Seanad Éireann díospóireacht -
Thursday, 17 Oct 1996

Vol. 148 No. 17

Hepatitis C Tribunal: Motion.

Mr. Manning

I move:

Seanad 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 and

(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 Preparation (Licensing of Manufacture) Regulations, 1974 and in advising on the grant of Product Authorisations under the European Communities (Proprietary Medicinal 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 October 9th, 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.

It is the wish of Dáil Éireann that all persons employed by Government Departments and State Agencies concerned shall give their full co-operation to the tribunal in its inquiries, and the Departments and agencies shall fully co-operate with the tribunal by providing all documents and information requested of them.

The Minister for Health shall inform the person selected to conduct the inquiry that it is the desire of the House that the anonymity of the victims of Hepatitis C who come before the tribunal be preserved if they so wish, in so far as that may be possible.

Minister for Health (Mr. Noonan,

Limerick East): 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 I have now introduced. Whereas the Dáil had an opportunity to discuss at some length all the issues which form the background to the setting up of the tribunal, prior to my introducing the motion there earlier today, I have not had the opportunity of discussing the issues in this House. I therefore propose before commenting on the terms of the motion to address certain criticisms which have been made of my handling of this whole matter and to outline briefly the steps I have taken to ensure continuing confidence in the adequacy and safety of our blood supply.

Much of the recent criticism to which I have been subjected has centred on the State's handling of the High Court case taken on behalf of the late Mrs. McCole. It seems to me that, at the heart of the attacks is a refusal by my opponents, especially in the Dáil, to recognise the statutory independence of the Blood Transfusion Service Board and the adversarial nature of our courts. The State has taken great care to provide an alternative to the courts for those seeking compensation and it has also, particularly in the Chief State Solicitor's letter of 21 July 1995, addressed to the solicitors for Positive Action, set out very clearly the State's legal position in relation to the defence and Court cases taken by persons seeking redress through that route. I cannot change the way in which court cases are conducted: that is a matter outside my influence and I would ask no more than the acceptance of that simple fact by those who object to how cases are dealt within our judicial system.

I have been criticised in relation to a letter which issued from the Chief State Solicitor on 21 July 1995 which set out the State's legal position on the legal cases in question. Contrary to what has been alleged, the letter did not issue to the late Mrs. McCole but to the solicitors of Positive Action, who are also Mrs. McCole's solicitors. It was not a letter to Mrs. McCole.

The refusal to admit liability on behalf of the State has been a major accusation against me. My role and responsibilities in relation to the BTSB are governed by the provisions of the Health (Corporate Bodies) Act, 1961, and the assumptions on which it is based; the terms and intent of the relevant establishment order; and the accepted conventions of our public service regarding the responsibilities of Ministers and their Departments in relation to executive agencies under their control. The Health (Corporate Bodies) Act was intended to provide the Minister with a legally efficient means of establishing a body which would discharge a specialist executive function, under the governance of a suitably constituted board; would be likely to discharge that function more appropriately and expertly than could be done from within the Department; would be a centre of expertise, and would have a large measure of autonomy in the discharge of its task, subject to the controls set down in the relevant establishment order, mainly in relation to personnel, finance and audit matters. The model relies heavily upon the professional competence and integrity of the specialist staff employed in agencies such as the BTSB, and the general competence of boards to exercise their role, to identify and address potential problems and to bring those they cannot address to notice in a timely fashion.

It would not, therefore, be either appropriate or viable for me and my Department to separately engage the expertise to enable me to question the minutiae of the operations of bodies under my aegis. Neither would it be appropriate for me to issue directives to the body on the conduct of its business, including the defence of cases taken against it in the courts. The BTSB is a separate legal entity: in this instance, the case against it is different in content and range from the case against the NDAB and the case against me as Minister for Health. I did not at any stage attempt to direct the BTSB or the NDAB, now the Irish Medicines Board, in the decisions they took in defending any of the court cases taken against them. It would be totally improper for one defendant to compel another defendant to take any particular course of action in its conduct of the proceedings.

I have been criticised for not admitting liability on behalf of the State, as if it and the BTSB were one and the same entity, with the same case to answer. The interest being defended by two parties is not identical. Let me explain in very plain terms what admitting liability on behalf of the State would mean. I am being criticised and accused of drawing nebulous distinctions because I will not accept liability on behalf of all Ministers and all officers of the Department who dealt with the BTSB over the years. If I were to do so, I would act against all available legal advice and, indeed, against my judgment of the state of affairs.

There has been considerable hurt and resentment expressed about the State contesting the late Mrs. McCole's request for anonymity in pleading her case. I fully understand and appreciate these feelings but I have to point out that the courts must operate in accordance with the law, even in the most heartbreaking circumstances.

In relation to the late Mrs. McCole's application to prosecute her claim using a fictitious name, I would like to inform the House that on 22 September 1995 Mrs. McCole's counsel were told that while the confidentiality of her medical condition and other intimate matters would be maintained by the State parties, as a matter of constitutional law their client could not proceed under an assumed identity. This was confirmed in subsequent correspondence. Her counsel and solicitors took a different view and ultimately Mrs. McCole brought a motion before the High Court seeking a ruling on the point. The application in this regard was decided on 14 February 1996 by Ms Justice Laffoy who dismissed it. The court in its judgment stated it had no jurisdiction to allow the plaintiff prosecute her proceedings using a fictitious name, and to do so would contravene Article 34(1) of the Constitution which requires justice to be administered in public. The Attorney General is, like anyone else, bound by the provisions of the Constitution. It is not open to him to ignore the explicit provisions of the Constitution.

There has been much criticism of the State opposing an early hearing in the late Mrs. McCole's case for tactical reasons, or at least that is the allegation. The plaintiff's initial application for an early hearing was withdrawn by her lawyers and when it was ultimately reentered on 26 April 1996 it was pointed out that the case would not be ready for trial in June as the plaintiff's lawyers requested, and the President of the High Court adjudged it should proceed on 8 October 1996. The President of the High Court said that in exceptional circumstances the court will give priority to cases and fix an early trial date but that this power must be exercised sparingly as it affects other litigants. The judge also stated that the defendants had met the plaintiffs claim fairly and stated they would be in a position to go ahead in October. The Judge added that the rights of both parties have to be weighed and considered it relevant that should her condition deteriorate, the Compensation Tribunal was available to her. Thus the date of 8 October permitted her case to be listed in advance of thousands of other waiting litigants who did not have recourse to a Compensation Tribunal but also enabled her lawyers to amend her claim substantially.

I want to refer now to one item of discovery in the McCole case and to the allegations that both the Minister of State, Deputy Brian O'Shea, and I misled the Dáil when asked to comment when this item of discovery was made public by the solicitor for the plaintiff. I will circulate what I said in the Dáil.

I did not argue as to the culpability or otherwise of the BTSB in respect of these events. It would be totally improper for me to do so. I am informing the House that I based my view, when I issued the statement in support of the Minister of State, Deputy Brian O'Shea, on the report of the expert group. I believe a letter subsequently on 27 May 1996 from Dr. Miriam Hederman O'Brien to Deputy Séamus Pattison, Chairman of the Select Committee on Social Affairs, supports my position. I have included it for the information of Senators, but will not read it into the record.

A major priority at all times when items such as the safety of blood or blood products are in question is to ensure that there is confidence in the blood supply. The House will appreciate the central importance of our blood supply to the daily workings of our acute hospital services. At any one time we have only a three day supply of blood to meet the demand for blood in our health services.

I am convinced that the action I took in April 1995 in assigning Professor Shaun McCann and Mr. Liam Dunbar to the medical and administrative posts at the BTSB was correct. The urgent need to take steps such as management restructuring to restore confidence in the BTSB as a means of ensuring continuity in blood supplies did not allow for any avoidable delay in vacating the post of chief medical consultant. Given the terms of Dr. Walsh's contract of employment, any alternative to voluntary early retirement would not have produced an outcome for many months, if not years.

I am also convinced that the approval I gave to a major consultancy project at the BTSB undertaken by Bain and Company, which had worldwide experience in the area, was the correct decision. The consultants' report was published in May 1995 and the recommendations made complemented those in chapter four of the expert group report concerning the organisation and management of the BTSB.

The main objective of the board and the central direction of the recommendations in the two reports on the development of the BTSB as the national centre of excellence in transfusion medicine and laboratory science are in line with best international practice. The achievement of this objective and the making available of blood and blood components to the highest standards of safety and efficacy is being pursued with diligence by the board. While the complete implementation of all the recommendations contained in both reports will take some time, significant progress has already been made by the board and the new management over the last year. Strategically, the board has redefined its role and function and its contribution to the development of health care services on the lines recommended in the two reports.

Both reports identified the management of the BTSB as the major priority requiring urgent and significant attention. The appointment of a chief executive officer as the sole executive head of the organisation addresses the most important management recommendation in the reports. The chief executive officer leads the entire organisation and, in association with the medical director and senior manager, has addressed many of the other critical management problems identified. Significant progress has been made in defining authority, improving reporting relationships, facilitating the input of staff into the decision making process, and in improving communications within the entire organisation.

To support further progress in these areas the medical, scientific and finance sub-committees have been reconstituted. The participation of the chief executive officer in the medical and finance committees has ensured effective decision making at executive level and that the board is fully informed of the emerging policy and procedural changes.

A clearer focus is in place concerning the business and cost efficiency aspects of the board. Improvements have also been realised, particularly in contract negotiations and the supplies function.

As well as co-ordinating the consultant medical resources of the board, the medical director provides expert clinical advice to the board and to the organisation encompassing all clinical matters relevant to the operation of a transfusion centre and such clinical matters as referred to in both reports. An ongoing review of all aspects of the organisation's procedures and processes including donor and patient care, blood collections, laboratory processing and testing has been established.

The following developments have taken place: the revision and introduction of guidelines for donor selection; negotiating formal arrangements with a major hospital for microbiological and virology support for the organisation; introduction of revised standard operating procedures for blood collection, processing and storage; introduction of new technology to improve temperature monitoring of all aspects of blood and blood component storage; introduction of bar coding of blood and blood components to log such products from collection to dispatch; appointment of medical consultants to sessional commitments at major hospitals; clinical roles and sub-speciality interests of the consultants medical staff are being agreed; the interface between medical consultants and the various functions of the BTSB has been redefined and will be further substantially improved when sub-speciality interests are finalised; the appointment of additional specialist consultants with particular interest in transfusion medicine is currently being pursued; and the board is establishing a research and development fund. Proposals for research projects have been sought from professional interests and an interdisciplinary group has been established to review proposals.

It is against the background of these and many other factors that I decided to recommend the establishment of a tribunal of inquiry to the Government. This decision has been represented as a volte face, out of line with the positions I had previously taken. This is not the case. I could not accept the need for an inquiry as long as there was a prospect that the contested issues would be the subject of a judicial determination in the High Court. Once it became obvious that this was unlikely in the foreseeable future, I came to the view that an inquiry was the only way of putting the facts beyond doubt.

There is a particular point I want to clarify before this House. Deputy Mary Harney contested something I said in the Lower House. I referred to the fact that High Court proceedings were fixed for 8 October 1996 and that such proceedings would be a judicial examination and determination of this matter. I couched my language in different terms in the Seanad. The reason I did so was that I received a letter from the solicitors for the plaintiff. Senators can see for themselves the relevant part which I quote for their information. In effect, I received a solicitor's letter saying there was an objection to the way I had said something in the Dáil, so I said it differently in the Seanad.

The establishment of a tribunal of inquiry is the ultimate mechanism available to the Dáil and Seanad to establish the full truth surrounding any matter of major public concern. It is not a power that is lightly used. Indeed, 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 it 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 the 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.

In drawing up the terms of reference, the Government's objectives might be summarised as follows: to enable the tribunal to address fully all the relevant matters of serious public concern; to ensure clarity in relation to the boundaries of the task to be undertaken by the tribunal; and 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.

Senators 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 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, Members 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. It will have 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 the work which might otherwise have to be undertaken by the tribunal. It can rely on the full co-operation of my Department and all other bodies under my aegis in undertaking the further researches its work will involve and in gathering the testimony necessary to complete its task. Indeed, the terms of reference as amended by the Government following this morning's debate in the Dáil now incorporate a specific direction on full co-operation.

The tribunal is being asked to report on an interim basis not later than the twentieth 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.

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 very 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 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 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 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. The cost of the tribunal will be a charge on the 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 very difficult and sensitive issues, surrounding one of the worst public scandals for many years. Many different groups will look at it to provide explanations as to how all 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 and the Government 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 no easier way to achieve the degree of certainty 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 which I have proposed to my colleague Ministers in the EU to enhance blood safety and self-sufficiency within the community have met with a steady and enthusiastic response not because they are particularly innovative or radical. It is 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 very best practice in 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 whole 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 in relation 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 of us in the House in doing their work. I hope that all Senators will support this motion which I now recommend to the House.

I refer to unfortunate remarks I made in the Dáil yesterday. I apologised to the McCole family and to members of Positive Action. This morning in the Dáil I indicated that I withdraw all reference to those and that includes any adverse comments made to the legal profession which I withdrew unequivocally.

An Cathaoirleach

Amendments Nos. 2 and 3 cannot formally be moved at this stage. Their content can be discussed in conjunction with amendment No. 1 and each amendment can be formally moved when amendment No. 1 is disposed of.

Mr. Finneran

I move amendment No. 1:

In paragraph 9, to delete ", in so far as these questions relate to the terms of reference above".

I, on behalf of Fianna Fáil, welcome the decision of the Minister of Health to set up a tribunal on a statutory basis to investigate the circumstances of the many people who were infected as a result of the actions of a State body and who have not found a solution to their problem to date. I have moved one amendment to the motion and a second one will be moved, because I, and my party, feel the terms of the tribunal as set up by the Minister are inadequate. We want to enhance the terms of reference of the tribunal.

On 1 November 1995 I, on behalf of my party, submitted a motion to this House asking the Minister to do what he is doing today. On that occasion he decided in his wisdom to oppose that motion and, indeed, put down an amendment to that motion. Some of the Independent Senators went along with the Minister's thinking and put down their own motion. Time has shown that if the Minister had listened to us at that time, we would not have had the trauma which we have had to date. In particular, we would not have the major public debate on the death of Mrs. McCole. This is one of the great tragedies of modern Ireland. A State board is responsible for infecting up to 1,600 people with a faulty blood product. On numerous occasions in this House I explained to the Minister that the only way to resolve this problem and to get to the bottom of the scandal was by having a statutory tribunal look into it. The Minister gave many reasons that should not have been the case. He mentioned the beef tribunal and the cost which the State incurred through large legal fees. He did not want to go down that road again. He proposed an alternative — an ad hoc tribunal to deal with compensation. He wooed and won, to some extent, the groups representing the infected women, but they were not satisfied and some went to court.

A few days before the unfortunate death of Mrs. McCole, a State body admitted liability and apologised for what had happened. That took place at a very late stage. Eighteen months earlier the Minister had accepted the resignations of people employed by the board. They left their jobs with golden handshakes at a time when people were complaining that they had been infected by a product supplied by the board.

While the Minister personally might not have known all the circumstances at the time, he has had ample opportunity since to investigate what happened. In fact, the Minister has acted in a somewhat stubborn, if not conceited, manner when the House has debated this matter, and there have been many such debates. On each occasion the Opposition arguments were talked down and dismissed by the Government with a conceit I found disturbing. In my discussions with Positive Action they were, to a great extent, of the same opinion. Positive Action have done something that very few others have been able to do. They have kept their eye on the ball and organised themselves. They kept a steady pace in their campaign and eventually they cracked something that the Minister and his officials were not prepared to crack.

There were two disturbing aspects to the case. In the first place, the Minister and the Department of Health tried to distance themselves from the Blood Transfusion Service Board. I do not know how the Minister could do such a thing. The BTSB is an organ of the Department of Health in so far as it is a statutory body and the Minister for Health oversees the board. The Minister accepted the resignations of the board members when they knew they had done wrong and thought they would jump ship, which they did. Unfortunately, the investigation that was instigated did not receive — and the Department did not insist that it receive — documents and evidence from people relevant to the case. Documents were withheld and people who should have given evidence did not appear. That was a cover-up. The cover-up continued until liability was admitted and an apology offered. They were only offered by the BTSB. We still have not reached a stage where the Minister or his Department have admitted liability or apologised on behalf of the State. I do not doubt that when this House debates the matter again some months hence, the tribunal will have established the facts and the full truth will be available.

Questions of guilt, compensation and right and wrong are involved. The Minister attempted on many occasions to indicate that this case is all about money. He said he would establish an ad hoc tribunal and give people the money to which they were entitled through the tribunal. Yesterday in the other House he indicated that if the McCole family had gone to the tribunal they would have been better off than going to the courts. That is most disturbing. It begs the question of whether the Minister has his hand in the tribunal's pot. Does it mean that the ad hoc compensation tribunal is acting on the Minister's orders? How could the Minister tell the Dáil that the McCole family would have done better financially in the tribunal than in the courts? On what basis did the Minister make that statement?

Compensation was an important factor; money had to be given to people who were infected by the State. However, what those people wanted was the truth. They wanted to know what had happened over a period of 20 years, particularly after the problem had come to the attention of the Minister and the Department of Health. They believed the only way they could find the truth was through a statutory tribunal. My party and I indicated over 12 months ago that the statutory tribunal was the only way out of this quagmire. However, the Minister chose a different road and now he is proposing to take the road we proposed a year ago. It is a step in the right direction and, we hope, towards establishing the truth.

Many questions still must be answered. The McCole family, in the series of questions contained in their letter, has raised many important issues. Who authorised the legal strategy that was followed in the McCole case? Somebody had to orchestrate it. It is hard to understand how the Department and the Blood Transfusion Service Board, who knew they had done wrong, would go to the wire and send a threatening letter to people who were trying to reach the truth just days before the death of the woman concerned. Why has the board admitted liability now? What was discovered a few weeks ago which led to the admission of liability? Why did it not make the admission six or 12 months ago? Does it mean that a document simply fell off a shelf two weeks ago? The public is amazed at the admission of liability at this stage.

What is so secret about the 1976 file? It might as well be the third secret of Fatima. Surely the Minister for Health is in a position to look at that file and tell us what is in it. Why is the information in the file not made available to everybody? The public and the Oireachtas are entitled to know what is in the file. Were duplicates made or is there just one file?

There are many more questions to be asked and, for that reason, my party has put down amendments to the motion. Our amendments demand that the Government direct all persons employed by Government Departments and State agencies to give full co-operation to the tribunal in its inquiries. That is of paramount importance. We also demand that the Government direct all Government Departments and State agencies concerned to co-operate fully with the tribunal. To date neither the Department nor the Blood Transfusion Service Board has co-operated. We now know that when the expert group tried to establish the truth not only were people deterred from attending but documents were also withheld. On this occasion State agencies and the Department must supply all documents and information requested. These demands should be included in the motion. It is a necessary safeguard. There are still some dark corners and unless power is given to the tribunal to ensure that the Department and other State agencies give every document requested then we will not get to the bottom of this.

The expert group were shunned when they tried to get that information. We do not want that to arise again. The truth of this scandal must come out once and for all. All people, Departments and agencies must be compelled to co-operate fully with the tribunal.

The second element of our first amendment ensures that people's privacy is protected. We do not want people who come before the tribunal to have their names splashed all over the newspapers. They should be able to protect their privacy if they wish and this must be explicitly stated.

Our additional amendment involves the deletion of words in paragraph 9. Our intention is to see that all questions relating to the late Mrs. McCole are answered. There can be no picking and choosing. Our fear is that through the current wording the Minister and the Government are attempting to limit the scope of the inquiry and to limit answers to the burning questions in the McCole case.

These are our two main concerns, although we have others. What is the position of those people who have already gone before the ad hoc tribunal? What happens to those people who have taken a final settlement? Where do they stand? Can the Minister tell us their rights if they wish to seek further compensation? I believe they are entitled to go back to court or to the tribunal. If necessary, they should receive whatever additional support, financial or otherwise, is required.

We are setting up a tribunal which is 12 months overdue. The Minister for Health and his Department fudged the issue all the way through. They stubbornly stood against the wishes of the victims, of Positive Action and of the Opposition in both Houses. The tide eventually turned against the Minister, his Department and the Government. It was just prior to Mrs. McCole's death that a State agency decided to cave in, admit liability and apologise. It was very late in the day and we are late setting up a tribunal to investigate something which should have been over and done with at this stage. We could have prevented the trauma, hardship, stress and worry of over 1,000 victims in this country who were infected by a State board, not one member of which has been carpeted, reprimanded, sacked, charged or has had anything done to them other than had their resignation accepted by the Minister and given a pocketful of money to go away. The woman who was infected was taken right to the wire in the courts.

The public has become very sceptical of State boards and Departments over the handling of this issue. Apart from establishing the women's entitlements, this tribunal is needed to return some transparency, decency and openness. As far as the public is concerned there has been a massive cover up for 18 months and no one has taken responsibility, least of all the Minister or the Department of Health.

Miss Ormonde

I second the amendment by Senator Finneran in relation to broadening the terms of reference to ensure that all persons involved in this scandal will be required to co-operate with the tribunal and that all documentation relating to it will be made available. The amendment will also ensure that the names of victims will not be disclosed if they do not wish it. I hope this amendment will be accepted.

I welcome this motion because it will help to establish the truth. It is a scandal that so many women have been infected with this disease. Questions have to be asked as to why this happened. Why did the truth not emerge before now? The Minister has already stated that the BTSB is a separate legal entity, nevertheless it must be held accountable. That has not happened. The Minister is politically responsible. He has to take action. It is important to get all the facts and the Minister is answerable on that score alone.

First we had a compensation tribunal which definitely seemed to be a cover up. That was the perception. Rather than let the truth emerge we had this tribunal established rather than using the courts. This was deeply resented. We are dealing with people's lives. We are not dealing with a piece of research or test cases where we have sub A group and sub B group and then we make a final conclusion as to what blood content is working and what is not. This time we are dealing with people. Men, women and children were going to the blood bank, either to give or receive blood, knowing that somewhere in the background something was not right.

Why did the Minister choose to establish a compensation tribunal? Did it take Mrs. McCole's death to bring this issue forward? My perception is that the public are ill at ease about this very sensitive issue. Let us get to the truth once and for all. It has been going on over 20 years. We had the expert group who investigated this under Dr. Miriam Hederman O'Brien, yet their terms of reference did not enable them to be furnished with all the documentation. It seems that some people were not interviewed about this saga. The issue of why that documentation was not brought forward was not raised in the Dáil until March this year, when it was propelled by Fianna Fáil. It was denied in the Dáil by the Minister of State, Deputy O'Shea, that that file was necessary to change the expert group's findings. Something went wrong there. Why? Why did the file suddenly appear after two years? I am not saying the Minister knew about it but the buck stops with him. The current Minister has to take the responsibility to ask the BTSB what went wrong, why there was a cover up and why this file was not produced long before it was. Why did it take until June before we got to the end of that?

The Minister would not listen to the demands of the victims for the truth, an admission of liability and an apology. All Mrs. McCole wanted was the truth. She wanted those who were responsible — the Department of Health — to be accountable to the public. The Minister for Health refused to listen and facilitated the cover up by the BTSB. I hate to use that language; it is not my style to make such statements in the House.

We let down the public and the victims who innocently used the blood bank. I am glad the tribunal has been set up — although it has taken 20 years — and that the truth will come out. Perhaps it is the best thing that ever happened because we need to look at the administration and professionalism of the BTSB. I hold its professional and administrative staff responsible. They had a say in how the organisation was run and how its affairs were administered in terms of documenting case studies and deciding which blood content should be allocated to them.

I accept that the Minister apologised for what he said yesterday, but I was very upset by it. I was amazed that such a professional Minister would have such a lack of empathy with the people who are suffering. We are talking about people, not numbers.

Propelled by Fianna Fáil Members of the other House, there has been movement on this over the last two years. My colleague, Deputy Geoghegan-Quinn, documented the series of events from 1976 to today. The "Questions and Answers" programme last Monday week was the first time the public entered into dialogue on this matter. It did not take root in the public arena until that night. There was great shock at the revelation that these people had been victimised by the blood bank in relation to how the anti-D product was administered.

With the setting up of the tribunal, we will come to the end of this awful saga and have a little more openness. Do not forget that when we were in Government we were told we were not open or transparent but that the new regime would deliver magnificent openness, transparency and accountability. It has failed absolutely on the first test.

Why was there a cover-up? Why did the BTSB suddenly produce the famous file? Who frustrated the late Mrs. McCole's endeavours to get at the truth? It is necessary to answer these questions if we are to restore public confidence in the blood bank, which plays an important role. It is a shame that confidence in it has been undermined. I welcome the tribunal and its broad terms of reference. I hope the amendment will be accepted.

Mrs. Taylor-Quinn

I welcome the Minister to the House. The motion proposes to establish a tribunal to investigate the terrible tragedy of the 1,600 women infected with hepatitis C. There has been a great deal of discussion and newsprint in recent times about this terrible problem. It is extremely important that none of us loses sight of the fact that 1,600 women, through no fault of theirs, were infected with hepatitis C. If I was one of those women I do not think I would be as responsible, reasonable, cool or constructive as they have been in their approach to this very serious and sensitive issue.

In 1971 I was a student in UCG. I gave a pint of blood and I received a card saying I had ORH negative blood. That meant nothing to me but I found out subsequently that I was one of 8 per cent in the country and, as such, I was a universal donor. I also found out that if I married a man with positive blood there was a real danger of producing blue babies. Sometime afterwards, a medical student told me about the development of the anti-D injection which would prevent the development of antibodies after a woman had given birth. That was greatly welcomed by all women in that position. Since then, any woman in that situation, where positive blood has been crossed with negative, has received an injection of anti-D. I am sure Senator Henry is in a better professional position than I am to elaborate on that issue.

In 1983 I gave birth to my first child who was a twin — I had been pregnant with twins. Prior to that I had an anti-D injection and after his birth I had another injection. I was delighted to have produced a baby and went about my business until this scare emerged a short time ago. It was then decided that all women who had had anti-D injections should be tested.

As someone who received three anti-D injections, twice in 1983 and once in 1989, I was extremely afraid of going for that test. I was one of the last to go to my GP for a blood test. I was afraid I might be told I had hepatitis C but I do not. However, I was quite fearful and it took me a long time to go for the test. We should all put ourselves in the position of the 1,600 women who had the test and received a positive result saying they have hepatitis C. They fully understand the significance of that result.

A great deal of unfair criticism has been heaped on the Minister. The Minister has held this portfolio for less than two years. He has been criticised for not apologising and for not accepting liability. I have known him for almost 20 years. He is a caring, committed man who has a great sense of public duty and public office. He has taken his responsibilities as Minister for Health very seriously. The Minister in private can say he is extremely sorry about what happened. However, we must appreciate that constitutional constraints prevent him from saying that in public. It is important that we separate the Minister's constitutional role from his role as a private individual.

The BTSB is a semi-State body for which the Department of Health is responsible. Each semi-State body has a statutory responsibly and must act accordingly. I deplore that we had to go this far before all the relevant information was presented and that more information was not available to the Hederman O'Brien inquiry. Recent statements by a doctor in the BTSB and by its medical director have shed more light on this. It is a pity that did not happen sooner. Those statements have made it clear that some Opposition politicians are more interested in politics than in facts. They failed to take the opportunity of a Dáil committee hearing with the BTSB to examine more thoroughly the question of the missing file or of donor X. That is a reflection on their sincerity and motivation.

The BTSB has shown appalling insensitivity in the manner in which it has handled this case. It has displayed a lack of understanding of the women concerned. Its handling of the Mrs. McCole case was particularly harsh and it does not deserve commendation. I am delighted the Minister has stated in the terms of reference that co-operation from Departments and State agencies will be obligatory. It is important that justice is seen to be done. It is also important that victims who wish to remain anonymous can remain so under the terms of reference.

The situation as regards the blood supply is serious. If the Minister has done one good thing it is that he has managed to retain confidence in the donor system and despite this crisis, supplies to the BTSB continue. We must not lose sight of the fact that thousands of people in hospital urgently need blood. I wondered what I would do if I had to go into hospital to be injected with a blood product. People who have low haemoglobin counts are often injected with blood injections. I am happy to say that I have been fully reassured and would have confidence if such a situation arose.

What was done by the former Minister, Deputy Howlin, when he set up the Miriam Hederman O'Brien inquiry was highly commendable. Many of its recommendations are being implemented by the BTSB and the Department of Health. The Minister has appointed two people to the BTSB, Shaun McCann and Liam Dunbar, both recognised as being at the top of their professions. The Bains group reported on the BTSB and the Minister has assured us of further research in this area, which is welcome.

During our EU Presidency the Minister will preside over the EU Health ministers. He has made the supply of blood in Europe a priority and he is anxious to ensure an agreed policy among member states. Given the variations that exist within member states, uniformity is important. I commend the Minister for prioritising this issue.

The motion is: "To inquire urgently into and report and make such findings and recommendations as it sees fit in relation to the following defined matters of public importance." It is important that we find out how and when the BTSB first became aware that anti-D manufactured by it had become infected with hepatitis C and what action it took. I hope the tribunal will come up with a response. The consequences of this for blood products and the blood supply will be apparent when the report is produced.

Condition 4 of the terms of reference of the tribunal refers to: "The response of the BTSB to a letter of 16th 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." I am delighted that has been included. I would be extremely annoyed if my blood was being tested without my being advised of it. We have a right to personal integrity and any intrusion without our agreement is not acceptable. I welcome the inclusion of this condition in which that issue can be addressed. The question of retrospective licensing is a matter of public concern which needs to be teased out. I am delighted the eminent Mr. Justice Thomas Finlay, who has wide experience, has taken on this responsibility.

Senator Finneran proposed an amendment to the terms of reference of the tribunal, which reads: "In paragraph 9, to delete "in so far as these questions relate to the terms of reference above"." The letter the McCole family wrote to the Minister on 8 October included five questions. I gather four of these questions can be dealt with under the terms of reference of the tribunal. I would like to read those questions into the record. The McCole family asked:

1. Why did the Blood Transfusion Service Board used plasma from a patient undergoing therapeutic plasma exchange when it was unsafe to so?

2. Why did the Blood Transfusion Service Board ignore the ample warnings of jaundice, hepatitis and adverse reactions to Anti-D in 1977 and again take no steps when they were informed of the infection of Anti-D with hepatitis C on December 16th, 1991?

3. Why did the Blood Transfusion Service Board not inform the infected women in 1991, and why did they not report the infection to the Department of Health as they were obliged by law to do?

4. Why was the Blood Transfusion Service Board permitted to manufacture Anti-D unlawfully and without a licence under the Therapeutic Substances Act, 1932, from 1970-1984?

Question No. 5 is the one where the difficulty arises. In its letter of 20 September 1996, the BTSB admitted liability and apologised but only in the context of a threat that if it proceeded with a case of aggravated exemplary damages and not succeed, it would pursue her costs. What was the justification for this threat?

I understand there is a separation of power in relation to the legal and departmental position, and one is in a different situation and a body apart. For legal and constitutional reasons, it would not be possible to deal with that particular aspect. The fact that the pertinent questions raised in the four questions can be dealt with by these terms of reference is welcome and, given from where we have come, we have proceeded a long way. The terms are tight and I compliment and commend the Minister's openness in accepting various proposals which have deepened the terms of reference.

Suggestions have been made that there is a cover-up. Will somebody tell me what Deputy Noonan has to gain by a cover-up? He has absolutely no responsibility for the crisis. It is not of his making as it happened over 20 years ago and at intervals since then. Not only that, he was not in Government but in Opposition. Since coming to office, he has taken a hands-on approach and dealt with the issue directly. He has been open to a variety of suggestions and acted in an extremely responsible and fair way.

Questions have been raised about compassion and lack of sensitivity. Everybody empathises with people in difficult situations but the reality is that action is needed at the end of the day. The Minister for Health, Deputy Noonan, established a tribunal of compensation. Many cases have gone through it and many women have been compensated and are extremely happy with it. Other women have chosen to go to the courts which is their right but what the Minister did is unprecedented in Europe. No other European country has set up a compensation tribunal. In France, they put people in jail but the reality is that nobody has received compensation. Similar situations exist in other member states.

This Minister has adopted a progressive approach. He has empathised in a positive way and acted positively in the interests of the victims concerned. When all discussion is concluded and everything calms down people will realise that the Minister has met the sensitivities and worries of the victims and done as much as is humanly and constitutionally possible to do in his position.

Dr. Henry

I welcome the Minister's speech. This dreadful incident has given us a knowledge of haematology which we would not have had before. I thank Senator Taylor-Quinn for explaining why the McCole family's fifth question was causing such difficulty. I also thank her for pointing out the most important fact, that this is an international problem. I know we are dealing with one specific case but this problem is in evidence all over Europe. Indeed, an article in today's Irish Medical Times entitled “Canada hit by hep-C scare” tells of 5,000 recent donors who may have become infected, so this is an extremely serious problem on an international scale.

The editorial in The Irish Times last Wednesday stated: “The real scandal is that it has come to this; that a tribunal of inquiry is necessary to establish facts which must already have been known in the Blood Transfusion Service Board (BTSB), in the Department of Health and, perhaps, in other State agencies”.

I support this statement. The real scandal is that there are those who could and should have spoken to the expert group and have not done so because I am sure far more information was available than that which they received.

When this débâcle started, I had two main concerns, the first of which related to the health care of the infected patients and how they were being treated. I think the patients have been well cared for from a health point of view. The natural history of infection by hepatitis C is really not well known yet, nor is there any adequate known treatment. However, whatever screening processes were necessary were put in place and carried out and, where it was felt advisable, liver biopsies were carried out and the results made known to patients. All those who need the care of a hepatologist are receiving it and all others are assured that their health care will be of no financial cost to them as it will be taken on by the State for the duration of their lives. I welcome all those provisions.

Unlike some others, I welcomed the setting up of the compensation tribunal because, as I said on several occasions, the adversarial system in this country, where patients must go to court to get damages which are due to them for injuries, can often be more stressful than the original injury. While we know that hepatitis C causes damage to the immune system as well as the liver, we are certain that a very great deal of damage is done to the immune system by stress. Therefore, the simpler it is made for those patients who do not want to go to court and want to go to the tribunal, the better. I quite understand that people were happy with the results of the tribunal because they feel a weight off their shoulders. They will now try to put it behind them and get on with their lives.

My second concern was that we should do all we possibly could to ensure that this sort of episode could not happen again. I say "do all we possibly could" because we must remember that blood products are biological and constantly open to infection and change. Therefore, even though one thinks a problem is solved, a few weeks later this may not be the case.

The initial episode causing infectious hepatitis C clearly came from the anti-D produced and sold by the Blood Transfusion Service Board from 1977. The source of the infection was a lady who was undergoing dialysis to lower her very high anti-D levels. The woman became jaundiced but her blood tested negative for hepatitis B. This is what one would normally expect, that one would try for hepatitis B, and I will go on later to the famous request form for information. Therefore, it was concluded that she had environmental hepatitis, infectious hepatitis, jaundice — whatever one would like to call it. At that time, these terms were not being used in a very precise manner. It is important to remember that jaundice really only means that the skin and the sclera go a green-yellow colour due to a pile up of bilirubin in the tissues and in the interstitial fluid. It could be due to numerous things. I think medical terminology is being misunderstood quite often along the way in this case.

They decided to use this blood because, at that time, it was felt that hepatitis A was not transmitted by blood. I want to say that it is probably not transmitted but there is such a change of knowledge in these fields that I am constantly terrified of anybody saying anything definite. Muir's Textbook of Pathology lists the mode of spread for hepatitis A as “oro-faecal (parenteral)”. Even Muir is careful in case it emerges that a person might contract the disease in a manner other than oro-faecal. This is a very difficult area with which to deal. The blood bank resumed the use of blood from the 1976 donor thereby breaking its own rules that it should not use blood from jaundiced patients. This was not an international rule; it only applied to Ireland. Blood transfusion services in countries where hepatitis A is common would be forced to use such blood. In addition, it was considered that the disease was not spread by means of blood transfusion.

We must consider the information available regarding hepatitis at that time. It is always good to thank those who have helped with one's research because one might need them in the future. I thank the librarians of Trinity College, the Royal College of Physicians and Mercer's Library in the Royal College of Surgeons, Professor Donald Weir and my daughter, Dr. Meriel McEntagart, who carried out a computer search on my behalf.

The first evidence regarding suspicions about non-A, non-B viral hepatitis was given at a symposium in March 1975 at the National Academy of Sciences in Washington. Did any officials of the BTSB or the Department of Health attend that meeting or read the reports that were published the following November in the American Journal of Medical Sciences?

Two important papers issued from the Washington symposium. The first, "The emerging pattern of post-transfusion hepatitis", discusses the possibility of a non-A, non-B hepatitis in transfusion hepatitis. It states, "additional human hepatitis virus(es) may exist". Experts at the time were not sure whether such viruses did exist. The paper refers to the fact that some voluntary donors who tested negative for hepatitis B appeared to have contracted another form of the disease which might have been transmitted by serum. It also suggests that perhaps this form is a variant of hepatitis A.

Another useful paper was delivered at that meeting which did not mention non-A, non-B hepatitis. However, the abstract stated: "The existence of additional viruses of human hepatitis is suggested by data concerning transfusion-associated disease and multiple episodes in the same individual".

The key indexing terms attached to the paper do not refer to non A, non B hepatitis. It was probably easy to miss the connection. The paper goes on to discuss viruses in human hepatitis and states that more than two viruses may cause the infection. It further states that this was not appreciated until 1962 because of a predominance in previously studied situations of transfusion-associated disease caused by pooled derivatives. The paper in question contains much technical information which is difficult to understand. However, it stresses that the possibility must be considered that there is more than one additional agent to hepatitis A and B. However, it is somewhat unsure in this regard.

In July 1975, an article appeared in The Lancet under the leader headline “Non-A, Non-B?”. It begins by stating that blood transfusion is dangerous at the best of times and that the transmission of syphilis and malaria is well recognised. The article also points out: “Even when a case of hepatitis is recognised as being “transfusion-associated”, it is a long, and sometimes hard, road to trace the source with certainty and identify the virus with precision”.

It continues:

All this seems to point strongly to hepatitis-B virus being the major hazard of blood transfusion so far as hepatitis viruses are concerned, although post-transfusion hepatitis is certainly not the exclusive preserve of hepatitis-B virus.

At that time, medical experts were still concentrating on hepatitis B. The article further states:

However, before a hypothetical hepatitis-C virus is produced, a touch of Occam's razor is not inappropriate. These patients might have a hepatitis A differing antigenically from the MSI of FEINSTONE et al.

This shows that there was a tremendous lack of knowledge and it does no one credit to state that things were as definite as certain people seem to believe.

Another paper published in The Lancet, which is widely read in this country appeared under the title “Clinical and Serological Analysis of Transfusion-Associated Hepatitis”. It states: “The attainment of hepatitis-free blood-transfusions has been a frustratingly slow, but progressively realistic goal”.

In 1975 medical experts were experiencing difficulties in attempting to identify the viruses in question. The article goes on to state:

The aetiology of non-A, non-B hepatitis after transfusion remains obscure. One could argue that these transaminase elevations do not represent viral hepatitis, but every effort was made to exclude other known causes of hepatic enzyme elevation.

It appears that questions were being asked as to whether people were contracting hepatitis after a transfusion rather than an infection. Efforts were made to identify the virus but it proved difficult to do so.

Pathologic Basis of Disease by Stanley Robbins states that “The subject of viral hepatitis is one of the most exciting and rapidly unfolding areas in medicine”. So speaks an academic working well away from the coal face who does not refer to non-A, non-B hepatitis in his book. Churchill Livingstone, a well known publishing house in the medical field, published a more specific article, “Systemic Pathology”, in 1978. In the section dealing with the alimentary canal, a specialist on this condition states:

When the term viral hepatitis is used without further qualification it conventionally relates only to the conditions now generally distinguished as type A viral hepatitis and type B viral hepatitis.

It goes on to discuss type A viral hepatitis — epidemic hepatitis — and type B viral hepatitis — homologous serum jaundice. The individual in question knew his subject but he refused to include any information regarding non-A, non-B hepatitis. Davidson's Principles and Practice of Medicine also refuses to mention non-A, non-B hepatitis. Our knowledge of this problem was inadequate at that time and it is fine to begin apportioning blame with the benefit of hindsight. Indeed, people have gone so far as to suggest that it is not a virus at all.

I inquired whether officials of the Department of Health or the blood bank attended that conference because I wish to know the level of interest shown by the BTSB in modern research at that time. Did the Department of Health provide sufficient funding for officials to attend the conference? For most of its existence, the blood bank has operated in a very isolated manner.

Definite information about non-A, non-B hepatitis appeared in The Lancet on 10 November 1984 in an article entitled “Non-A, non-B Hepatitis”. This article refers to the usefulness of serological tests. By the date of publication, hepatitis A had been better identified but the authors remained unsure regarding non-A, non-B hepatitis. They state: “Two or more agents are believed to be responsible for NANB hepatitis but attempts to isolate these agents have hitherto been unsuccessful.” They go on to state:

The most convincing studies of NANB hepatitis in man have concerned its parenteral transmission... [that is through blood or injections. They are still not in a totally definite position.] Although hepatitis A and B are readily identifiable by serological methods, great difficulties have been encountered in devising tests for NANB agents... We cannot exclude the possibility that NANB viruses induce little or no antibody production.

There may be a number of immunologically distinct non-A non-B viruses which could explain the discrepancies which have been reported. Even when they have definitely decided there are non-A non-B viruses, there is still trouble. It is important to keep this in context with what is being discussed.

Hepatitis C was identified in 1989 and when the situation became very bad. The expert group has been very charitable in the way it has dealt with people involved. By that time tests had been developed internationally which were not accurate. However, I wonder why the blood bank appears to have decided to do nothing at that time.

The tests were throwing up too many false positive results. A false positive result is not nearly as serious as a false negative result. A false positive test means that one thinks that some people have the condition who do not have it. It is unfortunate if they are told and it turns out they have not got the condition. However, a false negative result means that people who have a problem are being let loose without it being recognised. At that time, did the blood bank do the tests even though they were not reliable? Did it decide to discard all blood which tested positive? I cannot work this out from the report.

There is a large information gap between 1989 and 1991. Did it decide to get rid of all the blood or was that the time when the second hepatitis C positive donor slipped into the net? There is a second donor because we know there is another serologically different hepatitis C donor. I have not been able to get much information on that point.

I have not been able to get much information about the supposed consultant's report done on the women in Baldoyle who had hepatitis in the late 1970s. Whatever about throwing out the fresh blood, did anybody think of testing the old blood products for hepatitis C? We know there had been an appalling problem before this with HIV infected Factor VIII. Did anyone realise that, although the tests were not accurate, the blood products should be tested? Did anyone alert the Department of Health to the presence of hepatitis C? Who was the representative from the Department of Health on the board of the blood bank? Did he or she report back along a chain of command to the Department and, if so, how high did that chain of command go?

Much has been made about the fact that Dr. Terry Walsh, for reasons best known to himself, only showed the letter from the Middlesex Hospital confirming the infection to his chief biochemist. However, people should have become suspicious without that. Having had the débâcle of HIV something more should have been done.

The report of the expert group states in section 3.70: "We could find no evidence that the BTSB formally reviewed its initial decision to supply an intravenous product at any stage prior to the discovery of the hepatitis C incident in February 1994". I find that almost unbelievable. Have the files of the various officials involved at that time been examined? They would be most important.

I will not quote Tennessee Williams about mendacity and the smell of it but somebody is being very economical with the truth. The whole matter needs examination. I was misled about the status of WinRho when it was brought in as an emergency in February 1994.

I want to try to sort out the medical details about which Professor Shaun McCann felt obliged to speak on Pat Kenny's radio show. I do not think that either Professor McCann or Mr. Liam Dunbar hid anything from the expert group. What turned up was a blood request form that goes with a blood sample. Thousands go to the laboratory every day and normally one throws them out. I do not think it significant that they did not see it. Neither the Minister nor the Minister of State lied to the House about this.

A biochemist, Dr. Caroline Hussey, who is an expert in industrial microbiology and a professor of haematology from London were on the expert group. If I go to work and someone hands me a report on a urine sample with indicates certain levels of bacteria, white cells, blood cells and pH, I do not need a request form saying "urinary tract infection". I know the form went to the laboratory because I know the answer I received. The same applies in the case of the blood bank. It is to denigrate these two experts to say they would not have understood from what came back from the virology laboratory what was being sought. Of course they would have known, just as any professional would have known.

I cannot understand why some people harp on and on about this point because there are more serious questions to be asked. There are questions about information not being passed between 1989 and 1991. There was a great fluttering in the dovecotes in early 1992. One should look again at sections 3.72, 3.73 and 3.74 of the expert group's report where the production of anti-D is suddenly being questioned. What started that fluttering in the dovecotes? We were told there was nothing to report until the admission in February. Frankly, I do not believe it. Something happened around that time, although I do not know what.

However, there is the fact that Terry Walsh did not produce the Middlesex letter. I do not know what the civil servants are doing keeping letters in their drawers. This is the second time this has happened in the recent past. Files need to be examined. Something happened then, although I do not know what.

It is wrong for people to harp on about the request form. I write them out every day and if I expected to get them back I would have to prepare for a mountain of paper because most of them return with a negative result. This is not an instance in which anything was hidden and people should stop accusing the Minister and the Minister of State, Deputy O'Shea of hiding it. The professional integrity of Professor McCann and Mr. Dunbarr is at stake as is the implied stupidity of Dr. Hussey and Professor Bellingham. Dr. Miriam Hederman-O'Brien's letter which is quoted makes this perfectly clear.

The request form is not of significance as it is the same as the one used in the urine analysis example I gave. If the results came back indicating other diseases I would know what was being looked for and I would not have to see the request form.

The McColes are most anxious to have these questions answered and if the final questions cannot be answered, perhaps the Minister will ensure it is answered outside the tribunal.

One other matter we should consider in this House is whether only certain doctors should be allowed prescribe blood and blood products. Do we need to go that far? We in the medical profession have perhaps looked on blood too casually. However, it can be seen from what I quoted how desperately difficult it is to constantly identify what is going wrong with viruses in blood products. Constant reporting is necessary in this situation. Another measure which could be adopted is to ensure people attend international conferences to keep up to date. The blood bank was allowed to be far too isolated and, perhaps, was grossly underfunded by the Department of Health who may have a considerable share of the blame for the period 1989 to 1991 because of that.

Mr. Maloney

The anti-D and hepatitis C story is a tragedy which needs to be addressed for a number of reasons. I congratulate the Minister and the Government for facilitating this debate. It was obviously a difficult decision but the Minister has nothing to hide on the subject of the blood transfusion system in Ireland. However, it is important we get to the bottom of this mystery.

The tragic death of Mrs. McCole, a fellow Donegal person, was a major personal tragedy for her family and has focused public attention further on the hepatitis C issue. In situations such as this, there is always the temptation to make political gain and it is unfortunate that some Members of the Oireachtas have been unable to resist such temptation. Some of the political points scoring which occurred in this debate, aimed at people who were not even Members of the Oireachtas when women were being infected, has not helped in the search for truth.

Many of the allegations against the Minister were dealt with by him in the Dáil yesterday. He has shown that, contrary to Opposition claims, he did not delay and obstruct Mrs. McCole's case from the beginning to the end. Remarks were made yesterday which probably should not have been made and the Minister moved quickly to address them. His apology was most welcome and it is obvious from the remarks of Positive Action that it was accepted by them.

The provision of an adequate supply of blood and the assurance it exists is extremely important. Without it, many operations would not be possible. It is therefore right that the first imperative of policy for the Minister has been to protect the integrity of the blood supply and he addressed the issue at all times. He said it was a sensitive issue and had to be addressed in a proper way. The great danger of such an imperative is that it could ultimately be used to justify a cover up. That is why the Minister's decision to ask this House to hold a judicial inquiry is welcome. It proves there is not and will not be any cover up. If all questions had been properly answered from day one, we would have no call for an inquiry, but it is welcome.

We as public representatives are entitled to the truth. More than us, the women who have been infected, who have been placed at terrible risk, who cope every day with suffering and who may even die are entitled to know the truth. The children and loved ones, who cope with illness and anxiety, are also entitled to the truth. I worked for many years as a nurse and saw the effects of hepatitis and what it can do to people. The stress, the depression, the strain on families and the colour of the person's skin are all horrible. It is an issue which must be dealt with very sensitively.

There have been no heroes in this saga so far with one exception: a woman who fought to her death bed to know the truth. Her interest in money was so minimal, she instructed her lawyers to fight for an admission and not for money. She left behind her a monument of personal integrity and courage. Every Member of this House and of the wider community owes Brigid McCole a debt of undying gratitude. She fought on in pain and weariness against the delaying legal tactics of the Blood Transfusion Service Board until she could fight no more. If the truth comes out and people are found to have been negligent, it is important they are dealt with severely. She fought with the support, not of shysters as one of the newspapers described them last week, but of honourable legal people prepared to fight for her without any guarantee of recompense. The innuendo I read in newspapers last weekend that Mrs. McCole's lawyers were profiteering from illness and death amazed me. These newspapers did not seem to know there were four substantial legal teams involved. Three of them, for whom it appears money was no object, were against Mrs. McCole. Only one represented her. It was her legal team, unpaid as far as I know, who secured the admission of liability which the entire political establishment was unable to secure. The only consolation for these people is that the woman who had been campaigning for truth and justice in this matter knew what they did and how they won against the odds.

I said earlier that Mrs. McCole had left a monument of personal integrity behind her. The greatest monument we could build for her and her family would be to publish the truth of what happened to her. I welcome the Minister's appointment of the former Chief Justice Mr. Thomas Finlay to the chair of the tribunal. I have no doubt he will obtain the truth which the McCole family seek. We know this is a human tragedy. We do not know whether there was wilful conspiracy behind it, simple human error or criminal stupidity and negligence. We do not know if all factors involved have been identified with sufficient clarity to ensure this cannot happen again. Until we do, none of us, who may after all need blood at some time in the future, can rest easy. Until we do, none of us can say that justice has been achieved for innocent victims; people whose only crime was to seek an injection to protect their unborn babies.

There is one fundamental question which must now be answered. The Hederman O'Brien report into the causes of this infection covered much ground. It spoke of errors of judgment and made clear there was fault, but did not provoke or stimulate an admission of liability from the Blood Transfusion Service Board. The board carried on in the legal sense as if the Miriam Hederman O'Brien report had not been made. Several months later and before it knew of Mrs. McCole's deteriorating health, it changed tack and admitted liability. Why? What documents were discovered? What witnesses came forward? What information came to light? The only legal conclusion is that some information was withheld from Miriam Hederman O'Brien and her team which was sufficiently damning to change even the most intransigent legal advice. We need to know and must know what that was. If the truth is to be served, we must know what was hidden from the Hederman O'Brien examination. It finally came to light under the pressure of a court case.

Without that knowledge, it will be impossible to retain the necessary confidence in the blood supply. The Minister has striven at all times to maintain confidence in the blood supply. At the Blood Transfusion Service Board, people line up to be tested and if their blood is refused they imagine something is wrong with them. People go there in the belief they are doing good for others. It is important the Minister addressed that matter and he did so in a sensitive way.

There are other lessons to be learned from this controversy and I mention two of them. This case produced more than 1,000 victims who are entitled to and need to be served by politics. Instead, in too many cases, they have been subjected to the interaction between law and politics. They were sent to a limbo where the State and the establishment too often send people who have awkward questions to ask. There has been too much stonewalling in this case, too much use of legal tactics and too much obstruction. It is not fair to blame the Minister for that but the search for the truth must start with him.

Many of us have experienced the anxiety and stress that accompanies any serious illness. We sometimes feel that the medical profession does not like to be asked difficult questions. It is a profession that is sometimes unwilling to admit flaws or mistakes. Bad mistakes were made in this case but hardly a day goes by without someone suffering at the hands of a medical profession that can be bureaucratic, insensitive and unwilling to face plain truths. We all know doctors and nurses whose care and devotion are second to none but we also know people who have had painful and distressing experiences when they should have received better care.

If some of the work of the judicial inquiry to be established results in better appreciation among the medical profession of its own fallibility we would all be very well served. The Minister has set up the tribunal and we in this House look to him to ensure it gets the fullest co-operation possible. If the Minister needs any additional statutory powers to instruct any bodies under his control he will get those powers from this House. All Members feel this way. We want, and are entitled to, the whole truth. Brigid McCole must not have died in vain.

Mr. Dardis

Senator Honan is our spokesman on this but she had surgery recently and cannot attend, which she regrets very much.

I welcome the establishment of the tribunal. I would prefer if its terms of reference were broader but the tragedy is that the genesis of the tribunal was not the scandal that came to light but the fact that it took a life to precipitate the establishment of the tribunal. That is very sad. I wish Mr. Justice Finlay well in his search for truth, it is our hope and wish that the tribunal will lead to the truth because that has been our search for some time and it has not been very successful.

I accept the Minister's apology last night in the Dáil. However, I am still critical of many aspects of this whole saga. Perhaps he has learnt a salutary lesson about the scripts provided and the need to read them carefully before delivering them. The Minister accepts that it should not have been said. Last night I heard him on Vincent Browne Tonight on the radio when Jane O'Brien of Positive Action accepted his apology.

I met the Positive Action people yesterday as I left the House. I had not been listening to the debate in the Dáil and I wondered what was wrong. They were not angry but felt absolutely crushed to the extent that one did not want to interrupt them because they felt so defeated and deflated.

There is an underlying feature of all this that I find disquieting and I have referred to it in the House previously, the attitude of official Ireland to its citizens. Within the whole culture of secrecy that surrounds our public life, a contradiction in terms, there is a certain arrogance and a "we know best for the people" attitude; that we should not provide them with information which is not good for them; and that if they found out they would not understand. That is totally contradictory to the idea of a republic and needs to be examined closely as it is recurring.

The Minister mentioned the statutory independence of the Blood Transfusion Service Board and the adversarial nature of our courts. I accept the separation that exists between the Legislature and the Judiciary but I tire of the restatement of the legal position. I mentioned previously that frequently on the advice of the Attorney General or someone else we may not do this or that. In this instance particularly, if we have learnt anything it is that we are servants of the people. I do not dispute the need for lawyers to give their professional advice truthfully and to the best of their ability but I dispute the State taking such ultimate regard for that advice to the exclusion of the human dimension of the problem being addressed.

Did the refusal to admit liability come down to mere money? If that is the case how do we contrast that with the amounts of money mentioned for Luas in Dublin? There are some parallels between the discussions today and yesterday on Northern Ireland. I do not want to over-dramatise this but there are parallels between the condemnations we make in the case of people being killed and a certain callousness in respect of an individual life within our State.

It is regrettable that the State's alternative to what Positive Action sought was not what they sought or required. If there had been a more open approach at that time some of the more terrible subsequent events might not have happened. This legalistic approach goes right through the Minister's speech. I accept that from the purely legal point of view the BTSB and the State are not the same, but there has to be responsibility and accountability which must extend into the Department. It is the same with the delays in the court and the Minister's explanation of those delays but it brings us back into the legal framework and defensiveness which is not right or appropriate. There is a legal and a moral responsibility but, increasingly, in our society the moral responsibility is subservient to the legal responsibility. That is the wrong way around.

The Minister and all Members here represent the public. We are public representatives pro bono publico and we must frame our decisions and make our laws within that context. There must never be a situation where official Ireland and all its panoply of influence can exercise such enormous pressure on citizens trying to vindicate their rights. That balance has shifted in a very unsatisfactory direction.

Why was it necessary to reveal Mrs. McCole's name and to contest her request for anonymity? I fail to understand that. Why do we mobilise the State with all its power and influence against someone who is dying?

On the Order of Business today requests were made for us not to politicise this matter. The Minister has made similar requests. It is not my intention to politicise the issue, but if it is politicised to the extent that one's own party is attacked, then one must respond.

If Senator Honan were here today I suspect she would say it more forcefully than I, but on her behalf I must say that she first raised this matter in February 1994 when Deputy Howlin was Minister for Health. Senator Honan continually sought information in this House, her colleagues in the Dáil sought information and the matter was also raised on the Adjournment. It is wrong for the Minister to suggest the Progressive Democrats do not have the interests of hepatitis C victims at heart. Senator Honan's record suggests that she always had the interests of those victims at heart. It is worth recording that she herself received anti-D and so, on a human level, she was interested in their welfare, though fortunately she was not peronally infected by contaminated blood.

The discovery of documents revealed the BTSB knew in 1976 that donor "X" had infective hepatitis, and the Minister referred to some of these aspects earlier. Senator Honan, however, would continue to insist that the Minister and the Minister of State, Deputy O'Shea, denied there was anything new when it was clear to everyone that there was new and significant evidence. Senator Honan wishes that to be said on her behalf.

On the Adjournment debate in the Seanad, Senator Honan was told there was nothing new in the discovery of the documents. Those infected, and the wider public, want to know why and how all this happened. They do not want to be drip fed information in a slow transfusion, if I may use that phrase in this context, because the information frequently appears to have been contaminated.

How many people within the Minister's Department and the BTSB realised how serious this matter was? Was there a certain level of complacency as well as the defensiveness of official Ireland which I referred to earlier? Was that uppermost in their minds when they came to consider these matters?

If, at last, the State and its agencies become truly accountable rather than protesting to the House and to the public, the exercise will have been worthwhile despite the human tragedy involved. We can no longer hide behind selective disclosures of information. We frequently seem to hear that it is not in the national interest for the truth to be told, but the truth will always come out eventually. It is in the national interest that the truth should be told. The background to the establishment of this tribunal is far worse than the Fr. Smyth affair and infinitely worse than the beef tribunal, even though both these matters were very serious.

The Minister has already made the point that we cannot draw parallels between how this tribunal will operate and the beef tribunal because their procedures are totally different. The legal aspects of both tribunals are standard, but the new tribunal's terms of reference will be much narrower.

I am not an expert but references were made to a particular person being vilified. However, I found it disturbing when I heard on the news that it took two years to interpret the tests. The scientist in me came out in protest at that. From a scientific point of view it is not tenable to say that it took two years to interpret tests. I am open to being persuaded otherwise but from a purely scientific viewpoint I found that to be an astonishing statement.

I hope all the documents required will be made available to the tribunal and that it will be able to consider all these matters in full. I hope it will be able to look at political accountability apart from administrative accountability. Given the dominance of the law in all the arguments, why have no papers been sent to the Director of Public Prosecutions? I cannot understand that. Reference has been made to the contrast between what happened in France and what happened here. Our expectation is that the tribunal will arrive at the unvarnished truth which is what victims of this sad incident have a right to. They should know exactly what happened as well as why and how they became infected. Such an affair must never happen again.

Mr. Doyle

I wish to share my time with Senator O'Sullivan.

Acting Chairman (Mr. Maloney)

Is that agreed? Agreed.

Mr. Doyle

I remember only too well the morning of 23 February 1994 when the former Minister for Health, Deputy Howlin, announced in this House that he had been informed by the BTSB there was a possibility that an anti-D product manufactured by them was infected with what is now known as hepatitis C. My mind immediately flashed back to the previous difficulty we had with our blood supply in relation to HIV factor VIII when Deputy O'Hanlon was Minister for Health. Unfortunately, factor VIII was administered to haemophiliacs, quite a substantial number of whom died as a result. I hoped we would never have such a tragedy on our hands again but it seemed we had.

The Minister for Health immediately established an inquiry under the chairmanship of Dr. Hederman O'Brien. Its duty was to undertake an investigation into all the circumstances surrounding the infection of the anti-D product and other related matters. The group was informal in the sense that it had no power to compel witnesses or produce documents. In her report, Dr. Hederman O'Brien stated that her group's requests for information were generally met in full. Initially it required considerable probing to get the information required.

Shortly after the current Minister, Deputy Noonan, came into office he was presented with the report of the expert group on the BTSB. He was rightly of the view that the report could have damaged the confidence of blood donors and this would have a devastating effect on our health services. He took the necessary steps to strengthen the board with the appointment of Professor Shaun McCann and Mr. Dunbar so that the BTSB would continue its work under new management, would enjoy public confidence and we would never see a repeat of the hepatitis C tragedy. I was glad to hear Professor McCann say on radio this morning that there is no lack of public confidence in providing blood which our hospitals so badly need. I hope nothing that is said in this House will reduce public confidence in supplying blood.

In yesterday's debate in the Dáil, numerous Deputies showed genuine interest in the health of men and women who have been affected by this tragedy. On receiving the expert group's report, the Minister for Health also showed a compassionate interest in those who have been affected by this tragedy. The Minister's first concern was to appoint a compensation tribunal to provide fair compensation for those affected by hepatitis C. The compensation scheme approved by the Government offered numerous advantages over court proceedings. I am pleased to note that, to date, no award has been rejected by any claimant who went before the tribunal. It should be said that no one is compelled to go before the tribunal and they can if they wish also attend the courts. It is a matter for each person to decide whether to pursue their claim before the courts or the compensation tribunal. The Minister also showed his consideration for those who had been affected by setting up the compensation tribunal to avoid the adversarial system of the courts. The tribunal as distinct from the courts has only to establish that the claimant has been affected by the anti-D product and then it is up to the tribunal to assess damages to that person.

The Minister introduced the Health (Amendment) Act, 1996, which provided a statutory basis for the primary health care service for persons who suffered from hepatitis C. That has not been mentioned although it was a special provision. Services under this Act would be provided free of charge including general practitioner service, medicines, nursing services, home help and other services that might be required.

When I read the Dr. Miriam Hederman O'Brien report, I felt she had all the facts necessary to make the judgment she made in her report. It is alleged that a file showed that the BTSB knew from 1976 that a woman whose blood was being used without her knowledge or consent to make anti-D had infectious hepatitis and this information was not given to the expert group. It was only when the court case was being prepared for the late Bridget McCole that this file turned up. This might not be the only file that did not turn up. There could be other documents which were not made available to the expert group. I hope that they will be available to the tribunal. For that reason, the tribunal now proposed is justified. The facts about the infection are already in the public domain from the report of the expert group chaired by Dr. Miriam Hederman O'Brien and it should be relatively easy for the tribunal to confirm them. The most difficult aspect of this case is why the BTSB continued since 1991 to administer the anti-D product which could have been infected with hepatitis C. In November 1976, a female donor became jaundiced and the BTSB stopped using her plasma. It also at that time ordered tests for hepatitis B. Samples of plasma were taken and tested for hepatitis at UCD and also at the Middlesex Hospital. These tests proved negative.

In August 1991, the division of virology of Middlesex Hospital wrote to the BTSB offering to carry out newly developed tests for hepatitis C on the archive samples it had kept since 1977. In December 1991, it informed the BTSB that hepatitis C may have been related to cases of clinical jaundice from 1977. What is most difficult to understand is why the BTSB continued since 1991 to treat women and men with anti-D products when it knew there was a possibility that it could be infected with hepatitis C. If a local authority was informed there was a possibility of a contamination in its water supply, it would immediately cut it off. This did not happen unfortunately with the BTSB until 1994 and a substantial number of people between these dates had been infected. This infection could have been avoided. Paragraph (6.12) of the expert group's report states:

We consider that the failure to act upon this information promptly was a serious omission. Had the letter of 16 December, 1991 been followed up immediately it seems to us that the BTSB could have withdrawn its anti-D product and commenced a screening programme in December, 1991, or early in 1992, rather than in February, 1994.

This dereliction of duty of the BTSB is unforgivable. None of the senior employees of the BTSB has spoken in public about this matter and the tribunal's terms of reference clearly allows the crucial questions to be asked as to why this was allowed to happen. It is a scandal that a tribunal of inquiry had to be set up to establish facts which must already be known to the BTSB. The hepatitis C scandal is not just about the matter in which the BTSB administered contaminated products to its clients, it also underlines a fundamental lack of accountability in public administration. It is abundantly clear that the management and more importantly the supervision of the BTSB was grossly inadequate. I welcome the fact that former Chief Justice Mr. Finlay has agreed to chair the tribunal. The Minister and the Government deserve credit for framing terms of reference which meet the precise needs of those infected by this terrible tragedy.

Ms O'Sullivan

I am glad Senator Doyle concentrated on the health aspect of this debate. That is, and must be, the primary concern in the issue, though we are focusing today on the tribunal and getting at the truth. Throughout discussion, we have the faces of individual people in the backs of our minds, people who we know and whose families we know and whose lives have been overtaken by the tragedy of infection with hepatitis through receiving anti-D. That is the human element of this story which we have to keep at the front of our minds in discussing the issue.

I am glad the procedures have been put in place to look after, in so far as is possible, every aspect of the health needs of the people concerned. I welcome that the health boards are being asked to put a co-ordinator in place who is directly responsible for co-ordinating the health care aspects. This is important because those who have been infected should not have to search for the various aspects of care they need, whether it be direct physical health care, counselling or home help. It is important that the names and contact numbers of those individuals are available to those who need them. I support a call made in the Dáil that the home help needs, in particular, of these women should be fully looked after. There was some question that they might not have continuity of home help care and that the home helps might not be paid in the same way on a continuous basis. This is an important personal issue for the individual women concerned. I would like the Minister to take the concerns on board and ensure there is full continuity of care in that regard. The second issue is compensation and the financial aspect to it. I welcome the progress that has been made in that regard.

The issue being focused on is the question of getting at the full facts of what happened. I welcome the setting up of the tribunal and its terms of reference, its scope in time and other aspects of it and the fact that it goes back to 1970 and does not leave out any of the time in which this saga unfolded. As other speakers have said, the most critical time is from 1991 to 1994 when it appears the information given to the BTSB should have resulted in immediate action, but did not until 1994. That is the crucial timeframe but there are other aspects. I welcome the broad scope of the tribunal. I welcome the fact that there will be a legal team representing the public interest. This is an important aspect to what is being decided.

Speakers in both Houses referred to the legal and moral rights of this issue. That there is a public interest legal team is important. It will ensure it is not just a legal confrontation between those defending one side and those arguing the case on the other. Senator Henry gave us an insight into the complexities of the medical aspects in this issue. We should not gloss over them or expect it to be straightforward or easy to examine the detailed medical aspects. Perhaps we take a safe supply of blood for granted. Obviously ensuring a safe blood supply for those who need it is a complicated matter. It is important that an assurance comes from this tribunal that mistakes will not be made again so we can be confident of having a safe blood supply in the future.

I welcome the fact that the Minister has taken on board the concerns that were rightly expressed by the Opposition both here and in the Dáil with regard to full co-operation from Departments and State agencies and in relation to protecting, where possible, the anonymity of the people concerned. I commend and congratulate the brave members of Positive Action, and particularly Brigid McCole and her family. They fought a brave and difficult fight and they deserve our full support. I welcome the establishment of the tribunal and I hope it will answer all their questions.

Mr. Norris

I wish to share my time with Senator O'Toole and Senator Quinn.

Acting Chairman

Is that agreed? Agreed.

Mr. Norris

Apart from my general concern, I am interested in this issue because I have hepatitis which I am told I contracted from water in eastern Europe. However, one of the members of Positive Action indicated that it was possible to contract the virus from human immunoglobulin which I also——

Dr. Henry

It changes by the moment so do not take anything about blood for granted.

Mr. Norris

I will not. However, perhaps it could be examined. Having received two treatments while abroad with the Oireachtas Joint Committee on Foreign Affairs, I wonder if this might be the avenue through which I contracted the virus. Perhaps it is worth researching whether in certain circumstances it is possible to acquire the disease through inoculation.

I was saddened by events in the Dáil yesterday but I was impressed by the Minister's demeanour. He dealt with the matter in an extremely responsible way. He instantly apologised at the first available moment in a timely and gracious manner. This Minister is good and efficient and I believe the offence was caused inadvertently. I do not wish to cast aspersions on civil servants but it appeared that elements of the speech had a strong legal flavour and might have been included through draftsmanship other than that of the Minister. He seemed to be concentrating on getting issues of fact right and might not have paid as much attention to the surrounding circumstances. I also heard the Minister on the "The Vincent Browne Show" last night and again I was impressed with how he dealt with a difficult situation. Mr. Browne is an efficient journalist and he tried, using every guile he could, to get the Minister to admit liability. It would have been utterly wrong for the Minister to admit such liability.

Positive Action has drawn a matter to my attention which I wish to put on the record and on which I hope the Minister will comment. There is a clause in the terms of reference whereby the tribunal will examine points in a letter written by the McCole family on 8 October. However, Positive Action understands that it will only be considered in so far as it relates to the terms of reference and limits what may be examined in the letter sent by the McCole family. The organisation is anxious the allegation that there was some form of threat or intimidation should be included within the terms of reference. The Minister has dealt with this in some measure. However, it would be appropriate if it could be included in the terms of reference. Although it might not be germane in a legalistic sense it would help to allay public concern.

Members of the Irish Haemophilia Society have also expressed concerns. They are concerned about what they describe as the restrictive nature of the tribunal. They say there is no mention in the terms of reference of the blood products used on a daily basis by people with haemophilia which have infected those people with hepatitis C and other viruses. There is no mention of specific issues relating to those products. The tribunal will not look at the incident in 1982 when blood concentrates obtained from paid donors were imported by the BTSB and resulted in the death of haemophiliac patients from HIV infection. The terms do not include a 1986 incident when the BTSB was not heat treating factor IX concentrates in Irish plasma although it was internationally accepted practice to do so.

The society is seeking an expansion of the terms of reference to include all aspects of donor selection procedures, records maintained by the BTSB on the source of blood plasma and plasma, the BTSB's record in dealing with various viral infection disasters, the BTSB's recall and tracing policy, failure of the BTSB to introduce a plasma quarantine period, the criteria used by the BTSB to select blood products and the exchange of medical knowledge between different committees within the BTSB. The Minister might examine some of these matters and see if it is possible to include them within the terms of reference of the tribunal.

I was interested to hear Professor Shaun McCann, the new director of the BTSB, on the radio this morning. It is important that this person, who was brought in by the Minister to clear up a difficult and complicated situation, should be allowed to operate in an efficient manner. It would be most unfair if any opprobrium attached to him simply because he inherited a situation that must be cleaned up. He showed clear evidence of being able to deal with it in a comprehensive and useful manner. Having heard Senator Henry's contribution, it is clear that it is a complex area in which lay people easily get confused, particularly because of the incremental and developing nature of our knowledge. The efficiency of certain tests has increased and new tests have been introduced at various historical stages so that it was not possible to determine what infections had occurred. Hepatitis A, B, C, and D have been identified. Hepatitis G has now been reached and the experts do not know where it will end. As a lay person I am not competent to deal with the matter.

The Minister said he "cannot change the way in which court cases are conducted. That is a matter outside my influence and I would ask no more than the acceptance of that simple fact by those who object to how cases are dealt with within our judicial system". I cannot accept that. I am a frequent litigant and I always ensure that I direct how cases are run.

My last point relates to the disclosure of Mrs. McCole's name. Would it not have been possible for her to have sued under a name such as "Witness A" as happens in other trials? When we dealt with the refugee legislation, for example, the Government was extremely anxious to secure anonymity for people in those circumstances.

I would like to say more but I must yield to my colleagues.

Mr. Quinn

I wish to make two points. The first concerns the liability of the State in matters such as this. The principle of strict liability should apply here just as it increasingly applies in the commercial world. If blood transfusions were supplied by a private firm and not by the State that firm would be strictly liable when things went wrong. By this I mean that the fact that blood was contaminated and infected patients would be enough to establish liability on the part of whoever supplied it; it would not be necessary to establish negligence or wrongdoing. The damage caused is what creates the liability of the supplier not how it was caused.

Second, the Minister for Health is not the only party deserving of criticism on this issue. Mistakes were being made long before this Minister came into office. I am more concerned with the behaviour, practices and attitudes of people in the organisations behind the Minister. They cannot escape their due portion of blame. For instance, one of those affected, a person to whom I spoke yesterday, had a blood transfusion in November 1991. She felt reassured when the original announcement stated that only transfusions up to October of that year were at risk. That information turned out to be false and later, to her horror, she found that the November transfusion had infected her.

I am very concerned about the attitude which seems to prevail in some quarters to matters as grave as this. The nation rightly expects a great deal from this tribunal and it will be our duty to scrutinise the report with a focus on the future not the past.

Mr. O'Toole

This has been a difficult week for everybody involved and that includes the people in Positive Action who have done trojan work. It has also been a difficult week for the Minister. Things have gone wrong, mistakes have been made, but we all make mistakes. I appealed this morning on the Order of Business for us to deal with this as an issue focused debate rather than a personality focused debate. I deal every day with people who have difficulty accepting an apology. I have a very simple view—if people do not accept an apology they should reject it, but once it is accepted that should be the end of the matter. The Minister assessed his position and offered an apology. It is a difficult thing for a senior politician to do and it is a mark of the man's professional self-confidence that he did it. I appreciate it and that should be the end of the matter.

There is a problem here. Things did go wrong. I spent three hours in the Dáil yesterday and I have to say that, in my ten years here, I have never been so depressed and frustrated walking out of a debate even though I played no part in it. I felt that the problems associated with the issue were lost in the political tensions between the parties. It was not good for politics or public representation that none of us in either House emerges with honour from this level of debate and I share the blame with every other Member of the House.

The problem arose when the lawyers ran riot. I could never visualise the Minister standing over a dying person with a cheque in one hand and a form to be signed in the other. That is not his style, that is not the man and anybody who thinks it is is misinterpreting the situation. However, it is completely wrong that it should have happened and if there is blame to be cast, then it is on the Minister for his failure to control the lawyers. We all know how difficult that is. The Minister who rejects legal advice and then gets it wrong will never be forgiven; the Minister who accepts legal advice and gets it wrong will not be forgiven either. It is a no win situation. He should have pulled them back but it is very easy to make that point with the benefit of hindsight.

More was achieved in the course of this Ministry than at any other time. Issues were dealt with but that does not help the people who are suffering. That is where the difficulty arises because even though, as the Minister has said, compensation through the tribunal was as fairly administered as possible, it begged the questions about the truth, about who is responsible and where are we going. No matter what amount of money was paid there was still going to be a demand for the truth that is why this tribunal had to be established.

We had a motion in this House six or seven months ago and there was an amendment down in the names of most of the Independent Senators. On the same day discussions took place between Positive Action and the Minister and late that afternoon Positive Action indicated that it felt the compensation tribunal should be given a chance and the amendment was not pressed. Both the Minister and Positive Action took the correct decision that day; it is an understatement for us to say now that things did not work out. However, that does not mean that, with the facts people had at their disposal at that time, matters were dealt with improperly. That decision had to be taken but, now that we find ourselves in a mess, we should do our best to improve matters.

I do not know how many times I have stood in this House and pleaded for the words "in so far as it be possible" to be deleted from Bills. I know they are not the Minister's words; I know it is an anonymous draftsperson in some Department who is responsible. I have argued for ten years that they should be in a Bill only if they are inserted after every paragraph, every section, and every subsection because if it is not possible then it cannot be done. This is something that I have never understood.

I ask the Minister to be open on these issues. He will be judged on his record. There will be people who will always say he got it wrong and there will be others who will say he did it as well as any human could have done. He said that he made mistakes. The crucial mistakes made years ago were not made by Ministers, they were made by people in other places and we need to know where those mistakes were made. In addressing these issues we are looking for a balance between recognition of the problems and finding the truth.

Compensation is an issue which has been dealt with. Any wording in the motion we are doing tonight which gives a wrong impression should be eliminated. The fact that it might have to go back to the other House is not the issue; so be it. We do not need to pour over the bones of this any more. We do not need to know what went wrong in the last week but what went wrong all those years ago. We want to know why mistakes were not corrected in time to prevent other people being infected and which delayed treatment as we see it. I say "as we see it" because I am only informed to the extent of what I have read and been told. I do not put myself forward as an expert. I have avoided giving another lecture on the history of the issue or trying to point out where I think things went wrong. We should get the evidence, get the truth, get the internal reports and move the matter forward so that at least people will know what happened.

Ms Kelly

I thank the Minister for coming here. It would have been so much easier for him not to do so. That there is a certain amount of anger expressed here is only to be expected because there are many women who were infected through no fault of their own. As a woman I feel for them. Decisions were made to administer anti-D. Those decisions were made in good faith by the women and the medical staff. We have to find out why the blood was contaminated.

The terms of reference are fair. If they are broad enough to satisfy those who are most involved with the problem, who am I to say otherwise? If it has satisfied them it should satisfy us. I also agree with the time limit of 20 days for bringing back the report. We do not want it to drag on and on.

Terms of reference are usually set out before work is begun. Those working on a project often find half way through their work that the terms of reference are constricting. If that occurs in this case I hope the Minister will return to the House to seek an extension of the terms of reference. Aspects may arise which require further examination of which we or the Minister have not thought. I would like the terms of reference to be seen as enabling rather than restricting.

I know the Minister has taken many steps to ensure the safety of all blood products, both nationally and internationally. A conference was recently held in Adare, County Limerick, on that topic. This is a move in the right direction. We need more research on blood products and the possibility of other contaminants. We cannot sit still and say we have solved the problem. We must be aware of the possibility of other problems which might require similar action in the months and years to come. I have every confidence in the Minister seeing this through and ensuring the women are recompensed for their suffering.

Professor Lee

I agree with Senator Quinn about the strict liability of the State; I think it goes beyond the strict liability of the private sector. I also agree that this Minister has probably done the job better than anybody else would have, or has done, in the circumstances. This is essentially an ethical question. Although I am loathe to mention ethics, because on the scale of ethics we all stand condemned, nevertheless, the balance between the ethical and legal sides is still being got wrong. However belatedly, we should wholeheartedly recognise and accept that.

What is on the line now is not simply the credibility of the blood service and the Department of Health. It is awful that we have to have clauses demanding full co-operation from the public service. Those of us who have regarded the integrity of the public service as a prize of this State find it very difficult to have to insist formally on it. What is at stake now in the public mind is the credibility of the Oireachtas itself, that it be seen to get the terms of reference right, to want to get to the bottom of everything and to have no restrictive clauses.

For that reason, I support what Senator O'Toole said about the unacceptability of the phrase "in so far as that may be possible". That clause intellectually insults the Oireachtas every time it is used. I will oppose any amendment, or amendment to an amendment, which contains that clause. The credibility of the Oireachtas itself is now more at stake than anything else. That credibility should be sustained, which induces me to support the most open possible interpretation of everything and to oppose any attempt to restrict what we are now doing.

Minister for Health (Mr. Noonan,

Limerick East): I thank all Senators who contributed to the debate. Senators will appreciate that I will not be able to deal with all the matters which were raised but I will try to deal with some of them.

I take full responsibility for the speech I delivered in the other House yesterday. It is unfair to blame my officials in any way. I always read my scripts and I read that script thoroughly. I do not want to continue the suggestion that the fault somehow lay with my officials. The fault was with me and I accept responsibility.

Many Senators spoke about a cover up. A series of allegations have been made throughout this affair. The allegations are that there is a lack of information in one area or another. There is also an allegation of a cover up. However, if we were sure there was a major cover up we would not need the tribunal. The tribunal is there to establish the facts. We should proceed neutrally on that basis and stop making allegations at this stage. We should let the tribunal of inquiry, under Justice Finlay, decide what is the situation.

I thank Senator Taylor-Quinn, who spoke first on the Government side, for her support. I was very interested in Senator Henry's contribution. It is very important to get a medical view because matters are not as simplistic as they are frequently presented. I particularly thank her for her supportive comments on the file which is being waved over me all the time and for clarifying that situation.

Senator Dardis raised a number of points. I particularly agree with what he said about Senator Honan, to whom I wish a speedy recovery. Remarks I made in the other House were not directed at Senator Honan but at the Progressive Democrats' spokesman in that House in the heat of debate. No reference was made to Senator Honan who has on several occasions played a leading role in health debates in this House and no remark of mine was directed towards her.

Somebody said we should contrast the situation with that of France. The issue of people going to jail in France is always waved. That issue concerned factor VIII and HIV in the 1980s. We also had a problem with that here and Senators will recall it was the causal factor in the 1989 election. Compensation was not being paid to victims, particularly haemophiliacs, who got HIV from the blood product, factor VIII. The motion in the other House which, in effect, brought down the Government was on that issue. The 1989 election had to be fought before compensation was paid.

Members will see how much we have learned by the fact that on this occasion our first action was to ensure that compensation would be paid. We modelled it in the first instance on the kind of trust fund which was put in place for the haemophiliacs. We also tried to make very significant improvements on that so that, to pick up a point made by Senator Quinn, although liability is not admitted at the compensation tribunal, effectively it operates on the basis of strict liability. There is no proof of liability — the connection between hepatitis and the infected blood or blood product simply has to be established in the case of the plaintiff, and then compensation is measured. While it is not strict liability as outlined by the Senator, it is the concept under which compensation is paid.

The Irish Haemophiliac Association was referred to by Senator Norris. Many of its areas of concern, which Senator Norris listed, are encompassed in the terms of reference. The Department will meet the organisation early next week to discuss all aspects of its concerns. It is very important they are dealt with fairly. They have been doubly injured because many people who got HIV in the late 1980s have been subsequently infected by hepatitis C. That is a tragedy of double magnitude. We always meet that organisation and have very good relationships with it; we are very careful of its concerns at all times.

Senator Lee and Senator O'Toole referred to the wording of the amendment I have put before the House which states "in so far as it may be possible". Amendments were tabled by the Opposition in the other House which had to be recast for technical reasons. I can see the objections Senators might have to the words "in so far as it may be possible" but I am told it may be difficult for Justice Finlay to accede to the request we are making in the two Houses.

I ask Members to recall the miscellaneous section in the terms of reference. When there is a requirement on the tribunal to report back on an interim basis, after 20 oral hearings days, part of that requirement is to report on the adequacy of the terms of reference. This is not a cop out clause. It is simply that we do not want the Dáil or the Seanad to give a direction to the former Chief Justice which he would not be able to fulfil. However, this amendment will be brought to his attention. If he runs up against a blank wall and believes he needs a different term of reference, he can tell us what he needs in the interim report. That is the context in which this is being put forward. I would like Senators to accept it on that basis. It is being put forward fairly and in combination with the miscellaneous terms of reference. It meets the need.

The second amendment directs Departments and State agencies to co-operate fully with the tribunal. That amendment was brought forward by the Opposition in the Dáil and we had to alter it slightly for technical reasons. Occasionally in the other House the Government loses a Private Members' motion but that does not have force in terms of the Executive. While Parliament does many things, it does not direct by way of motion. Consequently, we wanted to word this in a way which was more appropriate. Any Government decision has the force of compulsion on civil servants to deliver. Government decisions are circulated to the relevant people in the Departments. It goes without saying that it will be followed. The decision to set up the tribunal carries a consequence of co-operation.

There are sanctions in the legislation under which a tribunal is set up. The High Court has the power to compel witnesses and to order the production of documents. Those powers are underpinned by legal sanctions, for example, fines of up to £10,000 on indictment and/or two years imprisonment. The powers of the tribunal are strong. I suggest the solution might be — we agreed this in the other House — that Seanad Éireann and Dáil Éireann would wish that persons as described would co-operate. By doing that, if the House were aware of non co-operation, it could take action by way of a motion, refer the matter to a special committee or deal with it in plenary session in the Dáil and Seanad. One would have the motion, the original Government decision which is an instruction to public servants and particular civil servants, the sanctions of the tribunal under the Act and the express wish of both Houses which would be incorporated in the terms of reference and which would give Members the right to revisit this if they were unhappy.

I cannot accept one of the amendments. The McCole letter laid out all the issues of concern about the infection which visited Mrs. McCole in 1976. The initial questions in the letter are directed towards that area. It will be possible to deal with them under the terms of reference of the tribunal. Senator Norris asked if there was an attempt to limit the investigation in respect of that. There is no attempt to limit the investigation. The last question which the family asked concerned the letter sent by the solicitors for the BTSB. The complaint was that the manner in which the issue of costs was dealt with was very onerous and not in accordance with what would be expected in a case of such delicacy. I hope I am paraphrasing that correctly.

I am advised that we will have a problem if we accept that. On account of the demarcation line between Parliament and the courts, the separation of powers is in danger of being infringed if Parliament seeks to pressurise by inquiry how any party conducts its litigation in the courts. Parties are free provided they stay within the law and the rules of court. Whatever other allegation is being made, there is no allegation that the solicitors in question did not stay within the law and the rules of court. They are free to defend their cases as they see fit in accordance with their legal advice. There is a difficulty that we would be crossing the constitutional line. The other requests made by Mrs. McCole's relatives are being dealt with fully within the terms of reference of the tribunal, and rightly so.

That was one of the good recommendations made to the party leaders by Positive Action in its letter dealing with the terms of reference. It was the first time I had seen that suggestion which I thought was an excellent one and we incorporated it in the terms of reference. I would like it if Members did not press that amendment. I can accept the spirit of the other amendments by recasting them as I have described.

I thank the House for its co-operation. This is an issue which concerned many people and I am pleased that the debate has been conducted in a non-political way and that real issues were addressed. I hope the new proposals, which would not have been in traditional judicial inquiries, will be effective. I hope the appointment by the Attorney General of counsel to serve the public interest will be an effective device. There have been criticisms that while all parties to a tribunal and the State are represented, the citizens — the public interest — is not. On this occasion an independent counsel will be appointed which will be served by a solicitor from the private sector.

In recent months a letter from the Chief State Solicitor's Office caused offence. We recognise that and, consequently, we believe it would not be proper to staff the public interest team from that Office. A solicitor from the private sector will serve in that capacity. I cannot predict the role in which the public service team will engage because we are breaking new ground. If the right people are in place, they will develop that role and if they are effective, they will be doing something on which future generations will insist in all tribunals. I hope it is an effective tribunal.

The second novel aspect of the terms of reference, if I may use that term, is the concept of an interim report. We want Mr. Justice Finlay to be in a position to report back to us. On the one hand we want him to report progress or the lack of it while on the other, we want him to tell us if he is having any difficulties which we may have the capacity to relieve. If there is an early report back, both Houses can look at the matter again if necessary. If the terms of reference have to be changed, we could do so quickly and to allow the tribunal to proceed.

I envisage a situation where, if the terms of reference are not adequate to meet the need, they could be changed in one or either direction, and maybe both. First, if the tribunal is inhibited because of the terms of reference from pursuing a line of inquiry which it feels it should pursue, then the terms of reference will be changed. On the other hand, if the terms of reference for one reason or another which we have not seen here or in the other House, enforce the tribunal to chase some irrelevancy, that the hare could be chased for the following three years without any particular benefit to anybody but because it had to be done under the terms of reference, then it would be proper that that would be pulled back also. We are not predicting what may happen; we are putting the mechanism in place so that it can report back to both Houses.

When the report is made I will communicate it to both Houses. It will be a report to the Minister for Health but it will in no way be a report other than a report for Members' information. The hearings of the tribunal will be in public under the Act, taking account of the anonymity issue which I mentioned already, and I hope it will proceed effectively.

There is one last aspect of the terms of reference to which I would draw the attention of the House, that is, the introductory sections which, it seems to me, will allow contending counsel to meet in the first instance to establish common ground. While the conclusions and recommendations of Dr. Miriam Hederman O'Brien's report have been put under severe pressure, I think contending counsel will find that they can agree much common ground arising from that report.

Then there are all the documents of discovery. There are over 5,000 documents which have been discovered at the BTSB in the course of the late Mrs. Brigid McCole's High Court case and all those documents are available. Therefore, this tribunal will start much farther up the road than a previous tribunal. I thank Justice Finlay for taking on this onerous task. I wish him well and every success.

Finally, by way of explanation, the 20 day report is not due in 20 days time but after 20 oral hearing days which puts it a little further down the line than 20 days from now. I am grateful to the Seanad for an analytical debate which has brought many issues to my attention. I am sorry I am not able to reply to all of them on an individual basis but we may get an opportunity in the future to return to this issue.

Mr. Finneran

On a point of order, is amendment No. 2 to be moved at this stage? I was unclear about the Chair's advice at the outset.

Acting Chairman

My advice is that the House must reach a decision on amendment No. 1 before moving to amendments Nos. 2 and 3.

Question put: "That the words proposed to be deleted stand."

The Seanad divided: Tá, 20; Níl, 16.

Tá

• Burke, Paddy.
• Calnan, Michael.
• Cashin, Bill.
• Cosgrave, Liam.
• Cotter, Bill.
• Doyle, Joe.
• McDonagh, Jarlath.
• Maloney, Seán.
• Manning, Maurice.
• Quinn, Feargal.
• Enright, Thomas W.
• Farrelly, John V.
• Hayes, Brian.
• Henry, Mary.
• Kelly, Mary.
• McAughtry, Sam.
• Ross, Shane P.N.
• Sherlock, Joe.
• Taylor-Quinn, Madeleine.
• Townsend, Jim.

Níl

• Byrne, Seán.
• Cassidy, Donie.
• Daly, Brendan.
• Dardis, John.
• Finneran, Michael.
• Fitzgerald, Tom.
• Kelleher, Billy.
• Kiely, Dan.
• Lanigan, Mick.
• Lee, Joe.
• Mulcahy, Michael.
• Norris, David.
• O'Brien, Francis.
• O'Kennedy, Michael.
• O'Toole, Joe.
• Ormonde, Ann.

Tellers: Tá, Senators Cosgrave and Burke; Níl, Senators Fitzgerald and Ormonde.

Question declared carried.

Amendment declared lost.

An Cathaoirleach

Amendment No. 2 has already been discussed with amendment No. 1. Is amendment No. 2 being pressed?

Mr. Finneran

Can I ask the Minister if, even at this late stage——

An Cathaoirleach

The discussion on the amendment has already taken place.

Mr. Finneran

I move amendment No. 2:

After paragraph 9, to insert the following new paragraphs:

"That a Government decision be made:

(i) directing all persons employed by the Government Departments and State Agencies concerned to give their full co-operation to the Tribunal in its inquiries and

(ii) directing all Government Departments and all State Agencies concerned to fully co-operate with the Tribunal by providing all documents and information requested of them;

That the Minister for Health should inform the person selected to conduct the inquiry that it is the desire of the House that the anonymity of the victims of Hepatitis C who come before the Tribunal be preserved if they so wish."

Mr. Fitzgerald

I second the amendment.

Amendment put.

The Seanad divided: Tá, 16; Níl, 20.

Tá

• Byrne, Seán.
• Cassidy, Donie.
• Daly, Brendan.
• Dardis, John.
• Finneran, Michael.
• Fitzgerald, Tom.
• Kelleher, Billy.
• Kiely, Dan.
• Lanigan, Mick.
• Lee, Joe.
• Mulcahy, Michael.
• Norris, David.
• O'Brien, Francis.
• O'Kennedy, Michael.
• O'Toole, Joe.
• Ormonde, Ann.

Níl

• Burke, Paddy.
• Calnan, Michael.
• Cashin, Bill.
• Cosgrave, Liam.
• Cotter, Bill.
• Doyle, Joe.
• Farrelly, John V.
• Henry, Mary.
• Howard, Michael.
• Kelly, Mary.
• McAughtry, Sam.
• Maloney, Seán.
• Manning, Maurice.
• O'Sullivan, Jan.
• Quinn, Feargal.
• Reynolds, Gerry.
• Ross, Shane P.N.
• Sherlock, Joe.
• Taylor-Quinn, Madeleine.
• Townsend, Jim.

Tellers: Tá, Senators Fitzgerald and Ormonde; Níl, Senators Cosgrave and Burke.

Amendment declared lost.

Mr. Manning

I move amendment No. 3:

At the end of the Terms of Reference, to insert the following new paragraph:

"and it is the wish of Seanad Éireann that

all persons employed by the Government Departments and the State Agencies concerned shall give their full co-operation to the Tribunal in its inquiries, and that the Departments and Agencies themselves shall fully co-operate with the Tribunal by providing all documents and information requested of them;

the Minister for Health shall inform the person selected to conduct the inquiry that it is the desire of the House that the anonymity of the victims of Hepatitis C who come before the Tribunal be preserved if they so wish, in so far as that may be possible".

Amendment agreed to.

Motion, as amended, agreed to.

An Cathaoirleach

When is it proposed to sit again?

Mr. Manning

At 2.30 p.m. on Tuesday next; there will be a debate on an agriculture motion.