Today is the first day of the hearings of the Infected Blood Inquiry. This is a very big deal. Thirty-five years ago, it began to be clear that there was something wrong with blood and plasma products. Much of the plasma in the UK had been bought from the US, which was getting it from prisoners and "skid row." In 1975, a Californian surgeon named J. Garrott Allen wrote to the Blood Products Laboratory, the government organization that imported plasma, and said that the plasma was unsafe. Plasma products such as clotting factors, which are needed by haemophiliacs and people with other bleeding disorders, are only found in tiny quantities in plasma, so to get enough to make a concentrate, you need to pool the plasma of tens of thousands of donors. It only takes one donor (or, actually, a seller) to contaminate the whole supply. From my book:
Yet in 1975 a California surgeon named J. Garrott Allen wrote to the Blood Products Laboratory in England, which had been buying American plasma products for years. Did they know, he inquired, that American plasma was “extraordinarily hazardous” and taken 100 percent from “Skid Row derelicts”? It also contained worrying levels of a new variety of unknown hepatitis, later called non-A, non-B, and finally C, which was more frequently encountered in “the lower socioeconomic groups of paid and prison donors.” The practice of selling blood became so popular with some socioeconomic groups, the press began to call it “ooze for booze.” Allen’s research showed that rates of hepatitis in prisoners and skid row donors were ten times higher than in the general population.23 Drug use, needle sharing, general poor health: all of these were risk factors. But nothing changed. Prisoners and the poor were too good a resource.
The consequences were awful. Here, more than 4,000 haemophiliacs were infected with HIV or hepatitis C or both. More than 2,000 have died (the figure changes constantly because they keep dying). Other people were infected with blood transfusions, and we don't know the extent of that. Nor do we know how many people are living with hepatitis C that they got with their plasma products or blood: hep C often doesn't show symptoms until liver damage is extreme, and there is yet no mass screening for hep C. When doctors at a London hospital did a pilot screening study, as I wrote in Nine Pints, "they found that rates were three times as high as was believed."
Other countries have had robust and comprehensive high-level inquiries. In Canada, the Supreme Court found the Red Cross, which ran the nation's blood supply, guilty of negligence. It was sacked, and the entire system was overhauled. France jailed a former health minister (though two others were acquitted). Japan jailed three officials of the blood supply organization, though for short sentences. Scotland had a government inquiry, the Penrose Inquiry, though it made hardly any recommendations and found no-one was to blame. Ireland had a decent inquiry too. England had the Archer report in 2009, but it was not sanctioned by government, it wasn't a statutory public inquiry, and the government paid its findings no attention.
I was asked yesterday why I wrote about the contaminated blood issue. It has been called the greatest tragedy in the history of NHS. It has been called variously a scandal, a tragedy or a criminal cover-up (by Andy Burnham, in Parliament). I wrote about it because if you know anything about it, you will want to know more, and when you know more you will be baffled and appalled that so little has been done in England to discover why people died, why tainted product continued to be exported around the world from the US (as Krever found in his report), even after corporate officials knew it was unsafe; why medical records and government files are mysteriously missing; why people who were infected, or whose family members were infected, have to beg for washing machines or basic goods from a complicated system of fund payments; why someone in Scotland who was infected is entitled to more money than someone over the border in England.
I salute the campaigners of Tainted Blood, Contaminated Blood Campaign, Factor 8 and many others, because they have had to fight all the way to get this inquiry. This has been a long road and today is the first day of another stretch. A statutory public inquiry is not a trial but it has serious powers (not providing requested documents, for example, can be a criminal offence). NHSBT has already waived its right to legal professional privilege which is a pleasing sign. So far everything I have read of the Infected Blood Inquiry and communications I have had from it have seemed assiduous and thoughtful. I hope that continues: there are serious wrongs to be exposed and righted, even 35 years too late.
Here is an extract from Nine Pints on "the problem with the plasma".