Vol. 476 No. 7
14 Mr. Cowen asked the Minister for Health the reason the optional HIV testing programme announced in 1996 following the revelation of another scandal involving the Blood Transfusion Service Board and was due to begin three months ago, has not commenced. [8436/97]
Limerick East): I have already informed the House that following the introduction of HIV donor screening test by the Blood Transfusion Service Board in October 1985, no lookback was undertaken between 1985 and 1989 in respect of earlier donations made by donors who are now screening positive for HIV. A lookback procedure was in place from 1989 onwards for newly presenting donors. As the House will be aware, the BTSB has intensified its HIV lookback to trace all recipients of potentially HIV infected blood issues.
Because there is no guarantee all or, indeed, any of the untraced issues will be traced, and also because of the possibility some donors who were HIV positive prior to the introduction of HIV donor screening in October 1985 did not donate after October 1985 and cannot, therefore, be identified, I decided to introduce an optional HIV testing programme to offer screening to blood transfusion and blood product recipients who may be at risk, however small that risk may be.
Before commencing such a programme it is absolutely essential that the risk, if any, involved for recipients must be determined as far as possible to enable each recipient to make a fully informed decision, in consultation with his or her general practitioner, in relation to availing of screening. The element of risk for recipients will vary according to the year in which they received the transfusion or blood product, and according to the product they received. I hope the preparations for the HIV testing programme, which are well advanced, will be completed in the coming weeks.
In the meantime, the BTSB targeted lookback is continuing and the following is the up to date position as of today. A total of 25 blood donors have tested positive for HIV since screening was introduced in 1985. Eight of those were first time donors and accordingly, no risk of HIV transmission to recipients was involved. In the case of ten of the remaining 17 donors, recipients of potentially infected issues were traced and none of the recipients tested positive.
Tracing recipients of the issues from the remaining seven donors has been rendered difficult by the absence of the BTSB despatch records for the period prior to 1986. Of the 33 issues from those seven donors, 15 were donated prior to 1981 and are not regarded as a potential source of infection. The residual problem relates to tracing the recipients of the balance of the 18 issues derived from the potentially infected blood donations made prior to 1985. Seven of these issues have been traced leaving 11 issues of concern outstanding.
I am grateful to the Minister for information on this aspect of the contamination problem. On 17 December last, the Minister indicated testing would commence in January 1997 as a result of a problem which had arisen where a person had been contaminated with HIV after receiving a transfusion. On 28 January, the Minister said it would start shortly and he was referring the matter to the Attorney General for advice. Given that when the hepatitis C crisis arose a screening programme was up and running in a matter of days, would the Minister not agree that the question of a HIV screening programme is as, if not more, urgent? Although he said on 17 December last testing would commence in January, it is almost April and it has not yet started. Would the Minister agree that is not the type of response people who have had transfusions and who would like their situation clarified should have to contend with?
(Limerick East): I assure the House I am proceeding as quickly as possible. The BTSB is continuing with its rigorous programme. As the Deputy pointed out, I sought legal advice on this matter. The nature of the legal advice is that the risk, if any, involved for a recipient must be determined as far as possible to enable them to make a fully informed decision on availing of screening. Since there are different categories of risk, albeit small risks, this must be presented to persons who might be involved so that they may make an informed decision on screening. As I informed the House, I hope the task will be completed in the coming weeks.
In an optional testing programme, I do not understand the reason — perhaps the Minister might elaborate further — a person cannot be allowed to make a decision to avail of a screening programme, if available, without it being necessary for the level of risk to be assessed for them so that they make a fully informed decision. Surely, the quickest way a person can come to a decision on this matter and clarify his situation is to allow him access to an optional HIV screening programme immediately? Is it not a matter for the person concerned to decide if he wishes to be screened rather than first having to establish the level of risk, which available legal advice suggests?
(Limerick East): I appreciate the Deputy's point which, at first glance, appears valid. However, I am advised it would not be proper from the point of view of effective optional testing or fulfilling legal obligations to advertise that persons who received blood or blood products between specific dates should come forward for testing, if they so wish. This would not precision persons at potential risk to make an informed decision. The nature of the information provided to persons at potential risk must be more refined for the optional testing programme to be effective and for the BTSB to fulfil the obligations required. The danger is — putting this in non legal terminology — that if we tell people who feel they need a test to get one, it will not indicate those who may be at risk rather than those who may not. We would not be appropriately focusing on persons who may require the test above those who do not require it. Give the Deputy's legal background, he will understand what I said.
I accept the Minister's point and will study what he has said and table further questions rather than pursuing the matter at this stage.
On a related matter, given that people have been told they have a month to decide whether to accept the damages given by the ad hoc compensation tribunal, will the Minister indicate if the Bill placing the compensation tribunal on a statutory basis will be ready by 5 April? If that is not possible, will the heads of the Bill be published before 5 April so that people can make an informed decision as to whether they should accept the damages offered to them by the ad hoc tribunal or wait for the statutory one? Undertakings were given that they could make that informed decision within a month of the publication of the tribunal report. Will the Minister indicate that he will enable people to make that informed decision by either publishing the Bill or its heads before 5 April?
(Limerick East): This is a different question and, although I will be replying to the debate on this matter later this afternoon, I will facilitate the Deputy. Those persons who have not made a decision to accept or reject an award of the compensation tribunal already communicated to them will not be disadvantaged by the statutory tribunal when it replaces the existing informal one. As I indicated in the House on Thursday, one of the elements assured by Government in respect of a statutory tribunal is that any benefit it may confer on existing applicants whose cases have not been heard or on future applicants will not operate in a manner which disadvantages anyone who has already had an award made or anyone who processes their claim in the meantime.
I want the tribunal to continue. It has set dates for hearings for several months ahead. I know people who have dates for hearings and who are anxious their cases be heard and awards made. The process will be geared in a manner ensuring that any benefit conferred after the statutory tribunal comes into place will be retrospectively conferred on those who have already had their cases heard or whose cases will proceed to hearings in the interim.
