17 January 2023: Closing Statement, Steven Snowden KC - A

It was pleasing to note that the hearing room was at least two-thirds full. It was “just like old times”. How sad to look back on the bulk of the time when the Infected Blood Inquiry has been doing its work when there were so few people able to attend, if at all. Some have waited over 40 years to see justice being done – in public – only to be stymied by of all things a virus.

 

Steven Snowden KC acts for Collins with their more than a thousand infected and affected core participants. The Sir Robert Winston treatment “disaster” truly was just that, a disaster. But it was not an “unavoidable” one, rather it was a “preventable catastrophe”. Why has the truth had to be squeezed out of Government? As Jeremy Hunt said in evidence, “The State closed ranks around a lie”. In terms of the clinicians, there had been in the evidence a description of “negligence” in the way certain patients were treated. While it is not for the Chair to determine actual wrong-doing and negligence, Mr Snowden sought to encourage the Chair to use the strongest possible language to describe what he sees the evidence as pointing to.

 

In preparatory summary, Mr Snowden listed the themes he would consider, touching only on highlights since the main presentation is in the final submission. The themes included: candour and engagement; the framework for Government responding; the experience of the infected and affected; various assumptions (including myths and lies); the particular matter of the Trelors school; and the issue of compensation.

 

On the topic of candour and engagement, Mr Snowden summarised the Government role as a provider to its population, but not in a commercial sense. The Government failed in that provision by supplying contaminated blood and products. This has been established by, as examples, respected judges and senior lawyers. Further, the Government should have acknowledged and acted on their moral responsibility to support people back when the issues were emerging.

 

There was a rush to produce and administer a new treatment for those with bleeding disorders. Patients were not advised of the known or possible risks. There appears to have been too much emphasis on financial considerations and on being at the forefront of innovative processes. The possibility of reducing risks by shifting toward self-sufficiency was neglected while commercial imports were preferred, while yet being described by at least one leading clinician as “dirty blood”.

 

The patients were lumped together and commodified as a cohort of test subjects and not as individuals. This dehumanisation was made worse by the way people were eventually told, or discovered by accident, that they had been exposed to a deadly virus. Quick chats in corridors or notices on a fridge were examples of the way people discovered that they might die. The people the patients had trusted with their lives abused that trust. As these localised cases were occurring across the country, the Government response was completely inadequate, even disingenuous. The “wonder product” for bleeding disorder patients was defended again and again.

 

Reference was made to the reflections by Bishop James Jones in relation those people harmed due to the Hillsborough tragedy. In particular  there was the resonating comment which summed up the key problem of people experiencing, “The patronising disposition of unaccountable power”. The public interest was put behind the reputational considerations.

 

The Sir Robert Francis framework study was illustrative of the way Government has continued to mistreat the infected and affected. The promises of a timeous response have been and were being broken again and again. The response publication dates were put back again and again. The timings were too coincidental in fitting with key milestones for the Inquiry. It was the same with the parity issue. Yet the issue of compensation is at the core of the Inquiry. The Government response will not be scrutinised by the Inquiry. That is not supporting people which the State has harmed, it is not good faith, it is not candour. In light of this, Mr Snowdon suggested a further Interim Report related to compensation, and in particular to a further round of interim payments. That approach would produce at least some accountability, and at least some understanding of the Government anticipated response to the evidence heard by the Inquiry.

 

The written submissions by Government and other official core participants appear to want to look both ways. They say there is no evidence, then go on at length to argue how the evidence presented supports their position. “This should not have happened”, has been said often by official witnesses. What has not been said is what it was they are saying should not actually have happened. What are they sorry for? Mr Snowden invited the Government’s KC to use her time making her final oral statement to answer key questions to explain what the Government accepts, what it admits to, what it has said sorry for, and what it thinks about the matter of compensation.

 

Official witnesses have cited the passage of time to explain an inability to recall incidents and information, as well as the factor of missing documents. It cannot be right for the body which delayed the Inquiry such that the passage of time was so lengthy, and which had stewardship over the lost records should then gain an advantage from its own decisions to act, or not to act, or its inability to safeguard documents which would have been helpful to the Inquiry in carrying out its work. Mr Snowden cited legal precedents which he felt were applicable.

 

On the moral responsibility or duty, it was recalled how the then Health Minister, Matt Hancock, had recognised the moral case and the need for the Government to support people, including financially, as it may be recommended by the Inquiry. The establishment of the World Health Organisation (WHO) was commented on as far as it details the responsibilities on a State for the healthcare of its citizens. The UK signed up to these principles as the WHO was set up just after the Second World War. The NHS Constitution was then referenced since it also sets out the responsibilities of the State, as delivered through its providing organisation, the NHS. The responsibility to act in a way which safeguards the population is to be provided at the highest level possible.

 

Examples were displayed which came from the period when viral infection issues were becoming of higher general concern, particularly in respect of AIDS. The internal communications illustrate the opposite of seeking to be responsible or of supporting people harmed by the State. The aim seemed to be one of distancing the Government from responsibility. Surely the preferential approach ought to have been that once a situation was recognised as having gone wrong, it should have been admitted to right away and addressed. Having not done that, the harms were in reality made far worse, and this would require an enhanced compensatory response which would not have been required if action had been taken at the time.

 

It was stated that not one infected or affected witness said they had received anything like a full explanation of the treatment and its risks. This is despite clinicians making vague statements about what they would normally have done. Such excuse-seeking assertions are simply not backed up in the medical records. The bleeding disorder patients were necessarily more trusting of the doctors. They were also in more frequent contact with their treating clinicians. The impact of contaminated blood had often destroyed that relationship.

 

On paternalism and condescending responses, not only did the clinicians act in a paternalistic manner in their dealing with patients, even after they had harmed them, but also the State did; even the bodies set up to provide “support”. Peoples’ experiences were degrading and condescending in their dealing with these bodies.

 

Due to time constraints, Mr Snowden quickly reviewed other topics covered at length in the submission document. These included: stigma, testing without consent; people being told they were “lucky to have survived”; people being misled and “fobbed-off” by the Government. Time and time again people did not live long enough to get the support they needed or the answers they so definitely sought.