The final report from the seven-year inquiry into the UK infected blood scandal has been published today, concluding that patients were knowingly exposed to risks and the medical catastrophe could have been largely, but not entirely, avoided.
The British medical scandal resulted in nearly 30,000 people being infected with hepatitis C and HIV, as a result of receiving contaminated blood or contaminated clotting factor products between 1970 and 1991.
Following years of increasing pressure from campaigners and MPs, former Prime Minister Theresa May announced a full UK-wide public inquiry into the scandal in July 2017. The final report, released on 20 May 2024, indicated that the disaster could have been prevented and that the UK government covered up the scandal “to save face and to save expense.”
Two main groups of National Health Service (NHS) patients were affected by contaminated blood products. In the 1970s, patients with blood clotting disorder haemophilia – including children enrolled in clinical trials – contracted HIV and hepatitis C from treatments using donated blood plasma. In addition to those with haemophilia, some patients who received blood transfusions during the same time frame were also infected. In total, it is thought that nearly 3,000 people from both groups have died.
The author of the report, Sir Brian Langstaff said while summarising the report’s findings, “I have to report that it could largely, though not entirely, have been avoided. And I have to report that it should have been.” The report has been presented to the UK House of Commons.
The UK has long struggled with blood shortages, leading the NHS to issue its first-ever Amber Alert in October 2022. The alert postponed non-urgent surgeries to reserve stocks for critical needs. In 2021, the NHS had to temporarily halt some blood tests over vial shortages.
In the 1970s, the availability of a new treatment for haemophilia, known as factor VIII/IX, necessitated the use of blood plasma, which was in short supply. This led to the UK opting for imports from the US. Plasma was extracted from donor blood, frozen, and treated to create a powder of pure factor VIII proteins.
Much of the imported blood was bought from high-risk donors, including prisoners and drug users. One vial could contain clotting proteins from tens of thousands of people, meaning it would take only one person carrying the virus to contaminate the entire batch.
Pharmaceutical companies Alpha, Armour, Baxter, and Bayer, which produced the infected blood products, have not compensated UK victims. However, in 1997, Bayer and the three other manufacturers agreed to pay $660m to settle cases on behalf of more than 6,000 haemophiliacs infected in the US in the early 1980s.
UK blood donations were not routinely screened for hepatitis C until 1991. However, in the 20 May report, the government claimed that screening for hepatitis C began as soon as the technology was available. Hitting back in response to this, the chair of the inquiry Brian Langstaff said “it [the comment] ignored all the countries that introduced screening before the UK. This amounts to 23 countries in total - including Japan, Finland, and Spain.”
The Hepatitis C Trust has said that there has been a surge in hepatitis C tests as media attention surrounding the scandal increased. The trust told the BBC that 12,800 people in England have requested NHS home-testing kits in just over a week, compared with 2,300 in the entire month of April.
