Infected Blood Inquiry
The Parliamentary Under-Secretary of State, Department for Culture, Media and Sport (Baroness Twycross) (Lab)
My Lords, with the leave of the House I shall now repeat the Statement delivered on Friday 26 July in the other place by my right honourable friend the Minister for the Cabinet Office:
“With your permission, Madam Deputy Speaker, I would like to take the opportunity to provide an update on the Government’s progress in responding to the infected blood inquiry’s report.
I want to start by reiterating that the inquiry’s final report laid bare harrowing aspects that make it vital we provide regular updates on this work. The infected blood scandal is an injustice that has spanned across decades on an unprecedented scale. Thousands of people have died and continue, sadly, to die every week. Lives have been shattered and the voices of victims have been ignored for decades. People have watched their loved ones die and—in one of the most chilling aspects that the inquiry brought to light—children were used as objects of research. It is hard to conceive of the scale of the damage done and the incredible suffering of all those impacted.
On 20 May, the country bore witness to the devastating findings of the infected blood inquiry’s report. It was a national moment, a profound moment of shame for the British state, and a moment of long-overdue recognition for the victims and their loved ones. My right honourable friend the Prime Minister, in his former role as Leader of the Opposition, acknowledged that
“suffering was caused by wrongdoing, delay and systemic failure”
by all parties
“across the board, compounded by institutional defensiveness”.—[Official Report, Commons, 20/5/24; col. 667.]”
The former Prime Minister issued an apology on behalf of the state for the devastating impact that the use of infected blood and infected blood products has had on countless lives. Today, on behalf of this Government, I reiterate that deep and heartfelt sorry. First, let me reassure the House that the Government are committed to acting on the findings of the infected blood inquiry report to ensure swift resolution. We are also committed to working on a cross-party basis, and will work with others to deliver the compensation scheme and get final payments to victims as soon as possible. It is vital that we shine a penetrating light on the lessons that must be learned, and that includes paying comprehensive compensation to those infected and affected by the infected blood scandal.
I would like to thank honourable Members who have played prominent roles in pushing the work to this point. My right honourable friend the Member for Kingston upon Hull North has always been—and I know will continue to be—a powerful advocate for this cause. Her work in pushing forward the cause and representing the voice of those infected and affected was unquestionably pivotal to reaching this point. I would also like to thank my predecessor as Paymaster-General, the right honourable Member for Salisbury. As I said yesterday at Questions, I am grateful for his work in the lead-up to the announcement of the compensation scheme, and indeed for his collegiate approach in doing so. I hope that we can continue to work together on this important issue.
The scale of the horror that was uncovered by Sir Brian Langstaff’s report almost defies belief. One of the issues that the report brought to light is the importance of addressing the unacceptable culture of defensiveness in the public sector. We must make sure that the reputation of people and protecting institutions are never put above public service. This Government will bring forward legislation to place a duty of candour on public servants and authorities to make sure that this kind of behaviour cannot happen again. That legislation must be the catalyst for a changed culture in the public sector by improving transparency and accountability. It will address the culture of defensiveness and help ensure that the lack of candour uncovered in the infected blood scandal—and, indeed, in too many other instances, such as Hillsborough and Horizon—is not repeated.
However, we also recognise that, as well as delivering institutional change, we must also provide financial redress to people whose lives have been irreversibly and tragically changed as a result of the infected blood scandal. One of the most powerful conclusions in the inquiry’s report is that an apology is meaningful only if it is accompanied by action. It is now my responsibility to carry forward this action, and I hope to lead that work not only with the support of this House, but with sensitivity and respect towards the people who have been so unfairly affected by this scandal. After all that has happened, listening to the voice of victims is crucial, and I will endeavour to work closely with the infected blood community as we progress this work.
I would also like to take this opportunity to update the House on the progress being made in establishing the Infected Blood Compensation Authority. The Victims and Prisoners Act 2024 legally created the authority on 24 May, and since that point the interim chief executive David Foley has been working closely with Sir Robert Francis KC, the interim chair of the Infected Blood Compensation Authority, to set up the compensation service. It is, frankly, no small task. The Cabinet Office is supporting the organisation as it recruits and sets up a service that is easy to access and simple to use. The Infect Blood Compensation Authority itself will then provide regular updates to the infected blood community and all others interested in its work.
Let me turn to compensation. On 21 May, I welcomed the former Administration’s announcement on compensation. There is an urgent need to get money to people in the most timely way possible. On 24 June, interim payments of £210,000 were made to beneficiaries of the infected blood support schemes living with infections, bringing the total paid in compensation to victims to more than £1 billion. However, we recognise that this is not enough, given that many others have also been waiting for far too long.
The Cabinet Office is working closely with the DHSC, the devolved Governments and the administrators of the existing infected blood support schemes to establish the process for making interim payments of £100,000 to the estates of deceased people who were infected with contaminated blood or blood products and whose deaths have not yet been recognised. Work is progressing to ensure that these payments are made as soon as we are able to. I am pleased to confirm to the House today that applications for these payments will open in October. The Government will set out further details in due course.
There is also the matter of the final compensation scheme. We are committed to delivering this work and delivery it quickly. We are also committed to getting it right. The proposed compensation scheme was published on GOV.UK on 21 May, and we are committed, as I indicated yesterday to the shadow Paymaster-General, to making regulations to establish the scheme by 24 August, as we are obliged to by the Victims and Prisoners Act. However, we also recognise the importance of building support and trust of those who will access the scheme. Sir Robert Francis undertook an engagement exercise in June at the former Government’s request, with the support of all parties. This exercise engaged those who have been most impacted by the scandal on the content of the compensation scheme. I have been engaging with Sir Robert to hear his advice following his meetings with members of the infected blood community. I am considering his advice carefully, with a view to publishing both his report and the Government’s position on it in advance of 24 August.
Finally, I reassure the House that there will be an opportunity to fully debate the content of the inquiry’s final report. I am conscious that, given the timing of the recent election, there has not yet been time for honourable Members to do so. It is essential, in my view, that Members of this House have enough time to digest and debate the devastating findings of the report. The Government are considering Sir Brian Langstaff’s recommendations, and we will provide an update to Parliament on the progress we are making to respond to the inquiry’s recommendations by the end of the year, as Sir Brian recommended in the report.
The infected blood scandal is one of the gravest injustices this country has seen. I want to end by paying tribute to the courage and determination of the victims of this scandal—those infected and those affected who fought so hard for justice. At every debate on this issue, we remember that they are at the centre of all this. It is for them that we must come together to restore the sense that this is a country that can rectify injustice. They deserve nothing less. I commend this Statement to the House”.
Earl Howe (Con)
My Lords, this is a welcome Statement and I thank the Minister for repeating it. During the passage of the legislation that underpins the creation of the infected blood compensation scheme, one thing that I am very glad that we all agreed on across the House was that we should not let party politics interfere with our collective aim of reaching a fair and workable set of legal provisions in response to Sir Brian Langstaff’s recommendations. It is therefore particularly welcome to see that collegiate spirit continuing under the newly appointed ministerial team, and I thank them for that.
The debate that took place last Friday in the other place served to clarify a number of important questions arising from the Statement and I do not therefore propose to dwell on matters that have already been covered. The main areas that I would like to touch on relate in one way or another to the projected timetable for delivering compensation and justice in all its forms. It is excellent to hear that the recent period of election purdah did not prevent the further interim payments of £210,000 being made to beneficiaries of the infected blood support schemes living with infections, as was promised by the previous Government.
However, the other promise that we made was to put in place as soon as possible arrangements to make an interim payment of £100,000 to the estates of deceased people who were infected with contaminated blood or blood products and whose deaths have not yet been recognised. To fulfil that promise, it is clearly necessary, as the Statement indicated, to reach consensus between the devolved Administrations and the Government in Westminster, as well as those in charge of the existing support schemes, on how exactly those arrangements should be implemented. Can the Minister say how those discussions are progressing? Is she confident that, when applications for those payments open in October, they will open across the United Kingdom, as opposed to just a part or parts of the United Kingdom?
Secondly, the Statement made it clear that the regulations to establish the scheme would be made on 24 August, which, as the Act provides, is exactly three months after Royal Assent. How will that work, procedurally and legally? One risk that we identified when the Victims and Prisoners Bill was being debated was that a three-month deadline for making regulations might be too rigid if the Summer Recess, and/or an election campaign, meant that the regulations would have to be made at a time when Parliament was not sitting. Our solution was to create the Infected Blood Compensation Authority in shadow form, with a view to timing Royal Assent for a date some time in July, when we judged that the risk of a parliamentary recess or Prorogation interfering with the making of regulations would be reduced. Because of reservations expressed by Labour shadow Ministers, it was not possible to build any flexibility into the statute to allow for those risks, which, as things have turned out, may be seen as unfortunate, because Royal Assent had to happen as soon as the general election was announced. Can the Minister clarify what the legal effect will be of the regulations being made when Parliament is not sitting? At what point will the Infected Blood Compensation Authority be legally in being?
Next, one of the key reassurances that I gave when taking the Bill through was around the need to listen to the victims. We envisaged involving the infected blood community directly in two ways: first, in setting the final shape of the compensation scheme and, secondly, in assisting Sir Robert Francis as interim chair of the authority in ensuring that the scheme, when up and running, was implemented fairly and with the full benefit of input from those whose lives have been directly affected by this calamity. As regards the former, it is good news that Sir Robert Francis completed his engagement exercise last month and that he will be publishing the outcome in advance of 24 August. As regards the latter, can the Minister reassure the House that it is still the intention for the infected blood community to be represented in the compensation authority through its committees and subcommittees? If so, is work proceeding now to give effect to that intention?
Could I next ask the Minister to confirm a point that I know is still a matter of anxiety for the infected blood community? It is a question that concerns those currently in receipt of support payments. As the responsible Minister, I gave the House an assurance that no one will be worse off under the final compensation scheme than they would have been under existing support schemes, and that an additional top-up payment would be made to anyone assessed as being entitled to less money than would otherwise have been payable via the infected blood support schemes. In other words, I promised that those people who have a legitimate expectation of receiving a certain sum of money from support payments over their lifetime will have that expectation honoured. Can the Minister confirm the assurance that I gave? Following on from that, can the Minister clarify for me whether what are now classed as ex gratia payments under the support schemes are now in effect to be rebadged as compensation?
I shall touch also on a further concern within the infected blood community, relating to access to necessary treatment. Victims have told me that parts of the NHS have been slow to recognise the moral and clinical urgency of treating those whose illness, or multiple illnesses in some cases, stems directly from receiving infected blood or blood products. Will the Minister ask her colleague in the Department of Health and Social Care to look into this and report to the House on how any difficulties of this sort might best be remedied? The Republic of Ireland issues a special card to those registered as having been infected by contaminated blood or blood products, so that there is no argument when someone presents themselves to the GP or the hospital. Is that an idea that could be considered here?
While on the subject of treatment, can the Minister say whether everything is on track in NHS England and the devolved Administrations to roll out the bespoke psychological support service for those infected and affected by the infected blood disaster?
Finally, the Statement is right to pick up Sir Brian Langstaff’s finding that there is a culture of institutional defensiveness that can too often rear its head in areas of the public sector. The Government have stated their intention to bring forward a statutory duty of candour to address that issue—and, indeed, this was a proposal that we debated at some length during the passage of the Victims and Prisoners Bill. It is an idea that has obvious appeal and no doubt the Government will bring forward legislation in due course when they are ready to do so. However, I said, during our debate, that it is an idea that merits a reasonably long run being taken at it before it is set in legislative stone—and I repeat that view today, because I do not in fact think that a duty of candour is of itself a magic bullet that is capable of changing what is often an ingrained culture.
The duty of candour that we have already in the NHS has not prevented some very serious and high-profile disasters arising out of poor care, or even criminal behaviour. Similarly, we already have the Civil Service code, which mandates honesty and transparency but has not, alas, prevented the kinds of cover-ups and dishonesty in departments of government that Sir Brian Langstaff has highlighted. So, finally, will any proposals to introduce statutory duty of candour for the public sector as a whole be preceded by extensive and thorough engagement with all those parts of the public sector to which the duty is intended to apply?
Lord Scriven (LD)
My Lords, I welcome the Minister to her place and wish her well in the role she is undertaking. We on these Benches also welcome this Statement and commit to a collaborative cross-party approach to this very important issue.
Victims of the infected blood scandal and their families have been waiting for decades to see justice. Tragically, as we know, thousands have died without ever having received compensation. The report of the inquiry into the scandal, chaired by Sir Brian Langstaff, laid bare the suffering inflicted, the cover-ups and the systematic failures of individuals and of the British state as a whole. Not only did individuals and the state fail to help these victims, but in many cases people were lied to, treated with contempt and dismissed outright. It is good to hear updates on progress, but victims have waited far too long and there are still some gaps.
I want to follow up on the comments by the noble Earl, Lord Howe, about the treatment and some dismissive approaches by the NHS. Rather than just having a card, now that patient records are electronic would it be possible to put an automatic flag in them so that the onus is on the service and not the individual to make sure that timely treatment is given by the NHS?
An infected blood compensation authority will be set up, but what framework is being set for a light-touch approach to those seeking compensation? We have seen that compensation schemes, such as for Horizon, can be complex and difficult for those who have been affected to navigate. What framework are the Minister and the Government asking the compensation authority to undertake that will make it as light-touch as possible but with appropriate probity in place?
Another problem with the Government’s proposals for compensation is that only infected victims and bereaved partners are entitled to the autonomy award. This is being used as a catch-all to cover, for example, clinical trials and the loss of the right to have children. Affected parents cannot claim this £50,000 award, but it is the only measure that looks to compensate for the financial outlay of supporting the child or children of the deceased and their partners over many years.
Another issue with the autonomy award is that it does not recognise infected and affected partners whose pregnancies have been terminated as a result of links to their blood infection. Does the Minister not agree that there is a good case for the autonomy award to be extended to specific affected individuals who can prove injury? I look forward to the Minister’s answers.
Baroness Twycross (Lab)
I thank the noble Earl, Lord Howe, and the noble Lord, Lord Scriven, for their contributions and thoughtful responses. The noble Earl has spoken many times from these Benches with great sensitivity and consideration, and I hope that we can work closely together on this issue as we move forward.
I also pay tribute to the work of many noble Lords across your Lordships’ House, including my noble friends Lord Ponsonby of Shulbrede and Lady Thornton. They worked closely with the noble Earl and the then Government throughout the passage of what is now the Victims and Prisoners Act to put in place the legislation required to provide the necessary legal framework to establish the arm’s-length body and to pay compensation with any further undue delays. It would be remiss of me not to mention the noble Baronesses, Lady Brinton, Lady Campbell of Surbiton, Lady Featherstone, Lady Meacher, and Lady Finlay, as well as all other noble Lords for their many years’ work on this matter in order to reach this point.
The work of Sir Brian Langstaff should also be recognised. As the chair of the infected blood inquiry, he has worked comprehensively for the past seven years, not least for the victims and families of the infected blood scan who for far too long were not given a voice. It is critical that we in your Lordships’ House continue to speak about this important issue.
The infected blood inquiry’s report brought to light the enormity of the scandal, the lives that had been shattered and the voices that had been ignored for decades. The inquiry described the infected blood scandal as a collective failing and provided a clear and powerful depiction of its subtle, pervasive and chilling aspects, which must not be forgotten. I pledge that this Government are committed to action and to ensuring that we work across your Lordships’ House to ensure that those who have endured unspeakable injustices finally receive the justice they deserve.
I turn to specific points and questions that noble Lords have raised. I apologise if I do not manage to cover them all. If it is not possible to do so, I will write in detail to noble Lords. The Government recognise that no amount of money will make right the wrongdoings of the infected blood scandal, but they feel that the compensation scheme is a step towards providing recognition for those infected and affected by this tragedy. I note the comments of the noble Lord, Lord Scriven, that this should not be a complicated process, and I will feed this back after this debate on the Statement.
As noted by the noble Earl, Lord Howe, Sir Robert Francis KC recently concluded an engagement exercise on the previous Government’s proposals for the infected blood compensation scheme. The Minister for the Cabinet Office has been engaging with Sir Robert to hear his advice, following his meetings with members of the infected blood community. The Minister is considering this with a view to publishing Sir Robert’s report, and the Government’s position on it, before 24 August.
During the summer, the made affirmative procedure will be followed, and there will be a full debate in your Lordships’ House in due course; I understand that it will take place in September.
In relation to interim payments, it is important that, as well as providing sufficient time to review Sir Robert Francis’s findings, we do not forget that speed, as well as simplicity, is of the essence. More than £1 billion have been paid so far in interim compensation. I am pleased that, last Friday, the Minister for the Cabinet Office announced that applications for interim payments of £100,000 to the estates of the deceased people infected by contaminated blood or blood products and who have not yet been recognised will open in October. The Government will set out further details in due course.
The proposed tariffs for the compensation scheme have been developed using the work of the infected blood inquiry response expert group, which included clinical and legal advisers assisted by social care specialists, and with reference to judicial guidelines. In line with the inquiry’s recommendations, the Government have not been constrained by the practice of the courts in setting compensation rates.
There will be no immediate changes to the infected blood support scheme. Under the current proposals, payments will continue to be made at the same level until 31 March 2025. They will not be deducted from any compensation awards. From 1 April 2025, people who receive infected blood support scheme payments will continue to receive them until such time as their case is assessed by the infected blood compensation authority under the new scheme.
The noble Earl, Lord Howe, asked about support for estates payments. I can reassure him that we are working across government and with the devolved Administrations to ensure that the process for applicants to obtain probate or confirmation is as smooth as possible for them.
The noble Earl rightly raised concerns about making sure that the duty of candour is properly rolled out. The Government will bring forward legislation to place a duty of candour on public servants and authorities to make sure that this kind of behaviour cannot happen again. This will be done through the Hillsborough Bill, which will be a means of putting measures in place to ensure that those working in the public sector will be rightly held to a high standard of candour. Cultures and behaviours also need to change. It is not just about legislation, but this Bill will support this change by bringing about consequences for those who fall short of standards.
I have taken on board what the noble Earl said about how consultations should include those affected, and I will feed this back. I do not have the details of that yet, but I will write to the noble Earl at the earliest opportunity.
I can assure the noble Earl, in response to his specific question, that no one will be worse off. The Cabinet Office is working closely with the Department of Health and Social Care and other relevant departments and organisations to give recommendations for consideration, and I am happy to pick that up at ministerial level as well.
I have already covered the regulation process and the “made affirmative” procedure. I will be brief, because I am mindful of time and the need to move on to Back- Bench questions. The committees and subcommittees will include members of the community. In a recent newsletter, the Infected Blood Compensation Authority announced that it was recruiting a permanent user consultant to help shape its work. This role will be open only to those with lived experience of the infected blood scandal. Finally, I reassure the noble Earl that the NHS support is now in place in England.
I assure noble Lords on all sides of your Lordships’ House that I want to work together closely as we progress this work, as has been the case in recent years—the noble Earl himself worked very closely on this. It is essential that we do this on a cross-party basis, which is the only way that we can face up to the failures of the past and make sure that tragedies on this scale never happen again. This will take leadership and a change of culture to move away from what Sir Brian Langstaff understandably described as “institutional defensiveness”. Moving away from that is absolutely critical.
Baroness Meacher (CB)
My Lords, I want to add bit of urgency to the point about full compensation. The noble Earl, Lord Howe, rightly referred to the urgent need for treatment for the victims of the infected blood scandal. It is ironic that we talk about the urgency of treatment and compensation decades after this happened. Nevertheless, it is good to hear that from the noble Earl, Lord Howe. The Minister referred to interim payments on a number of occasions, but these people do not just need interim payments. They have suffered and suffered for decades, and they need and deserve the full compensation as a matter of absolute urgency. I simply wish to leave that thought with the Minister.
Baroness Twycross (Lab)
I reassure the noble Baroness that the Government are absolutely committed to paying comprehensive compensation to infected and affected victims of the blood scandal. This is such a priority for the Prime Minister that he stated this publicly on his second day in office. I hope the noble Baroness can take some reassurance from that.
Baroness Ritchie of Downpatrick (Lab)
My Lords, I welcome my noble friend to the Front Bench. The Statement says:
“The Cabinet Office is working closely with the Department of Health and Social Care, the devolved Governments and the administrators of the existing infected blood support schemes to establish the process for making interim payments of £100,000 to the estates of deceased people who were infected with contaminated blood or blood products”.
Can my noble friend further elaborate on this issue and say at what stage the devolved Administrations will be ready to make such payments? As others know only too well, both victims and their families have waited a considerable time for due compensation. They also want to know whether support schemes will continue in some format.
Baroness Twycross (Lab)
I thank my noble friend for her question. On the urgency of ensuring that those affected and infected receive compensation, it is difficult to talk about urgency when people have quite clearly waited decades, in some cases, to get justice. A lot of dialogue is going on at official level with the devolved Administrations, and this will be taking place at ministerial level as well. Applications for interim payments will start in October and it is a matter of absolute urgency that that goes smoothly. Those discussions will continue to take place over the summer, in advance of 24 August, when the “made affirmative” procedure will go through. It is vital that those continue to proceed. Applications for payments will open across the piece in October and the compensation scheme will be a priority for this Government. As I said, the Prime Minister made it a priority and reaffirmed this on his second day in office.
Baroness Kramer (LD)
My Lords, the Minister raised the duty of candour as a mechanism to make sure that such horrors are not repeated, but will she take on board that a duty of candour alone is completely insufficient—the noble Earl, Lord Howe, raised this—so long as those who speak out become victims of retaliation? This is almost the norm, rather than the exception, despite the existence of employment tribunals, which are completely unfit for purpose in dealing with these situations. People will not speak out because they are not prepared to martyr their career, their family and their future. So will the Minister please support actions to provide proper protections for whistleblowers? Obviously, I have brought Bills before this House, but can that become a priority? Without that, a duty of candour is ineffective.
Baroness Twycross (Lab)
The duty of candour really matters. I appreciate that people are concerned about making sure that we protect public servants, which is right: we should protect them. But the duty of candour also relates to making sure that we have a culture within all our public services where, when things go wrong, people are able to say so and we do not have cover-up after cover-up. That is about not just whistleblowing but a culture that has protected the establishment and left people vulnerable and unprotected when they have been infected and affected by infected blood and infected blood products in this instance. Time and again when we have public inquiries, we see that people knew but did not speak out—and actually people have not always spoken out initially when there has been a formal public inquiry. So you cannot do that just by having a duty of candour within legislation; it has to be about the culture, which has to respect that, when whistleblowers speak out, they are protected. That is about not just legislation but the culture in which we want to operate our public services across the piece.