Review of health services available for persons who contracted Hepatitis C through the administration within the state of blood or blood products

Hepatitis C is a relatively common blood-borne infectious disease. It has been estimated that 3% of the world’s population is infected. Hepatitis C accounts for about 20% of cases of acute hepatitis and 70% of cases of chronic hepatitis. Its importance is that it is a major cause of cirrhosis and hepatocellular cancer1. End-stage liver disease secondary to hepatitis C virus infection is main reason for liver transplantation. Following the discovery in February 1994 that anti-D immunoglobulin manufactured by the Irish Blood Transfusion Service Board was infected with hepatitis C, a number of screening programmes were put in place to identify those persons who had been infected, either directly or indirectly. It is estimated that about 1,600 persons have been infected with hepatitis C through the administration of blood and blood products in the Republic of Ireland. Acute hospital services for persons diagnosed positive for hepatitis C were put in place in 1994 in specialist hepatology (liver) units at six designated hospitals: Beaumont Hospital, the Mater Hospital, St Vincent’s Hospital, Elm Park, and St James’s Hospital in Dublin, Cork University Hospital, and University College Hospital in Galway. More recently, St Luke’s Hospital in Kilkenny has been included in the list of hospitals funded to provide specialist hepatology services. These services, provided under the Health Act (1970), are free of charge and include access to both in-patient and out-patient treatment as required. On 23 September 1996, the Health (Amendment) Act (1996) came into effect. This legislation provided statutory entitlement to a range of primary health care services, free of charge, to persons who have contracted hepatitis C from the receipt of a blood product or blood transfusion. The services provided include general practitioner services, medicines, home nursing services, home support services, dental, opthalmic, and aural services, as well as counselling services. At the request of the then Minister for Health, each health board appointed a liaison officer to ensure the efficient delivery of services under the Act, and to serve as a contact point for individuals and various interest groups whose members can avail of services under the Act. A Health Care Package for secondary services was also agreed between Positive Action and the Department of Health and Children in 1995. This covered entitlements to hospital treatments and sought to ensure sufficient funding, staffing, and facilities to provide high quality and appropriate secondary care services to those requiring them as a consequence of hepatitis C.