Dáil Éireann díospóireacht -
Thursday, 20 May 1999

Vol. 505 No. 2

Adjournment Debate. - HIV and Hepatitis C Infection.

Mr. Lawlor

I thank the Chair for giving me the opportunity to raise what is a tragic human story and probably the worst health disaster to hit the State since its foundation – the infection of persons with haemophilia who entrusted themselves to the services of the State with HIV and hepatitis C through blood transfusions and blood products, the effects of which have been difficult and painful. Although the infections occurred in the 1970s and 1980s, they could only recently be detected. Hepatitis C screening is only possible since 1991. There are hints that big pharmaceutical and other medical research facilities could have improved on this.

Haemophilia is now easily controlled and sufferers have good life expectancy. Because of the lack of treatment in the early years, however, 65 people have died, 210 were infected with hepatitis C and 103 with HIV resulting in untold human misery.

The Government and its predecessor committed themselves to the establishment of a tribunal of inquiry which would involve an investigation of the Department of Health and Children. The discussions on its terms of reference have dragged on since Deputy Noonan was Minister. He was engulfed in controversy when he attempted to tackle and deal with this complex and difficult problem. Agreement was reached on the issues to be investigated in May 1997.

The Minister promised to present final draft terms of reference to the Cabinet on 30 March but – for justifiable reasons – this did not happen. He wants to be seen to take decisive action and the inquiry proceed. He hopes to finalise the terms of reference at a meeting at 11 a.m. tomorrow with the Irish Haemophilia Society. He should then publish them, outline where the tribunal will sit, its composition and possible duration. Officials of the Department should offer full co-operation and disclosure to the tribunal.

Some of my constituents are affected. They are among the most vulnerable and weakest in society. Their families are also affected. They wish to know the truth. A serious wrong was visited upon them innocently. I hope the Minister will move swiftly to clarify the situation and get the inquiry under way as quickly as possible.

Mr. Fahey

The Minister for Health and Children, the Attorney General and their officials have been endeavouring as a matter of priority to expedite the establishment of a tribunal of inquiry into the infection of persons with haemophilia with HIV and hepatitis C. The Government is fully committed to establishing a tribunal and on 23 February gave approval to its establishment.

The background to this decision is the infection of approximately 200 haemophiliacs with hepatitis C, of whom approximately 100 are also infected with HIV and the subsequent death of approximately 60 haemophiliacs as a result of their infection. The Irish Haemophilia Society which represents persons with haemophilia sought the establishment of a tribunal to investigate the infection and death of its members.

The completion of terms of reference for the tribunal has proved to be a very difficult and complex task involving issues requiring detailed examination and consideration. It appears that most blood products implicated in the infection of haemophiliacs with hepatitis C and HIV were manufactured outside the State and were imported for use by haemophiliacs here. Home produced products are also implicated. It was necessary to take advice from counsel here and consult with attorneys in the United States in relation to the jurisdiction of an Irish tribunal in examining matters arising outside the State.

Following examination and consideration of the legal advice, the Minister's and the Government's approach to the tribunal is as follows: that the terms of reference would allow the tribunal to discharge its task efficiently and effectively; that the tribunal would be workable and would be given practical terms of reference which cover important matters which are capable of being investigated and that the tribunal would not be required to embark on a long drawn out inquiry with little expectation of a useful outcome.

In this context, it is anticipated that the tribunal will examine the decisions taken within the jurisdiction in relation to the importation of blood products implicated in the infection of haemophiliacs and that it will be open to the tribunal to compare the actions and omissions here with those in other jurisdictions; to hear evidence from international experts; to examine international research and publications and to seek information and assistance from the US Food and Drug Administration, the US Centre for Disease Control and the pharmaceutical industry.

Following the Government decision of 23 February, considerable effort was expended in relation to finalising the text of the terms of reference. A difficulty remains in relation to how the international dimension of the investigation will be handled within the text of the terms of reference. Because of the special position held by the Irish Haemophiliac Society in that it represents persons directly affected by the HIV and hepatitis C contamination of blood products, the Minister and his officials have consulted with the society in relation to the issues which require to be examined by the tribunal.

The Minister wrote to the Irish Haemophiliac Society on 31 March 1999 in relation to the complex issue of the tribunal's remit in examining matters arising outside the State. He stated that he was prepared to see what could be done to clarify the international dimension within the parameters of the legal advice that was to hand. What he has in mind is the possibility of incorporating a provision which would enable, but not require, the tribunal to investigate anything arising outside the State that it considers relevant to its terms of reference in so far as it considers it practicable, appropriate and reasonable to do so, and in so far as it considers that the procedures adopted for that purpose can be carried out without unduly delaying the completion of the inquiry and with a substantial expectation of being able to obtain the evidence necessary for the inquiry.

The Minister and the Attorney General have arranged to meet with representatives of the society tomorrow morning and the Minister hopes that the meeting will resolve any outstanding matters relating to the drafting of the terms of reference. I reiterate that the Minister is fully committed to establishing the tribunal as a matter of priority but it is essential that the terms of reference, when finalised, will enable the tribunal to complete its task efficiently.