Blood is central to the myths British people tell themselves. One of the many consequences of the contaminated blood scandal is that it may blow those myths apart. For if this scandal can make us face the reality of how badly we are governed, and indeed how selfishly we govern ourselves, then some good may come from so much needless suffering.
The scandal began in the 1970s. At the start of that decade, Richard Titmuss, the great social democratic theorist, placed blood at the centre of the justification for the British welfare state with an argument that complacent we Brits could not help but feel reflected rather well on us. The NHS was not just morally superior to the greedy privatised US health system, Titmuss said. It was more efficient too. Because the British believed the NHS was a moral institution, they voluntarily gave it their blood free of charge, and would never dream of donating blood if there was a chance it might be contaminated.
What makes this scandal so shameful is that so many were complicit
In the US, by contrast, the market ruled. Prisoners, the poor and the homeless sold blood to make the money they needed to survive. Blood came from ‘Skid Row’, to use the language of the day. Desperate people took the money whatever the state of their health. As a result, US blood was bad blood, Titmuss argued, while British blood was good. Altruism and voluntary giving was superior to the corruptions of the marketplace, Titmuss concluded in his study, The Gift Relationship: From Human Blood to Social Policy, and he could prove it.
Modern historians who say empire defined post-war, post-imperial Britain miss how much people thought that, if we were no longer an actual great power, we were a moral great power instead. The NHS became ‘the closest thing the English people have to a religion’ in Nigel Lawson’s words, because it proved our goodness.
They weren’t necessarily wrong. But like all nationalisms that say the favoured people are intrinsically more moral than foreigners, a belief in British superiority was way too optimistic. In reality, there were not enough altruistic people willing to give blood, and the blood service itself was ineptly managed.
As a result, Sir Brian Langstaff has today said, in one of the most devastating reports ever written on British public life, that in 1973, the medical authorities allowed ‘the importation and distribution of blood products (Factor 8 concentrates) made in the US or Austria which carried a high risk of causing hepatitis, and were known to be less safe than current domestic treatments for bleeding disorders’. This was a mere three years after blood donation had been held as an example of the superiority of the British.
You did not need to be a genius in 1973 to know the risks. Sir Brian emphasises that knowledge of the dangers had been around since the 1940s.
It’s been an incredible experience listening to the victims of this scandal today. I’ve heard people talking about how they or their families have been raising complaints for nigh on 50 years. On BBC radio this morning, one described how her family had contacted David Owen, now Lord Owen, who was health secretary in 1974. Back in the 1970s, Owen campaigned for Britain to become self-sufficient in blood products because of the risk of Hepatitis infection from the blood sold by poor and desperate US donors. Nothing was done.
In one of the most telling passages of the report, Sir Brian emphasises how this 50-year-old scandal that killed 3000 people also kills our sense of ourselves. ‘It will be astonishing to anyone who reads this report that these events could have happened in the UK,’ he writes. ‘It may also be surprising that the questions why so many deaths and infections occurred have not had answers before now.’
However cynical we are about politicians, most people in the UK retain the hope that the system can be made to work eventually. Popular British fiction from Sherlock Holmes via George Smiley to Dumbledore attests to the yearning that somehow, somewhere, someone will appear who will overrule the incompetent fools and make everything all right. Yet in this case no one did for decade after decade, until Theresa May to her enormous credit ordered an inquiry in 2017 into the ‘appalling tragedy which should simply never have happened’.
May’s intervention illuminates a further dark corner. We know how to blame politicians. But this scandal is as much about the bishops and popes of our national religion: those who run the National Health Service.
Sir Bryan is not talking about politicians when he says that patients were lied to about the risks and, in some cases, infected during research carried out without their consent by the NHS. It was medical staff who failed ‘to tell people that they were infected and thereby denying them the opportunity to control the progression of their own illness more effectively and to prevent the spread of infection to others close to them’.
This is not to let politicians off the hook. It is just to say that the infected blood scandal goes far beyond the usual suspects and the usual whipping boys. What makes it so shameful is that so many were complicit. Sir Bryan talks of public servants peddling lies that included the ‘misleading’ oft-repeated statement that there was ‘no conclusive proof’ that Aids could be transmitted by transfusion of blood and blood products when the HIV epidemic let rip in the 1980s. The lying was followed by the deliberate destruction of official documents.
‘Standing back and viewing the response of the NHS and of the government, the answer to the question “was there a cover-up?” is that there has been,’ the report concludes. It continues:
Not in the sense of a handful of people plotting in an orchestrated conspiracy to mislead, but in a way that was more subtle, more pervasive and more chilling in its implications. To save face and to save expense, there has been a hiding of much of the truth.
Over decades successive governments repeated lines to take that were inaccurate, defensive and misleading. Its persistent refusal to hold a public inquiry, coupled with a defensive mindset that refused to countenance that wrong had been done, left people without answers, and without justice.
There is a lot to learn here. The first lesson is that we don’t regard the NHS or any other man-made institution with religious awe. We listen to and protect whistleblowers instead, something the NHS has been hopeless at doing throughout its history. In short, we should give the people who run it a harder time – and perhaps give blood ourselves.
Comments