Contaminated Blood and Blood Products

Chris Stephens Excerpts

Thursday 24th November 2016 Commons Chamber

[Diana Johnson]

My hon. Friend makes that point very well. Later I will compare and contrast the Scottish scheme, which is more generous.

[Chris Stephens (Glasgow South West) (SNP)]

The difference between the two schemes is important because hon. Members representing constituencies across the UK may have one constituent getting compensation under the English scheme and another getting compensation under the Scottish scheme, involving, as is currently the case, different amounts of money and different levels of compensation.

[Diana Johnson]

Yes; the hon. Gentleman makes a very important point. One of the unintended consequences of devolution is that we are ending up with such a mishmash of schemes, and that is of concern for the people affected.

--- Later in debate ---

[Chris Stephens (Glasgow South West) (SNP)]

It is a pleasure to take part in this debate and to follow my hon. Friend the Member for South Down (Ms Ritchie), who has consistently spoken with passion about this issue. I thank the hon. Member for Kingston upon Hull North (Diana Johnson) for securing the debate and for chairing the all-party group on haemophilia and contaminated blood.

I rise in this debate as a Scottish Member representing a Scottish constituency for two reasons. First, I want to speak on behalf of constituents such as Cathy Young, a stage 1 widow and member of the Scottish Infected Blood Forum. Like me, that group wants not only to express solidarity with those in other parts of the UK who find themselves in a different scheme, but to make the reasonable point that Scottish Members may find that they have constituents who are victims of infected blood and are covered by two different schemes, because the infection took place not in Scotland, but elsewhere in the UK. That is an important point. Members from other parts of the UK will find that they have constituents who are part of the Scottish scheme and benefit more as a result. Cathy wrote to me last night to say:

“I think for me personally, being a widow, obviously those still living with the horror of this disaster must be financially looked after, and not with payments that people feel that once again they’re just being fobbed off, but I would like both widows, and the deceased person’s estate, like children or parents of children who have passed away, to be recognised, and not with the insulting payment being offered. Our community deserve and demand the respect that has been denied us, and the justice that is long overdue. I send my total support to all those infected and affected by this disaster.”

Secondly, I want to raise issues relating to the proposed Scottish scheme that require this place to complete some work so that those infected in Scotland can receive their compensation. The Haemophilia Society points out that

“The Scottish scheme is comparatively more generous. The Scottish discretionary support scheme will also be better-administered, with patient involvement in governance; a goal to minimise means-testing and assessments; and a commitment to continue existing ongoing payments and ensure no beneficiary is worse off under the new support arrangements.”

According to analysis, the Department of Health could adopt many aspects of the Scottish scheme and still fall within the allocated budget. The all-party group calls on the Government to adopt those measures, particularly in relation to bereaved partners, and to reverse their plans for appointing a profit-making private administrator for the discretionary scheme. Any additional funds required to support those affected could be found, as the motion states, from the 2013 sale of the Government’s stake in Plasma Resources UK.

There are other differences between the schemes. Annual payments for those with HIV and advanced hepatitis C will be increased in Scotland from £15,000 to £27,000 to reflect average earnings. Those with both HIV and hepatitis C will have their annual payments increased from £30,000 to £37,000 to reflect their additional health needs. When a recipient dies, their spouse or civil partner will continue to receive 75% of their annual payment. Those infected with chronic hepatitis C will receive a £50,000 lump sum, which is an increase on the previous £20,000, meaning that there will be an additional £30,000 for those who have already received the lower payment. A new support and assistance grants scheme will be established in Scotland to administer and provide more flexible grants to cover additional needs. Scottish Government funding for the scheme will be increased from £300,000 a year to £1 million a year. As recommended, the Scottish Government will aim to deliver the new scheme through a single body so that those affected no longer need to apply to more than one body for funding.

However, the timing of the Scottish-wide payment system will depend on both Her Majesty’s Revenue and Customs and the Department of Health. Will the Minister outline what discussions the Department has had with HMRC about passing the relevant tax orders so that payments can be made to those entitled to compensation? They should be able to receive it with the minimum of fuss and should not be liable to tax. That has to happen whichever mechanism is used to make the new payments. To use the existing scheme to make the new payments, all four nations of the UK must agree, but only Scotland is signed up at the moment.

There are some important decisions to be taken before the Scottish scheme is established. They include changes to the threshold for receiving ongoing support, a re-examination of the ability of those with incomplete medical records to apply, an appeals procedure for those who think they should be in the Scottish scheme—that might apply to people resident in Scotland who were infected elsewhere, but want to apply to the Scottish scheme—a procedure for converting ongoing payments into a lump-sum settlement, and consideration of how the new discretionary scheme will operate in practice. The affected community will broadly welcome the replacement of the five trusts with a single scheme administrator, but the news that the new administrator of the proposed English scheme is likely to be a profit-making private company, which was not mentioned in the consultation documents, will be met with considerable concern. The tender process for a new scheme administrator started in September 2016. It was expected that the new administrator would take over in May 2017 following a transition period, but it appears that the deadline is now being pushed forward.

It is of grave concern to many hon. Members that Atos and Capita have attended Department of Health meetings to discuss bidding for the contract. It will be of utmost importance that the new supplier understands the complex needs of scheme beneficiaries and deals with all correspondence sympathetically. We all have concerns that if, as is likely, the successful bidder is a private company, it is not clear how the discretionary aspects of the scheme will be delivered. While the Department will own and publish a set of principles for discretionary support, as well as holding the budget, it will be up to the scheme administrator to consider applications for grants and other support. The Scottish scheme has the alternative option of a scheme administrator with more beneficiary involvement, and the original all-party group report recommended a similar thing. The Scottish discretionary support scheme will be better funded, as its funding is set to more than treble, while the English scheme will see a more modest 25% increase in 2018-19.

Before I conclude, I want to discuss some concerns relating to matters raised by the hon. Member for Worthing West (Sir Peter Bottomley) and health records. People who were infected during this disaster do not have the words “HIV” or “hepatitis C” on their death certificates, which is understandable due to the stigma attached to those conditions at the time. Will the Government or the scheme administrator consider that issue? There are people who were infected whose death certificates say something different, but their medical records will show that infection.

[Sir Peter Bottomley]

The hon. Gentleman makes a very good point. He might be about to put another question to the Minister, but in case he does not, I will. How will the Government try to get to the spouses of people who might have died 25 years ago? Those spouses might not know about this offer, because not everyone is involved in the networks.

[Chris Stephens]

That is very important. It is also up to us, as Members, to raise that issue with our constituents through newsletters and all the rest of it. The hon. Gentleman is right that there are people who lost their partners years ago and do not know about the scheme. I thank him for his intervention and I hope the Minister will consider that point.

There are clear points to address because we must ensure that the compensation is not subject to tax, as that would be ludicrous. We must also deal with the issue of the death certificates. Thank you, Mr Deputy Speaker, for allowing me to speak. I thank all hon. Members who have contributed to this first-class debate.

--- Later in debate ---

[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.

[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.