An incomprehensible pain: Key takeaways from the UK's Infected Blood report | contaminated blood scandal

1. The disaster was preventable

The key message of the 2,527-page report is that what is thought to be the NHS's worst care disaster was not an accident and was largely, if not completely, avoidable.

Inquiry chair Brian Langstaff concluded that between 1970 and 1991, patients were deliberately exposed to unacceptable risks of infection, a result of the failure of successive governments, the NHS and the medical community to put patient safety first.

Langstaff, who has been hearing evidence since 2019, wrote that successive governments were primarily responsible for the catalog of systemic, collective and individual failures that gave rise to the infected blood scandal, but that other governments also shared some.

Ministers' refusal to admit failure compounded the suffering of the people, Langstaff writes, resulting in a decades-long fight for the truth. He asked why it took until 2018 for a UK-wide public inquiry to be established.

It was surprising that something like this could happen in the UK and cause such an understandable level of suffering, Langstaff said.

2. Tens of thousands of victims were affected.

It is reported that more than 3,000 people died as a result of this incident. About 1,250 people with bleeding disorders are estimated to be infected with HIV, of whom about 380 were children and an additional 80 to 100 were recipients of blood transfusions.

It is estimated that 3,650 to 6,250 people infected with hepatitis C have bleeding disorders and 26,800 people have received blood transfusions, of which only 2,700 are alive as of 2019. Many of these people are undiagnosed.

Lives have been damaged and destroyed by pain, illness and loss. In the 1980s and 1990s, more families were affected as they cared for infected loved ones, as was the stigma associated with HIV and hepatitis C.

The report focuses specifically on Treloars School, which had a hemophilia center and whose students were used for unethical and flawed research into the use of blood concentrates. Of the 122 students with hemophilia who attended the school between 1970 and 1987, only 30 survived.

3. Hepatitis and HIV risks are known.

It has been well known since the 1930s that blood transfusions can transmit fatal hepatitis. The virus that causes hepatitis C was identified in 1998 but has been evident since at least the mid-1970s. HIV transmission through blood products was established in 1982. This is very well known among government officials responsible for blood product treatment.

Despite this, no decision has been taken to suspend import permits for hazardous concentrates. Since 1973, importing commercial blood products known as factor VIII concentrates produced in the United States and Austria has been found to have a high risk of hepatitis and is less safe than domestic treatments, but domestic supply should have been sufficient. In the mid-1970s, a professor warned that one commercial product was sourced 100% from skid row organics, and the World Health Organization (WHO) called for self-sufficiency.

A bad decision was made in 1983 not to stop imports of commercial blood products, and more could have been done to control their distribution.

The British Blood Service continued to donate blood in British prisons until 1984, despite warnings that it was unsafe.

Increasing the size of the pool for manufacturing factor concentrates is known to significantly increase the risk of viral transmission, but this has still not been done. These concentrates were unnecessarily given to children instead of safer treatments.

Despite the public emergency, universal testing of blood products for HIV and hepatitis C has been delayed. Previous governments falsely claimed that blood tests were quickly introduced.

For example, underfunded research into virus inactivation through heat treatment could have prevented many infections and deaths. Instead, there was an attitude of risk denial because the donor selection process was not sufficiently careful and rigorous, and the public was reassured that there was no conclusive evidence that blood products carried AIDS and that the risk of hepatitis C was minor and insignificant. Despite studies linking it to liver disease.

4. Patient safety was not prioritized.

Doctor culture was prevalent, patients were not informed of risks and alternatives, and many were not even told that they were infected. Once infected, many people were informed in an insensitive and inappropriate way and there were delays in seeking professional care.

Blood products have been used unnecessarily and incorrectly perceived by many clinicians as carrying little or no risk. Blood transfusions were given even when not clinically necessary, for example for postpartum replenishment. In many cases, medical records are destroyed, lost, or incomplete.

5. There was a government cover-up

The absence of a meaningful apology and a culture of cover-up by the NHS and government have further compounded the suffering of victims. Ministers cruelly repeated Margaret Thatcher's comments in 1989 that she had received the best treatment and therefore no compensation was needed.

Langstaff criticized the government's response, saying it had been characterized by a lack of transparency, candor and collective thinking among civil servants and ministers for decades. This was detrimental to the public interest.

He also warned that government decision-making is slow and protracted.

The report confirms that the scandal was covered up by the government to save face and save money, rather than an organized conspiracy. This included the deliberate destruction of relevant documents.

Instead of responding to thousands of HIV and hepatitis infections through investigation, protective layers within the NHS were closed down.

6. Now is the time for compensation and cultural change

The report makes a series of recommendations to the government, the main one being that a compensation system should be put in place now.

We also request that a permanent memorial be erected to honor those affected by the scandal.

Other recommendations target the culture and practices of civil servants, including attitudes to public health risks and the speed of decision-making, and the NHS, including encouraging reporting of concerns and accountability to leaders.

This includes requiring medical education institutions to update physician training. Strengthen your safety culture, including addressing a culture that dismisses patient concerns and is not fully transparent. a UK-wide review of medical safety regulations; auditing medical records; And the defensive culture of civil servants and government came to an end.

Support for people suffering from hepatitis C is also outlined. Anyone who received a blood transfusion before 1996 must be tested for the virus to identify the more than 800 people believed to have unknowingly contracted hepatitis C. People diagnosed with liver damage should have lifelong monitoring tests for liver damage every six months. If you have cirrhosis or fibrosis, you should see a senior doctor. Doctors who give blood transfusions and care for people with hemophilia must take extra steps to ensure safety. There should be a concerted effort to find undiagnosed people, including testing of people who received blood transfusions before 1996.

The government must commit to considering and implementing the recommendations within 12 months or provide sufficient reasons for rejecting them. The report notes that the government has not yet responded to all the recommendations contained in the interim reports published in July 2022 and April 2023. Langstaff said the failure to come up with a compensation plan was a serious failure that replicated the government's mistakes already made. past.

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