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The Guardian - UK
The Guardian - UK
World
Archie Bland

Monday briefing: The history of the contaminated blood scandal; Iranian president confirmed dead

Demonstrators in July 2023 hold placards reading message related to the NHS infected blood scandal.
Demonstrators in July 2023 hold placards reading message related to the NHS infected blood scandal. Photograph: Justin Tallis/AFP/Getty Images

Good morning. At about 8am in Tehran, Iranian state media reported that president Ebrahim Raisi was killed in a helicopter crash along with his foreign minister Hossein Amir-Abdollahian. The two had been in a helicopter that came down on Sunday in heavy fog in Iran’s mountainous northwest.

You can follow the latest updates on the situation on the live blog, and read Patrick Wintour’s analysis and Peter Beaumont’s profile. Today’s newsletter, though, is about the public inquiry on the contaminated blood scandal, which will publish its final report at 1230pm, almost seven years after it was ordered by Theresa May.

Sir Brian Langstaff’s report, and the government apology that will likely follow, are the culmination of a fight stretching back much further. It has been led by some of those who were infected with hepatitis C and HIV through contaminated blood products in the 1970s and 80s, for recognition that what they suffered was a grievous and avoidable disaster. Last night, that recognition appeared imminent: Peter Walker, Rachel Hall and Matthew Weaver report that the inquiry will call for the prosecution of those who bore the greatest degree of responsibility, potentially including current and former figures in the NHS.

The Guardian’s former legal affairs correspondent, Owen Bowcott, is one of those who covered the saga as it shifted from the margins to the top of the agenda. For today’s newsletter, I asked him to help explain how we got here – and what remains to learn when the report is finally published. Here are the headlines.

Five big stories

  1. Universities | Vice-chancellors and former ministers are warning that the cash crisis facing universities is so serious that the next government will have to urgently raise tuition fees or increase funding to avoid bankruptcies within two years. Some said increases of £2,000 to £3,500 a year for each student would be needed to stabilise the sector.

  2. US news | The rap mogul Sean “Diddy” Combs admitted that he punched and kicked his ex-girlfriend in 2016 in a hotel after CNN released footage of the attack, saying he was “truly sorry” and his actions were “inexcusable”. Combs previously settled a lawsuit with Cassandra Ventura after she sued him over what she said was years of sexual, physical and emotional abuse.

  3. Labour | The chief constable of the police force examining claims against Angela Rayner has defended the decision to investigate the Labour party deputy leader, vowing it would be done “fairly and impartially”. Stephen Watson, who leads Greater Manchester police, told the Guardian the investigation would “not necessarily” conclude with a file going to the Crown Prosecution Service.

  4. Slovakia | Slovakia’s prime minister, Robert Fico, is out of immediate danger but remains in intensive care four days after he was shot by a gunman, the country’s deputy prime minister has said. Robert Kaliňák, Fico’s closest political ally, told reporters: “We all feel a bit more relaxed now.”

  5. Brexit | Post-Brexit border checks will cost UK businesses £470m a year, the government’s public spending watchdog has said. The National Audit Office warned that there were “significant issues” ahead of the introduction of border checks last month, including critical shortages of inspectors.

In depth: ‘A lot of people were aware, for a long time, about how appallingly victims had been treated’

In the 1970s, a new treatment was developed for haemophilia, a rare disorder which prevents blood from clotting properly. The treatment products, replacement clotting agents made from donated human blood plasma called Factor VIII, were hailed as a medical breakthrough. But because there was not enough domestic capacity to meet NHS need, the UK started to import large quantities from the US.

American donors were paid, and some of those who gave blood – including drug addicts and prison inmates – were at high risk of infection. Blood from thousands of donors was pooled to create the drugs, and a whole batch could be contaminated if just a single donor carried a virus. The blood was not screened for hepatitis C or, when it emerged, HIV. The same tainted blood was given during transfusions, including during complications in childbirth. As a result, more than 30,000 people were infected with hepatitis C or HIV – many of them children. By the end of 2019, an estimated 2,900 people had died. The toll continues to rise.

For more detail on how this happened, see Haroon Siddique’s explainer from last week. Another key point he notes: there were plenty of warnings about the dangers posed by importing blood products from the US, but no action was taken for years. “The whole horrific story has come out bit by bit,” Owen Bowcott said. “Every year, the evidence mounted.”

***

The warnings

It is, in one sense, staggering that this story is still being told today. The World Health Organization warned about the dangers of importing blood from countries with a high rate of hepatitis, such as the United States, in 1974 and 1975. Also in 1974, civil servants and NHS officials were warned of an “epidemic of hepatitis A and B” in patients in Bournemouth, with nine patients all receiving treatment from the same batch of replacement clotting agents.

This World in Action documentary from 1975 explained the dangers of hepatitis infections from American blood products. And last month, the Observer revealed that officials at a subsidiary of the drug company Bayer wrote of its commercial blood product in the 1970s that since no definitive test for hepatitis was available, “the presence of such a virus should be assumed”.

The same story continued in the 1980s, after the emergence of Aids. But the government said that there was no conclusive proof and infected blood was used, untreated, until 1985.

A years-long failure to recognise the gravity of the situation is just one of the reasons that this story has been compared to the Post Office scandal. (Indeed, ITV recently commissioned a drama about the contaminated blood saga following in the footsteps of Mr Bates vs The Post Office.) “A lot of people were aware, for a long time, about how appallingly the victims had been treated,” Owen said. “A lot of them felt that they were used as guinea pigs, and that nobody had ever been straight with them.”

***

The government response

Documents that have emerged over the years paint a picture of a decades-long combination of incompetence and cover-up. Whole batches of files about the work of a blood safety advisory committee were shredded as the government faced the threat of legal action; patients who were given contaminated blood have complained that their medical files were destroyed or withheld.

In 1983, for example, the then health minister Ken Clarke denied that there was any threat from one untreated blood product, saying: “There is no conclusive evidence that Aids is transmitted by blood products.” In the same year, another minister, Hugh Rossi, told a constituent of his concerns over the “extremely worrying situation”, and in 1990 a government official wrote that he wanted to withhold Rossi’s letter from publication because it suggested that “Aids was being transmitted by blood plasma at a time when statements were being made that there was no conclusive evidence that this was so”.

“There were years of institutional reluctance to release this material,” Owen said. “One of the real heroes of this has been a campaigner called Jason Evans (pictured above), whose father died after receiving contaminated blood. He has put in an enormous number of requests and unearthed a great deal of material. Without him, there is a lot of this that we wouldn’t know.”

***

The campaigners

Evans, now 34, told the BBC last week that the scandal had “blanketed” his entire life. He is one of many victims and their families whose stories were instrumental to the commissioning of the inquiry by Theresa May in 2017,.

Taken as a whole, their stories – many of them told in the Guardian – represent a dizzying account of loss. For the long read, Robert James wrote an extraordinary piece about how his HIV diagnosis shaped his life, and his experience of giving evidence to the inquiry and hearing others do the same – and how, “after losing 20 friends, I stopped counting how many had died”. Liz Hooper lost two husbands treated with contaminated blood. Christopher Marsh (pictured above) lost his two brothers, and lives with hepatitis C himself. Nicholas Sainsbury, who attended a specialist boarding school, Treloar, which was equipped to treat his haemophilia, has HIV and hepatitis C – and 40 of the 55 pupils who were at Treloar in his first year have died.

“There is no doubt that these stories have given the inquiry impetus,” said Owen. “The agony of their examples lends so much weight to the argument, and they have moved the dial on public sympathy. It isn’t hard to see how giving those people a platform helped force some of this out.”

***

The inquiry

An independent inquiry was set up in 2007, but it did not have the power to force ministers to testify. It wasn’t until 2017 that a full public inquiry was ordered, with greater resources and the power to compel testimony under oath and the production of documents – although its conclusions remain recommendations, with implementation ultimately up to the government.

“The fact that Sir Brian Langstaff has been able to order all of that has made him very powerful,” Owen said. “He has been particularly good at pressuring the government to improve compensation, and to drag senior politicians in to testify. And he has been very adept at handling such a terrible tragedy – he has brought the victims with him, and given them time to voice their pain. That has been essential.”

***

The future

Compensation payouts before the inquiry began were piecemeal. In 2022, Langstaff recommended that the government pay £100,000 in interim compensation to those affected – partly out of a sense of urgency driven by fears that some would not live to see the inquiry’s final report.

Langstaff also recommended that the final compensation scheme be set up immediately – but the government refused, and only eventually committed to setting up a scheme within three months of the report’s publication after Labour forced a vote. “There has been a real reluctance over the years to pay out because the sums are so large,” Owen said. “You might detect the normal Whitehall practice of denial, then delay.” The government is now reported to be anticipating a final compensation bill of up to £10bn.

As well as compensation, we can expect Langstaff to set out where he sees ultimate blame for the scandal as lying. While he is not tasked with determining civil or criminal liability, he is likely to recommend prosecutions. One question is whether that will include corporate manslaughter charges against the NHS, a notoriously complex offence to prosecute but one which many victims and their allies - including Manchester mayor Andy Burnham - believe is proportionate, as this piece by Rachel Hall explains.

The government will deliver a detailed response to the report later this week, after Rishi Sunak makes an official apology to the victims and their families. For some victims, that may represent closure, and vindication. For others, it will never be enough. “There is no victory in this,” Evans said last week. “There is no glory, there is no day where we say ‘wasn’t this campaign of great success’.”

What else we’ve been reading

  • Saturday magazine ran a remarkable photography special: 38 pictures that shifted how women are seen in the world, like the one above, of an official trying to drag the first woman to compete in the Boston Marathon, Kathrine Switzer, off the course. Anne Enright wrote a great accompanying essay. Archie

  • The Irish wake is a centuries old ritual where, over three days, family and friends share stories, songs and food over the deceased who lays in an open coffin. The tradition is at risk of being replaced by a professional death industry – Rory Carroll spoke to the organisers behind the world’s first arts festival dedicated to preserving this rite. Nimo

  • Alex Lawson’s revealing report highlights the dubious links between arts institutions and Saudi Arabia that have attracted significant criticism for laundering the gulf states international reputation. Nimo

  • The Black Lives Matter movement died in 2024, Nesrine Malik writes – a movement triggered by police brutality that was too often addressed through magazine covers or politicians awkwardly taking the knee. In the place of that kind of attention, she identifies much quieter efforts towards racial justice that may ultimately be far more significant. Archie

  • There’s been a lot of discourse about “parentified” children online, as part of the internet’s growing obsession with using therapy-lingo in any situation. For the Cut (£), Rachel Connolly examines where this narrative came from and whether any of the claims about parentified kids actually rings true. Nimo

Sport

Premier league | Manchester City navigated the final day of the season smoothly to beat West Ham 3-1 and secure their fourth Premier Legaue title in a row – a new record. Arsenal did manage to beat Everton 2-1 thanks to an 89th-minute winner from Kai Havertz, with Mikel Arteta telling fans afterwards: Don’t be satis­fied because we want much more than that, and we are going to get it.” Meanwhile, Jürgen Klopp signed off as Liverpool manager with an emotional 2-0 win over Wolves at Anfield. Read Jonathan Wilson’s tribute.

Golf | American Xander Schauffele birdied the final hole to win the PGA Championship by one shot over LIV Golf’s Bryson DeChambeau at Valhalla Golf Club in Louisville, Kentucky, on Sunday to claim his first major title.

Boxing | After Oleksandr Usyk’s victory over Tyson Fury to become the first undisputed world heavyweight champion this century, Ukrainians celebrated the result as a symbol of their country’s strength. Barney Ronay wrote that it was “a tribute to Fury’s extraordinary fighter’s heart that he took it to the end”, but that Usyk “has a pretty convincing case to be called the greatest of all time”.

The front pages

The Guardian’s front page has the headline “Iranian president feared dead after helicopter crash”. But for most other papers it’s the contaminated blood scandal, with the Telegraph saying “PM’s horror and regret over blood scandal”. The Mail echoes a similar line with “PM’s apology for worst treatment disaster in NHS history”. The Express has “Least we can do! Apology to blood scandal victims” and the Mirror’s headline is “Blood on their hands” over the report to be released.

The Times runs with “Labour plan for gender change to be made easier”. In the Financial Times it’s “G7 allies warm to US plan of rushing funds to Ukraine as Trump threat rises” as the US presidential election creeps closer. And in the i it’s “Revolutionary AI trial offers breast cancer hope for millions on NHS, reveals Sunak” as it reports on the PM talking about possible improvements to speed and accuracy of tests.

Today in Focus

The rightwing Christian group and the battle over end-of-life care

The Christian Legal Centre is behind a number of end-of-life court cases that could be ‘prolonging suffering’, according to doctors. Hannah Moore speaks to Josh Halliday

Cartoon of the day | Edith Pritchett

Sign up for Inside Saturday to see more of Edith Pritchett’s cartoons, the best Saturday magazine content and an exclusive look behind the scenes

The Upside

A bit of good news to remind you that the world’s not all bad

Poverty, violence, political chaos and devastating natural disasters have defined Haiti for a long time, obscuring anything else about Haiti, its culture and its people. Among the mayhem, Haitians are still living their lives, creating music and visual art as an outlet and a symbol of hope. For decades Haiti’s population and its diaspora in North America (such as Cécile McLorin Salvant, pictured above) have been extraordinarily creative in all kinds of mediums: from the 80s with Jean-Michel Basquiat, whose father was Haitian, to artists today like Myrlande Constant and Frantz Zephirin who are producing impressive and exciting canvases.

And it’s not just individual artists, the deep history of rich cultural exports can be heard in 1940s jazz from New Orleans and modern avant garde music. Speaking of the influence of traditional Haitian rhythms have had on his art, Haitian-Canadian saxophonist Jowee Omicil says: “All the ceremonial rhythms I use have a deep meaning. In Haiti, slaves came from Guinea, Togo, Congo and Benin … they came with their rhythms. They had to unite and fight for their heritage. The sounds of freedom are what people were afraid of. They are sacred for us.”

Sign up here for a weekly roundup of The Upside, sent to you every Sunday

Bored at work?

And finally, the Guardian’s puzzles are here to keep you entertained throughout the day. Until tomorrow.

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