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Health (Amendment) Bill, 1995: Second Stage (Resumed).

Wednesday, 28 February 1996

Dáil Éireann Debate
Vol. 462 No. 3

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The following motion was moved by the Minister for Health on Tuesday, 27 February 1996:

“That the Bill be now read a Second Time.”

Debate resumed on amendment No 1:

To delete “now” and add at the end of the motion the following words:

“when the tribunal providing for the payment of compensation to persons who have contracted hepatitis C directly or indirectly from the use of Human Immunoglobulin-Anti-D and to persons of such other classes (if [885] any) as may be prescribed is placed on a statutory footing”.

—(Deputy Geoghegan-Quinn.)

Minister for Health (Mr. Noonan,: Information on Michael Noonan Zoom on Michael Noonan Limerick East): I thank all the Deputies who contributed to the wide ranging debate yesterday afternoon. A number of health issues not directly related to the Bill were brought under scrutiny. I hope we will be able, in due course, to pick up the points raised. In particular, I thank Deputies Máire Geoghegan-Quinn and Liz O'Donnell who made the main speeches on behalf of the Opposition parties.

Many women contracted hepatitis C as a result of infected anti-D product administered in 1977-78, but we should remember that anti-D has given life to many as well. Since it first came into use in the early 1970s approximately 2,000 young people are alive and in full health who would either not be alive or would be suffering from disability but for the anti-D product. The infected anti-D product saved lives. Even though mothers were infected with hepatitis C, the administration of the infected product saved the lives of their children. We should keep that in mind, because it is an intervention necessary in our maternity hospitals. The product now being used is imported and we have absolute guarantees of its safety. We do not want to scare people about the product.

We now have a better idea of the number involved. We have identified the number of women affected which is approximately 900. More than 58,000 people were screened of whom 900 tested positive, about half have antibodies and the others full hepatitis C. The link is established for that cohort. There are approximately another 500 people who have been infected by infected blood. Colleagues are aware that some of the women infected by the anti-D product subsequently became blood donors resulting in infected blood getting into the blood supply. We had a [886] look back system followed by an optional national screening programme to identify other cases. All the people in this category have not been identified but we think it will be approximately 500. There are 150 haemophiliacs, comprising the third group and members of the Irish Kidney Association who because of their disability are high blood users and have been infected as well. The total number is somewhere in excess of 1,600, but part of that total is an estimated figure.

Hepatitis C was not identified as a specific medical condition until 1989. Tests were not available for it until 1991 and accurate testing was as late as 1991-92. It is important to realise when commenting on those who ran the Blood Transfusion Service Board in the late 1970s that although procedures were not followed — as outlined in the Miriam Hederman-O'Brien report — and that was a factor in the infection of anti-D product at the time, it is also true that the results were unforeseeable because the disease was not identified until 1989, some 12 years later. My colleagues who have a legal background should toss that notion around in their heads before they talk in terms of the Director of Public Prosecutions taking action. I understand the Miriam Hederman-O'Brien report has been referred by Positive Action to the Director of Public Prosecutions and he will examine it in the normal way. It is not for us to tell him that because of political concern he should act in one way rather than another.

My attitude was that the chief executive officer and the chief medical officer should resign and they both retired ahead of time. My interest was to get new people to carry out certain reforms in the Blood Transfusion Service Board and ensure that confidence was restored in the service. Thankfully that has been achieved because there would be no hospital system without it.

There are two distinct issues for the men and women who have contracted hepatitis C. First, their concerns about their health and whether their future health needs will be looked after by the [887] State. Second, the method to be used to pay compensation to the victims of hepatitis C who contracted it from either infected blood product or infected blood. This was one of the first items I was briefed on when I was appointed Minister for Health just over 12 months ago. The policy positions I laid down at that time have not varied and it is not a question of making it up as we go along or the Minister being forced by the very effective Opposition into doing things he did not intend to do. During the first time I was questioned on this issue, I stated clearly there were two elements, first, we had to ensure that the health care needs of those infected were taken into account and that I would bring forward a health care package and second we would provide a system of compensation which was different from the courts system.

I am very glad that in consultation with Positive Action, Transfusion Positive, The Irish Haemophiliac Association and the Irish Kidney Association the individuals concerned and their representative groups are satisfied with the health package we are putting forward. We have had recent consultations with all groups and this Bill together with the amendments to take into account the needs of Transfusion Positive, have been agreed and there is no contention on the health care side. I know my successors will fulfil the commitments because the health care we are providing is statutorily based and comes either directly under the health Acts, from the health Acts by way of regulation, or is in the primary legislation we are discussing this evening.

The second issue is the question of compensation. Deputy Geoghegan-Quinn has tied the two together which I presume is simply a debating device rather than a statement of principle, because it is unreasonable to say we should not look after people's health care needs until compensation has been agreed. That is the effect of the amendment. I appreciate the Opposition frequently puts down amendments for the [888] purposes of debate but that is not a tenable position. Obviously we should continue to make progress in providing life long health care and, in this case, life long general practitioner services free of charge. It is worthwhile doing that even though Deputy Geoghegan-Quinn and others are still unhappy about the final position on the tribunal and even the fine print.

The tribunal has nothing to do with health care in spite of the arguments of some Deputies. The health package is separate. The issue that runs from the tribunal and which gave rise to its formation is simple: how could people be compensated? Some Members said the tribunal is not about money. Of course it is about money. With the health package agreed the part that remains in contention is solely about money, about how compensation would be paid. It is down to whether it should be paid through the High Court, in the normal way that a claim for damages would be met or paid in a more effective way through a compensation tribunal. We always said we would set up an alternative to the courts system. If people want a statutory system they have it in the High Court. The alternative was supposed to be informal — non statutory — with many advantages which I outlined.

We had fruitful negotiations with Positive Action and other groups up to Christmas. Just before Christmas I was in a position to go back to Government and suggest serious amendments after consultation, in particular, with Positive Action. I tabled a number of amendments and announced that the tribunal would go ahead. The outstanding items which Positive Action was pressing before Christmas are not being pressed now, instead it is pressing different requirements. Many of these requirements are matters of procedure for the tribunal. I am anxious to reconcile the differences between myself and those in Positive Action who have represented the women. If we can meet the points now being raised I would not be reluctant to do so. I do not want a situation to develop where I may be given [889] another list in two months' time. I want the matter concluded. The tribunal is scheduling work from March onwards. As soon as it begins to process the applicants before it, I will still have power to change the tribunal but it is more difficult when it is up and running.

The position with the tribunal is that applications are coming in every day. The format is a little complicated but that is necessary because the tribunal needs information to put it in a better position to assess compensation. Certain documents have to be attached to the application form and some 85 full applications are to hand at the tribunal. The tribunal has scheduled work from March and April.

The tribunal has also been notified by a solicitior that 100 further applications will be lodged in the next two weeks. We are already looking at a module of business of 185 applicants. It is clear what will happen. As it processes its work and as the fears which have been expressed are proved to be unfounded people will gain confidence in the tribunal. Their legal representatives before the tribunal will say it is working well and confidence will be established. That confidence will run through the legal profession. I have no doubt an extensive number of applicants will come forward.

I do not want to leave unfinished business. The people have concerns about the procedures within the tribunal and I would like to see what further we can do. It is like all processes. I will not be able to do everything that is being requested but if something else has to be done to build up the confidence of the individual applicant I will do it. This is one of the more difficult issues that has faced the health services in living memory. The health care pakage is in place. What is out of place — and it is only by a matter of detail — is the tribunal. I would like that those who have worked so well in bringing it this far would be happy at the end of the day.

[890] I wish to deal with one or two points which arose and, in particular, to respond to Deputy McDaid who raised a point, which he also raised on Question Time. Clause 4 (c) of the compensation scheme provides that where any of the persons who have contracted hepatitis C from a blood product or blood transfusion has died as a result of having contracted hepatitis C, any dependent of such persons will have access to the tribunal in their own right. Clause 4 (b) of the scheme provides that any person responsible for the maintenance of any of the persons who have contracted hepatitis C from a blood product or a blood transfusion and who has incurred financial loss and-or financial loss, as a direct result of providing such maintenance arising from the hepatitis C condition, will also have access to the tribunal. It is a matter for the tribunal to determine the level of compensation in all cases in accordance with the law of tort which is exactly the same conditions as apply in the Surpreme Court.

I have quite an amount of information in my briefing notes about individual points raised but it is not crucial-information and Deputies have probably got much of it in the course of Question Time, in respect of the funding.

An Leas-Cheann Comhairle: Information on Joe Jacob Zoom on Joe Jacob I understand the Minister wishes to conclude the business. In two minutes' time we will be required to suspend the sitting in accordance with the Order of the House and there are one or two items to be dealt with.

Mr. Noonan: Information on Michael Noonan Zoom on Michael Noonan (Limerick East): I am sorry I am not in a position to answer fully all Deputies' queries but I will provide the information anybody seeks by way of letter.

Question put: “That the words proposed to be deleted stand.”

[891][892] The Dáil divided: Tá, 68; Níl, 52.

Allen, Bernard.
Barrett, Seán.
Barry, Peter.
Bhamjee, Moosajee.
Boylan, Andrew.
Bradford, Paul.
Bhreathnach, Niamh.
Bree, Declan.
Broughan, Tommy.
Browne, John (Carlow-Kilkenny).
Bruton, Richard.
Burton, Joan.
Byrne, Eric.
Connaughton, Paul.
Connor, John.
Costello, Joe.
Crawford, Seymour.
Creed, Michael.
Crowley, Frank.
Currie, Austin.
Deasy, Austin.
Deenihan, Jimmy.
De Rossa, Proinsias.
Dukes, Alan M.
Durkan, Bernard J.
Ferris, Michael.
Finucane, Michael.
Fitzgerald, Brian.
Fitzgerald, Eithne.
Fitzgerald, Frances.
Flaherty, Mary.
Flanagan, Charles.
Gallagher, Pat.
Harte, Paddy.
Higgins, Jim.
Hogan, Philip.
Howlin, Brendan.
Kavanagh, Liam.
Kemmy, Jim.
Kenny, Seán.
Lowry, Michael.
Lynch, Kathleen.
McCormack, Pádraic.
McGahon, Brendan.
McGinley, Dinny.
McGrath, Paul.
McManus, Liz.
Mulvihill, John.
Nealon, Ted.
Noonan, Michael (Limerick East).
O'Keeffe, Jim.
O'Sullivan, Toddy.
Pattison, Séamus.
Penrose, William.
Rabbitte, Pat.
Ring, Michael.
Ryan, John.
Ryan, Seán.
Shatter, Alan.
Sheehan, P.J.
Shortall, Róisín.
Taylor, Mervyn.
Timmins, Godfrey.
Upton, Pat.
Walsh, Eamon.
Yates, Ivan.


Ahern, Dermot.
Ahern, Michael.
Ahern, Noel.
Aylward, Liam.
Brennan, Matt.
Brennan, Séamus.
Briscoe, Ben.
Browne, John. (Wexford).
Burke, Raphael P.
Byrne, Hugh.
Callely, Ivor.
Connolly, Ger.
Coughlan, Mary.
Cullen, Martin.
Davern, Noel.
Fitzgerald, Liam.
Foley, Denis.
Geoghegan-Quinn, Máire.
Haughey, Seán.
Hilliard, Colm M.
Jacob, Joe.
Kenneally, Brendan.[893]Quill, Máirín.
Ryan, Eoin.
Smith, Brendan.
Kirk, Séamus.
Kitt, Michael P.
Kitt, Tom.
Lawlor, Liam.
Leonard, Jimmy.
Martin, Micheál.
McDaid, James.
Moffatt, Tom.
Morley, P.J.
Moynihan, Donal.
Nolan, M.J.
O'Dea, Willie.
O'Donnell, Liz.
O'Donoghue, John.
O'Hanlon, Rory.
O'Keeffe, Batt.
O'Keeffe, Ned.
O'Leary, John.
O'Malley, Desmond J.
O'Rourke, Mary.
Power, Seán.

[894]Smith, Michael.
Treacy, Noel.
Wallace, Mary.
Woods, Michael.

Tellers: Tá, Deputies J. Higgins and B. Fitzgerald; Níl, Deputies D. Ahern and Callely.

Question declared carried.

Amendment declared lost.

An Ceann Comhairle: Information on Seán Treacy Zoom on Seán Treacy I declare the Bill read a Second Time in accordance with Standing Order 94 (2).

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