Infected Blood Inquiry

Lord Scriven Excerpts

Tuesday 30th July 2024 Lords Chamber

[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.