14 July 2022: Milburn - C

We’ve been to the year 2000 to still be covering vCJD issues. Treasury meetings were easier for Mr Milburn at that point, which was different from the previous “fights” he had had over budget issues. Baroness Jay had been the one to convince Frank Dobson to not support people infected with viral Hepatitis. By the time Mr Milburn was in charge of Health, she was leader of the House of Lords. They exchanged letters to continue to agree each other that it was right in their eyes to stick with the line of not providing support to HCV people. (You massage my ego and I’ll massage yours.) A reference to the infectivity of commercial products during the discussions attracted an intervention by the Chair to clarify how infections were also arising from Scottish produced material, some of which was used in England.

As the Haemophilia Society continued with its high-profile campaign for compensation for Hepatitis C patients, the DH were looking in detail at options in case they were forced to deal with the matter. Yvette Cooper was the relevant Minister. Mr Milburn was not involved in receiving or needing to respond to an options appraisal. The options themselves covered various aspects of a potential response. It included the decision (yes, that’s a decision too) to “do nothing”, and all the way to doing things like making small payments, have an Inquiry, and many other considerations. A common theme was the worry that if haemophiliacs were supported, there would be pressure to include whole-blood groups; and from then, there might be other groups making their case having recognised the setting of a precedent. The more that possibility grew arms and legs, the closer it would get to the no-no of no-fault compensation. It was clearly acknowledged in these internal documents how HCV was a “devastating and debilitating disease”. Yvette Cooper was preparing to go on maternity leave (the first Minister ever to do so). Ms Cooper was replaced by John Hutton after her leave started. Charles Lister was still the key civil servant throughout, and he continued to have his hands all over the business. The witness went on another mini-masterclass on the foibles of doing Government. A realisation that something had to be done would open up further questions about what else might be argued as having to be done. In reality, after all the work involved in producing a hefty appraisal report, they stuck with “do nothing”, because there “no negligence” (yadda, yadda, yadda).

By 2001, there are “various developments in Scotland”, as evidenced by the communications including with Susan Deacon. The Health Committee at the Scottish Parliament was calling for financial help for people infected by Hepatitis C. Round about the same time there was an announcement of the compensation scheme for vCJD.

A Joint Ministerial Committee in late 2001 had Hep C issues on the agenda (the last item) but because of the time given to other issues, the meeting never got to that item. The witness accepted his lamentable chairing skills. These events coincided with the Haemophilia Society’s “Carpet of Lilies” campaign (not a finest hour period in the grand scheme of things). The CMO was moving towards thinking there should be some kind of provision, but the resistance to setting a new precedent and avoiding no-fault compensation were still the go-to preferred option. Scotland had also set up the Lord Ross Expert Group, which elicited a concern about maintaining a unified response. Other communications described Mr Milburn as remained “unequivocal” in his opposition to providing support to HCV infected people. In response to this, being someone else’s judgement, it sounded like a bit of an accent was slipping back into his voice. His way of responding was to list the various other significant budgetary requirements he had to meet, alongside the quite unknown and possibly very costly impacts of vCJD, let alone HCV. However, he said his thinking was being increasingly opened up to how untenable it was becoming to continue to resist the calls to support virally infected people.

On the aim to maintain a UK-wide response, the witness thought this was a throw-back to pre-devolution times. When the Interim Report of the Ross Expert Group was released, the witness did not think he read it, indeed he did not think he even received it. There was growing awareness of the potential of significant difficulties arising from the devolution settlement when it came to maintaining unanimity. It led to the period when Mr Milburn was seen to be describing Malcolm Chisholm as needing to “tough it out” against the pressures to do something about HCV-infected patients. He could not recall all the details of their conversation, but there was an 18-minute phone call. He could not recall who initiated the phone chat. They already had a reason to speak related to the consultants contract business, and money for HCV would be a side issue. Counsel pointed out the differences in how the witness had described the phone call ambience, and the note which was full of quite strong language seeking to stop Mr Chisholm from breaking ranks. Mr Milburn had already been “stung” by Scotland announcing free personal care, thus putting pressure on the DH to do the same for England and Wales. The witness was making it sound like Mr Chisholm was seeking guidance on the devolution position for him to act or not act unilaterally. He then used the softest language when it came to how he described trying to stop the Scots in their tracks by seeking to twist the matter into being a Reserved social security competence. It became a constitutional concern, dragging in the relevant law officers, but resulting in the judgement that what Scotland was proposing was a devolved matter so they could do their own thing. Counsel pressed the witness by reminding him that it was not just a matter of trying to settle a constitutional question, but an attempt to put pressure on Scotland to keep in line. Mr Milburn stuck to asserting the constitutional aspects and didn’t want to go there; with “there” being to convince Mr Chisholm to stop doing anything that might put pressure on England to follow suit. It became clear that wild horses could not draw an admission of brow-beating big brotherhood out of this man.