Health Committee, 31 Jan 2006

Meeting date: Tuesday, January 31, 2006

Official Report 278KB pdf

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Hepatitis C

We move on to item 4, which is to consider the evidence that we have received and any follow-up action that members may wish to take. If members are minded to pursue the issue, we can make time available in the committee's forward programme—there are some spaces in the programme. I would ask members to keep that in mind. I invite views on the evidence. The intention is to reach consensus on what we want to do, so I ask members to keep their comments relatively brief.

I was taken with the open, reasonable position that Malcolm Chisholm took back in 2003 when he said that if there was any new evidence, the Executive would call an inquiry. On balance, that was a fair position to take, and it has been maintained by his successor. I was appalled when I heard what I consider to be the brand new evidence that was presented to us this afternoon about the failure to trace those who have been infected by hepatitis C. I was shocked when Andrew MacLeod, on behalf of the minister, said that the Executive does have the records. People are finding themselves with hepatitis C years after the event and no apparent effort is being made to trace others so that we can tell them that they are at risk. As Kate Maclean pointed out, when we have had scares involving dentistry and so on, the automatic reaction has been to trace people. Why has that not happened? I cannot understand it. If new evidence has just been given to us, what other evidence is there? The point is that we do not know.

I am struck by the application of the witnesses; they said that they were not blaming anybody and that they just want to know the truth. What has swayed me quite strongly is not only that appeal, but the fact that we have what I consider to be new evidence. A public inquiry is overdue. The balance is heavily in favour of such an inquiry and I would fully support a call for one. It is such an important issue that we must get to the bottom of it.

I was not around when the previous evidence was taken, but some impressive evidence was given today. Given that the minister said that he would come back to us on a significant number of issues, I would be inclined to defer a decision until we have his response.

My longstanding support for an inquiry is no surprise to anybody, but if I had not already held that view I think that I might have been persuaded by today's evidence alone. For such a long-running issue, the minister was shockingly ill-informed. The civil servants, who must be even closer to the detail of the issue, seemed unable to answer even the most basic questions. To the people listening in the public gallery it must have confirmed more than ever the need for an independent inquiry to consider all aspects of the issue. The minister kept talking about what has happened in the past and about many of the technical aspects of the issue. It is true that some of those aspects have been fixed, but what he did not seem to get was that people are concerned about what is happening now. He did not appear to recognise that that could be part of the scope of an inquiry. The evidence on both sides has not been tested—not contested, as the minister seemed to keep saying—in a judicial context. That needs to happen. I am more persuaded than ever that the issue has to be taken out of this arena and put into an independent arena, where all the evidence can be considered.

What we have heard today concerns two issues: the issue of the public inquiry, which has been under discussion by the committee, off and on, for many years, and the issue of traceability, on which the minister has said that he will come back to us with further information. Before any final decisions are taken by the committee, we should see what that information is.

I agree that we should wait for what the minister has to say when he returns to us. I have always been in favour of an inquiry. Even if I had not been, I would have been after today's evidence. There is a duty of care to the people who have not been traced and a duty of care to the nation. The health service must know who the people are who received blood transfusions and blood products. I am appalled that they have not been traced and re-tested, so that they can get an early diagnosis.

From what has been said, I am not convinced that we have learned lessons and that there would be no delay in diagnosis for patients. What has come out of today's evidence is the fact that patients' notes carried information about them and that blood tests were done on patients without their knowledge—they were told of their diagnosis only at a later date. I am not sure that that has definitely been ruled out.

I am also disturbed by the fact that the procurator fiscal might decide not to go ahead with an investigation. There are other issues that are related not to hepatitis C but to blood-borne infection generally, and the procurator fiscal might not carry out an investigation if he did not know that the death was in any way related. That depends on the clinicians' being completely open with the procurator fiscal. In some cases, patients may not know that they are suffering from an infection; therefore, they would not come into it. It is possible that, through nobody's fault, somebody could die of an illness related to a blood-borne infection and the procurator fiscal would not know about it.

I am for waiting for what the minister has to say, but not much could be said that would push me against my feeling that there needs to be a public inquiry.

I place on record my thanks for the time that you have allowed me, convener, as a non-committee member. I agree with a lot of what has been said so far. It is up to the committee what it chooses to do.

On the issue of waiting for further information, I remind members that this inquiry has been going on for years. Successive ministers have reassured people, on successive occasions, that they have reviewed all the information and judged that a public inquiry is not merited. We have seen today that the minister has not reviewed all the information and is quite badly informed. It was especially striking when he said that hepatitis C was not identified until 1989. Frankly, that is playing politics with health issues. Non-A, non-B hepatitis was identified from the 1970s onwards. It was known as a virus that could be caught from blood products and it was known that patients had it; it just did not get a name until 1989. The fact that the minister did not acknowledge that gives me cause for concern.

I am also concerned that the minister is unable to answer questions about really important issues. Some of those questions concern documents relating to trials compensation that I have obtained from other sources; however, some of the letters about trials compensation to which I refer are among the information that has been released by the Executive. Still, the minister sits there today and says, "I don't know about that." That does not give me confidence that his judgment about the absence of a need for a public inquiry is sound. I think that the case for a public inquiry has been overwhelmingly made. Any more information that could be obtained would be great, but I do not think that it would change that. A public inquiry is long overdue.

I was not a member of our predecessor committee when it considered the issue and I have therefore not sat through all the evidence on the subject. However, I have sat through some of the evidence that this committee has heard. Many questions were raised in today's evidence taking, but it did not reach the conclusion that I thought it would reach.

Before we say that we will go down the road of a public inquiry—

Calling for a public inquiry.

Before we ask for a public inquiry, we should get some answers from the Lord Advocate on the procurator fiscal service and from the minister on traceability, about which I am very concerned. In previous health scares, people were recalled for tests. I do not understand why that was not done in this case, either at the time or subsequently.

We should discuss the issue further. If we call for a public inquiry, we need to be absolutely clear about the remit and scope of such an inquiry. We may not be able to do that today. I understand that some members may not be happy about this suggestion, but we need to hear more evidence. If we have time, the committee—by way of a small group or a whole committee inquiry—should look at the evidence before coming to a decision on whether to call for a public inquiry and the form that such an inquiry should take. I do not want us to rush into anything today. I am concerned about the lack of answers to some of the questions that were put today. I am also concerned about some of the issues that were raised.

I agree with the point that was made on traceability; the issue is vitally important. I also agree with what was said about the Lord Advocate. If other members had not said that, I would have raised the point. We should ask the Lord Advocate for a response to what was said today about the procurator fiscal service.

I am glad that we will wait until another meeting before we decide whether to call for a public inquiry—

We have not decided that yet, Helen.

We are waiting until another meeting before deciding whether or not to call for—

No, I am still hearing views on the matter. After I have heard them, we will decide. Members cannot pre-empt the decision. Do you think that we should wait, Helen?

Yes. Clearly, the resource implications of an inquiry are significant. We only need to look at the cost of the many public inquiries that have been held across the land. Saying that does not diminish in any way the concerns that the members of the Scottish Haemophilia Forum brought before us today, but, as Kate Maclean rightly said, there are other ways of addressing the matter. When Susan Deacon was in post, we addressed the equally serious matter of organ retention.

Over the time that I have been a member of the Health Committee, and during the time of our predecessor committee, I have seen the very practical approach that members have taken to the issue: they achieved what they could over the time. Those members should be congratulated on their work on the subject. Present committee members have also adopted that practical attitude.

Someone said today that decisions are made out of fear, love or compassion. Sometimes they can also be made as a result of political opportunity. We should not go down that road. Some issues concern everyone on this cross-party committee and give us pause for thought. In the 20 or 30 years from the first instance of the problem, our health service has supposedly moved on and is now treating people in a modern way. However, we would have expected it not to have condemned these people but to have sought out, identified and given help and assistance to them. It is a serious concern that that has not happened. We have made a practical response to the issue and we should continue to work on that basis. Our job is to ensure that people get help and assistance and that the practical issues that have been raised, such as those about the fiscal service, are addressed.

A couple of weeks ago, I voted against a public inquiry. I have little faith in them: no public inquiry or fatal accident inquiry that I know of resolved all the issues and gave people closure. It would not resolve the issues in this case. However, the committee can resolve many of the underlying issues, and it is our responsibility to focus on them.

I have heard from everybody around the table. I intend to write to the Lord Advocate to seek clarification on and answers to issues that arose at today's meeting in respect of the Crown Office and Procurator Fiscal Service.

There are outstanding issues that the minister said he would come back on, and we hope to get a speedy response to them. Duncan McNeil is a voice against a public inquiry; five members want to defer a decision on a public inquiry until they have answers from the Lord Advocate and from the minister; only two members want the committee to say today that it will call for a public inquiry. The committee's view is clear—unless members want to take a formal vote—the preponderance of voices says, "Let us wait until we get some of the responses."

Depending on the responses, a number of options might be open to the committee. It may decide to call for a public inquiry. However, it may decide that some of the past issues that a public inquiry would address can no longer be explored but that today's discussions have introduced some new issues that the committee might decide to follow through. Some of the questions about traceability are quite worrying. Whether those questions are a suitable subject for a public inquiry remains to be seen, but they could be viewed as matters for the committee to inquire into.

There are a number of ways forward. However, at this stage, the majority—although not unanimous—view of the committee is that we would prefer to wait for responses from the Lord Advocate and the minister to the outstanding issues that were raised today. The committee wants those responses before it comes to a final decision.

If we are to wait for responses, can you give us a timetable of when we might revisit the issue?

The earliest opportunity would be late February or March after the recess.

There is no point in people reinventing the wheel, so I suggested to the clerk that I make the documents that I have accessed available to everybody.

Thank you. That would be very useful.

Putting them in SPICe would allow any member of the Scottish Parliament to access them.

That might be a good idea.

That would involve cataloguing them all.

I would not want the documents to go to SPICe, only for people to find that they must wait two or three weeks to look at them.

Thank you very much. The next meeting of the committee will be next Tuesday and will begin the formal part of our care inquiry. We will have a round-table session on a number of care issues.

Meeting closed at 16:23.