The scandal that claimed the lives of 3,000 people treated with contaminated blood was sparked by a ‘chilling’ cover-up by the NHS and government, a damning report has found in what Rishi Sunak has declared a ‘day of shame’ .
In the long-awaited conclusion of a five-year public inquiry, Brian Langstaff, who chaired the inquiry, said on Monday that the disaster “could have been largely, but not entirely, avoided” – but successive governments and others in authority “have not done so”. . puts patient safety first.”
He said the death toll was rising weekly among the 30,000 people infected with hepatitis C, HIV or both between the 1970s and early 1990s, either by receiving transfusions during surgeries or by blood plasma products imported from the U.S. to treat hemophiliacs to treat.
The 2,527-page report contains a litany of examples of ignored warnings about what would become the worst treatment disaster in the history of the NHS. Doctors and ministers were informed of the risks, but patients were lied to and infected during tests conducted without their consent or, in the case of children, that of their parents. There were also delays in informing patients of their infections, which in some cases could take years.
“The NHS and successive governments have added to the pain by refusing to accept that anything wrong had been done,” Langstaff said after receiving a standing ovation from more than a thousand victims and victims at the Central Hall in Westminster, London, on Monday. affected people who had gathered to hear the report’s findings.
“Moreover, the government has repeatedly maintained that people were receiving the best available treatment and that testing of blood donations began as soon as the technology was available. And both statements were untrue.”
With the current government under fire in the report for its failure to compensate victims, Rishi Sunak said he would implement last year’s recommendations “at all costs”. He also issued a “heartfelt and unequivocal” apology for the scandal – including for “the loss and destruction of important documents, including ministerial advice and medical records” – on what he called “a day of shame for the British state”.
NHS England chief executive Amanda Pritchard also apologized to those who “put their trust in the care they received from the NHS over many years” and were “severely let down”.
The report offers vindication to campaigners who, after decades and despite denials, have maintained that risks were ignored, lies told and tracks covered.
Langstaff wrote: “The answer to the question ‘was there a cover-up?’ is that there has been. Not in the sense of a handful of people plotting an orchestrated conspiracy to deceive, but in a way that was more subtle, more pervasive, and more chilling in its implications. To save face and costs, much of the truth has been hidden.”
He condemned a culture in which “financial and reputational considerations predominated”.
Among thousands of tragic stories, he described as “unconscionable” the use of children as “objects of research” at Treolar school in Hampshire, where only 30 pupils remain of the 122 who attended the specialist school for people with haemophilia between 1970 and 1987. . .
In response, many of those affected experienced mixed emotions. Andy Evans, 47, chairman of Tainted Blood, who was infected with HIV and hepatitis C as a small child, said it was a “momentous day”, adding: “We have been under attack for generations.”
He added: “When we told people they didn’t believe us. They said this wouldn’t happen in Britain. Today proves that this can happen – and did – in Britain.
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“When you’ve been working towards one day for 40 years, there’s no wrong or right emotion, but for the campaigners who’ve been doing this for so long – relief, absolute relief, will be a dominant emotion. That is certainly the case for me.”
Rosamund Cooper, 50, was diagnosed with von Willebrand disease, a bleeding disorder, when she was eight months old, and discovered she was infected with hepatitis C when she was 19. She said: “We were told it was an accident. We were told… that the decisions made at the time were the best possible.”
The report “shows that that is not the case, and that people covered up things, denied things, hid things from us, which is shameful.”
Langstaff said the risks of hepatitis from blood transfusions or the use of plasma were known before the creation of the NHS in 1948 and that if measures had been taken to reduce these risks, suggested by the World Health Organization in 1952, “it is reasonable to assume that a significant portion of the harm targeted by this investigation could have been prevented.”
Significantly, he found that the risks were sufficiently clear that factor VIII products imported from the US, made using blood plasma from high-risk donors including prisoners and drug addicts, and used to treat haemophilia, were never licensed in 1973 should have been paid for import – and that should not have happened. other similar blood products later in the same decade.
As for AIDS, the report says, by mid-1982 it was clear to “some physicians and some in government” that whatever the cause could be transmissible through blood and blood products. But the ministers continued to give safety guarantees, as did the doctors. Despite the risk, it was decided in July 1983 not to suspend continued imports of commercially produced blood products.
Langstaff said: “The failure of doctors to tell people about the risks of infection from blood or blood products, the failure to tell people about the availability of alternative treatments, the failure to tell them they were being tested for HIV or hepatitis C and sometimes the inability to even immediately tell them that their treatment had infected them with HIV or hepatitis; the inability to explain these devastating diagnoses personally, personally and with feeling – these failures were widespread. They were wrong. They were unethical.”
Reflecting the loss of trust in the state among victims and relatives, Langstaff said he would not consider the investigation until the government has implemented its recommendations or given good reasons not to do so, giving the government a year to respond substantively.