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1.12 pm

Mr. John Marshall (Hendon, South): I congratulate the hon. Member for Leeds, East (Mr. Mudie) on his success in securing the debate, and on his speech, with which, perhaps unusually in this place, I agreed 100 per

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cent. I also thank the hon. Gentleman for his courtesy in inviting me to take part in the debate, and I apologise on behalf of my hon. Friend the Member for Wealden (Sir G. Johnson Smith), who cannot be here because he has other parliamentary duties. My hon. Friend has authorised me to say that he would have liked to be here, and I am sure that he too would have agreed with everything that the hon. Member for Leeds, East said.

I also pay tribute to the work of the Haemophilia Society, whose chairman, the Rev. Alan Tanner, is a constituent of mine. The society has done magnificent work for its members.

Like the hon. Member for Leeds, East, I draw the parallel between the haemophiliacs who suffer from human immunodeficiency virus and those who suffer from hepatitis C. The cause of their illness is precisely the same. Both groups received infected blood products through the national health service. Both were given what was hoped to be life-enhancing treatment, which instead caused a life-threatening illness.

For both groups the consequences, too, will be the same. About 600 to 700 people will suffer a painful and premature death. Of course I accept that not all those infected with hepatitis C will suffer in that way. Indeed, 20 to 25 per cent. of them will be completely cured as a result of treatment with alpha interferon. But others, who neither die an early death nor enjoy a complete recovery, will suffer a life of pain and worry for many years to come.

I believe that when we consider those three categories of people we already have the key to a solution. The first principle is that no one should be denied treatment and the possibility of a full cure through interferon alpha. The other day, some of us met representatives of Schering, the company that produces that drug, and they expressed concern that in some parts of the country people who could benefit from treatment with interferon alpha were being denied it. I hope that the Minister will be able to give a lead on that matter, especially as, when my hon. Friend the Member for Bolton, West (Mr. Sackville), who is now the Under-Secretary of State for the Home Department, was a Health Minister, he spoke to us on that matter.

Haemophiliacs who develop cirrhosis of the liver should be treated absolutely on a par with those who develop HIV. For both groups the prognosis is the same. All those people face the prospect of an early death, they are all suffering physically, and they and their relatives are suffering mentally and emotionally.

Indeed, if the onset of cirrhosis of the liver were to be the trigger for the main payment, the Minister could tell the Treasury that the scheme would not cost too much money this year. The cost would be spread over four or five years, and would have relatively little effect on total Government expenditure while doing an immense amount of good for the individuals concerned. Those who do not suffer from cirrhosis of the liver could be given a more modest payment.

Last week I invited the Minister to read the Haemophilia Society's report, and in it he will have seen cited the case mentioned by the hon. Member for Leeds, East--the family with three brothers, all of whom died, two from HIV and one from hepatitis C. Those who died from HIV had been compensated, but the third had not. How can we say to the mother of those three sons that

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two were worthy of receiving Government money but the third was not? That does not stand up on the ground of logic, nor on the ground of compassion and human kindness.

When we debated the subject before, the then Minister talked in global sums and mentioned a figure of £6 billion, representing the cost of a total no-fault compensation scheme. That is not what we are asking for. We ask simply that a relatively discrete small group of people should receive some assistance as a mark of the financial hardship and of the physical and emotional pain that they are suffering.

Of course someone in the Treasury, or even someone in the Department of Health will say that that would create a precedent. However, the argument about precedent is the argument of administrative convenience; it is not the argument of compassion or of Christmas--you and I, Mr. Deputy Speaker, have just come from the Christmas carol service. The precedent was created when the Macfarlane trust was set up and the Government rightly decided to make ex gratia payments to haemophiliacs infected with HIV, and then to non-haemophiliacs infected with that virus. The Prime Minister took a major part in both those decisions, so I hope that the report of our debate will be sent to him so that he can act upon it.

1.18 pm

The Parliamentary Under-Secretary of State for Health (Mr. John Horam): I congratulate the hon. Member for Leeds, East (Mr. Mudie) on his success in the ballot and on securing the debate. He put his points in his typically warm-hearted and down-to-earth way. I am delighted to see that he is well supported today, not only by Opposition Members but by Conservative Members, too.

I know that many hon. Members are concerned about the situation of haemophiliacs who have also had the misfortune to contract hepatitis C, which adds to the difficulties that they already have to face. The problem has been raised several times in the House. Last week, I answered a question on the subject from my hon. Friend the Member for Hendon, South (Mr. Marshall), to which the hon. Member for Leeds, East added a supplementary question. My hon. Friend also initiated an Adjournment debate at the end of the previous Session. I am also aware of early-day motion 3, which has a large number of signatures.

Let me say that I have great sympathy--and will always have great sympathy--for patients who have become infected with hepatitis C through blood transfusions or blood products. The Haemophilia Society originally launched its campaign for help for people in this situation in the spring. The hon. Member for Leeds, East will be aware that the Haemophilia Society has recently issued an interim report--I stress that it is an interim report--on its hepatitis C impact study.

I have just come to the Department of Health, and there is a great deal to read. I would like to read the Haemophilia Society's report thoroughly, but I have not yet had the opportunity to do so. I shall make that a very high priority, but I want to read the report and not merely a brief. I am aware that the report graphically describes the problems experienced by some sufferers who find that they now have to contend with the effects of hepatitis C

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infection on top of the effects of haemophilia. The hon. Member for Leeds, East graphically and eloquently explained those severe problems in his speech.

The great benefits to patients of medical procedures rarely come without some risk, and I would like to put the matter into that context. It is important to remember that it is not always possible at the time treatment is given to fully appreciate the risk or to avoid suspected or known risks. In the case of each individual patient, a balance must be struck between the benefit to be gained versus any possible risk. The patients we are now discussing received the best treatment available in the light of medical knowledge at the time. I do not think that either the hon. Gentleman or my hon. Friend will dispute that.

The factor 8 concentrate--the cause of the infection-- has brought great benefits to patients with haemophilia. Previously, only about 5 per cent. of patients with severe haemophilia reached the age of 40, whereas by 1980--as a result of factor 8 concentrate and drugs--the life expectancy was very close to that of normal males. There was also less need for the periods of hospitalisation, and boys had a better chance of achieving a reasonable education. Additionally, the convenience of patients being able to keep concentrate in a domestic fridge and treat themselves at the first sign of a bleed meant a considerable reduction in long-term disability. All those benefits have come about as a result of the blood products which, simultaneously, have been the cause of the infection.

Most haemophilia patients infected with hepatitis C were so infected before the blood products were treated to destroy viruses in 1985, and well before tests for hepatitis C became available. Before then, the only way to safeguard blood was to limit those from whom blood was taken by a system of self-deferral. This excluded, amongst others, those known to be suffering from hepatitis, or any other liver disease, and drug misusers.

The basic facts are quite straightforward and are not in dispute. The figure of just over 3,000 for those infected, which was quoted in the recent Haemophilia Society report and again today by the hon. Gentleman, is substantially in line with the Department's own estimates. A figure of a total of 50 deaths from hepatitis C in patients with haemophilia has been suggested, and has been cited in the early-day motion to which I have referred.

While every death is a tragedy for the individual concerned and their family and friends, it is important to keep a sense of proportion. I understand from the United Kingdom Haemophilia Directors that, of 126 haemophilia patients known to have died in 1993, 12 showed the cause of death as liver disease, of which hepatitis C may have been the cause. That is less than 10 per cent. That figure of 12 for 1993 contributes to the figure of 50 which we are talking about as the number who have died so far in this way. Eight of those 12 were also HIV-positive.

I do not minimise the impact of such tragic losses on individual families, but it is vital that we do not lose sight of the fact that, fortunately, many of those infected will be able to continue to lead a reasonable life. We owe it to those individuals infected to ensure that the public perception of this illness is not distorted. If people are given the impression that there is little to choose between hepatitis C and HIV, we risk the very stigmatism which was such a sad aspect of the early days of HIV awareness.

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It has been argued that the fact that ex gratia payments were made to those who contracted HIV through blood or blood products means that payments should also be made in the present case. As both the hon. Gentleman and my hon. Friend will be aware, the Government have not accepted that proposal so far. We believe that different prognoses have been made for those with hepatitis C and those with HIV.

Many people infected with hepatitis C may live for a long period without any symptoms appearing, and my hon. Friend has conceded that. Fifty per cent. of sufferers may progress to chronic hepatitis with varying degrees of good or ill health. Perhaps 20 per cent. of infected patients will develop cirrhosis--a progressive destruction of the liver--that may take 20 to 30 years to be fully apparent. The majority of those years will be trouble-free in terms of ill health and, as I have mentioned, only a small proportion will die of liver disease.

The Haemophilia Society's report of its hepatitis C impact study makes a valuable contribution to our understanding of the effect of hepatitis C in this situation.


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