Hepatitis C victims need to know the full truth

IT IS now two years and three months since the then Minister for Health, Brendan Howlin, commissioned an independent expert group, under the chairmanship of Dr, Miriam Hederman O'Brien, to investigate what is arguably the worst scandal in the history of the State. The infection of hundreds of women with a" life threatening illness, hepatitis C, by contaminated blood supplied by the Blood Transfusion Service Board (BTSB) is the only known case in" which negligence on the part of a State institution has led, and will continue to lead, to direct loss of life. Yet, after 27 months, we still do not know the full truth about what happened and why.

What happened in this case, in my view, is worse than the beef scandal, worse than the Greencore and Telecom scandals, worse even than the Brendan Smyth affair. In France, a similar scandal involving the HIV virus instead of hepatitis C led to the fall of very senior politicians and to a number of prosecutions resulting in long prison sentences. Here, yet again this week, we had a Dail debate that left critical questions unanswered and the victims in the dark.

What those victims need to know, not just as a matter of general curiosity but as the key aspect of their claims for compensation, is this. When did the BTSB know that a woman whose blood was used to manufacture the anti-D product administered to them had infectious hepatitis? From documents submitted to the High Court it appears that the BTSB knew all along that the woman whose blood had been used to make anti-D in 1976 "had been clinically diagnosed as suffering from infective hepatitis". However, not only does this information not appear in the report of the expert group, but it is clear from that report that the BTSB claimed it believed at the time that the woman's jaundice was caused by environmental factors and not therefore by infectious hepatitis.

In April, I wrote here that "it is clear that the expert group" did not know "that the BTSB was aware that the woman involved had been diagnosed as having infectious hepatitis", and I asked why and how was critical information withheld from the expert advisory group? I pointed out that a Dail reply on these issues from the Minister of State at the Department of Health, Brian O'Shea, was hopelessly confused and inadequate.

Subsequently, the chief executive of the BTSB, Liam Dunbar, admitted that the file showing that the donor had been diagnosed as suffering from infective hepatitis had not been shown to the group. The least that should follow such an admission is a full and frank explanation of what happened. That explanation should have come from the Minister for Health, Michael Noonan.

MICHAEL Noonan wrote to me last week, enclosing a letter written by Dr Hederman O'Brien to the Dail select committee on social affairs which would, he said, "clarify for you some of the issues you raised in your article".

Dr Hederman O'Brien's letter does nothing of the sort. All it says is that she has not become aware of any information that would "contradict a conclusion" or "invalidate a recommendation" of her report. This might appear to be a statement of some significance in the context, but it isn't. Since the report concluded that the BTSB should not have used blood from the woman whatever the cause of her jaundice, the new information does not contradict that conclusion or invalidate the recommendations based on it.

The issues raised by the new information about culpability and compensation are outside the terms of reference of the expert group, and Dr Hederman O'Brien makes it plain that she will not comment on them. "If a member of our group were to encroach on the domain of the courts where litigation is concerned or to purport to act after our mandate has ceased, it would jeopardise not only our own report but public confidence in any future group commissioned to enquire into any particular issue." The group cannot, she says answer questions which should be directed elsewhere".

This letter from Dr Hederman O'Brien is as might be expected from someone of her integrity, scrupulous and rigorous, but it says nothing at all about the questions I raised. She says the expert group asked for all relevant documents from the BTSB, not whether she is now satisfied that it received them. And, in a letter that is notable for the care with which words are chosen, she states that the group outlined in its report the events as disclosed to us.

THE problem is not with Dr Hederman O'Brien but with Michael Noonan. As an answer to very serious questions about an appalling public scandal, he points to a letter which says that those questions "should be directed elsewhere". He hopes that a letter from someone who is, from the highest motives, ate great pains to stay away from the issues under scrutiny will "clarify" those very issues. He fails to take responsibility for providing basic information about the fact that the public health system has caused life threatening and irreparable harm to many hundreds of women. He refuses to do anything to restore public confidence in the system for which he is answerable.

And worse than any of this, he is insisting that the victims of this scandal must apply to the tribunal established to compensate them before next Monday. If they do so, their cases will be judged in the absence of critical information about the actions of the BTSB.

If they accept awards made by the tribunal, they will be required to "agree to waive any right of action which the claimant may otherwise have had against any party arising out of the circumstances of the claimant's claim and to discontinue any other proceedings instituted by the claimant". What this means in English is that if a woman accepts an award from the tribunal, the shutters will come down on all further claims against the individuals and institutions responsible for her illness.

The facts that emerge from the High Court case against the BTSB, currently set for October, will not be taken into account.

And should the woman reject the award, she faces the stark choice of taking her chances in the High Court.

It is just about conceivable that the fact that the vast majority of the victims are women has nothing to do with this state of affairs.

But I wouldn't like to bet on it. In the same week last year that the tribunal was established, a priest made unsubstantiated claims about the deliberate infection with HIV of perhaps five men in the Dungarvan region by a young woman. That story drove the media, not just in Ireland but around the world, wild with excitement. Yet the infection with a similarly incurable virus of as many as 1,800 people, most of them women, through the wilful recklessness of a State institution, is not nearly so exciting. If it were, even a Minister with Michael Noonan's skills might find it harder to ignore it than he now does.