To meet demand, the Scottish National Blood Transfusion Service must find 5,000 donors each week.

In England and Wales, NHS Blood and Transplant supplies 8,000 units of blood daily. The system is fundamental. Ultimately it relies on trust.

In the late 1970s and early 1980s, that trust was put at risk when it became clear that blood products - "factor concentrates" - designed to alleviate haemophilia were contaminated. Sick people were being infected with the hepatitis C virus (HCV) and, it transpired, with HIV. In increasing numbers, they began to die.

This was, and remains, a national and international scandal. At its heart lay pharmaceutical companies sourcing plasma from high-risk donors. Health agencies, in turn, were accused of failing to ensure the quality of their supplies. Governments then faced charges of covering up the truth, either to preserve public confidence, or to stave off legal actions.

Haemophilia Scotland estimates that at least 500 Scottish families have lost someone to the disaster, or are living with its consequences. More than 200 people are believed to have died. This suggests that around 5,000 individuals have been infected in the UK. The Tainted Blood campaign broadly agrees: 4,800 infected with HCV, and 1,200 of those left with HIV. Of the last group "380 or so people are still alive".

Why is this still controversial three decades on? You could as well ask why the UK Government has refused a public inquiry for so long, or why it was left to the Scottish Government to establish Lord Penrose's inquiry in 2008. The latter produced its 1,800 page report yesterday, just as David Cameron was apologising on behalf of his government. Neither response counts as good enough.

That might sound perverse. After all, the Penrose Inquiry has been scrupulously at work for long enough. For his part, Mr Cameron sounded entirely sincere when he recognised the sense of injustice experienced by victims while promising £25 million to support any "transitional arrangement to a better payment system". It might be understandable for campaigners to dismiss the inquiry report as a whitewash. What else can now be done?

As it happens, a great deal. Two issues preoccupy those who demand justice: responsibility and fair compensation. Despite a plethora of cases around the world, neither has been dealt with here. Lord Penrose was given 12 terms of reference. The first four call on him only to "investigate the systems in place" during the disaster. The Prime Minister's promise of £25 million comes, meanwhile, as his own Department of Health is facing legal action over the issue of compensation.

Given its limited terms of reference, it was perhaps hardly surprising that the Penrose Inquiry would produce limited findings. A single recommendation - that those who had transfusions before 1991 should be screened - is little enough to show, however, for the time spent delving into what the report calls "the stuff of nightmares".

You could argue that Lord Penrose did as much as he could. If so, you would have to question why he was asked only to "identify any lessons and implications for the future". The report asserts that everything that could have been done at the time was done. The fact remains that other countries have done far more since in dealing with the disaster's aftermath.

In 2001, the Canadian Red Cross was found guilty of negligence. In France, a health minister was convicted and two officials imprisoned. In Ireland, the Lindsay Tribunal was established as long ago as 1999. In Japan, three drug company executives were jailed after substantial compensation was extracted from the industry and the government. In the United States, in 1997, four firms agreed to pay $660 million to settle cases on behalf of 6,000 haemophiliacs.

In the UK, the Skipton Fund, established by the English Department of Health on behalf of ministers across the UK, in theory makes ex-gratia payments to those given HVC by the NHS. Yet while those who have contracted HIV receive £14,574 a year, 3,000 individuals registered with the fund as infected with HVC receive nothing. Hence the action for judicial review, claiming illegal discrimination, facing the department, the Skipton Fund, and the Caxton Foundation, another government "charity".

Those supporting the action do not believe HIV sufferers are treated fairly. They assert instead that HVC have suffered abominable treatment. That the Government is addressing the issue through wholly-controlled "charities" is, in this saga, symptomatic, but it helps to explain why the Penrose report is denounced as a whitewash.

Those afflicted were given tainted blood. If it did not kill them, it ruined their lives. Those responsible have still not been dealt with; those who have suffered have yet to receive real recognition or compensation. As Mr Cameron would have it, this "should not have happened". But it is still happening.