Fintan O'Toole: It is now 10 years since the most serious of all Irish scandals, the infection of up to two thousand people with contaminated blood, emerged in public. Astonishing as it may seem a decade on, this awful story continues.
As I showed last week, documents obtained under Freedom of Information reveal the continuing failure of the Blood Transfusion Service and the Department of Health to make sure that all blood donors who tested positive for Hepatitis C have been informed of this critical fact. The Minister, Mícheál Martin, has known in detail about this scandal for at least three years and has done nothing. Why on earth would the most decent and talented member of the cabinet allow this mess to continue?
The simple and depressing answer is Cork. It happens to be Mícheál Martin's power base. It is also the centre of the problem. The BTS has long had two centres - one in Dublin and one in Cork which is responsible for the Munster area. While it is by no means clear that the Dublin centre informed all donors who tested positive of this fact, it at least had a policy of doing so.
In Munster, on the other hand, the policy was the opposite. The head of the Cork unit, Dr Joan Power, consciously decided against telling donors what she knew.
Dr Power made it clear to the Finlay Tribunal that she decided on this policy in good faith, in the belief that since the tests then available sometimes gave false positive results, it was best not to upset these donors. No one doubts that this concern on her part was an entirely well-motivated feeling on the part of a fundamentally decent professional. She believed that she was acting in accordance with the best medical ethics.
This belief, however, was at odds with the preponderance of the medical evidence accepted by the tribunal, "that there was an ethical obligation to inform a person who tested positive in any fashion of that fact, lest they wish to make the choice of having further investigation or treatment". Mr Justice Finlay described the policy operated in Munster as "quite an inadequate response to the responsibilities \ had towards donors". He was especially mindful of the fact that, where Hepatitis C caused liver damage "the earlier intervention took place the better" .
Given these strong and definitive findings, the BTS was obliged to put its house in order by finding out what had gone on in Munster and establishing whether all donors had now been informed. Almost nothing was done until June 2000, when one such donor instigated High Court proceedings. At that point, the BTS finally tried to establish how many Munster donors had not been informed and identified a total of 28.
In March 2000, the medical director of the BTS asked Dr Power for the addresses of these donors so that they could be contacted. She declined to give him the addresses.
A Department of Health memo from July 2002 notes that "Dr Power is insisting that the 28 donors are her patients and that she alone has the right to contact them. Dr Power indicated that if any other doctor makes contact with the donors, she would report that person to the Medical Council".
This dispute proved to be disastrous to the internal stability of the BTS, an organisation that desperately needed a period of calm efficiency in which to re-establish its battered reputation. The tensions between Dr Power and the senior BTS officials in Dublin fed into a wider wrangle over the future of a separate BTS service in Munster.
Already, the widely-respected chairman of the BTS, Prof Patricia Barker, had resigned because of the infighting. Now, the equally respected CEO, Martin Hynes, was effectively forced out. He put Dr Power on administrative leave over her refusal to give the addresses to the medical director. In turn, however, the board of the BTS suspended him, and after an expensive court settlement, he resigned.
A critical factor in all of this chaos, however, was Mícheál Martin's decision to appoint a disproportionate number of people from Cork and from the Southern Health Board area to the board of the BTS. While all of these people are distinguished professionals committed to public service, the heavy Munster presence on the board has inevitably made the whole subject of the policy adopted in Munster even more sensitive. An independent inquiry into the issue, which has been promised but not established, would have to examine both the conduct of the Cork office and the involvement of Cork University Hospital. One of the revelations from the files is that two consultants at Cork University Hospital (CUH) were taking part in a joint study with Dr Power of test results from blood donors. An obvious area to be addressed by any inquiry would be how much CUH staff knew about these results and whether they were satisfied that the donors had given informed consent to the testing. Through no fault of their own, this presents potential conflicts of interest for the other two CUH staff members who are on the BTS board.
These problems and conflicts have prevented a proper inquiry and delayed the urgent task of protecting public health. In any functioning democracy, a Health Minister would be called to account for such an extraordinary failure.