Limerick East): I move:
That Dáil Éireann:
Bearing in mind
(1) The serious public concern about the circumstances surrounding the contamination of blood and blood products and the consequences for the health of a significant number of people.
(2) The report of the Expert Group which was published in April 1995
(3) The fact that further documents, testimony or other information, not available to the Expert Group, may now be available relevant to some or all of the matters following;
resolves that it is expedient that a tribunal be established, under the Tribunals of Inquiry (Evidence) Act, 1921, as adapted by or under subsequent enactments, and the Tribunals of Inquiry (Evidence) (Amendment) Act, 1979, to inquire urgently into and report and make such findings and recommendations as it sees fit in relation to the following definite matters of public importance:
1. The circumstances in which anti-D, manufactured by the Blood Transfusion Service Board (BTSB), was infected with what is now known as hepatitis C and the implications thereof, including the consequences for the blood supply and other blood products.
2. The circumstances in which the BTSB first became aware that anti-D, manufactured by the BTSB, had become, or might have become, infected with what is now known as hepatitis C.
3. The implications of the discovery at 2. above, the action taken by the BTSB in response to the discovery and the adequacy or otherwise of such action including the consequences for the blood supply and other blood products.
4. The response of the BTSB to a letter of 16 December 1991 from the Middlesex Hospital, London in relation to human immunoglobulin-anti-D and the adequacy of such response including the consequences for the blood supply and blood products.
5. Whether the National Drugs Advisory Board in carrying out its functions in advising on the grant of a manufacturing licence for anti-D under the Medical Preparations (Licensing of Manufacture) Regulations, 1974 and in advising on the grant of product authorisations under the European Communities (Proprietary Medical Products) Regulations, 1975 carried out its functions properly.
6. Whether supervision of the Blood Transfusion Service Board and the National Drugs Advisory Board, in respect of the matters referred to in paragraphs 1-5 above, was adequate and appropriate in the light of
(i) The functional and statutory responsibilities of the Minister for Health, the Department of Health and the boards.
(ii) Any other relevant circumstance.
7. Whether anti-D was a therapeutic substance for the purposes of the Therapeutic Substances Act, 1932 and the regulations made pursuant to it and whether the grant of a manufacturer's licence during the years 1970-1984 would have been appropriate and could have prevented the infection of human immunoglobulin-anti-D with hepatitis C.
8. The relevance to the foregoing of any further documents, testimony or information not available to the Expert Group, which became available subsequent to the completion of the group's report.
9. The questions raised by the family of Mrs. Brigid McCole, in their open letter published on 9 October, in so far as these questions relate to the terms of reference above.
And that the tribunal be asked to report on an interim basis not later than the 20th day of any oral hearings to the Minister for Health on the following matters.
The number of parties then represented before the tribunal.
The progress which has been made in the hearings and the work of the tribunal.
The likely duration (so far as that may be capable of being estimated at that point in time) of the tribunal proceedings.
Any other matters which the tribunal believes should be drawn to the attention of the Minister at that stage (including any matter relating to the terms of reference).
And that the Minister for Health should inform the person selected to conduct the inquiry that it is the desire of the House that the inquiry be completed in as economical a manner as possible and at the earliest date consistent with a fair examination of the matters referred to it.
The Government decided on 8 October to move a motion in both Houses of the Oireachtas establishing a tribunal of inquiry into the hepatitis C infection of blood and blood products manufactured and distributed by the Blood Transfusion Service Board. On 15 October I announced details of the proposed terms of reference of the tribunal determined by the Government and these are set out in the motion. Yesterday the House had an opportunity to discuss at some length all the issues which form the background to the setting up of the tribunal. In these circumstances, I do not propose to go into the level of detail which would be the norm in introducing such a motion to the House.
The establishment of a tribunal of inquiry is the ultimate mechanism available to the House to establish the full truth surrounding any matter of major public concern. It is not a power that is lightly used—this is only the sixth occasion since 1975 that this procedure has been invoked. A tribunal of inquiry established under the Act has the same powers, rights and privileges as are vested in the High Court or a judge of the High Court. These include the compelling of witnesses to attend and the production of documents before it. It is an offence to disobey a summons to appear as a witness, not to produce documents requested by it or to obstruct or hinder the tribunal in its functions. Persons found guilty of an offence under the relevant Acts are liable on conviction on indictment to a fine not exceeding £10,000 or up to two years' imprisonment or both.
The hearings of the tribunal must be in public unless the tribunal considers that it is in the public interest to refuse to allow the public or any portion of the public to be present for reasons connected with the subject matter of the inquiry or the nature of the evidence.
There has been a general welcome for the Government's decision to establish the tribunal. Despite the costs involved it would appear that, because the infection of blood and blood products is such a major scandal and because there is a need to use all available means to establish the full facts of what happened, there is an acceptance that on this occasion a tribunal is the right mechanism. The establishment of the truth is obviously of most importance to those whose health has been affected by the infection of the blood and blood products. I accept that for them this is probably the single most important expectation that they have of the Government and Members of this House. It is also of considerable importance to the well-being of the democratic system that we can be seen to address the critical issues of accountability and responsibility through the systems available to us.
I will now address the terms of reference and, in particular, draw to the attention of the House some of their special features. In drawing up the terms of reference, the Government's objectives might be summarised as follows: first, to enable the tribunal to address fully all the relevant matters of serious public concern; second, to ensure clarity in relation to the boundaries of the task to be undertaken by the tribunal; and third, to enable the tribunal to conduct its task as effectively and efficiently as possible consistent with a fair examination of all matters referred to it.
Deputies will have noted that the terms of reference are quite detailed and extensive, in contrast with shorter and more general terms which have characterised other such inquiries. This is designed to balance comprehensiveness with clarity and to assist the tribunal in containing the task to those matters which must be addressed. However, Deputies will also note that provision is being made to allow the tribunal in its interim report to draw the Minister's attention to any matter relating to the terms of reference which it considers needs to be addressed.
The inquiry will start with a considerable advantage, in so far as it will have available to it the report of the expert group, so ably chaired by Dr. Miriam Hederman-O'Brien, which was published in April 1995. It will also have full access to all the documents discovered in preparation for the recent High Court case taken by the late Mrs. McCole. This represents a significant proportion of all the work which might otherwise have to be undertaken by the tribunal. I need hardly say that it can absolutely rely on the full co-operation of my Department and all other bodies under my aegis in undertaking the further researches which its work will involve and in gathering the testimony necessary to complete its task.
There is a specific reference to the questions raised by the family in their open letter published on 9 October. Yesterday I appologised unreservedly for any upset I may have inadvertently caused to the members of the family in raising questions about the conduct of Mrs. McCole's case by her solicitors. I again assure each and every one of them of my deep regret about any hurt which my remarks caused. I hope they accept my apology in the spirit in which I have been gladly willing to make it and repeat it in this House today. I also made adverse references to the solicitors and counsel for the late Mrs. McCole in my contribution yesterday. I withdraw these unequivocally.
The tribunal is being asked to report on an interim basis not later than the 20th day of any oral hearings and the matters to be covered in that report are specified. This, coupled with the expressed wish to conduct the inquiry in as economical a manner as possible, consistent with a fair examination of the matters referred to it, reflects the Government's concern with maintaining confidence in a tribunal of inquiry as an effective and efficient means of getting to the bottom of contested matters of major public concern. These provisions are innovative but they derive directly from the experience gained in the establishment and conduct of previous inquiries.
Finally, I draw the attention of the House to the specific reference to the supervisory responsibilities of the Minister and the Department of Health. Because of the concept of the Minister as corporation sole and the reality that functions are exercised on his behalf by the officers of the Department of Health, it is considered appropriate to include both. I was particularly anxious to avoid any suggestion that I am not prepared to be fully accountable for any responsibilities I hold in relation to the matters under review.
I am pleased to inform the House that Mr. Justice Thomas A. Finlay, the former Chief Justice, has agreed to be the chairman and sole member of the tribunal. I express appreciation to him on my own behalf and that of the Government for agreeing to undertake this difficult task of major national importance. I wish him every success in his task and I again assure him of the unstinting co-operation of my Department and the other statutory agencies.
The Government has agreed to the Attorney General's recommendation to make provision for the appointment of three legal teams — the tribunal team, the State team and a public interest team. This is the first time that a team representing the public interest will be appointed. The tribunal has the power to authorise the legal representation of any person appearing to it to be interested. It may also refuse such representation. It is a matter for the tribunal alone to decide who should be represented and the 1979 Act authorises the tribunal to direct that the costs of any person appearing before it should be paid by any other person, including the State.
The work of the tribunal will get under way as soon as the necessary physical and support arrangements can be put in place. Its cost will be a charge on the Department of Health Vote and will be met by way of Supplementary Estimate in 1996 and subsequently as necessary.
I have outlined the main features of the tribunal's terms of reference and the arrangements for the conduct of its task. It is being asked to address difficult and sensitive issues surrounding one of the worst public scandals which has arisen for many years. Many groups will look to it to provide explanations as to how this happened and to draw conclusions on the systems or other failures which led to such a sad outcome for so many innocent people. I did not lightly propose its establishment to the Government, which took great care in finalising the scope of the tribunal's work. If there had been an easier way of addressing the issues, which have concerned people within and outside the House, I would have chosen it but there was not an easier way to achieve the degree of certainty that was being demanded.
It is no consolation that we are not alone in the difficulties which have arisen in the field of blood transfusion. The measures I have proposed to my colleague Ministers in the EU to enhance blood safety and self-sufficiency within the Union have met with a ready and enthusiastic response not because they are especially innovative or radical but because every Minister for Health recognises he or she cannot take for granted a continuing and adequate supply of safe blood and blood products unless there is zero tolerance of anything other than the very best practice and everything relating to the harvesting, factoring, distribution and use of blood and all its derivatives. The principles and practices necessary to achieve this are generally known and agreed. The challenge is to implement them rigorously and consistently, no matter how routine the operation may appear to the casual observer.
As we establish this inquiry into past failures we must renew our commitment to support the implementation of the many measures which have been recommended in the Hederman-O'Brien and Bain reports with regard to the improvement of the blood transfusion service and of haematology in our hospitals. The provision of resources to do this is essential but so also is the maintenance of public confidence and the reassurance of those charged with providing a high quality service that they have the support of all in this House in doing their work. I hope all Deputies will support this motion and I recommend it to the House.