Years of fighting for an admission of being wrong

Anti-D mothers from the outset wanted rights and not charity from the State

Anti-D mothers from the outset wanted rights and not charity from the State. This was why an admission of liability from the Blood Transfusion Service Board was so important to infected women. That admission would give the first clear indication that the blood bank was wrong in making and distributing an infected product. It took a great deal of time to secure this admission.

In April 1995, Michael Noonan brought advice to the Rainbow Government from the Attorney General that the BTSB was negligent in making anti-D in 1976-1977 and from 1991 to February 1994.

The advice was that it was imperative that no one should give an indication of this negligence. That same Cabinet meeting also agreed to establish an ex gratia compensation scheme. This in essence was the government strategy.

All of this emerges clearly from the recent report on the legal strategy adopted by the defence in the case of the late Bridget McCole. The effect of this strategy was that anti-D women were being offered an ex gratia compensation scheme, where they would sign away their legal rights without knowing the full facts.

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We are now discovering the extent of what was deliberately suppressed about the BTSB's culpability and we are comparing and contrasting this with the minimal information revealed to victims and to the public by an administration that was committed to "openness and transparency".

The clear message from the recently released Macken report is that a co-ordinated strategy was in place whereby various government agencies frustrated the demands of the victims.

It is now clear why all women who issued High Court writs were threatened with the might of the State; why there was an intensive public advertising campaign to promote the ex gratia compensation tribunal; why the legal strategy was excluded from the terms of the Finlay inquiry and why the former government resisted our call in April 1996 to establish a tribunal of inquiry into information which was hidden from the Expert Group.

We now know it was the courage of one exceptional woman, Bridget McCole, which brought the house of cards tumbling down on the public charade that the blood bank was not negligent.

A key sentence on how important it was for the Government rigidly to control the hepatitis C problem is contained in the advice of Mr Ian Finlay SC, on March 15th, 1995. Mr Finlay wrote that the case of anti-D women had "been greatly strengthened by the Expert Group's findings". Unless this compensation scheme provided attractions which a court could not offer, claimants were likely to sue and "the scheme could become a dead letter and the State's financial liability could be greater".

The Rainbow Government is vulnerable to the charge that it made the cost to the State rather than the legal rights of victims its over-riding concern.

When the Cabinet was informed of the blood bank's liability, the State devised details of its own compensation scheme to ensure that cases from anti-D women would not have to go to the High Court.

The contents of the Expert Group report were known to the State but the 900 women who had tested positive were being told by the blood bank this was an "act of God" - no one was to blame.

The question of how this contamination occurred was uppermost in the minds of infected women when Positive Action first met then health minister, Brendan Howlin, in June 1994. During a lengthy meeting there was just one reference to compensation. Mr Howlin was asked simply what he proposed to do regarding the issue. Shortly after, in July, the first legal advice to the State was that a sustainable claim could be made for negligence. The State knew this was no "act of God".

The report of the Expert Group was handed to Michael Noonan shortly after he became Minister for Health in December 1994. He did not publish the report until the following April. In the interim, he had legal advice which confirmed negligence and put the flesh on a compensation scheme.

Positive Action, as a group, retained its own legal advisers at this time. The team, led by former Attorney General John Rogers SC, was clear that there was a sustainable case for negligence in the courts; if a compensation tribunal was to be established, it should be on a statutory footing, there should be an admission of liability and health care must be guaranteed.

It was always the intention of Positive Action to seek the establishment of the best possible compensation scheme, but the State consistently resisted any alteration to its preferred solution which was, as we were later informed, a "benevolent institution". These opposing positions were to form the focus of strong disagreement between Positive Action and the Minister for Health during the next two years.

At an endless series of meetings during this time, Michael Noonan and Department of Health officials appeared to find it difficult to comprehend the need for solutions to the anti-D tragedy which would fully reflect the extent of the wrong done to the victims.

The Minister said, in public, women could go either to the High Court and prove liability or to his tribunal where negligence need not be an issue. Mr Noonan did not say in public that during this time, hundreds of women were being frightened by letters from the State's legal team saying it was difficult to understand how they could choose to ignore the (compensation) scheme and warning them of the uncertainties, delays, stresses, confrontation and costs which would be involved if they went to the High Court.

The State, the letter added, would fully defend actions, if necessary up to the Supreme Court. Bridget Mc Cole personally bore the brunt of the State's determination that no anti-D case should go to court but others were threatened and cajoled also.

Angry and frustrated at the lack of action on meeting health needs, Positive Action drew up its own proposals in August 1995. The group also published its own draft bill that September on establishing a compensation scheme in statute.

During this time, the intensive political lobbying continued. There wasn't a member of the Rainbow parties who did not know how important it was to have an admission of liability and the permanence of a statutory compensation scheme. There was tea and sympathy from members of the Cabinet, but nothing appeared to break down the determination that compensation is sues should be dealt with behind closed doors, where negligence would not be an issue.

It was only after the Finlay inquiry concluded in March that the Rainbow Government did, at last, concede to a statutory tribunal.

Bridget McCole's own High Court action began in the summer of 1995. Her courage in taking the first and very public High Court ac tion was watched closely by the other anti-D women.

They bore a powerful, silent admiration for a woman who embodied their collective view that the anti-D scandal could not be sidelined or dismissed. When Mrs McCole was refused consent to use an alias, it sent shock waves through the body of other infected women. Michael Noonan knew from Positive Action how private many wo men were about their hepatitis C infection. No doubt he would have recognised the significance of the comment from the Attorney General contained in a letter to the Chief State Solicitor on September 28th, 1995, that opposing Bridget McCole's wish to use an alias had a "tactical value" in promoting the Government's scheme. Bridget McCole's wish for a June 1996 court hearing was also denied her.

This was of great importance to her as her health was deteriorating. Instead, the start of her action was fixed for October 8th, 1996. To the other anti-D women, it was important there be a High Court determination before the June 17th closing date for the compensation scheme. They were already aware of revelations in the McCole discovery of documents that indicated how the report of the Expert Group did not contain all the relevant information. Michael Noonan refused to extend the June 17th closing date until after the McCole case was determined. He still has to explain why he refused that simple request and why it was so vital for the Government to ensure this was upheld.

On September 9th last, a joint opinion to the BTSB from three senior counsel said it was their "unanimous and unequivocal advice that it is imperative for the Blood Transfusion Service Board to concede on the issue of negligence".

This was the first advice on liability to the blood bank which appears in the recently released report. It begs the question as to whether the blood bank sought counsel's opinion before this.

While the blood bank eventually admitted liability it did not, at this stage, concede on the issue of aggravated and/or exemplary damages. The £175,000 settlement in the McCole case did not include these additional damages. With the forthcoming establishment of a statutory compensation scheme, all victims will be able to claim aggravated and/or exemplary damages or have a 20 per cent payment on top of their award from a reparation fund. It is a sad irony that Bridget McCole may be the only victim of the contaminated blood scandal who will not receive such an additional award.

The admission of liability to Mrs McCole contained a threat that frightened a woman who had endured so much during her life. Michael Noonan as Minister for Health was given an opportunity by the BTSB, according to an interdepartmental memorandum dated September 17th, 1996, to "disagree" with this letter.

As this was a most significant letter containing the first admission of liability by the blood bank, why was he, as Minister for Health, not made aware of the content of this letter which was obviously known about within the Department of Health?

The human cost to infected wo men of how this tragedy has been handled has been enormous. Now the Minister for Health and Children, Mr Cowen, has delivered answers to key issues about what legal tactics were employed; he has revealed documents that the Rainbow Government said could not be made public.

Positive Action feels, even with the revelations in this latest report, a public debate is still needed on the principles of why such an indefensible position was adopted by the blood bank and why the State parties sat by and concealed information.

Bridget McCole, in the last months of her life, would often say if only Michael Noonan could see how sick she was then it might make a difference. It took her death to make a difference.