We were delighted to include an interview with author, journalist and podcaster, Cara McGoogan, in our Autumn 2024 issue of the Drift + Focus magazine.
McGoogan's book The Poison Line about the infected blood scandal went into the box we curated around the theme 'wrong', alongside Mark O'Connell's book A Thread of Violence. You can read our interview with Mark here.
Right from page one, which starts not in the lab, hospital bed or courtroom, but on the backroads of Louisiana, McGoogan draws you into the humanity of the story. Nothing is held at arm's length, nothing taken at face value.
These are real people, victims and perpetrators, and they must be heard and held to account, respectively.
We spoke to Cara McGoogan to find out more.
Photo: Desiree Adams/Penguin Random House
Can you remember how and when you first came across the infected blood scandal? Did you know straight away that it was a story you needed to look at in more detail?
I was working as a feature writer for The Telegraph back in 2019 when I saw a diary note announcing the start of the Infected Blood Inquiry. I knew very little about the scandal back then but went to the opening week of hearings. I was so shocked by what I heard that I convinced my editor to let me write two pieces for that weekend’s paper. I travelled to hospital with one survivor after they gave harrowing testimony.
From that week I knew there was so much more to say - and that the public knew very little about what had really happened.
There are so many players involved and so many points along the poison line when people could have acted differently. Is it possible to apportion blame to anyone one person or organisation more than any other? Is there a hierarchy of blame?
For me blame travels backwards along the poison line, from the point of patients receiving Factor VIII to the manufacturers who sold it. It starts with the doctors, who were at the end of the line. They could have intervened - warned patients and chosen to use different products - but in most cases didn’t.
Next comes the politicians and civil servants in the UK who allowed infected Factor VIII to be imported knowing the risks. But for me the most culpable party is the pharma companies - Baxter, Bayer, Armour and Alpha. They took inordinate risks in collecting and pooling plasma, failing to research viral inactivation and not withdrawing products they knew were infected.
This scandal seems slightly different from, say, Hillsborough, Bloody Sunday or the Post Office, in that part of the battle for justice in those cases also involved fighting the media to even be seen as victims. In this case, from the get-go the media saw blood poison victims as completely innocent, yet it’s still taken decades of fighting to get recognition and accountability. Why do you think that is?
I think here the question is about the depth of the cover-up. For many years victims and their families were told nothing could have been done differently to protect them. Their infections with HIV and hepatitis were a ‘tragic accident’. That wasn’t true. You could go so far as to say it was institutional gaslighting.
It may have been clear that people who received infected blood products were victims early on, but it took decades for the true scale of the scandal to emerge - how people received their infections, the way they’d been lied to before and after, and the complete failure of the state to own up to its mistakes and support them.
The UK seems particularly bad at remedying injustice. It seems to take 20 to 30 years of fighting in most of these cases. Is it as simple as needing enough time to pass for enough of the people who made the key decisions to either die or retire for the system to say ’this is now no longer anything to do with us and we can safely investigate’. Is that too trite?
We have a problem with candour in our public institutions when things go wrong, which can be seen from the police to the NHS to the civil service. A lot of it comes down to weighing up the costs, for example of compensation or investigating fault. We need to learn as a country that covering up scandals like these is much more costly in the long run.
To the general public, Rishi Sunak’s statement in May after the publication of the final report from the inquiry, might have appeared to bring the scandal to a close, with the Infected Blood Compensation Scheme apparently ready to deliver proper financial compensation to those infected and affected. It seems that might not be the case and those who fought to get to this point still have a fight on their hands. Why have they needed to take further action against the government and also Treloar, the school at the centre of the crisis in the UK?
Survivors of this scandal and bereaved relatives have fought for 40 years to get to this point. They have seen governments ignore recommendations made by inquiries, including for compensation. When Rishi Sunak announced the General Election two days after apologising to those impacted by infected blood he left people with a sour taste, a feeling that they could once again fall through the cracks.
Until proper compensation is worked out they will need to keep fighting. I’m very pleased that there is now public awareness, which will hopefully support their cause.
One of the many shocking stories you refer to was one in which a victim’s liver failure was consistently and wilfully misdiagnosed as being as a result of alcoholism not infected blood, making the person ineligible for a life-saving liver transplant. Their subsequent death seems at the very least to be manslaughter to our untrained way of thinking. Why isn’t it? Might there still even be criminal prosecutions in the future?
That person’s story is tragically all too common in this scandal. Not only were patients given infected treatments, they then experienced poor care in light of their positive statuses. At this stage I think we will probably find that too much time has passed. Doctors have long since retired or passed away. Hospital executives moved on. Civil servants stepped down.
I know some campaigners would like to have seen corporate manslaughter charges but the other hurdle is that it was only introduced as a crime fairly recently, long after the infected treatments were prescribed.
If something like this were to ever happen again - which I dearly hope it won’t - that is an avenue victims could consider.
It would be nice to think this couldn’t happen again but these scandals and cover ups keep on coming. Have lessons been learned this time? What needs to happen to change the cover up culture? Will the Hillsborough Law make any difference?
Experts I’ve spoken to are pushing for a duty of candour in public life - from hospitals to government. The fact it doesn’t already exist was shocking to me. I think it’s urgent that we rectify that. Hopefully vigilance from the public with greater awareness of and interest in historic scandals will help prevent cover-ups like these from happening in the future.
We found your book incredibly gripping. You manage to weave together huge amounts of complex information in a way that keeps the people and the human cost at the heart of the story. How hard was it to marshal all the information you had into something so readable?
Thank you so much, I worked really hard to balance the gravity of people’s stories with the historical evidence and the needs of readers. The aim for me was to tell as many people as possible about the infected blood scandal. I was acutely aware that I needed to keep readers with me given how emotionally difficult the story is. Getting readers to care about the interviewees was so important to achieving that.
And I had great inspiration in how to weave a the personal stories with wider context from classics of narrative non-fiction like In Cold Blood by Truman Capote.
What was the experience of writing a book like for you and how does it compare to creating a podcast? Do you prefer one over the other?
They are both extremely gratifying and challenging in their own ways. Bed of Lies is a very collaborative experience, speaking with the series producer Sarah Peters on a daily basis. In a podcast you’re bringing people’s stories alive using their own voices which allows you to draw in listeners in a very intimate way.
I had more space in the book to follow investigative leads and tease out complex historical events involving deceased culprits like Professor Arthur Bloom. I hope readers think the two compliment one another - and I’d love to continue working in both mediums.
Your first podcast series looked at the spycop scandal. We sent our subscribers Donna McLean’s book Small Town Girl in their Summer 2023 box, which beautifully describes her experience of discovering she was in a relationship with an undercover cop. Do you have another cover up in your sights, either for a new series or another book?
I am so pleased your subscribers have read Donna’s book - it’s a shocking and vital account of her experience in the spycops scandal. Readers might also be interested in Deep Deception by Lisa, Alison, Belinda and Helen Steel.
I am actually working on the third series of Bed of Lies now, which will be out in October. It’s about a whole new scandal that has worrying parallels with the first two series. In this series I’m returning to the ethics of spying and the culture of cover-up, but this time in Northern Ireland during the Troubles.
*
This interview in our Autumn 2024 Drift + Focus magazine.