The infected blood inquiry - where do we go from here?

Sasha Batchelor, Client Executive

The start of last week in British politics was dominated by the long-awaited release of the infected blood inquiry, until the Prime Minister’s surprise calling of a General Election took Westminster by storm. While attention has already moved on, it is crucial that we reflect on and learn from this inquiry’s findings. 

Described as the biggest treatment disaster in NHS history, this scandal led to more than 30,000 people being infected with Hepatitis C and HIV through contaminated blood products and transfusions, and to the deaths of around 3,000 people. The Prime Minister described it as a "day of shame for the British state” and offered a "whole-hearted" apology to victims. 

Amid welcome cross-party consensus, the General Election has not delayed justice any longer. In one of the last acts of Parliament, the Infected Blood Compensation Authority was created. A second round of interim payments totaling £210,000 will be delivered this summer and the compensation package is expected to total around £10 billion. 

However, tireless campaigning from support groups, politicians and journalists alike will continue, with increasing demands for pharmaceutical companies to contribute to the compensation package.

Beyond compensation, one of the most consequential findings was the evidence the blood scandal was made worse by a “chilling” NHS and government cover-up, exposing victims to "unacceptable risks". Politicians of all stripes stressed the need to learn from the mistakes of the past, but we have heard these sentiments before. 

Many observers have pointed to the fact that a series of recent inquiries - including investigations into NHS and maternity services - have consistently pointed to a culture of defensiveness and willingness to cover up problems across the health service and wider British state. 

Despite the recurrence of similar themes and suggested recommendations, there are increasing frustrations that little has substantially changed. 

However, the infected blood inquiry could present a glimmer of hope and finally provide the impetus behind much needed reform. There is growing momentum behind one of the core inquiry recommendations to establish a so-called ‘duty of candour’ in law.

If extended beyond its current application to NHS staff, this would obligate public servants to tell the truth or face criminal sanctions. This is widely viewed as a major step in the right direction to help tackle what the Institute for Government has described as “institutional inertia”.

While the Victims and Prisoners Bill included a statutory duty to review candour laws by the 1st of January 2025, it is notable that Sir Keir Starmer and other prominent Labour figures quickly endorsed this idea. 

The trajectory of this issue is clear to see, with Shadow Health Secretary Wes Streeting recently reasserting Labour’s commitment to reform the NHS, arguing that this must begin with “a policy of radical candour”.

Whoever forms the next government must ensure that enacting difficult but necessary reform, starting with proposals like this, does not fall by the wayside. While this would be a step in the right direction, the proof will be in the pudding as history suggests that tackling these deeply rooted cultural barriers has been a seemingly intractable task thus far. 

More broadly, if public inquiries – including the ongoing Post Office and Covid-19 inquiries – will continue to play such a salient role in British politics, we must ensure that they are as effective as they can be in preventing and addressing institutional failures.

In 2017 the Institute for Government outlined several suggestions to ensure public inquiries lead to real change. These included a role for select committees to examine annual progress updates from the Government and making public inquiries publish interim reports in the months, rather than years, after events. 

These and other similar proposals have been neglected for far too long thus far and should serve as a starting point to improve the public inquiry process in this country. 

Addressing this is of paramount importance, with health experts and commentators already warning that we are repeating the same mistakes towards victims of sodium valproate drug scandal victims.

The cross-party reaction to the infected blood inquiry and hints that reform is coming down the track is certainly something to be welcomed, but it is imperative that we do all we can to ensure that this is not yet another case of gone and then forgotten. 

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