Earl Howe (Con)
My Lords, with the leave of the House, I shall now repeat in succession two Statements delivered earlier in another place. The first was made yesterday by my right honourable friend the Prime Minister. The second was made earlier today by my right honourable friend the Minister for the Cabinet Office. The first Statement, by the Prime Minister, is as follows:
“Mr Speaker, Sir Brian Langstaff has today published the final report of the Infected Blood Inquiry. This is a day of shame for the British state. Today’s report shows a decades-long moral failure at the heart of our national life. From the National Health Service to the Civil Service, to Ministers in successive Governments, at every level the people and institutions in which we place our trust failed in the most harrowing and devastating way. They failed the victims and their families, and they failed this country.
Sir Brian finds a ‘catalogue’ of systemic, collective and individual failures, each on its own serious, and taken together amounting to ‘a calamity’. The result of this inquiry should shake our nation to its core. This should have been avoided. It was known that these treatments were contaminated. Warnings were ignored, repeatedly. Time and again, people in positions of power and trust had the chance to stop the transmission of those infections. Time and again, they failed to do so.
Sir Brian finds ‘an attitude of denial’ towards the risks of treatment. Worse, to our eternal shame, and in a way that is hard even to comprehend, they allowed victims to become ‘objects for research’. Many, including children at Lord Mayor Treloar College, were part of trials, conducted without their or their parents’ knowledge or consent. Those with haemophilia or bleeding disorders were infected with HIV, hepatitis C and hepatitis B through NHS treatment, through blood clotting products such as factor 8, including those who had been misdiagnosed and did not even require treatment. Many were infected through whole blood transfusions. Others were infected through their partners and loved ones, often after diagnoses had been deliberately withheld for months or even years, meaning that these infections should easily have been prevented.
I find it almost impossible to comprehend how it must have felt to be told that you had been infected, through no fault of your own, with HIV, hepatitis B or hepatitis C; or to face the grief of losing a child; or to be a young child and lose your mum or dad. Many of those infected went on to develop horrific conditions, including cirrhosis, liver cancer, pneumonia, TB and AIDS, enduring debilitating treatments, such as interferon, for these illnesses—illnesses the NHS had given them.
Many were treated disdainfully by healthcare professionals, who made appalling assumptions about the origin of their infections. Worse still, they were made to think that they were imagining it. They were made to feel stupid. They felt abandoned by the NHS that had infected them. Those who acquired HIV endured social rejection, vilification and abuse at a time when society understood so little about the emerging epidemic of AIDS. With illness came the indignity of financial hardship, including for carers, those widowed and other bereaved family members.
Throughout it all, victims and their loved ones have had to fight for justice, fight to be heard, fight to be believed and fight to uncover the full truth. Some had their medical records withheld or even destroyed. The inquiry finds that some government papers were destroyed in
‘a deliberate attempt to make the truth more difficult to reveal’.
Sir Brian explicitly asks the question:
‘was there a cover up?’
Let me directly quote his answer for the House: ‘there has been’. He continues:
‘Not in the sense of a handful of people plotting in an orchestrated conspiracy to mislead, but in a way that was more subtle, more pervasive and more chilling in its implications. To save face and to save expense, there has been a hiding of much of the truth’.
More than 3,000 people died without that truth. They died without an apology. They died without knowing how and why this was allowed to happen, and they died without seeing anyone held to account.
Today, I want to speak directly to the victims and their families, some of whom are with us in the Gallery. I want to make a wholehearted and unequivocal apology for this terrible injustice. First, I want to apologise for the failure in blood policy and blood products, and the devastating—and so often fatal—impact this has had on so many lives, including the impact of treatments that were known or proved to be contaminated; the failure to respond to the risk of imported concentrates; the failure to prioritise self-sufficiency in blood; the failure to introduce screening services sooner; and the mismanagement of the response to the emergence of AIDS and hepatitis viruses among infected blood victims.
Secondly, I want to apologise for the repeated failure of the state and our medical professionals to recognise the harm caused. This includes the failure of previous payment schemes, the inadequate levels of funding made available and the failure to recognise hepatitis B victims.
Thirdly, I want to apologise for the institutional refusal to face up to these failings—and, worse, to deny and even attempt to cover them up—the dismissing of reports and campaigners’ detailed representations; the loss and destruction of key documents, including ministerial advice and medical records; and the appalling length of time it took to secure the public inquiry that has delivered the full truth today.
There is layer upon layer of hurt, endured across decades. This is an apology from the state to every single person impacted by this scandal. It did not have to be this way. It should never have been this way. On behalf of this and every Government stretching back to the 1970s, I am truly sorry.
Today is a day for the victims and their families to hear the full truth acknowledged by all and, in the full presence of that truth, to remember the many, many lost loved ones. But justice also demands action and accountability, so I make two solemn promises. First, we will pay comprehensive compensation to those infected and those affected by this scandal, accepting the principles recommended by the inquiry, which builds on the work of Sir Robert Francis. Whatever it costs to deliver this scheme, we will pay it. My right honourable friend the Minister for the Cabinet Office will set out the details tomorrow.
Secondly, it is not enough to say sorry or pay long-overdue compensation and then attempt to move on. There can be no moving on from a report that is so devastating in its criticisms. Of course, in some areas medical practice has long since evolved, and no one is questioning that every day our NHS provides amazing and life-saving care to the British people. But Sir Brian and his team have made wide-ranging recommendations. We will study them in detail before returning to this House with a full response. We must fundamentally rebalance the system so that we finally address this pattern, so familiar from other inquiries such as Hillsborough, where innocent victims have to fight for decades just to be believed.
The whole House will join me in thanking Sir Brian and his team, especially for keeping the infected blood community at the heart of their work. We would not be here today without those who tirelessly fought for justice for so many years. I include journalists and parliamentarians in both Houses, especially the right honourable Member for Kingston upon Hull North, but most of all the victims and their families, many of whom have dedicated their lives to leading charities and campaign groups, pouring their own money into decades of running helplines, archiving, researching and pursuing legal cases, often in the face of appalling prejudice. It is impossible to capture the full pain and injustice that they have faced. Their sorrow has been unimaginable. They have watched loved ones die, cared for them as they suffered excruciating treatments or provided their palliative care. Many families were broken up by the strain. Hundreds of thousands of lives have been knocked off course, dreams and potential unfulfilled.
But today, their voices have finally been heard. The full truth stands for all to see. We will work together across Government, our health services and civil society to ensure that nothing like this can ever happen in our country again. I commend this Statement to the House”.
Baroness Brinton (LD)
My Lords, from these Benches, we echo the apologies made by both the Government and the Labour Benches. We are truly sorry for what has happened. We pay tribute to everyone in the infected blood community. I particularly want to thank those watching us, whether in the Public Gallery here or online. Talking to people at Central Hall yesterday, I discovered that a number of people have watched every single time this House has debated infected blood. We may not see them, but they see us.
From these Benches, we also pay tribute to Sir Brian and his team for a truly remarkable seven-volume report which speaks truth to power for the infected blood community, and we pay tribute to the parliamentarians in both Houses who have fought for justice over the decades, including Dame Diana Johnson, who currently leads them. We also pay tribute to the many charities and organisations who have worked with the IB community, be they infected or affected.
From these Benches, we will continue to hold government to account until everything is resolved. Having said that, we certainly welcome both Statements. We echo the points made from the Labour Front Bench: we believe that there are issues relating to criminal charges for corporate manslaughter and other possible crimes, so can the Minister say whether Sir Brian’s report is being forwarded to the police and the DPP for consideration?
There is one person who is not in her place today, the noble Baroness, Lady Campbell of Surbiton. She was exhausted by yesterday. She is one of the affected people in this House—but not the only one. She told me that she welcomes the government apology; her sorrow is that it took decades of personal hardship and relentless campaigning to arrive. She is delighted by the appointment of Sir Robert Francis KC, as are we; he is someone in whom the IB community has considerable trust. Finally, she said that she wants to listen hard to the community responses over the coming weeks to the events of yesterday and today in respect of the compensation intentions. Everyone will need time to process the inquiry’s findings. She and many others are completely exhausted, and that is why she is unable to be with us tonight.
Today’s compensation Statement sets out much welcome detail. As the Minister knows, from these Benches we welcome the establishment of the arm’s-length IB compensation authority, the announcement that Sir Robert Francis is the interim chair and the clarity about who is eligible, especially the inclusion of those affected, not just infected. We also welcome the different categories of tariff. Ministers have heard repeatedly in both Houses that it is vital to recognise how people’s lives have been affected in so many ways.
However, the Statement also raises some questions that are not quite so clear. First, have the Government understood that people with lived experience of infected blood must be represented at all levels on the IBCA, including the board? Both Statements were silent on that, so I wonder what guidance Ministers will give Sir Robert on involving people with lived experience.
Secondly, the Statement confirms that anyone already registered with one of the existing support schemes will automatically be considered for compensation under the new scheme. But what about those we have discussed repeatedly in debates on the Victims and Prisoners Bill: those who are known about but whose claims have not yet been recognised and therefore are not registered? The Statement yesterday talked about documents going missing and even being destroyed. I have heard today from a victim who says that her claims, made over five years ago, are stuck because the NHS has lost two or three key pages from her records, so she cannot move forward. Can the Minister say what will happen to cases such as hers? She asked, “How can we fight a machine that is still protecting itself?”
There is a second group of people who are harder to reach, as they have not yet been identified; they may have only just become aware that they are infected with hepatitis. What arrangements will there be for them? Not only are they outside the timetable for the main compensation scheme, given what the Minister said, but they appear not to be referred to under the interim scheme arrangements as announced. What is the timescale for each of those two groups? The Minister knows about them, because we have talked about them before, so it is no surprise to him that they remain concerned about their position.
It is also good to see that those receiving compensation will be disregarded from means-tested benefits assessments, but I return to my old question: can the Minister confirm that there will be no clawing back of past benefits as new compensation payments are made? That was not at all clear in the Statement.
The Statement outlines support schemes especially for widows and how they will fit into the new scheme. I thank the Minister for making sure that they will not lose out. We look forward to seeing the details of the scheme.
Finally, the increase in the interim scheme payments of a further £200,000 is welcome. As with the main scheme, what are the proposals and timescales for ensuring that those not yet registered will get speedy support, registration and payments? That is not mentioned, either, in the timetable.
Sir Brian’s report is a wake-up call to government, including the Civil Service, the NHS and the Department of Health and Social Care, and to Parliament. We must give thanks to all who have relentlessly spoken up from the community, the press and the media and in Parliament; but for them, we would not be here today. Only through fulfilling Sir Brian’s recommendations —all of them—will there be vindication for the victims and corporate and state changes in culture in the future. We must all ensure that we never have to face a scandal like this again.
Earl Howe (Con)
My Lords, I am grateful to the noble Lord, Lord Collins, and noble Baroness, Lady Brinton, for their supportive comments. I agree with the noble Lord, Lord Collins, that if ever a cross-party approach was warranted, it is now. I have no doubt that, going forward, his party, as well as mine, will wish to see justice fully done in the way that we—I hope—are agreed on.
Lessons must indeed be learned. The Prime Minister’s Statement yesterday expressed the shock and shame that all right-thinking people will feel in response to Sir Brian Langstaff’s report, the implications of which are profound. It is important that the Government take time to digest fully the gravity of its findings. The wrongs that have been done are devastating and life-altering for so many individuals, so ensuring that nothing like this can happen again is a priority. We will provide a comprehensive response in due course.
A number of questions were raised by both the noble Lord and the noble Baroness. First, the noble Lord, Lord Collins, asked about a debate in the House of Lords. I know that this proposal is currently under active consideration by the usual channels, and I would personally welcome such a debate.
Secondly, both the noble Lord and the noble Baroness asked me about the possibility of criminal charges and whether relevant evidence would be made available in such circumstances. I can certainly give that assurance, but it is a little early to say whether the report will be sent to the police or the Director of Public Prosecutions. We will consider the report in depth over the coming days and weeks, and it is no part of the Government’s wish to stand in the way of justice being done across the piece.
I am delighted that Sir Robert Francis has been welcomed as the interim chair of the compensation authority. He is trusted by the community, and I know that he wishes to work very closely with representatives of the community on both the way that the scheme as proposed is validated and the way that the compensation authority is established and is working. In other words, the provision that we have made in the Victims and Prisoners Bill for committees and sub-committees to be set up within the compensation authority will allow Sir Robert to populate those committees as he wishes, and as he is asked to do, with representatives of the infected and affected communities. I have little doubt that there will be arrangements at board level to ensure that the views of those committees and sub-committees are reflected in the board’s considerations going forward.
The noble Baroness asked whether there would be any clawing back of past benefits. I can assure her that there will not be.
As regards those who are not known about and who may feel that they have a claim—some, perhaps, lacking the evidence to prove a claim—we will address situations of that kind in the guidance that comes forward, and provide a means for those people on a page of GOV.UK to feed in their interest and their claim to entitlement in as simple a way as possible. The application scheme that we are setting up will be electronic; the aim is to make it as simple and as user-friendly as possible. Support will be provided for those who need it, and I will be happy to write to the noble Baroness with more specific details of how different groups of people will be able to access the compensation authority in due course.
Baroness Meacher (CB)
My Lords, I will say just a few words from these Benches—we are a little depleted this evening. I strongly support the words of the noble Lord, Lord Collins, and the noble Baroness, Lady Brinton. They were very constructive and helpful. I also want to say how much I personally appreciate the fact that the noble Earl, Lord Howe, is responsible for this area of work. We are incredibly lucky to have such a committed and devoted Minister who, I feel absolutely confident, will pursue this and ensure that the compensation is properly provided to the people who so desperately need it. The noble Earl will, I know, collaborate; he had a very good meeting with a small number of us and it was very clear that he will welcome continued collaboration, and I certainly look forward to that. I give a special welcome to the Front Bench for the noble Earl, Lord Howe.
Earl Howe (Con)
I am, as ever, very grateful to the noble Baroness, Lady Meacher, for her kind words. I can assure her that it has been a privilege for me to be involved as a House of Lords Minister in working through these proposals and to be standing here today to announce them. I am more than ready to continue that work as we fashion the compensation scheme, together with Sir Robert Francis and those impacted by this scandal.
Lord Lansley (Con)
My Lords, as a former Secretary of State for Health, I very much share the sense of failure that was forcefully expressed by the Prime Minister in the other place yesterday. From my personal point of view, I want to say how deeply sorry I am for the pain and misery that so many of the victims and their families have experienced.
I remind my noble friend that that is exactly the same expression of regret that I made in another place on 10 January 2011, and which my noble friend at this Dispatch Box repeated on the same day. At that time, as my noble friend will recall, we had conducted a review over some months, following Lord Archer of Sandwell’s independent inquiry. We believed, on the basis of the ministerial review of Anne Milton, the Member of Parliament for Guildford, that we were substantially meeting—and enhancing—the level of support payment for relief that would be provided to victims and their families and meeting many of their needs. Clearly, it was inadequate, and the Prime Minister has expressed that view.
Can my noble friend say whether the Government will now focus very hard on the question of why I, he, our ministerial colleagues, and other Ministers and other Secretaries of State—I heard Andy Burnham say more or less exactly the same thing yesterday—believed that we were doing what was needed and what was right at that time but did not share the view that we needed to make compensation payments on the scale of those that were made in Ireland because we did not share the same liability as had been accepted in Ireland?
That was clearly not true. Ministers were repeatedly advised that something was true which was not true. That is not to absolve us, because we take responsibility as Secretaries of State for our departments and for what has been done or has failed to be done during our time in office, and collectively we must accept that responsibility. However, this must be a case of never letting the scale of that failure within government be repeated in the future in any other circumstances. I hope that my noble friend can say that that internal examination, based on the inquiry, will be proceeding forthwith.
Earl Howe (Con)
I am grateful to my noble friend and well remember the Statement that he refers to, which I repeated in this House in January 2011. He is exactly right. Both he and I were advised at the time that there was no comparability between the situations in the Republic of Ireland and the United Kingdom—that they were entirely different. That was not true, but it was the advice that we received. We did as much as we could, I am sure my noble friend will agree, to honour the spirit of the late Lord Archer’s report, which was at the time a very thorough piece of work, although he did not have access to all the evidence, as we now are aware. So it does raise the question of how successive Secretaries of State for Health in the Labour Government, the coalition Government and no doubt beyond were advised in the way that they were by officials. This is a question that merits the closest scrutiny and I undertake that that will be done.
Baroness Featherstone (LD)
I was not going to speak, because I find it very emotional. For anyone in this Chamber who does not know, my nephew died aged 35. He was a haemophiliac. He was infected with hepatitis C and exposed to CJD. He left a 10 month-old daughter. But I wanted to put on the record my admiration and heartfelt thanks to Sir Brian Langstaff. It was an absolute miracle that he chaired this inquiry, because he did not hold his punches yesterday, did he?
I also want to put on record my thanks to Theresa May, whom I worked with in the Home Office and whose ear I bent regularly. She was the first politician to do things right by commissioning this inquiry. Although it has taken five years and has been agonising for all those people—including my sister, who lost her son and now has Alzheimer’s—yesterday felt at last like a day of reckoning when justice was finally done. She campaigned for 40 years for that day, against all the odds. She was treated by civil servants and Ministers as if she was dirt on their shoes, quite frankly. I cannot even begin to express it.
There is so much that I would like to say, but, as this is meant to be questions, I will just say that I had evidence. I met Sir Chris Wormald. He lied to my face then apologised in writing afterwards. This was all given in evidence to the inquiry. Yes, all the things that the Minister has said will be done must be done, but there are so many of these situations. Denial and cover-up seem to be systematic, whether it is Grenfell, Bloody Sunday, Hillsborough or any of those things. This duty of candour has to really mean “never again”. I am sick and tired of hearing “never again” after all these inquiries. If it is not “never again”, there will be some recompense to those who were affected but it will not change anything. In this country, when it feels like everything is going to hell, this is an opportunity to perhaps turn it around and make sure that we become the good, honest Government and citizens that we always should have been.
Earl Howe (Con)
My Lords, I very much identify with the remarks of the noble Baroness and extend my personal sympathy to her with regard to the death of her nephew.
She referred to the duty of candour. It is perhaps not surprising that Sir Brian Langstaff has made such a recommendation. We need to think about it very carefully. As the noble Baroness will know, this House passed an amendment, proposed by the party opposite, to consider a duty of candour as part of the Victims and Prisoners Bill. I am still not sure that Bill is the right place for it; I think we need to take a longer run at this issue in the light of the full dimensions of Sir Brian’s recommendations.
However, it is not an issue that is going away. Nothing can ever compensate those who have lost loved ones or had their lives ruined by this terrible disaster. However, we can create a scheme that delivers monetary compensation speedily, efficiently and accessibly, in a way that is consistent with the proper management of public funds. Above all, the scheme must treat people with the kind of respect, dignity and compassion that the noble Baroness says was singularly absent along the way for those who required help and support.
These are basic rights which too often people impacted by the scandal have been denied. They need to feel that there is a system there to support them that is collaborative, sympathetic, user-friendly and as free of stress as possible. I know that that is the aim that Sir Robert Francis has at the top of his mind as well.
Baroness Finn (Con)
My Lords, Sir Brian’s report highlighted within government a culture of evasion, chicanery and half-truths that has perpetuated the anguish of victims and relatives for decades. I was particularly disturbed to read in volume seven of Sir Brian's report his conclusions on the destruction of several key documents by civil servants that were central to both his inquiry and earlier civil litigation before the courts. He found that it was,
“more likely than not that the authorisation to destroy the files was because the documents contained material dealing with delays in the UK to the introduction of the screening of blood donations for Hepatitis C, which was anticipated (or known) to be a live issue at the time. If this is right, it was a deliberate attempt to make the truth more difficult to reveal”.
Does the Minister agree, first, that it is to be condemned that civil servants sought to destroy evidence that potentially hid their own complicity in events; secondly, that it is disturbing that not a single official has been able to recall who gave the order to destroy these documents, or why; and, thirdly, that it is a great shame on the Civil Service that not a single individual has been held accountable for destroying evidence in this way?
Earl Howe (Con)
My Lords, I share my noble friend’s profound disquiet and shock at some of the facts that Sir Brian Langstaff has uncovered—not only as regards the actions of civil servants but also his exposé of moral failings on the part of individuals and institutions at every level of our system of government. These failings, and in some cases cover-ups, over decades raise profound questions about how in the future we can ensure integrity, honesty and transparency in the business of government—as the Civil Service Code and the Ministerial Code currently require.
The recommendations that Sir Brian Langstaff has made, particularly in the area of learning lessons and ending what he called the “defensive culture” of the Civil Service, will receive the most serious consideration across government and we will publish a comprehensive response to all his findings in due course.
Baroness Finlay of Llandaff (CB)
My Lords, my own profession is covered in shame with the findings in this report. The noble Baroness, Lady Campbell of Surbiton, should really be with us tonight. She went through everything with her first husband, who died; I remember his funeral well and the whole story was a tragedy. There will be recommendations that affect clinicians, as well, coming out of this. The Prime Minister’s Statement says:
“Of course, in some areas medical practice has long since evolved”.
I wish it was in every area of practice. To hear that people have been treated with disdain is frankly shameful.
I know there is a review by the Department of Health and Social Care going on at the moment. The review is taking evidence—it is on the website—on the duty of candour. I hope that that will be looked at very carefully, particularly in the light of the report. In terms of records, we have heard about Civil Service records but also patient records being lost, with patients being unable to access their own records and having to go through complex processes even today. That is something that at a personal level I feel needs to be considered as well, in order that people can access information.
I would like to ask the Minister what plans there are to work with the professional bodies to ensure that the findings here mean that there is proper candour, that whistleblowers are empowered to say what they need to say, that open conversations do occur over diagnosis and where people want access to the records, and that it is recognised that clinical studies do not need more regulation on top of them but need to be freed up to be really open and honest, because we move things forward in medicine through clinical studies and it would be really sad if the concept of trials fell into disrepute because there has been disrepute in the past and because things have been badly conducted. Some aspects, particularly of medical research, have changed and improved, but it is essential that people benefit from better care.
I know that my noble friend Lady Campbell of Surbiton welcomes the appointment of Sir Robert Francis, whose background and experience are exemplary. On behalf of her and the rest of your Lordships, I thank the noble Earl, Lord Howe, for keeping his door constantly open, seeing every one of us and managing people with great compassion.
Earl Howe (Con)
I am grateful to the noble Baroness for those remarks, and I associate myself with all that she said about the noble Baroness, Lady Campbell of Surbiton. She, of all our colleagues, has been personally affected by this awful scandal, and has lost a husband in the course of it. I am by no means alone in having enormous admiration for her. Although I well understand why she cannot be with us today, following an exhausting day yesterday, we are all sorry not to see her.
The noble Baroness, Lady Finlay, was right to express a view about how we should not inadvertently turn off the tap on innovation and medical advances in the health service by adopting an overly risk-averse approach. That would be the wrong thing to do. At the same time, it is fair to remind ourselves that, since the 1990s, there have been huge changes in the way that the NHS is regulated and the checks and balances that exist for clinical trials and the like.
Certainly, our blood supply is now one of the safest in the world. Over the last decade, the Government and system partners have delivered major initiatives to advance patient safety across the NHS. They include the patient safety strategy and the Patient Safety Commissioner —thanks to my noble friend Lady Cumberlege. The NHS is subject to greater oversight and regulation today—some have said that it is perhaps excessive, but I do not agree—but with a modern focus on patient safety and on evidence-based medicine, with a constitution brought in by the last Labour Government that sets out the rights of all of us to care and to treatment free of charge.
While I am the first to echo the guilt expressed by the Prime Minister yesterday, I think that we can look forward to a period of greater transparency and openness and greater patient safety in the light of the changes that have been made in recent years.