State should be obliged to tell the truth as core democratic principle
She was ultimately offered compensation, but refused it and took the State to the Courts, because she wanted to know the truth of what happened. She wanted to know how the contamination had got into the blood she was given, and whether or not the “system” had been reckless or negligent in giving her that blood.
She died before she knew the truth. In the course of her legal action, the Blood Transfusion Service Board (BTSB) made a lodgement to the Court. A lodgement is a sum of money (the amount is known to the plaintiff but not to the Court) that sends a message to the plaintiff in a case. A simple, brutal message: If you are awarded more than this sum, you will get your costs. But even if you win, and you’re awarded less than the lodgement, you will be liable for all the costs of the case. It’s a device that’s often used to persuade people — in this case a dying woman who only wanted the truth — to settle their action before it is heard.
But at the same time as that lodgement was being made, the then Minister for Health Michael Noonan was telling the Dáil that the High Court case would be a good way to get at the truth of what had happened. He, it seemed, was happy to let the case run, but a State agency for which he was responsible was doing its utmost to force Bridget McCole to settle out of court. We may never know the extent to which Mr Noonan was involved in that strategy to force a settlement, but he has always denied any involvement at that stage (earlier, he had been very hostile to her position).
In the end, and shortly before her death, Bridget McCole did receive an apology. But not the whole truth. Ultimately, it was decided by the Government to set up a Tribunal of Enquiry, and another battle was fought within Government over the terms of reference.
The “system” was determined nothing would emerge that would damage the reputation of the BTSB (“the integrity of the blood supply” was their great mantra), and the first draft of the terms was shocking in its failure to seek any transparency. Eventually, the terms were amended to include a number of other issues, including, for example, the basic questions asked by the McCole family.
The resulting report by Judge Tom Finlay (no relation, I’m sorry to say) was damning. It named the names of those responsible. It assigned blame. Again and again it said the BTSB had failed. It found it had acted unethically. It used words like inadequate, inappropriate, wrong.
And in relation to one of the McCole family questions the Tribunal gave a simple, short answer that told us all we need to know about the “system”. Why, the family asked, did the BTSB not inform the infected women in 1991?
Judge Finlay said, very simply, (telling the women in 1991) would have “involved facing up to the consequences of the wrong that had been committed in 1977, something the relevant officers of the BTSB were not prepared to do.”
They had developed and distributed blood plasma using blood from a donor they knew to be infected with Hepatitis, and they weren’t prepared to admit it. Two of them were subsequently charged with criminal offences, although those charges were later dropped.
I had a number of “behind the scenes” involvements in the story of Bridget McCole and the Hepatitis C scandal, and it gave me perhaps the clearest and sharpest view I’ve ever had of the “system” and how it operates. Not for the first time, and certainly not for the last. But nothing that has ever happened since has altered my view.
The system is implacable and relentless. There are three groups in the main in Ireland for whom the system has no time. In broad policy terms: It distrusts women; it ignores children; and it regards people with a disability as a burden and a nuisance.
It exists to protect and preserve itself. It has language all of its own to use when it wants to insist, and to hide behind when things go wrong: Value for money; avoidance of risk; systemic failure; the integrity of the … (and you can insert a phrase here, like integrity of the blood supply, or integrity of the cervical screening service). These are just a few of the cover-up phrases.
The system has rules, policies, procedures and processes. If someone needs a medical card because they are dying of an incurable disease, the system will only supply it if it’s within policy and procedures are followed. And followed at the pace the system dictates.
But the system is also made up of the men and women who work in it. It is they who make the rules, they who develop the self-serving language, they who resist accountability. They’re not all public servants by any means — you only have to read the Ryan Report, for example, to realise how implacable the religious orders were, as a system, in defending and protecting themselves against the truth.
When you put all this together, it’s called culture. Culture is often defined as “the way we do things around here”, and when it comes to our systems of public and private policy, the way we do things around here never involves telling the uncomfortable truth. The law can change that.
But all this talk about a “duty of candour” in the health system falls far short of what is needed. Real change will only come when it becomes a crime to conceal the truth in any situation where a person has been hurt or damaged, in either the public or the private sectors. Our right to be told the truth needs to be a principle and a mandated practice throughout our democratic system, as important and as central as our right to vote.
Before I finish, I want to say something about next Friday’s referendum. For a variety of reasons, I haven’t expressed any view on how people should vote on what is a crucial issue. But if it’s not an impertinence to my readers, I do have to say one thing.
You only have to look around the world to see what damage can be done if people can’t vote or don’t vote. There’s a huge responsibility on all of us to consider our vote, to think it through. And I’ve always believed that we should be trying to elect what we want to see, rather than reject what we don’t. Too many decisions are made because we’re afraid of the worst, rather than because we hope for the best.
So whatever way you intend to vote on Friday, vote. This is the one opportunity we get to force systems to acknowledge us and even to be instructed by us. You’ll walk away from the polling station knowing (a) that you’ve done your job, and (b) that they have to listen. That’s a good and powerful feeling.
Why, the family asked, did the Blood Transfusion Service Board not inform the infected women in 1991?
