Dáil Éireann debate -
Thursday, 22 Oct 1998

Vol. 495 No. 6

Adjournment Debate. - Hepatitis C Incidence.

Mr. Cosgrave

I thank the Chair for allowing me raise this matter. The House is well aware of the scandal of infection of over 1,600 women with the hepatitis C virus from contaminated blood products. With around half the cases now dealt with by the compensation tribunal, the final cost of this scandal to the taxpayer will be over £350 million. To put it in perspective, this sum would build nearly three new hospitals. All those infected are deserving of compensation and full health care.

To date, none of those who caused this infection has been brought to justice. Indeed, many of those criticised in the Finlay report on the blood tribunal are taking legal action to quash adverse findings against them by the tribunal.

The name of one brave women is etched on the minds of all those who have followed this tragic affair. The late Brigid McCole was hounded by the last Government — of which my party was a member. Only on her death bed did the blood bank settle reluctantly for a miserable sum. Mrs. McCole was forced to go public as the State used every legal technicality to deny her the right to the truth and proper compensation. The same approach was used recently in the Mary Quinlan case. We now have the spectre of the current Minister for Health and Children adopting a hard cop approach to other sick women infected with hepatitis C, particularly in the case of Mrs. Sandra Fallon of Chicago.

In a breathtaking display of inhumanity the Government has refused to provide health care to a woman who, clearly on the evidence presented, received contaminated anti-D product at Castlebar hospital in 1993. There is a scandal in this case which must be exposed. The Government came to power on the promise of dealing compassionately with victims of hepatitis C infection. What is the Minister's current attitude? He asked Mrs. Fallon to prove her case to the Blood Transfusion Service Board, the agency which infected her, covered up the scandal and claimed she had a different strain of the virus to others who were infected. This claim was made despite a test carried out at the UCD virus reference laboratory which shows Mrs. Fallon has the same virus as others.

The Minister asked Mrs. Fallon to go to the compensation tribunal. However, privately he knows it cannot examine the scandal of this case or get to the truth. What is the Government scared of? This is the first international case of its kind and what has it revealed? Since this scandal became public in early 1994 the blood bank has not made any proper attempt to trace Irish women who received contaminated blood products and who subsequently went to live abroad before the scandal broke. In newspaper advertisements this week the BTSB states that international advertising, which is to follow, will help trace those abroad who were infected. The blood bank has waited nearly five years to undertake that search of sick and dying Irish women abroad. This is a scandal.

The Minister's handling of Sandra Fallon's case is inhuman. He should ensure that the BTSB provides Mrs. Fallon with the health care she needs until the issues in contention are resolved. By refusing to do so he runs the risk of allowing a sick woman to die, a woman infected by this State. She is as deserving as others who have been infected.

Because she is from America the State seems to want to question her status and morals with snide insinuations about how she might have contracted the virus from other sources. My daughter had to suffer the same insinuations, yet she considered herself lucky because despite the inhuman things that happened to her she has been receiving treatment. What future faces my grandson in the unlikely event that tests prove positive? Will he have to travel this long road for justice?

The public have seen and heard Mrs. Fallon. She is a genuine person, a mother of a young boy and the wife of a deeply caring father. The hospital records provide good grounds to support her case that she received contaminated anti-D. We also know that more than 300 batches of potentially contaminated anti-D were sent to Castlebar General Hospital. There is good reason to believe that her medical records were altered to cover up the fact that she received contaminated anti-D. Those who are not directly affected by the hepatitis C scandal may feel a little weary of the subject. They should remember how this State treated Mrs. Brigid McCole and how the members of the Government criticised the former Minister, Deputy Noonan, over his handling of the issue. The lessons of the past have not been learned. That is something which should concern every citizen who may have reason to use the health services some day.

Mr. Cowen

I recognise the Deputy's abiding interest in these matters for the reasons he outlined in his speech.

Mr. Cosgrave

I am not looking for sympathy, I am looking for results.

Mr. Cowen

I was not suggesting that. I was showing some magnanimity and it should not be misinterpreted as anything else. I recognise the Deputy's abiding interest in this issue as a result of what he said in his speech. What I said should not be misinterpreted in any other way.

Mr. Cosgrave

I am not looking for sympathy.

Mr. Cowen

I am sorry the Deputy has taken it that way. I expressed a genuine sentiment which has not been reciprocated.

I welcome the opportunity to respond to the Deputy's questions in this case, as there have been a considerable number of inaccurate statements on these matters. I again express my sympathy for Mrs. Fallon. It is most unfortunate that she has contracted hepatitis C and from my contacts with other sufferers I can understand the difficulties she is experiencing at this time.

There is a serious dispute between Mrs. Fallon and the Western Health Board. The Western Health Board has stated that its medical records show that anti-D was not administered to her while under its care in March 1993. Mrs. Fallon is of the strong view that anti-D was administered to her following the birth of her child in Castlebar Hospital in March 1993, and has alleged that the medical record was later altered to denote that anti-D was not administered. This is a serious allegation, and I understand that the Garda have commenced an investigation into the allegation, at the request of Mr. and Mrs. Fallon, and they will examine the board's records in situ next week. At my request, the Western Health Board has also arranged for the solicitor acting for Mrs. Fallon to gain access to all the hospital's records relating to the case in their original format, and the solicitor will review those records at Castlebar Hospital next Tuesday, 27 October.

Mrs. Fallon tested positive for hepatitis C under the BTSB's blood screening programme in October 1997. Her test result showed that her virus was Genotype 3, which is associated with the anti-D contamination in 1991-94. However, a genotype is a broad classification and, using sophisticated technology, viruses from the same source can be shown to be related. Such tests are often carried out where a link between the anti-D product and the hepatitis C infection requires to be elucidated, particularly in relation to the anti-D product manufactured in 1991-94, as the level of infection in that product was very low. In Mrs. Fallon's case, this test was carried out by an independent laboratory which was jointly run by the Scottish Blood Transfusion Service and the University of Edinburgh. In its opinion, the test result indicated that the source of the hepatitis C in this case was not from anti-D. This is rejected by Mrs. Fallon on the basis that it is claimed it is possible for the hepatitis C virus to mutate. It is Mrs. Fallon's contention that her virus initially showed the same sequence, but has changed over time.

On the other hand, the independent laboratory's position is that, while mutations in the virus do occur, they develop at a defined and steady rate, and its judgment is that insufficient time has elapsed to account for the difference between the sequence in the 1991-94 anti-D product and the sequence relating to Mrs. Fallon's virus. Taking that scientific fact into account, the University of Edinburgh has come to the conclusion that the test result indicated that the source of hepatitis C in this case was not from anti-D.

I point out to the Deputy that the ex gratia scheme was introduced in 1994 to ensure that persons, who had contracted hepatitis C through the administration within the State of infected blood and blood products made available by the BTSB, did not undergo any undue hardship in availing of treatment for their condition. The ex gratia payments are made on an interim basis, pending the award of compensation by the compensation tribunal or the courts. The scheme is administered by the BTSB, not by the Department.

When Mrs. Fallon wrote to me last June, following the BTSB's decision to discontinue ex gratia payments to her, I acknowledged that she did not accept the basis on which the ex gratia payments had been stopped, and I undertook to request a report from the BTSB explaining its decision. I also pointed out that the compensation tribunal had the statutory authority to make decisions on causation, and that I would endeavour to arrange an early hearing for her on the causation issue alone, if that was her wish. When the BTSB submitted its report, giving details of the scientific test results, to which I have referred, a copy of the report was sent to Mrs. Fallon. The offer of an early hearing before the compensation tribunal on the causation issue independent of considerations of compensation, was also reiterated at that time. It was also pointed out that the BTSB had notified Mrs. Fallon on a number of occasions that it would review its decision on the ex gratia payments on receipt of medical evidence regarding the administration of anti-D as alleged.

The reasons I have always proposed the compensation tribunal as the proper forum to have this issue resolved are as follows: the tribunal is an independent statutory authority established by the Oireachtas to determine causation on the balance of probabilities; it affords the best opportunity of having the issue resolved quickly; approximately 1,000 claimants have availed of the compensation tribunal to date; and the four groups representing people who contracted hepatitis C through the administration of blood and blood products have confidence in the tribunal's ability to resolve claims for compensation, including the question of causation.

In the media presentation of this case, there have been a number of inaccurate statements made concerning the tribunal's powers and procedures. It was claimed, for instance, and reiterated this evening, that the tribunal does not have the power to compel witnesses to attend or to give evidence or to produce relevant documents.

An Ceann Comhairle

The five minutes the Minister had to reply are exhausted. If the House is agreeable he may conclude his reply. Is that agreed? Agreed.

Mr. Cowen

I am obliged to the House. The powers given to the tribunal by the Oireachtas are quite clear. Section 4(11) of the Hepatitis C Compensation Tribunal Act, 1997, provides that a claimant may require the attendance of any person at a tribunal hearing to give evidence in relation to the claimant's claim, or require any person to produce to the claimant any document in relation to a claimant's claim. Section 3(10)(a) of the Act provides that the tribunal may, on its own behalf or at the request of a claimant, where a person has failed to comply with a requirement of the claimant under section 4(11), give notice in writing to any person requiring them to attend the tribunal or to produce any documents which relate to the hearing. Section 3(1)(c) of the Act provides that a person to whom such notice is given who refuses or wilfully neglects to attend the hearing, or to give evidence, or to produce the relevant documents, shall be guilty of an offence.

As I understand it, Mrs. Fallon has so far indicated that she is not prepared to have her case heard by the tribunal, even though this could be arranged within three or four weeks. My whole strategy has been to achieve an early resolution of this case in the interests of all parties, not to take sides on the issue. There are evidently two sides to the story. There are a number of parties involved in this case, including the medical and nursing staff at Castlebar Hospital, one of whom is now deceased. Understandably, the allegations being made have caused considerable upset. I am very conscious also of Mrs. Fallon's distress as she has been infected with hepatitis C whatever the cause. In the circumstances, it is inappropriate that the efforts to resolve this issue, which concern many aspects of patient confidentiality, be carried out in the media.

I assure the Deputy of my continuing efforts to have this issue resolved.