PEOPLE living with haemophilia and other blood clotting disorders in the 1970's and 1980's were already "vulnerable and disadvantaged".

Then, says Scottish sufferer Bill Wright "came this cruel catalyst of contaminated blood" which created confusion, sickness and pain.

Lives were turned upside down and many people died.

Haemophilia, when the blood does not clot because of a protein deficiency, carries a number of risks. Bleeding internally into the brain or gut can be fatal. Bleeding into the joints can cause permanent damage and disability.

But in the first half of the 20th century there was little patients could do to repair their bodies beyond taking bed rest.

When concentrated plasma treatments became available in the 1970s's, made from large pools of donated blood, it was seen a significant step forward. Patients were able to treat themselves and parents inject their children. The Penrose Inquiry report says: "The lifestyle of individuals with haemophilia was greatly improved."

But, the blood products, supplied both by commercial companies in the US and manufactured by the NHS itself, carried blood borne viruses which were not identified until the 1980s: Hepatitis C and HIV.

According to Penrose, 478 people in Scotland were infected with Hepatitis C as a result of therapies for bleeding disorders and 60 contracted HIV.

Alongside them, some patients with other medical conditions who required blood transfusions received donor blood carrying the viruses. Penrose estimates 2500 were infected with Hepatitis C and 18 with HIV.

Could more have been done to prevent the viruses being passed on as understanding of the conditions emerged?

The patients campaigning for answers cite documents which they say show information was available to the medical establishment before action was taken.

Many describe being kept in the dark about contracting the infections, only discovering almost incidentally years later what was wrong with them.

But in the statement which was read on behalf of Lord Penrose, the inquiry chairman, he said: "Careful consideration of the evidence has... revealed few respects in which matters should, or more importantly could, have been handled differently."

Once the risk of HIV emerged, he said, "all that could reasonably be done, was done" to prevent further infections.

For Hepatitis C, however, he did find that there were avoidable delays in screening donor blood for the virus. A decision to start doing this should have been taken in May 1990, he said, and Scotland could have moved more swiftly than the rest of the UK to begin screening before September 1991.

Witnesses told the inquiry collecting blood donations from prisoners was with hindsight "inadvisable." In 1975, 2.38 per cent of blood donated in Scotland came from jails and the practice was not stopped until 1982. But the report stops short of criticising the practice.

As for the way the NHS told patients they had been infected by the treatment which was supposed to improve their lives? Lord Penrose spoke of the "doctor-patient " relationship in the 1980s being different from the one we know today. He put the problem down to a "genuine lack of information as the understanding of the conditions developed" and doctors of that time not being "used to sharing all information available with patients in the way they do today."

In fact he highlighted the suffering of the clinical staff who discovered the treatments they had used were actually threatening lives. One doctors describes "waves of hope, followed by waves of despair." This, said Lord Penrose, is "the stuff of nightmares".

XREF LEADER