 The First Item of Business is a statement by Shona Robison on the Penrose inquiry. The cabinet secretary will take questions at the end of her statement and there should therefore be no interventions or interruptions. I call Shona Robison, cabinet secretary, around 10 minutes. I am grateful for the opportunity to make a statement in response to the Penrose inquiry report that was laid in Parliament yesterday. I would like to thank Lord Penrose and his team for their work. Lord Penrose is currently unwell and this prevented him from launching the inquiry report in person yesterday. My thoughts are with him and his family. I would also like to personally thank affected patients and their families for providing evidence of a very personal and sensitive nature that cannot have been easy. I would want to recognise that some of them have joined us in the gallery today. The affected patients and their families must be foremost in our minds today. I met some of those who have been affected yesterday and I heard their stories. Many people have died or suffered long-term disability and hardship as a result of those infections. Relatives have had to sacrifice careers to provide care and support. In some cases, partners and loved ones have themselves become infected. Patients, families and carers have dealt with those difficulties with immense, enduring courage. Although those events took place well before this Parliament was ever established, on behalf of the Government of Scotland and the NHS in Scotland, I want to say sorry to everyone who has had to deal with the devastating impact of infected NHS blood and blood products. I want to recognise that those events absolutely amount to one of the greatest healthcare-related tragedies that are ever witnessed in this country. We must keep the people who have been affected at the centre of our thoughts throughout this process. I can only express my deepest sympathy and regret to them. Lord Penrose has delivered a comprehensive report of almost 1,800 pages. It is a detailed and independent assessment of how those tragic events unfolded. I realise that there may be some criticism of the cost and length of time that is taken for the inquiry to report its findings. I am also very aware that, for many, the inquiry conclusions do not meet their expectations and the outcomes that they would have wished to see. Those were complex issues covering a long period of time back to 1974. In light of the number of people who have been affected, the number of people who have died and given the seriousness of those events, the people who were affected have now had the opportunity to have their stories heard by a fully independent public inquiry. Turning to the findings, the evidence from affected patients is crucial. Lord Penrose sets this out in full within his report. It stands as vital if distressing testimony as to what affected patients and their families have endured. The report has provided estimates of the number of patients likely to have been infected. Those add to what we know already and they allow us to be more certain about the scale of the impact of those events. Lord Penrose has also identified delays to the introduction of hepatitis C screening in Scotland as a key thing that could have been done differently. Screening in Scotland was held back so that it could be introduced simultaneously across the UK. Clearly, those events predate devolution and that would simply not happen now. There are other things to learn about the approach of clinicians and healthcare staff about the way that the health service works, the importance of patient safety and how that relates to expert advice. In particular, Penrose makes certain observations about the NHS's paternalistic attitude to patients in the 1980s, particularly in relation to patients being given information. This is not the way in which the NHS in Scotland works now and Penrose himself acknowledges that the approach to patients today is very different. All of those lessons from Penrose will instruct how we continue to build on the progress of our patient safety programme. Lord Penrose recommends that the Scottish Government should take all reasonable steps to offer a hepatitis C test to anybody who might have been infected before 1991 by a blood transfusion and who has not already been diagnosed. We accept that recommendation and we will consider carefully how to take that forward. It is important to reassure people that we have previously made efforts to find those who have been infected, including a look-back exercise in 1995 and awareness raising campaigns as late as 2008. We expect that there will be very few people, if any, who were infected with a blood transfusion and who have not been diagnosed by now. However, anyone who wants to know more will be able to find information on the NHS informed website or from organisations such as Hepatitis Scotland, Humifileus Scotland and the Scottish Infected Blood Forum. There is no barrier to hepatitis C testing in Scotland. Anyone who has been exposed via a blood transfusion before September 1991 or by treatment for a bleeding disorder with blood products prior to May 1987 can be tested at their GP practice. It is important that anyone who has been infected is diagnosed so that they can access the best clinical care and support. When talking about clinical care, I should also take the opportunity to make clear that our current blood safety record is excellent and the risks of viral transmission by blood transfusion in Scotland and the UK are exceedingly low. Donor selection criteria, stringent testing of blood donations and advances in technology mean that the blood supply is as safe as it can be. It is safe to give blood and it is safe to receive blood. I want to talk about the further steps that we will now take to support those who have been affected. There are two payment schemes for those who have been infected with hepatitis C, which the Scottish Government contributes directly to. The Skipton Fund, which provides lump sum and annual payments, and the Caxton Foundation, which provides discretionary payments to affected people and dependents. Over the past 10 years, the Scottish Government has already contributed more than £30 million to those funds for affected people in Scotland. Separately, there are payment schemes that predate devolution for those who have been infected with HIV. Those are managed by the UK Department of Health. It is right to acknowledge that many patients and their families are of the view that the payments that they receive are insufficient. That view is reflected in the Penrose report. We have already committed to reviewing those schemes and we will now move ahead with that. Given the two HIV support schemes predate devolution and are managed by the UK Department of Health, we will work with the other UK countries to take forward this review. I recognise that the UK Department of Health yesterday announced a one-off payment of £25 million to support any transitional arrangements to a different payment system. Of course, we will ensure that any required contribution from Scotland will be met in 2015-16. We must resolve the issue as quickly as possible. I will go into the review with a view that we should be able to conclude our work in time to make an announcement by no later than World Team Affiliate Day in April 2016. I am also of the view that we must listen to the view of affected patients. I had the opportunity to hear from affected families yesterday, and it is very clear to me that we have to improve the system. In Scotland, we will be establishing a patients and families reference group to help us with the review of those schemes. I also want to say a few words about the work that we have been doing and will continue to do with patients and families and the organisations that support them, such as the Himaffilia Scotland and the Scottish Infected Blood Forum. I met representatives from those organisations over the past few weeks and again today. Both have provided suggestions of various actions that we can take forward. We have already funded the Scottish Infected Blood Forum to carry out a scoping exercise to investigate the support needs of those affected, and that will contribute to the evidence base for the review of the financial schemes. We are separately working with Himaffilia Scotland to develop a pilot of additional social work support for affected people. We have also funded a pilot of additional psychological support to affect a patient through one of the Himaffilia centres in Scotland, and I am committed to successful completion of the pilot and to learn any lessons for what additional support we can provide generally. I can also confirm that a national managed clinical network, essentially a Himaffilia committee, will be established for inherited bleeding disorders. That will closely involve patients and help improve clinical services for the future. Finally, both Himaffilia Scotland and the Scottish Infected Blood Forum do vital work in supporting the affected patients and their families. I am pleased to confirm today that the Scottish Government will commit to providing core funding for both organisations for the next three years to ensure that they can continue their good work. I have asked today both organisations to help to establish the reference group to help to take forward the Penrose recommendation, the other actions that I have highlighted and the consultation on the review of the financial schemes. We will also be more than happy to discuss providing support to any other organisations who work with affected patients and their families. The conclusion of the Penrose inquiry is a watershed moment. We can now say with some certainty that we understand how this tragedy unfolded. People who have been affected have now had the opportunity to be heard and to put on record what happened as part of an independent public inquiry. I want to finish by reiterating how sorry I am that those infections happen through NHS treatment. I have great sympathy to all those affected and will continue to work closely with and offer support to them in any way that we can. The Penrose inquiry was looking at what has happened, but we must now focus on better supporting those affected going forward. In doing so, I can promise that we will continue to listen to them and work with them. I recognise that this statement will not immediately fulfil the desires of all those who have been affected. However, I hope that my comments reflect the Scottish Government's intention and my intention to move forward and work with patients and their families in the coming years. The cabinet secretary will now take questions on issues raised in her statement. I intend to allow around 20 minutes for questions after which we move on to next business. If any member wishes to ask a question of the cabinet secretary, please press your request to speak button now. I call Jenny Marra. I add the sympathies of those benches to the remarks that were made by the cabinet secretary just a few moments ago and thank her for advance copy of her statement. The Penrose inquiry, published yesterday, laid bare the full horror of the blood contamination that led to so many lives being lost and devastated by hepatitis C and HIV. The testimony of the victims in the report and the stories that we heard from those who attended yesterday's event were nothing short of harrowing. Bill Wright, chair of Hemophilia Scotland, described the blood contamination episode as one of the most distressing stories in the history of the NHS, and it is difficult, Presiding Officer, to argue with his analysis. He, like many others, was disappointed, as the cabinet secretary said, with the findings in the report. The most commonly used description of the report by families yesterday was whitewash. Parliament and Government do not have any say over the findings of the report, but we can take the opportunity to put things right for many patients. With this inquiry now over, can the Scottish Government ensure that new and improved treatments that are being developed for hepatitis C are made available for the victims of this dreadful episode as soon as possible? Given that the First Minister stood shoulder to shoulder with the victims, first as Opposition leader and as health secretary, now that she is First Minister and the six-year inquiry that she ordered is over, will her Government now make good on the commitments for financial support? As the cabinet secretary has just announced, financial support will be made available by April next year. After waiting six years for this inquiry to report, is it not reasonable that the Scottish Government make good to that commitment to victims now and put financial support in place without any more delay? I think that it is unfair to ask victims to wait yet another year when they have waited so long and the Government has had so long to prepare for this day. Can I first of all say that, of course, anyone who requires treatment through the new drugs and is clinically approved and recommended for treatment through the new hep C drugs, should receive that. First Minister said earlier on on behalf of the Scottish Government an apology for what had happened, and it is important that we recognise that. Jenny Marra talked about what Bill Wright and others have said, but if she had listened to what Bill Wright and others had said, she would have heard Bill Wright say that he wanted to sit down through the reference group and discuss what the proper support should be, that they want to be involved in the review of the financial arrangements. That call has come from those who have been affected, and therefore I think that Jenny Marra should understand the view of the patients and campaigners on the matter, that they want to talk to us about what those financial arrangements should be. It is in listening to Bill Wright and others that we have come to the conclusions today that I laid out in my statement that the reference group would be established a proper forum for discussing those matters. It was Bill Wright himself who asked for World Heemophilia Day to be the point in time by which those new arrangements should be put in place. I very much listened to the views of those who have been affected. Over the past few years, I sat on the health committee and listened to the first round of evidence on that, and I have met Bill Wright and others over many, many years, and over the past few weeks and indeed today, so I will absolutely listen to those voices as we take that forward. I thank the cabinet secretary for advance sight of her statement, and I associate the Scottish Conservatives entirely with the sentiments that she has expressed. I also thank the First Minister for having the courage to initiate the inquiry and to say that I am actually quietly proud that it was the Scottish Government and the Scottish Parliament that, in fact, initiated the inquiry that took place. I have three very brief points. One, I would like to associate myself too with the approach that the cabinet secretary has taken in relation to the response to the relatives and others affected. It is important that, through our actions, we are able to counteract through practical approach any characterisation of the report as a whitewash. It is easy to understand why some might say that. I do not characterise it that way myself and I support the action that she has taken. When she does expect to be able, in her own mind, as a timeline, to advise us on what further action she might arise as a result of the consideration of the recommendation that has taken place, and I also ask her in relation to the HIV compensation just to confirm that she will act with the Westminster Government to ensure that the implementation of the provisions of that are as smooth as possible. Just on the last point first, the general election being in the time frame that it is, that some of those discussions with the Westminster Government will obviously have to take place after the 7th of May, but we obviously want to have those discussions as soon thereafter. I also thank Jackson Carlaw for his comments. That has been a very long inquiry and I very much recognise the families and those affected have waited a long time for what happened yesterday and we should bear that in mind. He is also right to say that action is important and it is not about looking back, it is about looking forward. The work on the reference group, when I met with some of those affected in campaign groups earlier on, they were keen to get that work under way and so am I. The reference group discussions will happen in short order and thereafter they will decide on the priorities going forward. Some of that is about the review of the financial arrangements but there are also other things that we can get on with quite quickly in my view, particularly around things such as the psychological and social work supports that many have said need to be improved. I would like to get on with those in short order and I will certainly be keen and happy to keep Parliament updated on the progress of that. I commend to the cabinet secretary, Robert Mackay, a constituent of mine, whom many of us will remember, sat with others outside the old Parliament and all the others, campaigning for an enquiry and commend the Government for doing it. Nothing will bring back the health we know that, but on financial matters, which at least to some extent might give them some security, I notice that you have committed to reviewing the financial support schemes. Can you confirm that other UK countries will co-operate with that review and, if not, Scotland will go ahead, as it has with its enquiry, with its own review? I say first of all that we have already initiated discussions that, certainly at official level, we would want to begin to discuss the review of the financial arrangements on a UK basis, not least because the existing financial schemes are delivered on a UK basis. However, as I said yesterday and again confirmed today to those affected in their families, I am very clear that Scotland will not be held back if we cannot reach agreement across the islands to move forward. I believe very strongly that we need to move forward. I hope that we can reach agreement across the islands that that should be the case across the four countries. However, I am also very clear that, if we cannot, we will get on and do what is right for those here in Scotland. Rhoda Grant, Fyngor Llywodraeth Cymru. Can I pay tribute to those who have campaigned and, indeed, still continue to campaign on behalf of those who are affected with the scandal? The Penrose inquiry report highlights the issue of patient records and the fact that parts of some patient records are missing. That causes a great deal of distress to patients and, indeed, suspicion that those were tampered with. Can I ask what the cabinet secretary is doing to address that and identify what happened to the records and why? I think that the Penrose report looks into that in some detail and has gone through a lot of information around that. Clearly, if there are other aspects of what Penrose has identified through his report, even if it is not translated into a recommendation, we would be happy to look into that. The focus and desire of those who are affected in their families is around the support going forward. It is important that we focus our attention on that and what more we can do to make sure that people are supported. Yesterday, I heard some very difficult stories about the hardship that people are facing and that it had been made more difficult than it should have been for people to get some of the basic financial support through the existing schemes. In my view, that is not good enough and that should be our focus of attention going forward. That will certainly be the priority that I give. Obviously, there are other matters, but I think that we should focus on the support requirements of those who are affected in their families. I apologise to the cabinet secretary for missing the earlier part of her statement. One of the main findings from the Penrose report is that doctors at the time were very paternalistic and did not give relevant information to patients. How can we be sure that that is no longer the case? Through the Penrose report, that comes across that the relationship that people had with clinicians in the 1970s and 1980s was a paternalistic one, where consent and informed consent were not recognised in the way that they are recognised now, whether that was in relation to test results. We have moved a long way in the NHS now that it is very much about recognising the patient's rights and the right requirement to consent and for that to be informed consent. I recognise the journey that the NHS has been on since then. Of course, the patient's safety programme has dealt with many of those matters in making sure that we have one of the world-leading patient's safety programmes. That is something that we should be proud of in our NHS of today and recognise that we have come on a long journey since the days of the paternalism of the past. I can also pay tribute to the campaigners and acknowledge that the cabinet secretary and the First Minister have taken a close interest in this since the early days of the Scottish Parliament. Does the cabinet secretary agree that an important part of the review has already been carried out by the Scottish Infected Blood Forum, with its 8CV contaminated blood scoping exercise? Is the cabinet secretary minded to accept the recommendations of that exercise, remembering that one of the recommendations is that all the recommendations should be actioned within the lifetime of this Parliament? I think that the work of the forum has been very important in giving us a really good starting point. The scoping work that it has done will be a useful starting point for the reference group. We have certainly discussed that today as being very helpful in making sure that the reference group can get under way and get on with the task in hand, and we will certainly be using the work of the forum to do that. I thank the minister for her statement and agree with all of her statement. As she will be aware, I have worked with Hemophilia Scotland over the last few years, and I pay tribute to the families, in particular to Bill Wright. Recently, I hosted a reception in this Parliament with a play pertaining the disaster factor 9. I ask the cabinet secretary if she will be requesting the health committee to discuss this report urgently, and if time can be allocated to discuss the report in the chamber after any action by the health committee. I saw the play factor 9. It was a moving, powerful play indeed, and it was very powerful. Obviously, it will be for the health committee to decide whether it wants to seek to look at the report. It is not for me to guide it in that respect, but I would certainly be very willing to make myself available to appear in front of the committee should they wish to have a look at the report, but also the work that is going to be happening thereafter in terms of the work of the reference group. I certainly would make myself and my officials available for that. In terms of parliamentary time again, I will be very happy to make time available at the most appropriate moment to come back and revisit progress, perhaps around the reference group as we begin to take matters forward. I would certainly be keen to make sure that we keep Parliament well informed of the progress that is being made there. Jim Hume, followed by Bob Doris. I first place on record my thoughts for the victims and families of those affected under dignified campaign. Of course, I thank the cabinet secretary for advance sight of the statement. Presiding Officer, almost half of the people living with hepatitis C in Scotland are undiagnosed and only about 3 per cent of those receive treatment. The hepatitis C trust argued that it is a moral imperative that we find and diagnose those people before they develop advanced liver disease. I wonder what the Government is doing to find those who need to be diagnosed and ensure that they are all provided treatment. A lot of work over the years has gone on to attempt to trace people, to find people who are not diagnosed in order for them to be offered a test and therefore to open up opportunities for treatment and support. Obviously, with the Penrose recommendation, there is an imperative on us to see what more we can do in that respect, and we will be discussing the best way of taking that forward so that, again, we can try to make sure that we pick up people who have not already been diagnosed. That is very important, because I am sure that, as Jim Hulme knows, there are now a very different set of drugs and treatments available than there was previously. Therefore, getting people diagnosed and on to the most appropriate treatment is very important. I am happy to keep Parliament informed of the work that we undertake to do that. Bob Doris, followed by Johann Lamont. Cabinet Secretary, will the Scottish Government ensure that those living with hepatitis C due to contaminated blood get full and speedy access to a range of now curative medicines that have been developed recently? I also note that, quite often, the NHS does not prescribe some of those medicines until late stage hepsi, but the disease has been sitting within their bodies for a significant amount of time. Early access to curative medicines would be vital, I think, for many hepsis sufferers. Obviously, those are clinical judgments and someone would have to be clinically suitable for any drug or treatment, but, with that caveat, it is very important that, particularly for those who have been affected through the infected blood and blood products, they are given the opportunity to have those treatments, but, again, they obviously have to be clinically suitable for those treatments, and that will be a clinical judgment. Cabinet Secretary, I have a constituent whose husband was a hemophiliac who contracted hepatitis C through treatment and died young, having suffered immensely, not just from his condition, but from a fear of stigma that led to a desire for secrecy, which brought further burdens to him and to my constituent. My constituent hoped that Penrose would answer a simple question, and that was why it did happen. Critically, whether people were infected after medically it was known that there was a serious problem with the contamination of blood, could the cabinet secretary outline what her response is to that question and what now can people at my constituent do to feel that they have fought hard enough to secure justice for their loved ones? I recognise the pain of her constituent and her constituent's family, but many others I met with many affected yesterday. I was very struck by those personal stories and testimony. One of the things that Penrose did allow was, for many of those, that testimony to be put on the record and recorded. Penrose also looked back into many of the issues that Johann Lamont is referring to about what was known, what action was taken and what action wasn't taken. Being an independent inquiry came to the conclusions that Penrose came to. As I said in my opening statement, I recognise that, for those affected and their families, for many of them, those conclusions have not met their expectations of what they wanted to see the Penrose report come up with. The best response that I can give to that, and I think that this is what those affected and their families want, is now to get on with the action that is required to support them in a better way. That was the message that I got yesterday and the message that I got today, and that is absolutely what I am determined to do. It is a moral obligation for us to make sure that those affected have the proper and adequate support to be able to get on with their lives in more comfort than they are at the moment, and that will be the focus of my attention over the next few weeks and months. I pay tribute to the many families, not just in the gallery but throughout Scotland as well. Given what we know happened in relation to HIV and Hep C, how can we be sure that the blood supply is safe from new infections, which might now still emerge? As I said in my statement, the processes around blood donation and the treatment of blood and the safety of blood are very, very strictly controlled. The message that I want to give today is that we have one of the safest processes and safest products here in Scotland and indeed in the UK throughout the world. It is important that that message goes out because I would not want anyone who has been reading or listening to some of the really difficult issues around the Penrose report to be afraid of receiving blood or blood products here in Scotland or, indeed, giving blood. It is really important that the message goes out that the blood in Scotland is safe and people should not be afraid to be a recipient of blood or blood products or, indeed, importantly, to give blood. Thank you, Presiding Officer. Would the cabinet secretary agree with me that this is the biggest medically-caused tragic event since Thalidomide and, indeed, arguably bigger? We should all regret the process taking so long. Even now, if more support beyond the excrasher funding made by Labour is now put in place, many of the victims and their families may never have closure nor the lives lost, of course, can never be restored. Cabinet secretary, new medicine is rarely risk-free, so can she give us any indication as to whether we have a firm timetable for a no-fault compensation scheme? I think that I said in my statement that this was one of the biggest tragedy that has faced our health service and those who were in receipt of treatment through our health service. I think that I was clear about that in my statement. The issue that I have said to others about getting on with the review of the financial provisions and the method and the timescale for that has not been something that I have decided upon. That has been in consultation with those affected and they want to be involved in those discussions. They want to have ownership of those discussions and they want that to be done in a proper process. That is why what I announced in my statement has been driven by those who have been affected. I think that it is absolutely critical that we listen to them. The next step will be the reference group. We have already had some discussions today about getting that under way. Then we will begin the detailed discussions around those financial provisions and whether we can move forward with those on a UK basis or whether we need to do something in Scotland. Again, I have said to others that I am open-minded about that and that will depend on the response from other parts of the UK. However, what I am absolutely clear about is that we will not stand back and we will not stall from getting on with our moral duty to make the lives of those affected and their families better. That is what I am going to be focused on over the next few weeks and months to make sure that we deliver that. Thank you. That ends the statement from the Cabinet Secretary on the Penrose inquiry. Before we move to the next item of business, I say to members that I allowed the statement to run on naturally to allow everybody who wishes to ask that question and to get an answer. That does mean that we are going to be very, very tight for time for the rest of the afternoon, so I hope that you will bear that in mind.