The real face of the Deep State

In 1987 the then health secretary wept at the harrowing stories of the haemophiliacs who caught HIV from transfusions of infected blood. Not that his tears did much good. Around 25 years later his successor reported that the Treasury was blocking a public inquiry into the scandal for fear of the cost of compensation.

The UK was not alone in being hit by this scandal. But while Canada set up a Royal Commission in 1993, Ireland established a tribunal and compensation scheme in 1997 and France prosecuted its premier, ministers and officials in 1999, Britain stalled, denying responsibility, hiding the truth and doing all it could to avoid paying compensation. 

If you seek the fabled Deep State, here it is. It is not found in the campaigning lanyard-wearing civil servants who have so annoyed a government minister, those targeted as enemies of Brexit or even the Treasury officials who dared to doubt Liz Truss’s economic strategy. The deep state is found in the dead hand of officialdom and the compliance of ministers that prioritises institutions over the people they are meant to serve.

The seven-volume Langstaff report into the greatest scandal in NHS history may detail an extreme and awful saga but it is only the worst example of what has been seen in multiple episodes, from the Post Office prosecutions to the Windrush affair, an all too familiar pattern of defensiveness, denial and delay.

For the infected blood tragedy is in fact two scandals; the first specific and shocking, the second dully familiar. The first concerns the narrow groupthink and cold paternalism which disregarded warnings over blood products from high-risk sources, errors which cost 3,000 lives, mostly but not solely haemophiliacs, and put 30,000 at risk of infection with either HIV or hepatitis. 

But then came the second, the years of deceit, self-justification, destruction of documents, obfuscation and indifference as the NHS, department of health officials, ministers and prime ministers closed ranks. Their actions were driven by back-covering, a wish to avoid exposing the NHS to legal liability and, above all, the desire to save money. To that end officials maintained a fiction that patients had received “the best treatment available”; that, in the words of one former prime minister it was just “incredibly bad luck”.

The response is a masterclass in evasion, a first-class degree in “computer says no”. While other countries faced up to their errors, the UK turned away.

When ministers pressed officials, they were stymied by a system which knows they will soon move along. In 2002, the then health minister, Yvette Cooper, requested an internal review into one aspect of the scandal. Though completed within months, it was delayed till 2006 and its conclusions altered to fit the official line. Even when efforts were made to ease the financial plight of victims, they were miserly, without admission of fault and motivated solely by political pressure.

And while the primary errors belong to the 1970s and 80s, the obstruction runs through to modern times. In 2020, when it was clear a public inquiry (itself forced only by threat of a parliamentary revolt) would lead to a compensation scheme, ministers continued to delay, pushing the costs into another year and perhaps another government.

Similar patterns can be seen in the case of the sub-postmasters who were wrongly prosecuted and jailed as a result of failings in a new IT system. This too is a story of injustice continuing well after it became clear that something had gone wrong. Post Office leaders suppressed information. Ministers came and went, either not asking the right questions or allowing the issue to be shovelled back to the very people responsible for the injustice in the first place in the name of arm’s-length operational independence.

The walls of obstruction are only breached by investigative journalism, dogged individual MPs and — in the case of the Post Office — a TV dramatisation. Both scandals were in plain sight for decades while governments played for time. Ministers hid behind process, not wishing to “prejudice” ongoing reviews or litigation. And though public inquiries ultimately delivered justice, it is often so delayed that those responsible have moved on. Unwanted recommendations are ignored or quietly shelved.

The Windrush scandal, which saw legitimate British citizens denied access to public services and even deported, was blamed on what an inquiry called the “institutional ignorance and thoughtlessness” of the Home Office. And there are countless other examples, both in the NHS and elsewhere. A 2021 report into a decades-old murder case found senior Metropolitan Police officers obstructing the new inquiry to safeguard the force’s reputation. 

When the state gets something wrong an institutional defensiveness kicks in until the failure can no longer be denied. Money must be saved, accountability must be dodged, faith in the institution cannot be jeopardised. And the victims? Well of course it is all very sad, but mistakes happen you know.

Langstaff’s recommendations might help but this is a battle with a culture which has not altered in decades. He depicts not an orchestrated conspiracy but something “more subtle, more pervasive and more chilling”, an institutional groupthink which hides the truth “to save face and to save expense”.

This week, Rishi Sunak promised both compensation and change. The money will be forthcoming. I wish we could be so confident about the change.

robert.shrimsley@ft.com