IBCA Finally Acknowledges Missing Evidence — But What About the Families Left Behind?
A new IBCA policy recognises that some deceased victims' hepatitis C infections can be accepted without direct diagnostic evidence. But after decades of missing medical records, destroyed evidence and families fighting to establish the truth, serious questions remain. Why has this recognition taken so long, why are strict cut-off dates being applied, and what happens to the families who still fall outside the rules?
By Anonymous · Oct 27, 2026
“The absence of a medical record should not automatically become the absence of justice. Families should not carry the consequences of evidence lost decades ago.”
On Monday 26 October 2026, the Infected Blood Compensation Authority (IBCA) published an important announcement concerning historical HIV and hepatitis C co-infection in certain deceased claims.
For some bereaved families, this change could make a meaningful difference to how their loved one's infection is recognised and how compensation is assessed.
But it also raises questions about the timing of the decision, the boundaries of the new approach and the treatment of families whose historical medical evidence is incomplete.
The Unheard Voice welcomes any change that helps deliver fair compensation.
However, welcoming progress does not mean abandoning scrutiny.
And it certainly does not mean forgetting the families who are still searching for answers.
WHAT HAS ACTUALLY CHANGED?
IBCA has confirmed a specific evidential approach for certain deceased people who contracted HIV through treatment with Factor VIII or Factor IX between 1978 and 1985.
Research indicates that people who contracted HIV through these treatments during that period were also very likely to have contracted hepatitis C.
However, direct evidence of hepatitis C infection may not survive, and in some cases diagnostic evidence may never have existed.
Under the announced approach, claims managers can determine on the balance of probabilities that hepatitis C co-infection occurred when all the specified conditions are satisfied.
The deceased person must have had a confirmed, eligible HIV infection.
They must have had confirmed treatment with Factor VIII or IX between 1978 and 1985 which caused that HIV infection.
They must have died in 2011 or earlier.
And there must be no information on file suggesting that they were not infected with hepatitis C, such as negative test results.
Evidence supporting these conditions may include National Haemophilia Database information or surviving treatment records.
This is not an automatic entitlement for everyone with haemophilia, everyone who contracted HIV or everyone whose medical records are missing.
Nor does it mean that somebody who falls outside these specific conditions cannot establish an eligible infection through other evidence.
It is an evidential approach for a defined historical group.
That distinction is essential.
MISSING RECORDS WERE ALREADY RECOGNISED
There is another point that must be made clear.
IBCA has not suddenly discovered that medical records can be missing.
Its existing guidance already recognises that historical medical documents may be unavailable and that claims managers can seek alternative supporting information.
The announcement of 26 October does something more specific.
It explains when a particular combination of confirmed HIV infection, historical Factor VIII or IX treatment, date of death and other available evidence can support recognition of hepatitis C co-infection without direct diagnostic confirmation.
This distinction matters because families must not be led to believe that all missing-record cases have suddenly become eligible for a new presumption.
They have not.
But the announcement demonstrates the importance of applying historical medical research and the balance of probabilities when direct evidence is unavailable.
And that raises a wider question.
Are families across the compensation scheme receiving clear, consistent explanations of how incomplete evidence is assessed?
WHY IS THIS APPROACH BEING ANNOUNCED NOW?
The Infected Blood Inquiry published its final report in May 2024.
It documented devastating failures and the experiences of people who endured decades of illness, uncertainty, stigma and loss.
For many families, the absence of historical medical records has been a longstanding obstacle to establishing exactly what happened.
Some have approached hospitals repeatedly.
Others have contacted GPs, searched historical archives or sought information from specialist databases.
Many have been trying to reconstruct the medical histories of relatives who died years or even decades ago.
Against this background, it is reasonable to ask why IBCA is announcing this particular evidential approach in October 2026.
When was the underlying research first considered?
When did IBCA determine that these historical circumstances justified this approach?
Were claims managers previously given different guidance?
And have any families experienced additional evidential difficulties because this particular policy had not yet been introduced?
These questions do not establish that IBCA previously acted unlawfully or incorrectly.
They are questions about the development of a public compensation process and its impact on bereaved families.
Families deserve transparent answers.
THE 2011 CUT-OFF NEEDS EXPLAINING
One of the most significant conditions is that the deceased person must have died in 2011 or earlier.
This raises an obvious question.
Why was that year selected?
A person who died in 2012 could have received the same contaminated Factor VIII or IX treatment during the same historical period as someone who died in 2011.
That does not necessarily mean their evidential circumstances would be identical.
The availability of diagnostic testing, the likelihood of surviving records or other medical considerations may provide a legitimate explanation for the distinction.
But the announcement does not provide a detailed account of the evidence supporting that particular boundary.
The Unheard Voice believes IBCA should explain it.
Was the date selected following a review of historical testing practices?
Was it based on research into the availability of diagnostic records?
How many potentially relevant deceased claims fall outside the cut-off?
And can families whose relatives died after 2011 still establish hepatitis C co-infection through the normal evidential process?
Importantly, falling outside this particular approach does not automatically mean that a family is ineligible for compensation.
Other evidence may still establish infection under the scheme's existing requirements.
That distinction must remain clear.
WHAT ABOUT HEPATITIS B?
The announcement specifically addresses historical HIV and hepatitis C co-infection.
It does not introduce an equivalent evidential presumption for hepatitis B.
This is significant because some people affected by contaminated blood and blood products experienced multiple infections, including hepatitis B.
However, it would be medically incorrect to assume that the research supporting hepatitis C co-infection necessarily supports the same conclusion for hepatitis B.
Different viruses have different transmission histories, probabilities and clinical characteristics.
The relevant evidence must be assessed accordingly.
Nevertheless, where historical hepatitis B records are incomplete or missing, families deserve to understand what evidence IBCA considers and how its clinical advisers reach their conclusions.
How are historical diagnoses assessed?
How is evidence of previous infection distinguished from evidence of chronic infection?
What weight is given to historical treatment records, later laboratory results and specialist medical opinion?
And what happens where essential records have been destroyed?
The new announcement does not resolve these questions.
But it provides a timely opportunity to ask for greater transparency.
WHAT ABOUT PEOPLE INFECTED THROUGH BLOOD TRANSFUSIONS?
The newly announced approach concerns a specific group of people infected with HIV through Factor VIII or IX treatment.
It does not automatically apply to those infected through blood transfusions.
Some transfusion recipients and their families also face serious difficulties establishing historical infection where medical records are incomplete.
A surviving hospital record may confirm that a transfusion occurred without identifying the individual blood units administered.
Historical donor records may no longer exist.
The original diagnostic results may be missing.
But the existence of a transfusion alone does not establish that it caused a particular infection.
Claims must still be assessed against the evidence available.
What matters is that the absence of a particular document should not automatically prevent proper consideration of credible medical history, clinical findings and alternative evidence.
The balance of probabilities requires an assessment of whether something is more likely than not to have happened.
It does not require absolute certainty.
Nor does it mean that every possible infection route must automatically be accepted.
The Unheard Voice believes families deserve clear explanations of how this standard is applied, particularly where records have been lost through no action of their own.
WHAT HAPPENS TO CLAIMS ALREADY DECIDED?
IBCA has stated that deceased infected claims already compensated on the basis of HIV alone will be reviewed where the new approach applies.
It currently believes that only a small number of claims will require review.
According to the announcement, affected families do not need to take action because IBCA will contact them.
This is a welcome commitment.
However, it leaves further questions.
What happens to claims previously rejected because hepatitis C infection could not be established?
What happens to cases currently undergoing reassessment?
Will all relevant ongoing claims be assessed using the new approach?
And how will IBCA ensure that families are told whether the change affects their case?
The published announcement specifically describes reviews of certain already compensated HIV-only deceased claims. It does not fully explain the arrangements for every previously rejected or disputed claim.
That distinction matters.
Families should not assume that their earlier decision will automatically be reopened unless IBCA has confirmed that this applies.
Equally, they should not assume that a previous refusal necessarily prevents them from asking whether the new approach is relevant.
For families with an existing disputed claim, obtaining advice from their legal representative or contacting IBCA for clarification may be appropriate.
Clear public guidance would reduce confusion and unnecessary distress.
THE WIDER QUESTION OF FAIRNESS
The infected blood scandal was not a single event.
It involved decades of treatment, different viruses, different sources of infection and people whose experiences varied enormously.
Some survived.
Some died before the full truth became publicly known.
Some families have extensive medical documentation.
Others have only fragments.
A compensation system dealing with this history must be capable of recognising those differences without creating unnecessary barriers.
That requires consistency.
It requires medical expertise.
It requires transparency.
And it requires the ability to explain why evidence is sufficient in one case but insufficient in another.
The introduction of a specific historical co-infection approach is potentially valuable.
But its success should ultimately be judged by how fairly and consistently it is implemented.
FIVE QUESTIONS IBCA SHOULD ANSWER
First, why now?
When was the historical evidence supporting this approach first considered, and what led to its announcement in October 2026?
Second, why 2011?
What clinical or evidential reasoning supports the requirement that the deceased person must have died in 2011 or earlier?
Third, what happens to previous decisions?
Will IBCA clarify whether rejected, disputed or ongoing deceased claims may be reconsidered where the new conditions are satisfied?
Fourth, what about other infection circumstances?
How will IBCA explain the assessment of incomplete evidence in hepatitis B claims, transfusion cases and infections outside the defined treatment period?
Fifth, how will consistency be demonstrated?
Will claims managers receive clear guidance, and will families be given understandable explanations of decisions affecting their loved ones?
These are legitimate questions about the fairness and transparency of a public compensation scheme.
They do not diminish the importance of the announcement.
They seek to ensure that families understand exactly what has changed and what it means for them.
BEHIND EVERY MISSING RECORD IS A HUMAN STORY
Every missing medical record represents more than an administrative difficulty.
Behind the paperwork is somebody who received treatment, experienced illness or lived with the consequences of infection.
Some lost their independence.
Some lost their livelihoods.
Some required years of support from relatives.
Others died long before the compensation scheme was established.
The families left behind have carried their memories, searched for answers and, in many cases, fought for recognition for decades.
They were not responsible for maintaining NHS medical records.
They were not responsible for the destruction or disappearance of historical documents.
And they should not be expected to produce impossible evidence without proper consideration of what alternative information may establish.
At the same time, fair assessment requires reliable evidence and sound medical reasoning.
These principles are not contradictory.
They are both essential to a compensation system that deserves public confidence.
RECOGNITION MUST BE FOLLOWED BY TRANSPARENCY
The Unheard Voice welcomes IBCA's announcement as a potentially important improvement for a defined group of deceased claims.
It recognises that historical medical evidence can sometimes support an infection finding even when direct diagnostic confirmation is unavailable.
But the wider questions remain.
Why were these particular boundaries selected?
How will previous decisions be handled?
And what reassurance can be given to other families whose surviving evidence is incomplete?
The purpose of asking these questions is not to undermine progress.
It is to make sure progress is explained, applied fairly and understood by the people it is intended to help.
Because behind every claim is a person.
Behind every missing record is a history.
And behind every deceased victim is a family deserving of a fair opportunity to establish the truth.
The absence of a medical record should not automatically become the absence of justice.
The Unheard Voice will continue seeking answers, examining the evidence and giving a platform to families whose experiences must not be overlooked.
One community. One voice. No one left unheard.