Almost 50 years and no justice on contaminated blood.

Rishi Sunak is used to being heckled on Wednesdays. Each week, he stands at the dispatch box where he and MPs on both sides interrupt, laugh and heckle at one another for a set time of 30 minutes. This week, however, the prime minister’s Wednesday hecklers were an unfamiliar audience.

The rowdy atmosphere was gone, replaced with hushed solemnity, and Sunak had to sit in front of his hecklers for nearly three hours. The individuals before him were women and men infected and affected by the contaminated blood scandal – the biggest treatment disaster in the history of the NHS. And what played out in that room provided a glimpse of what victims have been subjected to for more than four decades: justice delayed and denied to many.

As the minutes and hours ticked by, the most powerful man in the country offered vague statements – but no timetabled commitment to starting the compensation process despite repeatedly accepting the moral case for it. Payment of compensation is the one meaningful action the state can now take in recognition and recompense for lives destroyed.

At one point during the questioning, the prime minister appeared to look at his watch. We can only speculate what he was thinking. But if he was wondering how much more time he would have to spend thinking and talking about the subject of the inquiry, he’s not alone.

It is now 49 years since the World Health Organization first raised the alarm about the looming tragedy. That and subsequent other warnings were ignored by the decision-makers of the day, and tens of thousands of men, women and children went on to be infected with HIV and hepatitis through contaminated blood and blood products given to them by the NHS. What happened next is the story of how a disaster became a scandal. There is evidence of institutional cover-up and repeated resistance by governments to properly investigate what happened.

It’s now six years since those infected and affected by contaminated blood finally secured a public inquiry; three years since the government’s then paymaster general, Penny Mordaunt, said on the issue of compensation that the government “should begin preparing for this now”; 16 months since a report on compensation and redress was published by Robert Francis KC; and almost four months since Brian Langstaff, chair of the infected blood inquiry, took the rare step of publishing an interim report detailing his final conclusions on compensation, recommending that a compensation scheme be established immediately and begin its work this year.

“Many who should benefit from compensation are now on borrowed time,” he wrote. They do not have the luxury of waiting. A person infected with contaminated blood dies on average every four days.

One of the many inspiring campaigners on this issue that I have met over the years is Nicholas Sainsbury. Nicholas gave evidence to the infected blood inquiry back in 2018. He had attended Lord Mayor Treloar college (now Treloar college) as a child and was one of dozens at the school infected with HIV and hepatitis through infected blood products – 72 of the pupils later died. Earlier this year, after decades demanding justice, Nicholas also died. For many like him, compensation will come too late. And that is a tragedy itself.

The chair of the infected blood inquiry has done everything he can to lead Rishi Sunak and his government towards delivering justice for those infected and affected by the scandal. This week, Langstaff invited not only the prime minister, but the paymaster general, the leader of the House of Commons and the chancellor of the exchequer to sit and face victims of the contaminated blood scandal and account for what they have – or have not – done to provide redress.

Langstaff’s leadership of the inquiry has been exemplary – and should be a model for future public inquiries. Those infected and affected have been at the heart of proceedings: sitting directly in front of the person giving evidence, with the lawyers at the side and journalists at the back; providing questions to the counsel to the inquiry, Jenni Richards KC, that can then be put directly to ministers; interacting directly with the chair during the breaks, as well as through the more traditional formal mechanisms. Langstaff has shown compassion, commitment and respect for those whose lives have been torn apart by this scandal, as he sifted evidence in pursuit of the truth.

So what happens next? When is the government going to set up a compensation scheme, and will it start its work this year, as Langstaff requested? Despite four of the most senior ministers facing questions at the inquiry for more than eight hours this week, we still don’t know. Sunak would say no more than the government was working “as quickly as possible”, “as quickly as thoroughness allows”, and “at pace”. Only Jeremy Hunt gave any real insight into the extent of ministerial discussions that are taking place.

Not good enough. As Langstaff said to the prime minister: “There aren’t any details. There is no timeline. There is no structure yet in place … if it troubles my conscience, I would think it would trouble the conscience of a caring government and you have said that’s what you would wish to be.”

Rishi Sunak’s government is nearly out of time to do something meaningful – and using the present difficult economic situation as cover, it seems, despite the “moral case” for compensation. Contaminated blood victims are not responsible for the current state of public finances – but the state is clearly responsible for the damage it did to infected blood victims.

So no more platitudes, no more delays. No more, in Jeremy Hunt’s words, “institutional inertia”. Launch the compensation scheme for people infected and affected by contaminated blood. Justice now.

First published in The Guardian