the policy for this new payment for the bereaved and on elements of the wider discretionary payment. As soon as the policy is confirmed, the Department will publish it and give guidance on who is eligible and how to access the payment as easily as possible.
I recognise that, as has been clear from this debate, some do not feel that the new payments that have been announced are sufficient. However, they are based on the consultation response, and a judgment was made to provide support to the widest group of people possible to recognise the pain and suffering of those who have been affected by this tragedy. There are never really any right answers when designing a support scheme in recognition of such awful circumstances. Difficult judgments have to be made in relation to prioritising support. We consulted on the proposals and used the responses gathered to announce reforms that, for the first time, provide annual payments to all infected individuals rather than waiting for more people to get sicker before they receive support.
The hon. Member for Kingston upon Hull North raised issues about other viruses. We have not expanded the scheme to include other viruses, including vCJD. In that case in particular, that is because there is already a vCJD compensation scheme that offers no-fault compensation. It was set up by the Government for vCJD patients and their families in recognition of their wholly exceptional situation. The scheme provides for payments to be made, in respect of 250 cases, from a trust fund of £67.5 million. Over £41 million has been paid out by the trust to date. There are currently no proposals to extend the infected blood system of ex gratia payments to include other viruses or infections that were contracted through routes other than NHS-supplied infected blood. This is based on the advice of the Advisory Committee on the Safety of Blood, Tissues and Organs. For example, hepatitis B was not involved in the schemes when they were set up because the blood donor hepatitis B screening test had been introduced in the 1970s. There are other reasons for not including hepatitis E that I am happy to write to the hon. Lady about in more detail should she wish me to do so.
We now arrive at the devolved nations section that I mentioned to the hon. Member for South Down (Ms Ritchie). Many colleagues have referred to the Scottish Government’s reforms. We are working closely with officials from Northern Ireland in keeping them up to date on our progress with implementation. These beneficiaries, as the hon. Lady said, will be eligible under the Northern Irish scheme to continue to receive support at their current levels. I am happy to ensure that my noble Friend Lord Prior is made aware of her concerns about the potential impact on Northern Irish victims.
The hon. Member for Linlithgow and East Falkirk (Martyn Day) rightly raised the importance of co-ordination between the devolved nations on the support schemes. Given the significance of the points that he raised, and some complexities about the co-ordination of business, it is important that I ask my noble Friend Lord Prior to contact him directly on those points so that these matters can be co-ordinated effectively. I can reassure the hon. Gentleman on one point: the £500 winter fuel payment is now automatically included in the payment that people in England are getting as part of the support scheme. That means that they do not have to apply for it, as was the case previously. I hope that he will accept that that is a degree of progress.
Many colleagues point to the Scottish scheme as a blueprint for what they would like to see introduced in England, but there are some differences, as the hon. Gentleman noted. In England, there are about 2,400 individuals with hepatitis C stage 1 who were not receiving any annual payment. We have introduced a new annual payment for all those individuals so that they can get support now rather than waiting for their health to deteriorate before they are eligible for it. The Scottish Government have made their own judgments. They have chosen to provide a lump sum payment, and there are currently no proposals for annual payments to the hepatitis C stage 1 group.
We have put in place other measures to avoid the sense that, as the hon. Member for Hammersmith (Andy Slaughter) suggested, this support could be grudging, or that, as the hon. Member for Kingston upon Hull North mentioned, people could feel as though they were being treated as beggars. We have specifically put in measures to avoid this. For example, as we announced in response to the public consultation, people should not feel as though they have to jump through hoops to prove that they are worthy of support. We have no intention of introducing individual health assessments to registrants of schemes as a means of making people feel as though they have to prove their eligibility. Another key element is a special categories mechanism, with appeal, for those with hepatitis C stage 1 who consider that the impact of their infection, or the treatment for it, is similar or greater than for those at stage 2, such that they could qualify for stage 2 annual payments. This is a particularly beneficial aspect of the scheme.
Members have raised the issue of those who could clear hepatitis C infection. They will remain entitled to compensation under the scheme. The shadow Minister is right that those who clear the virus during the acute phase are not included in the scheme, but that is because the body fights off the infection before the severe health impacts occur. That has been the judgment of the expert advisory group, which we have been pleased to listen to.
Chris Stephens
Will the Minister deal with the question of tax rules? Has she had any discussions with HMRC on that issue?
Nicola Blackwood
I thought I had already answered that. These schemes are exempt from tax and we are continuing to ensure that the ongoing schemes will be subject to the same tax rules.
Several colleagues raised the issue of a public inquiry. The Prime Minister has been very clear that we do not believe that a public inquiry would provide further information. The things that a public inquiry could achieve, according to media reports, are establishment of the facts, learning from events, preventing a recurrence, catharsis, improving understanding of what happened, and rebuilding confidence and accountability. It is difficult to see what more information could be made available through a public inquiry given that action was taken as soon as possible to introduce testing and safety measures for blood and blood products as these became available, with the introduction of health and heated products, and that the Government have published all documents associated with this event from the period 1970 to 1985, in line with the Freedom of Information Act 2000. However, I am sure that campaigners will continue to make their case.
We have heard a lot about when this year’s payments will be made. I share that concern. When I was appointed as Parliamentary Under-Secretary of State with responsibility for public health and innovation, I made resolving this issue one of my highest priorities. I am not prepared to suffer any further delays. It is not fair that affected patients should suffer the continuing uncertainty that has been raised by colleagues. I have told the Department that it must announce the scheme immediately. I am pleased to announce that letters to all hepatitis C stage 1 sufferers were sent out on 11 November informing them of their new annual payment and asking them to claim this through the existing schemes. The schemes have said that they will be able to make these payments by 22 December. Letters to those at stage 2 and those with HIV have been sent this week, and their additional payments will be made shortly before Christmas. The schemes are also planning to send all letters to bereaved partners and spouses before Christmas with the aim of paying their new lump sums before the end of the financial year, and certainly during March 2017. Details of the payment schedules are now available on the schemes’ website. In addition, as already announced, all new and increased payments will be backdated from April 2016 or the date of joining the schemes, if later.
I believe it is right that the Government’s focus is on considering how best to create and implement a system with the increased budget that is affordable, that redesigns the inconsistencies that we have heard about, and supports those most affected by these tragic events now and into the future. I will continue to listen to the concerns of those affected. I hope that I have responded to those concerns as effectively as I possibly can.