Hepatitis C
The next item of business is a statement by Nicola Sturgeon on hepatitis C. As always, the cabinet secretary will take questions at the end of her statement, so there should be no interventions.
Almost exactly two years ago, on 18 April 2006, the Scottish Parliament's Health Committee called for a public inquiry into the issue of people who had been infected with hepatitis C through national health service treatment. However, that call was rejected by the previous Administration.
The Scottish National Party manifesto for last year's Scottish Parliament elections promised to right that wrong and to establish an inquiry. I confirm that the Scottish Government will honour that commitment. I am pleased to announce that, under section 28 of the Inquiries Act 2005, there will be a judicially led public inquiry into the transmission of hepatitis C from blood and blood products to NHS patients in Scotland.
Although much of the public debate around this issue has centred on hepatitis C, many people also contracted HIV from NHS treatment with blood and blood products. As it would be very difficult to separate the circumstances in which hepatitis C and HIV were transmitted, I have decided that the inquiry will also investigate the transmission of HIV.
In my statement, I will set out the background to the issue, the reasons for my decision and the timing of my announcement. I will also confirm who will chair the inquiry, the issues that it will examine and what will happen next.
Many people in Scotland have suffered or died as a result of the transmission of hepatitis C and HIV through NHS treatment. Although nothing will ever compensate them or their families for that, they deserve answers to the complex questions that surround their or their loved one's infection with hepatitis C or HIV as a result of NHS treatment with blood and blood products prior to the introduction of a test in 1991.
The transmission of hepatitis C and HIV through blood and blood products is a tragedy that has blighted the lives of many people in Scotland. That is why we are committed to a thorough inquiry to get to the bottom of what happened. We owe—and are determined to provide—an explanation to patients and the public of what took place.
I pay tribute to all those who for many years have campaigned for an inquiry. The haemophilia community, most notably the Scottish haemophilia forum, other patient groups and individuals have worked tirelessly for more than 15 years and in the face of opposition from previous Scottish Administrations to raise awareness of this issue and to keep it on the political agenda. I hope that they feel today that their efforts have at last paid off and that they are now a significant step closer to the answers that they deserve.
I also pay tribute to the Parliament's previous health committees, which, on several occasions since 1999, have considered petitions and heard evidence on the matter. It was, of course, the Health Committee that was instrumental in persuading the then Scottish Executive to agree financial assistance to hepatitis C sufferers through the Skipton Fund, which it had resisted doing for some time. When in opposition, the current Scottish Government supported the hepatitis C ex gratia payment scheme, and I am pleased to report that since its introduction in 2004 the scheme has benefited hundreds of Scottish sufferers to the tune of £14 million.
In announcing a public inquiry, I recognise that the events in question took place many years ago, when knowledge of blood-borne viral infections was much more limited and the science involved was not as advanced as it is today. However, records show that, at the time, there were indications of an unidentified virus affecting blood supplies, and there was a scientific debate about its importance and the precautions that should be taken. One of the inquiry's important roles will be to examine whether, in light of the epidemiological and scientific knowledge available at the time, all that could be done to protect the public was done.
I also recognise that many key documents have been released into the public domain and that there have been a number of previous inquiries and investigations into the issue, including the look-back exercise that was undertaken between 1995 and 1997 and the investigation that was carried out in 2000 into the introduction of heat treatment for blood and blood products. Although those inquiries provided valuable information and advice, they were carried out by Government and therefore lacked independence. In other words, we have not yet had an investigation with the credibility and authority of a full Scottish public inquiry.
That is why, on 16 August last year, at a meeting with representatives of the haemophilia community, I confirmed that the Scottish Government would honour our commitment to hold an inquiry. At that time, it was my intention to await publication of the report of the private independent inquiry in England, which is being conducted by Lord Archer of Sandwell QC. I understand that Lord Archer is in the final stages of completing his report, and that it will be published early in the summer.
However, on 5 February this year, Lord Mackay of Drumadoon published his opinion that the decision of the former Lord Advocate not to hold a fatal accident inquiry into the deaths of the Rev David Black and Mrs Eileen O'Hara was incompatible with article 2 of the European convention on human rights. Lord Mackay also held that both the Lord Advocate and Scottish ministers had statutory powers under which they could set up public inquiries into the deaths of the Rev David Black and Mrs O'Hara, and that such inquiries would satisfy the convention rights of the deceased.
Following careful discussion, the Lord Advocate, who is the head of the death investigation system in Scotland, and I decided not to appeal against Lord Mackay's determination. We also decided that progress towards establishing an inquiry need not await the outcome of the Archer inquiry, and concluded that we should proceed to hold a Scottish public inquiry under section 28 of the Inquiries Act 2005.
I am pleased to announce that the right hon Lady Cosgrove has been appointed to act as chair of the inquiry. We are privileged to have a person of Lady Cosgrove's calibre to conduct the inquiry. A distinguished former judge and sheriff, she will bring her wealth of knowledge and experience to the task, and I am sure that I speak for the whole Parliament when I express my gratitude to her for agreeing to undertake this important review.
I can confirm that there will be no other appointments to the inquiry panel. The chair will have a critical and pivotal role in determining the framework of the inquiry, which will be inquisitorial rather than adversarial. The inquiry will have the capacity and resources to carry forward a thorough investigation of the issues.
Let me turn to the issues that will be examined by the inquiry. The final terms of reference will, of course, be announced in due course, following further discussions and agreement with Lady Cosgrove. However, I can confirm that the inquiry will have a remit to investigate the deaths of the Rev David Black and Mrs Eileen O'Hara, and will address the terms of paragraph 125 of Lord Mackay's judgment, which stated:
"any practical and effective investigations of the facts, of the nature required by Article 2, must be capable of addressing when each Mrs O'Hara and Rev Black became infected with the Hepatitis C virus and whether any steps could have been taken by the Scottish National Blood Transfusion Service or by other individuals and public authorities involved in the NHS in Scotland that might have prevented such infection occurring".
The inquiry's terms of reference will ensure that the inquiry is compliant with article 2 of the convention in relation to those deaths and any other deaths that have occurred as a result of the deceased having become infected by the hepatitis C virus, in relation to which, given the particular facts and circumstances surrounding those deaths, an article 2 compliant inquiry should be held. In addition, the terms of reference will allow for an in-depth inquiry into the circumstances of the transmission of hepatitis C and HIV from blood and blood products that were used in NHS treatment, and the consequences of the transmission of each of those viruses for the patients affected.
Parliament should, of course, be aware that, under the terms of the Inquiries Act 2005, provision is made for the remit of the inquiry to be adapted or changed as the inquiry progresses, should that prove to be necessary and appropriate.
As I said, I acknowledge that considerable information about these matters is already in the public domain. The job of the inquiry will be to scrutinise that evidence methodically in an effort to establish the facts in what is an extremely complex issue with numerous strands. For example, the inquiry may choose to consider the sources of blood and blood products used by the NHS in Scotland at the time; the demand for blood products, including factor VIII for haemophiliacs, and the steps taken to achieve self-sufficiency in Scotland; the introduction of heat treatment for blood and blood products and whether that could have taken place earlier than it did; the introduction of effective screening of blood donations for the hepatitis C and HIV viruses and whether relevant tests were put in place as quickly as possible; and the Scottish National Blood Transfusion Service's practices at the time.
It is important to emphasise that those are only examples of what the inquiry might consider and that there will be many difficult matters to consider. It will be for Lady Cosgrove to develop the shape of the inquiry when the terms of reference have been agreed. However, there is no doubt that the people affected and their families deserve nothing less than answers to those questions. If those people are to achieve any sort of closure, we need to get to the bottom of what was without doubt one of the most tragic episodes in NHS Scotland in the provision of treatment with blood and blood products.
The Scottish Government will take steps to release all relevant papers to the inquiry team as quickly as possible. I am sure that all members appreciate that the inquiry will consider a complex set of issues and events that took place a long time ago and will therefore need time to gather and absorb background papers before it starts to take evidence.
In the meantime, officials are taking steps to put in place an appropriately resourced inquiry team, to locate appropriate premises and to secure information technology support. Although a location has yet to be identified and decided on, we will ensure that the venue is fully accessible by public transport and for people with restricted mobility. We will also, of course, provide appropriate access to information to people who might give evidence to the inquiry in due course.
I hope that members of all parties will agree that this announcement is a fitting response to the concerns of the people who campaigned long and hard for many years for an effective public inquiry into the issues. No one—absolutely no one—can undo the pain and suffering of the people who were affected. However, those individuals and their families have a right to a deeper explanation of how hepatitis C and HIV came to be transmitted through NHS treatment in Scotland. They also have a right to an assurance that lessons for the future have been learned. I hope that the inquiry that I have announced will provide both explanation and assurance, and I commend this statement to the Parliament.
The cabinet secretary will take questions on the issues raised in her statement. Around 30 minutes are available for questions, after which we will move to the next item of business.
I thank the cabinet secretary for the advance copy of her statement and join her—as I am sure that all members do—in expressing deep regret to the people who contracted hepatitis C and other diseases via contaminated products. I very much welcome her statement and I agree that Lady Cosgrove's agreement to undertake the inquiry is extremely welcome. We should thank Lady Cosgrove.
The cabinet secretary said that she is aware that Lord Archer is due to report the findings of his independent inquiry in the next month or so. In an answer to a parliamentary question in November, the Government said that it would wait until that report was published before it determined the scope of and legal framework for the inquiry. That position has changed.
The cabinet secretary accepted that many reports have been produced and much evidence will be available to Lady Cosgrove. She gave illustrations of matters that might be in the inquiry's remit, but will she provide the Parliament with clarity on the inquiry's boundaries and scope? When will the remit be fully clarified?
Will the cabinet secretary provide further justification of her decision to include HIV in the inquiry? Given that other conditions, such as Creutzfeldt-Jakob disease, are associated with contaminated products, why will just HIV and not other conditions be included? Indeed, why is HIV included, given the specific nature of the hepatitis C issue, because of the nature of the non-A, non-B hepatitis that was originally identified?
The cabinet secretary has indicated that the inquiry must investigate the circumstances of the deaths of the Rev David Black and Eileen O'Hara, and that it should review any related deaths. How will those related deaths be determined? How many such deaths are involved? I assume that HIV deaths, as well as hepatitis C deaths, will be included in that. Can the cabinet secretary confirm that? How much has she budgeted for the inquiry?
I am sure that we all hope that this inquiry, together with the Archer inquiry, will give some closure to affected individuals and their families, and that it will also conclude the issue for the Scottish National Blood Transfusion Service. With all the evidence that is out there, we might not get all the answers that we want, and we should be sanguine about that.
I thank Richard Simpson for his remarks. I pay tribute to the contribution that he made on the issue in the first session of Parliament, on the Health and Community Care Committee. I said in my statement that previous Administrations had turned down calls for an inquiry. Although that is correct, some Labour members were honourable exceptions and contributed to the debate. I count Richard Simpson among them.
I will run through the various points that Richard Simpson raised, starting with the question about cost. It is important to have a robust and thorough inquiry; it is also important to keep costs to a minimum. As Richard Simpson is aware, we have set aside £3 million over the course of the comprehensive spending review period to meet our manifesto commitment. The terms of reference and the conduct of the inquiry, which Lady Cosgrove will be involved in determining, will have an impact on its final cost, and I undertake to keep Parliament fully informed about that. Richard Simpson might also be aware that the Inquiries Act 2005 contains a specific obligation on the chair of an inquiry to keep costs as low as possible. I assure him that close attention will be paid to that.
Richard Simpson asked about the clarity of the inquiry's remit. I assure him that the remit will be finalised over the next few weeks, in discussion with Lady Cosgrove. When the remit is finalised, I will publish it and ensure that members are notified. Richard Simpson asked about the Archer inquiry, the other inquiries that have taken place on the matter and the wealth of information that exists. All that information will be available to Lady Cosgrove.
As I said in my statement, it had been my intention to await the publication of the Archer report. The Lord Mackay judgment somewhat changed the circumstances and we have therefore decided no longer to do that; however, the report will be available to Lady Cosgrove, along with all the other information at her disposal. She will no doubt decide what weight to give that report and how much input it should have into her inquiry.
Richard Simpson asked about the specific part of the inquiry's remit that will ensure that the deaths of the Rev David Black and Mrs O'Hara are investigated and ensure ECHR article 2 compliance. He is right to emphasise my statement's reference to any other death that might fall into that category. Ultimately, it will be for Lady Cosgrove to determine whether there are other specific deaths that should be investigated in that way. I understand that a very small number of other deaths have been notified, and that not all of them might have a causal connection with hepatitis C. Clearly, however, Lady Cosgrove will require to give attention to that matter.
I thank the health secretary for the copy of her statement. The Conservatives, too, acknowledge that no one can undo the pain and suffering of the individuals and families concerned. With that thought in the background, we welcome the inquiry to investigate thoroughly all the facts, and indeed the allegations, surrounding the management of contaminated blood products, especially as the issue has been on the Parliament's agenda since 1999. We fully welcome the appointment of Lady Cosgrove to take up the remit.
I wish to ask about the inquisitorial terms of reference and remit of the inquiry, which have still to be agreed between the Government and Lady Cosgrove. If a substantial amount of evidence is forthcoming in relation to compensation payments, will the Government revisit the matter of compensation to victims, given that, as the health secretary has said, the remit can change as the inquiry progresses? Is there a timescale for concluding the inquiry?
I pay tribute to Conservative members, who, like SNP members, have campaigned for an inquiry for some time.
The inquiry is not a court of law and will not be able to award compensation to anyone who has been affected. The Skipton Fund has been established for some years. A large number of hepatitis C sufferers have received ex gratia payments through the fund, to a total of about £14 million. It is not the purpose of the inquiry to change those arrangements in any way. It would be inappropriate for me to pre-empt the findings of the inquiry. Issues that are thrown up by the inquiry, whether in this area or others, may be for the Scottish Government to consider, but I stress that the financial arrangements have been catered for through the Skipton Fund.
At this stage, it is not possible to put a timescale on the inquiry. Once Lady Cosgrove has all the papers and has had the opportunity to study them, she will no doubt be able to say more about what she considers to be an appropriate length for the inquiry. For understandable reasons, there is likely to be a reasonably long lead-in time for Lady Cosgrove and her supporting staff in the inquiry to absorb and properly analyse the papers. That is why I do not anticipate oral evidence sessions starting much before the end of this year. However, Lady Cosgrove will be able to give more information on that as she becomes more familiar with the background and circumstances of the inquiry.
I, too, thank the cabinet secretary for the copy of her statement. I apologise for Ross Finnie's absence—he is unwell, but we look forward to his return to our throng shortly.
Ross Finnie is firmly wedded to the principle that we must await the outcome of the Archer inquiry before we embark on our own inquiry. I seek reassurance from the cabinet secretary that the conclusions and recommendations of the Archer report will be fed into Lady Cosgrove's work, and that there will be sufficient flexibility in her inquiry to incorporate those findings, and to make any necessary changes.
I accept that towards the end of the statement, the cabinet secretary was giving us examples of areas of work that the inquiry may wish to consider, such as the source of blood and blood products. However, to a layman that may look a little prescriptive. I would welcome the cabinet secretary's reassurance that, notwithstanding the list of possible items of work, Lady Cosgrove, whose presence we welcome in the inquiry, will have absolute flexibility to take her inquiry in what she considers to be the best direction.
I assure Jamie Stone that Lady Cosgrove will be very much the master of the proceedings. I think that I made it clear in my statement that it will be for her first to agree with ministers the terms of reference of the inquiry, and then to determine its shape and conduct. It is right and proper that that is the case.
Jamie Stone's other point, which has been touched on by others, was the timing of my announcement vis-à-vis the Archer inquiry. I have said previously that it was always my intention to await the outcome of that inquiry. Lord Mackay's judgment, which was issued in February this year, somewhat changed the picture. For those who have not read Lord Mackay's judgment, he said that the action of the former Lord Advocate in refusing a fatal accident inquiry was incompatible with article 2 of the ECHR. He did not make a similar pronouncement on the actions of former ministers to refuse a public inquiry, because he was aware of the commitment of the new Government. However, in terms of that judgment, there was an obligation on Scottish ministers to return to court in fairly short order to outline our plans. That is why I am making the statement today.
I assure Jamie Stone, as I have assured other members, that Lady Cosgrove will have full access to the Archer inquiry. When the report is published, which we think will happen early in the summer, it will be a public document. It will be for Lady Cosgrove to decide what weight she gives to that report, as it will be for her to decide what weight she gives to any written evidence before her.
We come to back-bench questions, which will—as always—need to be slightly more succinct than the front-bench questions that have preceded them, if we are to get through them all.
In so far as there can ever be good news in relation to such matters, this is certainly a good news day. We are dealing with unfinished business. Back in November 1999, I lodged a motion calling for exactly what has been announced today. The motion was signed by 71 members from across the parties.
Can the minister assure us that, as part of the inquiry, we will be able to draw a line under the matter and restore a high degree of confidence in the important Scottish National Blood Transfusion Service?
My next question follows on from Richard Simpson's question about other blood-borne viruses that cause debilitating and lengthy suffering for patients, such as CJD—which inevitably ends in death—and cytomegalovirus. Will the minister invite Lady Cosgrove to consider as well as hepatitis C and HIV all debilitating illnesses that are transmitted by blood-borne viruses?
I acknowledge Brian Adam's long track record on the issue. He was perhaps the first member to raise the issue, way back in 1999.
It is important that I say, as Cabinet Secretary for Health and Wellbeing, that I have confidence in the Scottish National Blood Transfusion Service. We are dealing with events that happened a considerable time ago. It is important, for those who have been affected and for those who were involved professionally at the time, that there is an independent examination of the issues and that answers are found, where possible. There is no issue in respect of a lack of confidence in the current work of the SNBTS.
I will now respond to Brian Adam's second question. I apologise to Richard Simpson, because he also raised the issue of other blood-borne viruses and I omitted to answer that question when I replied to him.
The issue is a difficult one and I will always consider carefully points that are made by my friend and colleague Brian Adam. As I have said, the final terms of reference will be agreed with Lady Cosgrove. However, it is important to make it clear that we intend at this stage to make the terms of reference specific to hepatitis C and HIV transmission. The circumstances and timelines surrounding HIV and hepatitis C are very similar—it is arguable that they are indistinguishable—which is not the case for other viruses. For that reason, it is important that we allow the inquiry to focus on those two diseases. That in itself will lead to a complex investigation, so I am not minded to extend the terms of reference, although all such issues will be matters for discussion with Lady Cosgrove.
I, too, thank the cabinet secretary for advance notice of her statement. I acknowledge the experience and the pain and suffering—which has been referred to—of those who have been infected with hepatitis C and HIV. That acknowledgement has always been important to this Parliament.
The cabinet secretary referred in her statement to the Skipton Fund. She is aware of the previous Executive's introduction of the hepatitis C action plan, the first phase of which is due to end in August. I specifically and succinctly ask the cabinet secretary the following questions. Can she assure us that the resources for the second phase of the hepatitis C action plan will not be used to fund the public inquiry and will be protected for those purposes? In which part of the health budget are the funds for the action plan located? From which budget will the funding for the public inquiry be drawn?
l thank Margaret Curran for her questions and I assure her that money will not be taken from the hepatitis C action plan to fund the inquiry. If Margaret Curran wants to look at the budget she will see the distinct entries for both elements. It is important that we do not send allegations that have no substance haring around the chamber.
I assure Margaret Curran that we are committed to the hepatitis C action plan. The Minister for Public Health, Shona Robison, will make a statement to Parliament soon, subject to the agreement of the Parliamentary Bureau, on the next phase of the action plan.
It is right to examine some of the historic issues around the transmission through NHS treatment of hepatitis C and HIV, but it is also essential that we remain focused on more current matters. There is still a big issue in respect of non-diagnosis of hepatitis C in many people in Scotland. We need to improve diagnosis; when we do so, we need to ensure that the support services are available for people with hepatitis C. Shona Robison will cover our plans in that regard in the coming weeks.
I pay tribute to Andy Gunn who stood out in all weathers in the first session of Parliament, to Philip Dolan and to my constituent, Robert Mackie, who all campaigned tirelessly for this inquiry.
It is my understanding that those who had been told they were infected with hepatitis C were not made aware for a considerable period that they might also have been exposed to HIV. It would be a welcome extension of the inquiry into HIV if two issues might be examined by Lady Cosgrove, who I accept is mistress of the proceedings. Can she examine how soon it was communicated to those who were infected with hepatitis C that they might also have contracted HIV, and also whether partners—past and present—of those who were affected can give evidence on the possibility that they themselves might have contracted HIV through having been exposed to it?
I thank Christine Grahame for her question. I assure her that those are matters for Lady Cosgrove and are very much issues that she may wish to consider in the course of the inquiry. Clearly, among the big issues is the pain and suffering that was caused by the fact that many people who contracted hepatitis C were not at the time advised of that, and that some who contracted it were advised of it but were not advised that they had also contracted HIV. We have to factor into our thinking the fact that medical practices and culture were different then. Nevertheless, there is no doubt that that is a source of great anxiety and concern to those who are affected. The look-back exercise to which I referred in my statement, which took place between 1995 and 1997, was intended to ensure that those who may have been infected with hepatitis C in previous years were identified and informed. That will have gone a long way towards ensuring that that is the case, although there is no guarantee that the exercise was comprehensively successful. Those issues will, I hope, be aired in the inquiry.
I think it was Richard Simpson who said earlier that there is no guarantee that people will get the answers they are looking for—of course, that is the case with any inquiry. In my experience of speaking to people who have been affected—Philip Dolan is one of my constituents—what they desperately want is to know that the issues have been properly examined—rigorously, robustly and independently. They also want to know that there can no longer be any suspicion—justified or not—that things have been swept under the carpet and kept from them. I hope that the inquiry achieves that, at the very least.
I echo the welcome of other members for the statement and the inquiry. The cabinet secretary will recall that in the course of the previous session's Health Committee's inquiry we found that records affecting many individuals had disappeared for a variety of reasons. What thought has she given to that important factor? Is it known whether those missing records are pivotal? What bearing might that have on the inquiry's deliberations? Will the minister encourage the inquiry to pay particular attention to that matter? If there is any question that victims have been left out as a consequence of the loss of their records, it would raise a variety of issues, especially in respect of compensation, if it is an outcome of the inquiry. Has the cabinet secretary anticipated whether there will be such a demand for compensation from the Government and considered what the costs might be?
Helen Eadie—for reasons that are, perhaps, understandable—is tempting me on to ground that would involve my pre-empting the outcome of the inquiry. I hope that all members accept that it would be inappropriate for me to do so. However, she raises an important issue, which Lady Cosgrove might well want to consider during the course of the inquiry, involving concern about the possibility that medical records have been lost or withheld. I should say that there is no direct evidence that medical records have been deliberately withheld or destroyed, although there have been difficulties in accessing medical records in some cases. Clearly, I am not in a position to comment on the rights and wrongs of that, but it is one of the reasons why I believe an inquiry is important.
It was as a result of evidence that was given to the Health Committee on 31 January 2006 that I became convinced that a public inquiry was the right thing to do. Accordingly, I very much welcome today's statement.
Can the minister confirm that everyone who gave evidence to the Health Committee will be able to give evidence to the public inquiry and will be given any help or assistance that they require in order for them to do so?
Again—I hope that members will appreciate why I am answering questions in this way so often—it is for Lady Cosgrove to determine the shape and conduct of the inquiry, which means that it is for Lady Cosgrove to determine who is asked to give evidence.
I hope that Mike Rumbles will take what I am about to say as a sincere comment. Having campaigned throughout the life of the Parliament for a public inquiry, and having had the opportunity to announce an inquiry today, I want to ensure that the inquiry is thorough and that everyone who feels that they have something to contribute gets the opportunity to do so.
Mike Rumbles will be aware that, under section 40 of the Inquiries Act 2005, the chair of the inquiry can award expenses to anyone who is asked to contribute to the inquiry. That would be the route by which people would be given the kind of assistance to which Mr Rumbles referred.
I welcome the statement and am pleased that this Government is doing the right thing, just as it is doing the right thing in relation to pleural plaques, as the Cabinet Secretary for Justice indicated earlier this session.
Can the cabinet secretary provide some guidance to people who are currently involved in legal action concerning hepatitis C, in particular with regard to how they should proceed from this point?
Stuart McMillan is absolutely right to point out that the Government has been determined to do the right thing by people who have been affected by HIV and hepatitis C.
It is not for me to give legal advice. People who are involved in legal action or are contemplating legal action will have legal advisers. It is right that that is the source of any legal advice that they take.
I, too, welcome the statement. What will be the role and involvement of the Scottish haemophilia forum in the inquiry? How will people who are affected by the issues that are covered by the inquiry be kept up to date with its progress? How will their views and experiences be heard and taken into account?
I paid tribute to the Scottish haemophilia forum in my statement. It has been instrumental in getting us to the point that we have reached today. There is no doubt in my mind that it has a big contribution to make to the inquiry, or that it will do so, although the comments that I have made previously about Lady Cosgrove's role must be made again in that regard: I hope to ensure that, in the course of finalising the terms of reference, the views of organisations such as the forum are taken into account.
Rhoda Grant raised a good point about keeping people fully informed during the course of the inquiry. These days, the internet is but one way in which that can be done. We will discuss that with Lady Cosgrove as we develop the overall shape of the inquiry.
My question is similar to Helen Eadie's. Will the inquiry be able to secure, and act on, information on people who might not know that they are infected?
Under the Inquiries Act 2005, the chair of the inquiry has wide-ranging powers to ensure that the inquiry has access to the information and evidence that it needs in order to examine the issues properly. I therefore expect Lady Cosgrove to make her own assessment of the kind of information that she needs and to ensure that everyone who has a contribution to make to the inquiry gets the opportunity to make it.