Mr. Speaker, I am pleased to speak after the interim leader of the Conservative party. My remarks will address some of the concerns she raised.
I read a letter that appeared in the Globe and Mail last Saturday which is relevant to this debate. The headline is “Why the hepatitis C decision is correct”:
Those who continue to argue for financial compensation for those who acquired hepatitis C through blood transfusions prior to 1986 are advocating government compensation for what was at that time a known but unpreventable risk. This is without precedent and could lead to endless requests for compensation from individuals who have experienced a wide variety of adverse effects of medical treatments for which there were no risk free alternatives.
The fact is that prior to 1986, the risk of post-transfusion non-A, non-B hepatitis was well established, but there was no way to reduce that risk.
Screening for hepatitis B had been in place since the early 1970s, but post-transfusion hepatitis continued to occur. This entity was called non-A, non-B hepatitis until 1989 when hepatitis C was first described.
This part of the letter is especially important:
In 1986 the United States and some European countries introduced surrogate testing of donated blood, whereby blood was tested for antibody to hepatitis B core antigen. Donated blood with the presence of antibody to hepatitis B core antigen was not used. We now know that the use of surrogate tests would have prevented 70 per cent of cases of transfusional hepatitis C. It is for this reason that the federal and provincial governments are offering financial compensation for those infected from blood products between 1986 and 1990.
We must not loose site of the fact that blood transfusion is often a life saving treatment and that many of those who acquired hepatitis C from transfusions prior to 1986 are alive today only because they received this blood. Furthermore, the majority of individuals with chronic hepatitis C are asymptomatic and over two-thirds will never develop serious liver disease.
Public policy must be based on sound underlying principles. Compensation for preventable harm is a given, but financial compensation from the public purse for a known but unpreventable complication of medical treatment for one particular illness sets a dangerous precedent.
We must not allow our genuine concern for those who acquired hepatitis C from blood transfusions to obscure rational public policy.
This letter was signed by Stephen D. Shafran, MD, division of infectious diseases, department of medicine, University of Alberta.
There are a number of things that deserve our attention in this letter, not the least of them being that Dr. Shafran points out that between 1986 and 1990 there was good reason why the government should be held accountable. It did not apply a screening process that was in use in the United States and in Europe. After 1990 obviously it applied it.
It is very interesting that the Leader of the Opposition today starts talking in question period about compensating for negligence. Until now the debate has been about compensating all victims regardless of government negligence, all victims who got hepatitis C from the blood supply regardless of whether the screening test was in place or whether it could have been in place.
I think we are all quite agreed that compensation would be proper as long as there is recognized liability on the part of the government. If that recognized liability goes back to 1981 and it is agreed that it should go back to 1981 then it would be appropriate to compensate those people.
However, I suggest that regardless of the meeting that is going to occur a little later this week it may be very difficult to argue that blood supply officials were negligent if they did not introduce a screening process not in use in the United States or in Europe until 1986.
In other words, there is the dilemma. Is a medical agency negligent if it does not introduce a test as soon as it is available anywhere in the world? I suggest there may be a problem there.
The interim leader of the Conservative Party expressed concern about the people who acquired hepatitis C after 1990. As she can see from this letter clearly, even with the test in place, it was not 100% successful. Thirty per cent of the people who took blood products from the blood supply system, even after the test was in place, acquired hepatitis C.
There was a risk that existed and that risk was not as a result of negligence on the part of any government official. The question then becomes is it then good public policy to award a cash payout. It is not compensation if there is no negligence. Is it good public policy to award a cash payout to anyone who gets sick as a result of some form of medical treatment?
A very dangerous precedent is in the process of being set if we decide to compensate those after 1990. I note that the Leader of the Opposition did not suggest that. He has changed his tune.
He has recognized that negligence is the only justifiable reason for compensation. He has avoided the whole issue of post-1990 sufferers of hepatitis C.
If we give money to people who become injured as a result of an unpreventable risk in the health system, where will it end? Hospitals now have the occurrence of super bugs. Despite every effort on the part of hospitals, occasionally patients come into the hospital and get sick by infections that are basically hard to detect and difficult to control.
What if a surgeon who is expert in his field, who is extremely competent and who has all the support imaginable, slips and a person gets injured, sick or even dies as a result of a non-negligence occurrence in the hospital?
We are in danger of setting a very dangerous precedent. The letter I read is from a person who is not a politician but an expert in the field of medicine and certainly should be accepted for knowing what he is talking about.