Health and Community Care Committee, 21 Jun 2000

Meeting date: Wednesday, June 21, 2000

Official Report 220KB pdf

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Petitions

Members will recall that in response to a petition that we received two weeks ago, we agreed to write to the minister to ask whether the inquiry that she had instigated internally into people who had contracted the hepatitis C infection from contaminated blood products covered only people with haemophilia or whether the scope of the inquiry was broader.

We have received a reply from the minister in which she tells us that the inquiry, the results of which she expects to be published before the recess—a copy will be given to the committee so that we can consider it and decide whether we want to pursue the matter—will cover only haemophilia and the narrow group of people who contracted hepatitis C as a result of the difference between the blood screening programmes in Scotland and England.

Members will remember that for just over a year there were differences between the blood screening programmes in Scotland and England and that the minister set up the internal inquiry to examine them. We are left with the wider issue of people who believe that they have contracted the hepatitis C virus through blood transfusions in other ways.

The committee has to decide what it will do with the petition. Members will recall that Cathy Jamieson spoke to us on behalf of her constituent two weeks ago. We said that we would like to ask the minister to speak to us about the findings of her internal inquiry once they are published. Members may wish to put the wider subject into abeyance until we hear from the minister, or they may wish to make a statement about the matter today. This is our final meeting before the recess, so it will be after the recess before we are able to do anything.

I would like some clarification. The third paragraph of the letter from the Executive says:

"Tragic though these cases are, the Minister is afraid she can see limited value in examining an issue on which we already know the outcome, and for this reason she does not intend to extend further the remit of this exercise."

Is the minister saying that she already knows the outcome of any exercise involving those who underwent routine operations, received blood transfusions and ended up with hepatitis C—that she knows that it would be a foregone conclusion—and that therefore they are not being excluded from this exercise? That is what I am reading into the letter. Compensation is a possibility at the end of the exercise. As I read it, it would appear that the people I have mentioned who have undergone routine operations will not be ruled out of the exercise

I read it the opposite way. We should ask the minister for clarification on that.

I agree. While we accept that there is hepatitis C among those who have haemophilia, it is also present among individuals who—as Mary Scanlon said—have had routine operations. I understand that the petitioner is in that group. Those individuals cannot be left in isolation. There is a problem. This letter is not helpful, because it does not clarify the matter. It keeps rolling together haemophilia and hep C. We accept that there will be people with hep C who are haemophiliacs, but there is a group that contracted hep C during the difficulties with the treatment of blood products. That is what we were trying to tease out from the minister. We should expand our letter and ensure that there is no dubiety in what we are pursuing.

There is ambiguity.

We can make use of the time available to us over the recess to get our own researcher to find further information for the committee about the manner in which people contract hep C and how they believe it is a direct result of national health service interventions.

I wish to ask the minister whether we know exactly when it was established that hepatitis C was a problem. I wonder whether that information was already known and should have been picked up earlier by the Scottish National Blood Transfusion Service. Others suggest that the service may have been ahead of the game, but there are questions surrounding the treatment and examination of blood and whether it was done timeously.

If the blood transfusion service acted as soon as it was known that there might be a problem, it is unlikely that there will be compensation. At least, there can be no compensation as a result of negligence; it can—as the minister says—be viewed only as a tragic occurrence.

We should ask the Scottish National Blood Transfusion Service or Susan Deacon whether the introduction to the report that she has commissioned will include substantial background information on hepatitis C—not just related to factor VIII, but to general transfusions. If the report will do that, we should await it; if it will not, we should consider the possibility of asking one of our number to interview the BTS during the recess to get a report from it so that we can consider this as soon as we come back.

I thank the committee for giving me the opportunity to take part in this discussion. Some of my constituents have approached me on this subject over a number of years—I saw a couple of them on Monday. I am encouraged by what has been said so far. The feeling last year was that this issue was beginning to be opened up and that a broad approach was being taken to the inquiry. My constituents have expressed their concern that the issue is being narrowed down to a more limited remit than that which they had expected last year.

When a number of us met representatives of the Haemophilia Society and others last year, we discussed the Executive's inquiry. We were encouraged by the language the minister used at the time, but the fallback was that there may be an opportunity for the Health and Community Care Committee to consider further some of the background circumstances that have driven the issue.

The sentence in the Executive's letter that Mary Scanlon referred to troubles me enormously because we do not know the answer. I do not think that the investigation will answer the questions that my constituents are concerned about. I certainly hope that there will be output from the minister's inquiry, but I think that there should be further investigation.

There is a danger—I say this with the greatest of respect—in the department looking at its own performance. There is a need for external eyes to examine the circumstances surrounding this matter, because public unease could be tackled by some productive work by the committee.

When several of us met representatives of the Haemophilia Society, they called for a full public inquiry. Their fears were allayed to some extent by comments the minister made to them about what the internal inquiry would involve. We must be aware that the committee has consistently said that we will look at the report that comes out of the internal inquiry, but not from the point of view of just accepting it. At that point, we will probably ask further questions about the findings and hear from the minister. If there are unanswered questions, we will probably have discussions with other bodies. It is critical that we see this as an on-going issue for the committee, based on previous statements that we have made on this matter.

The report is imminent. It seems inevitable that we will have to respond once we have seen what is in it. What struck me about the letter was that the distinction may not be between those who have contracted hepatitis C who are haemophiliacs and those who are not haemophiliacs: the distinction seems to be between those who contracted it between 1985 and 1987 and everybody else, whether they are haemophiliacs or not.

We will find out when we read the report, but from what the letter says it looks as if the report will focus on the factor VIII issue between 1985 and 1987. I read the controversial sentence at the end of the third paragraph to say that we know that lots of people contracted it through blood transfusions before then, but nothing is going to be gained by having an investigation. The issue is whether those people should get compensation. That is not an issue that requires scientific investigation; it is a matter of judgment whether we think people should get compensation when they contracted it through no fault of anybody, because nobody knew at that time that there was such a virus in the blood. In that sense, I do not think that the letter is as controversial as some members are making it out to be.

Does Mary Scanlon want to make a point before she leaves?

I would like to confirm the timetable. If the minister is giving us the report in the last week of term, or whatever we call it—I still think I am a teacher—

I have told you that you are not getting that gold star, Mary; it does not matter how hard you try.

Am I right in saying that a discussion and a visit from the minister on this matter will be on our agenda for the first week we return in September?

It will certainly be on the agenda at the beginning of the new term. We do not have the report yet and this is our final full meeting before the recess. We will not be able to do anything until after the recess, but it will be available to us fairly early on and, as I suggested, we could make use of the time over the recess to get further information. I will write to the minister for further clarification on the points the committee has raised and ask the Scottish Parliament information centre research team to do more background work for us so that we have that in place for when we come back from the recess.

Can I confirm that this is the committee's last full meeting before the recess?

Yes, unless we have statutory instruments to deal with, in which case a certain number of us will have to come in for extra meetings. If you recall, we decided we would use the two other meeting days before the recess for our community care inquiry visits.

We have a duty to consider all the affected categories of patients. You might also consider contacting the Department of Health in London, convener, on this matter. If memory serves me right, and while we are discussing the contaminants in the blood not being known at the time, this matter stems from the importation of contaminated blood from the United States in the mid-1980s. It was known as skid row blood. We have a continuing duty to examine what happens in the UK—some of that blood was sent to Scotland—and to consider compensation.

I would like to clarify something. I am unaware that Scotland has imported blood from outwith the United Kingdom. I think that only in certain instances has blood been brought in from England.

I am not aware of the particular case referred to by Dorothy-Grace.

You are not old enough to remember.

Thank you, Dorothy-Grace.

There was a big scandal at the time.

We could ask for some clarification on that. The research people would be able to tell us where blood products come from. I think that there have been some instances of foreign blood products being used in Scotland in the past.

As is obvious, we will all look at the report. Are you proposing that you, as convener, or Malcolm Chisholm, as deputy convener, will co-ordinate how we proceed over the recess? I am concerned that we might come back from the recess and want to look at the report but want a lot more information. Apart from talking to SPICe, there is the question of whether to talk to somebody during the recess.

I was going to suggest that we ask SPICe for the research, that I write back to the Minister for Health and Community Care seeking further clarification as we have outlined today and that the committee grants me authority to seek, during the recess, any further clarification and information from various bodies that I feel would be useful to colleagues when we return to the matter following publication of the report.

I am not sure whether I have to be appointed as a reporter or whether I can get agreement on that now, from here in the chair. Is it agreed that I proceed as I have just outlined?

Members indicated agreement.

I wish to add another point of information, again from memory. There was a controversy about the Conservative Government of the day not supplying enough money to the Scottish National Blood Transfusion Service, which very much wanted a heat treatment factor VIII centre to be set up. It was set up later, but the service wanted it set up earlier, when it became suspicious.

That should all come out in a SPICe paper following the internal report. It would be the kind of thing that the minister's internal report would pick up on. We will return to this serious matter after the recess.

Item 4 on the agenda is the new system for petitions. Members will recall that, some weeks ago, the committee discussed its responses to petitions and the fact that it gets a large number of them.

I think that we have dealt quite effectively with many of the petitions that have come our way—we have been talking about hepatitis C this morning partly as the result of a petition. The committee has a good record of picking up on the issues presented to the Parliament by members of the public, but we are all aware that the committee has a heavy work load and a broad agenda from which to choose items itself, and must deal with the Executive work load that comes to us.

We have taken a decision on coming up with a more formal system for dealing with petitions and of giving committee members an early warning system of the petitions that are heading to us from the Public Petitions Committee. Do members have any comments on the paper relating to agenda item 4?

I agree with most of what is in the paper, but I am slightly concerned by the last paragraph on page 1. Does it mean that we will consider petitions only every three months? If so, that is very inflexible. We do not know what is in some petitions. They may require to be examined more quickly than that.

I echo that concern. I think it would be better to keep things more flexible. On Stobhill, for example, partly as a result of the good work that Richard Simpson did, we were able to respond to the request for work to be done very quickly—our report was back within the month. The fact that we did not keep the matter on our agenda for two or three months helped to keep up the pressure.

I agree entirely that we need to be flexible and to be seen to be responsive—otherwise, why bother having petitions, as the immediate issue will often have been overtaken? Saying that petitions can afford to wait sends out the wrong message—that there is a lack of concern—but I still think that the fundamental issue, not just for this committee, but for all committees, is to ensure that only appropriate petitions filter through the system. Although there has been some improvement, I am not sure that we have got the process right. There is still a view that anything under the sun can come to the Scottish Parliament Public Petitions Committee. That is not the case. Unless we take a very hard line and say that we will examine only things that are appropriate and that we can legitimately affect, we will be snowed under.

On behalf of the committee, I have written to the convener of the Public Petitions Committee on that point, asking that further sifting be done. Yesterday, the Public Petitions Committee had a discussion about beta interferon. I argued that the Public Petitions Committee should get further clarification of the points being raised by the petitioners before the petition is sent to this committee. I think most, if not all, conveners and members share the view that the Public Petitions Committee could be doing a bit more.

I take on board Hugh Henry's point about responsiveness, but the other point that was made yesterday was that we should be doing everything we can to encourage petitioners to see the Parliament not as a first resort, but as a last resort—once the range of other options that is often available to petitioners, but which they may not have tried, has been investigated. That has not been a problem with many of the petitions that we have seen—people have been quite good—but in other cases, people have seen a newspaper article and put pen to paper.

I am sorry, convener; my comment about responsiveness did not mean that I think we should respond to everything—rather, where appropriate, we need to be seen to respond quickly and urgently. I entirely agree that the Parliament should not only be a last resort, but that it should be used only if appropriate.

I agree with the convener and Hugh Henry. It is evident from the number of petitions that we simply note that there is something wrong with the system. If the system were working properly, we would consider the petitions that come to us in a lot more detail. I hope that the Public Petitions Committee will consider the process over the recess and put in place stricter guidelines on what can be submitted and what can not.

The committee is working on new guidelines. Yesterday, a long, private discussion took place on the matter.

I agree with everything that has been said. It is good that people can petition the Parliament, but we are in grave danger of devaluing the whole system because of knee-jerk responses—someone reads something in a Sunday newspaper and suddenly it becomes a petition.

Richard Simpson had a suggestion about Malcolm Chisholm's point about the final paragraph on page 1 of the report.

We are going to be given the petitions early and we are being asked to comment on whether we should note them for discussion. If we recommend that a petition should be discussed, we should also have the option to say whether the matter is urgent. If we do not say that the petition is urgent, it should automatically go to the quarterly review. If two members think that a matter is urgent, we should treat it as urgent.

That seems a sensible proposal. Are we agreed?

Members indicated agreement.