You Keep Quoting Francis. So We Read Francis — And Langstaff Too

By The Unheard Voice

You Keep Quoting Francis. So We Read Francis — And Langstaff Too.

A special report from The Unheard Voice

The Government repeatedly points to legislation, regulations, expert advice and Sir Robert Francis KC when explaining the Infected Blood Compensation Scheme.

So we went back to the documents.

And the first thing that has to be made clear is that several different people, reports and processes are being discussed — and they should not be blurred together.

Sir Robert Francis KC produced the compensation framework and recommendations.

Sir Brian Langstaff chaired the Infected Blood Inquiry.

Professor Sir Jonathan Montgomery chaired the Government expert groups advising on the design of the compensation scheme.

Those are very different roles.

And understanding those differences matters, because families are repeatedly being told that the scheme reflects recommendations, expert opinion and legislation.

So we want to know exactly which recommendations were followed, which were changed, what evidence influenced those decisions and who was actually consulted.

Francis did identify bereavement separately

Sir Robert Francis’s original compensation framework did not simply treat every impact on affected families as one indistinguishable loss.

For affected people, his proposed categories included injury impact, social impact, family care, bereavement and bereaved family financial loss.

Bereavement therefore appeared as a distinct part of his original framework.

The compensation scheme that ultimately emerged does not reproduce that original structure in precisely the same form.

That does not automatically mean Government acted unlawfully.

Nor does it mean Ministers were required to adopt every recommendation made by Sir Robert Francis exactly as written.

But it creates a perfectly legitimate question.

When Government invokes Francis in explaining the scheme, which parts of his framework were accepted, which were modified and why?

Families deserve more than selected references to recommendations that support the present structure.

They deserve to see the complete policy trail.

If Francis is being relied upon as part of the justification for this scheme, then his recommendations should be examined in full.

Then there is Langstaff

Sir Brian Langstaff chaired the Infected Blood Inquiry.

His Inquiry published its final report on 20 May 2024.

The Government announced its proposed compensation scheme on 21 May 2024.

One day later.

That timeline does not prove that the Inquiry’s final findings were ignored.

It does not prove that every element of the scheme had been permanently decided before Sir Brian reported.

We should not claim either.

But the timeline unquestionably raises an important question:

How much of the fundamental architecture of the compensation scheme had already been developed before the Inquiry’s final report became available?

And perhaps even more importantly:

What actually changed after 20 May 2024?

Which findings from Sir Brian Langstaff’s Inquiry altered the scheme?

Which recommendations led to changes?

Which concerns raised by infected and affected people changed policy?

Which did not?

And why?

These are not hostile questions.

They are basic questions of accountability.

Who was actually involved?

This becomes even more important when we examine how the original expert process operated.

Later Government material acknowledged that the earlier expert group did not have the benefit of direct engagement with the infected blood community.

Sir Brian Langstaff has also spoken critically about the absence of direct involvement from those infected and affected during the original development process.

That distinction matters enormously.

There is a difference between:

helping to design a scheme

and

being asked for views once major parts of that scheme already exist.

Both may technically be described as consultation.

They are not the same thing.

If Government maintains that the community influenced the design of the compensation arrangements, then it should be possible to show exactly where that influence occurred.

Who was consulted?

When?

How many bereaved families took part?

How many estate representatives?

What concerns did they raise?

Which concerns changed policy?

And which were rejected?

Families should not have to accept the word “consultation” as the end of the discussion.

They should be able to see the evidence of what consultation actually achieved.

What does IBCA itself see?

This is where we want to be fair.

IBCA did not create the underlying policy framework it is required to administer.

Responsibility for the policy and regulations ultimately sits with Government and the Cabinet Office.

IBCA has been tasked with delivering the scheme.

That distinction matters.

We also understand that IBCA may not always be in a position to publicly criticise regulations it is legally required to administer.

It would place the organisation — and individual staff — in a difficult position.

But IBCA is still made up of people.

People who speak directly to bereaved families.

People who hear the distress.

People who encounter difficult estate claims.

People who deal with disputes involving medical records and evidence.

People who see the practical consequences of rules surrounding care, probate, severity and recognition.

So perhaps the fairest question is not:

Why doesn’t IBCA publicly condemn Government policy?

Perhaps it is:

Do the people inside IBCA see some of what the community sees?

Do they understand why death recognition remains such a profound issue?

Do they see the anxiety surrounding Hepatitis B?

Do they understand the arguments around care?

Do they recognise the distress that can arise from evidence disputes, probate problems and long waits?

We hope they do.

And where IBCA is able to pass those concerns back to Government, we hope it is doing so.

That is not asking IBCA to take sides.

It is simply recognising that an organisation administering thousands of individual claims may see consequences that were not fully appreciated when policy was originally designed.

Government has already heard the concern about the deceased

And this is important.

We no longer need to ask whether concerns about deceased infected people have reached Government.

They have.

The Cabinet Office’s April–June 2026 quarterly feedback report confirms that concerns relating to compensation for deceased infected people were considered.

The Senior Responsible Owner decided not to recommend a change to the scheme in that area.

So the argument has moved on.

It is no longer simply:

Have you heard us?

Government has heard the concern.

The question now is:

Why, having heard it, does Government believe the current position remains fair?

What evidence was considered?

Why was a change rejected?

What would need to be demonstrated for that decision to be revisited?

And through administering real claims, has IBCA subsequently identified consequences that Government should look at again?

That is the level of transparency families deserve.

Hepatitis B remains a serious question

Hepatitis B is recognised within the compensation scheme.

But the treatment of different forms and consequences of Hepatitis B and Hepatitis C is not identical.

For example, acute Hepatitis C has its own lower-level category within the scheme, whereas acute Hepatitis B is treated differently.

Families continue to ask whether the complete historical and medical impact of Hepatitis B has been properly recognised.

That question should not be dismissed by pointing to a tariff table.

A tariff tells us what Government ultimately decided.

It does not explain why that decision is medically or ethically correct.

Government should be able to explain the evidence used when drawing those distinctions.

And where credible medical evidence challenges the assumptions underlying a category, that evidence should be capable of being considered.

Hepatitis B is not a trivial infection.

The scheme itself recognises serious outcomes including cirrhosis, decompensated liver disease, liver cancer and fatal acute infection.

So asking whether the full Hepatitis B framework properly reflects the experiences of those infected is entirely legitimate.

Interferon proves that expert conclusions can change

Interferon provides an important example of why policy should remain open to scrutiny.

The compensation framework has already changed.

Government introduced a new Level 2B category for people with chronic Hepatitis B or C who underwent interferon treatment.

The Technical Expert Group concluded that care needs associated with interferon treatment were likely to have been inadequately reflected under the earlier framework.

That matters.

It demonstrates something very simple.

Expert advice is not scripture.

That does not mean experts should be dismissed.

Quite the opposite.

It means good expert processes should allow evidence to develop.

Medical understanding changes.

Lived experience provides additional evidence.

Research is reassessed.

Experts reconsider assumptions.

Policy evolves.

That is how a responsible compensation system should operate.

So we will not claim that Government medical experts have been “debunked”.

That would go further than the evidence supports.

But neither should expert advice ever be used as though it permanently closes debate.

The history of the interferon changes demonstrates why.

The process itself is causing distress

There is another issue which cannot be captured neatly in a compensation table.

Families repeatedly tell us that dealing with the compensation process is worsening their distress.

Claims can require people to revisit events they have spent decades trying to live with.

Death.

Illness.

Hospital stays.

Caregiving.

Lost careers.

Family breakdown.

Destroyed or missing medical records.

Years of uncertainty.

Years of stigma.

Years in which the truth was not fully known.

We need to be careful about how we describe this.

The Unheard Voice cannot diagnose psychological injury.

We cannot claim that the compensation scheme is medically responsible for every mental health difficulty experienced by a claimant.

But we can accurately report what families tell us.

And many tell us that the process itself is causing profound distress.

That should matter.

A compensation scheme created following catastrophic institutional failures should be especially careful not to create avoidable additional harm for people already carrying decades of trauma.

Government should be continually asking whether elements of the process are unnecessarily compounding that distress.

If they are, they should be changed.

The dead cannot attend another consultation

This remains at the heart of the dispute.

Thousands died before compensation arrived.

They cannot attend another roundtable.

They cannot complete another questionnaire.

They cannot explain what infection did to their career.

They cannot describe their treatment.

They cannot speak about the stigma.

They cannot challenge a medical assessment.

They cannot argue about how their life has been represented in a compensation calculation.

Their families are left to do that for them.

And those families are not arguing that somebody who died is inherently more valuable than somebody who survived.

That distinction matters.

The argument is not:

Death should automatically mean more compensation than survival.

The argument is:

Death should not mean less recognition simply because somebody did not survive long enough to claim for themselves.

That is why Francis’s original treatment of bereavement remains relevant.

It is why Langstaff’s findings remain relevant.

And it is why the decisions made by Government after both of those processes deserve continued scrutiny.

Legislation is not an answer to every question

This may be the most important distinction of all.

Families repeatedly hear explanations which begin with:

“The regulations state…”

“The legislation provides…”

“The scheme allows…”

Those answers may be factually correct.

But they answer only one question:

What does the scheme currently do?

They do not automatically answer another:

Is what the scheme currently does fair?

Legislation can be amended.

Regulations can be changed.

Policies can be reconsidered.

Expert advice can be revisited.

Government decisions can be challenged.

Indeed, this compensation scheme has already been amended.

So when a family raises a substantive concern about justice, simply explaining the existing regulation cannot end the discussion.

The existence of a rule does not prove the rule should never change.

Publish the trail

So our request to Government is straightforward.

Show the community the decision-making trail.

Show which Francis recommendations were adopted.

Show which Francis recommendations were altered.

Show which Langstaff Inquiry findings changed the scheme.

Show when those decisions were made.

Show how bereaved families were represented.

Show what concerns were raised.

Show what Government accepted.

Show what Government rejected.

And explain why.

When IBCA escalates recurring problems, show what happens to those concerns.

When medical evidence develops, show how it is reconsidered.

When consultation affects policy, show the change that resulted.

That is meaningful transparency.

Not another statement saying that people have been listened to.

Evidence that listening actually produced consequences.

Francis and Langstaff should not be used interchangeably

There is one final point worth making clearly.

Francis and Langstaff did not perform the same role.

Francis produced the compensation framework.

Langstaff chaired the Inquiry.

Montgomery chaired Government’s expert groups.

Government made the policy decisions.

IBCA administers the resulting scheme.

Keeping those roles separate matters.

Because accountability becomes impossible when every decision is simply described as having come from “the recommendations” or “the experts”.

Which recommendation?

Whose expert advice?

Which decision-maker?

At what stage?

Those details matter.

We will keep asking

The Unheard Voice is not alleging a secret conspiracy behind the compensation scheme.

We do not need to.

The published record already provides enough legitimate questions.

We will read Francis.

We will read Langstaff.

We will read the regulations.

We will examine the expert reports.

We will examine the consultation records.

We will compare recommendations with final policy.

And where they differ, we will ask why.

We will challenge medical assumptions where credible evidence supports that challenge.

We will ask who was consulted.

We will ask who was absent from the room.

And we will continue asking how this country intends properly to recognise those who died before justice arrived.

They are not asking for more because they died.

Their families are asking that death does not make them worth less.

More than three thousand people died in connection with this scandal.

They cannot interrogate the scheme themselves.

Their families can.

And they will.

We are not accepting mediocre recognition for our dead.

Not because we reject evidence.

Because we intend to keep reading it.

— The Unheard Voice