The infected blood scandal — and how it was allowed to happen

It may not have lodged itself in the public imagination as indelibly as the coal tip that flattened a primary school at Aberfan in 1966 or the lethal 1989 stadium crush at Hillsborough or 2017’s conflagration at Grenfell Tower. But the scandal in which thousands of people around the world were given transfusions or injected with blood or blood products containing deadly viruses during the 1970s and 1980s compels our attention and compassion as surely as any of those better-known tragedies.

Although I was familiar with the broad contours of the story, until reading Caroline Wheeler’s Death in the Blood and Cara McGoogan’s The Poison Line, I had failed to appreciate the depths of deception and genuine wickedness that enabled the infected blood outrage and permeated its aftermath. Both books make clear that this is a saga of governmental indifference, professional malpractice and commercial greed.

Doctors experimented on vulnerable haemophiliacs in their care without their knowledge or consent; pharma companies offloaded blood products that they knew carried deadly viruses on to countries where low prices were a priority. Records that might have thrown a crucial light on key decisions taken by the UK government were mysteriously destroyed during the 1980s and 1990s when legal developments in other countries seem to have raised fears in Whitehall that officials might be found liable.

When the Conservative government of the early 1990s agreed to make modest payments to some victims, they had to agree to forgo future legal claims in relation to their infection, even though many had already been diagnosed with hepatitis C — a fact that was kept from them until they had signed.

The similarity of material, right down to some of the same anecdotes and an overlapping dramatis personae, allows a direct comparison to be drawn between the two books. It is one that flatters McGoogan’s fluidly written, deeply reported and ambitious exposé. In contrast, Wheeler’s prose is at points pedestrian, and her book is largely focused on the UK — lacking McGoogan’s international perspective on a scandal that touched multiple countries.

Once it gets into its stride, however, Death in the Blood becomes a gripping narrative, strengthened by Wheeler’s longstanding connection to the story. In the first few weeks of her journalistic career more than 20 years ago, a chance call to the newsroom of her regional paper in Birmingham introduced her to a man living with the terror of having received infected blood and uncertain of his prognosis.

Over the years that followed, as Wheeler’s career advanced to national titles, she became not just chronicler but protagonist, playing a key role in the campaign for a public inquiry, eventually granted in 2017. Her account is particularly strong in revealing, in remorseless detail, how doctors who were meant to protect and care for their haemophiliac patients inexplicably agreed to use them as what she calls “unwitting human guinea pigs” to test out treatments.

A site for these experiments was Treloar’s, a Hampshire boarding school for children with disabilities. One of the “central villains of this piece”, Wheeler writes, was Dr Arthur Bloom, then considered one of the UK’s most distinguished haematologists. In a missive from 1982 unearthed by campaigners, Bloom makes clear his intention to administer products to control bleeding to previously untreated people, because “the previous trial subjects — in this case, chimpanzees — were no longer sufficient to guarantee the quality control” demanded by the manufacturers of the treatment, known as Factor 8. It has become known as the “cheaper than chimps” letter.

McGoogan reports that the former headmaster at Treloar’s, Alec Macpherson, was asked at the infected blood inquiry if the school should have exercised greater oversight. If doctors had failed to take action when they knew infected blood was being used, “that was remiss and that was a mistake”, Macpherson said. But he added: “[F]or us in the school . . . we didn’t have any authority or reason to interfere.”

Typically of this saga, some medical records have gone missing — but one chilling statistic brought me up short: almost one in three people infected with HIV through contaminated NHS blood products in the 1970s and 1980s was a child. By the end of the book, the reader is left longing for Bloom and other apparently culpable medics to be held to account. In fact, he died in 1992, many years before the public inquiry began to bring a measure of justice to victims. Two other doctors who could have shed light on the events were deemed too elderly to take the stand. 

While Wheeler focuses on British victims of the tragedy, along with UK politicians and Whitehall officials, McGoogan opens with a vignette that takes the reader directly to the source of the infected products — a notoriously grim prison in the US state of Louisiana. Here, inmates including drug users and others in high-risk groups for hepatitis and Aids were paid to give plasma. In a shocking passage, a former prisoner turned whistleblower confirms that he “knew people who had turned yellow [from hepatitis], then carried on donating. One way was to bribe the inmates who worked in the plasma centre with cigarettes,” McGoogan writes.  

The author displays an eye for the poignant detail. In the US, a haemophiliac adolescent lies dying on a mechanical bed in his family’s living room; 5ft 6in tall when first laid in it, he is around 6ft when he leaves it for the last time — “a teenager who had kept growing even as life escaped him”.

It is surely impossible to imagine that patients could now have a major medical diagnosis kept from them for years as many haemophiliacs and others did after contracting Aids or hepatitis C. But if some things have changed for the better, these books offer little reassurance that a similar situation could not arise again, should the state choose to close ranks. But for the bravery of a community whose members have continued to fight for recognition and recompense even as their health failed, this deeply shameful affair would never have been uncovered. 

As McGoogan points out, some countries have been far speedier than others at reaching a reckoning. In the 1990s, France jailed a senior haematologist, who grants McGoogan a revealing interview, insisting the case against him was fabricated. In Japan, as long ago as 1996, a financial settlement was reached with the victims; the head of one of the pharma companies involved made a televised act of contrition.

In the UK, however, the wait has been painful. Little over a week ago, Sir Brian Langstaff, the judge leading the country’s public inquiry, revealed that his final report, expected in the autumn, has been postponed until March — and with it, any hope of rapid compensation for victims already living on borrowed time. Despite Wheeler and McGoogan’s best efforts, the final chapter of this sorry tale remains unwritten.

Death in the Blood: The Inside Story of the NHS Contaminated Blood Scandal by Caroline Wheeler, Headline £22, 400 pages

The Poison Line: A True Story of Death, Deception and Infected Blood by Cara McGoogan, Viking £20, 416 pages

Sarah Neville is the FT’s global health editor

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