Isabel Hardman Isabel Hardman

Will the NHS change after the infected blood scandal?

The NHS logo on a sign outside (Getty Images)

The victims of the infected blood scandal have had to wait a very long time for there to be a public inquiry into what happened to them and the loved ones they lost, let alone for the report itself. The reason they wanted a public inquiry was that it would have the powers that other independent inquiries would not. They have also hoped it will lead to proper compensation, to conclusions that will stop another scandal with similar roots, and to a line being drawn under an injustice that has been ignored by the establishment, including the NHS, for too long. It is not yet clear if any of those things will happen, though. 

Perhaps the compensation bill will force change, but fixing the NHS and the civil service will take years, and many governments

The report’s findings are devastating, and the way Sir Brian Langstaff delivered them made clear that he felt those responsible had treated the victims appallingly. He expected an apology from the government this afternoon, but also said that ministers needed to be straight about ‘what the apology is for’. Doctors and civil servants knew of the risks of blood products to people with haemophilia and others receiving blood transfusions, but pretended not to. The notorious haematologist Arthur Bloom, insisted that he did not know of any patients who had been infected with HIV or hepatitis through these products, despite treating someone who he suspected had contracted Aids. Even worse than that, Langstaff described a defensive culture in the NHS and civil service. ‘Gaslighting’ is over-used in political discourse today, but this was a textbook example of governmental gaslighting. Documents were deliberately destroyed, Langstaff said, to make it harder to find the truth. 

Much of the commentary in the run up to this report has focused on the NHS, with the suggestion that our continuing belief that ‘doctor knows best’ and our love of the institution meant the scandal continued longer than it should have done. Langstaff blames the NHS, but seemed far angrier with civil servants and the way they sought to mislead successive ministers with a ‘nothing to see here’ approach. He quoted a minute where officials were irritated by a minister who sought to find out more about what had happened to mean so many people were infected with hepatitis or HIV. They complained that he seemed to be led by his sympathy for the victims. When another minister sought to get an accurate account of events, the report wasn’t published for four years and only then in a significantly altered state. 

Langstaff had suggestions for changes to break down the defensive walls of these big institutions. A culture that seeks to reward those who speak up, and punish those who remain silent. A duty of candour, and statutory obligations for civil servants, health service leaders and others. Patient safety needs to be the guiding principle. 

Ministers have been clear they will not talk about compensation today because they want the report’s findings to get prominence. Perhaps the staggering bill for the compensation will force change, but fixing the NHS and the civil service will take years, and many governments. The victims were palpably relieved as Langstaff delivered his findings. But like many others hit by scandals perpetuated by big and powerful organisations, they may yet feel the pain of seeing the cultures that harmed them and their families continue for many years.

Isabel Hardman
Written by
Isabel Hardman
Isabel Hardman is assistant editor of The Spectator and author of Why We Get the Wrong Politicians. She also presents Radio 4’s Week in Westminster.

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