Fifty years. Three thousand deaths. Thirty thousand infected with contaminated blood. That is what it took to force the British government to confess to a lethal series of errors and lies that devastated families.

Between the 1970s and 1990s, the NHSThe National Health Service, the publicly funded healthcare system in the UK. The NHS was founded in 1948. administered blood infected with serious diseases, including HIVA virus that damages your immune system. and hepatitisInflammation of the liver, usually caused by viral infections or liver damage caused by drinking alcohol. , to tens of thousands of patients. Many of them had haemophiliaA medical condition which prevents the blood from clotting as normal, meaning small injuries can cause severe bleeding. , and the blood was supposed to be part of their treatments. The state then tried to cover it up, according to a new report.¹

On Monday, Rishi SunakA British politician who was the Prime Minister of the United Kingdom from 2022 to 2024. finally apologised for the hurt caused by five decades of governments. He promised £10bn of compensation for the families of victims.

For those families it is the culmination of decades of campaigning against a state that seemed determined to ignore their sorrow and anger.

The problem is not just that the state inflicted this misery on people, experts say. It is the fact that it lied about it for so long. The report finds there was a decades-long cover-up of the scandal, just to save money and prevent embarrassment.

Which is why some think this could be a huge crisis for Britain's political system. They say the existence of society relies on trust in the state.

It is a debate that goes back hundreds of years. In the 1600s, John LockeA 17th Century English philosopher, known as the "father of liberalism". argued that all governments are based on trust. He suggested that at the beginning of society, the people had chosen to vest their trust in the government to safeguard their rights.²

If they fail to protect their citizens and their rights, he thought, those governments have broken these bonds of trust with the people. In extreme cases, it would be legitimate for the people to rise up and overthrow their governments.

His fellow philosopher, Thomas HobbesAn English philosopher who is regarded as one of the founders of modern political theory., had a different view. He thought people had come together in the beginning not out of trust, but out of fear. It was because they were afraid their rights would be violated by others that they gave the government the power to enforce the laws and protect rights.³

However, this meant that no resistance could ever be tolerated. Because the government was based on fear, not trust, it had a duty to ensure people would always be afraid of the consequences if they broke the law, even if they broke it to protect their own rights.

But when Locke and Hobbes were writing, the state was still relatively small. It did not even have a formal police force nor a permanent standing army. It did not offer healthcare to its citizens. Local governments, not the central state, provided basic welfare payments.

Today the government has stretched into every part of our lives. Father of the British welfare state William BeveridgeA British economist and politician, known for his role in designing the British welfare state. said he wanted it to look after the British people "from cradle to crave".⁴

The state is supposed to protect us from crime and foreign threats, care for us when we are sick and feed us when we are hungry.

And that means we have to have a lot more trust in it, because if it fails in these duties, that can devastate our lives.

Then people start to take things into their own hands. Profiteers offer healthcare at a cut-throat price. People arm themselves to protect their own property because the police will not. Society becomes a Wild WestUsed to describe the western USA during the 19th Century when settlers were moving into new areas. It was considered to be a lawless place. where anything goes.

Is this how society collapses?

Yes: If we cannot trust the state to fulfil its duties to us we have to do it ourselves. That means people making their own laws, their own police forces, using violence to defend their own rights.

No: What keeps us in line is not trust, but fear. For as long as the state is more powerful than us we will continue to obey its laws, whether or not we trust it.

Or... It can be a good thing for people to take matters into their own hands. If they organise as a community to provide vital services separate from those of the state, they can improve people's lives without using violence.

NHS - The National Health Service, the publicly funded healthcare system in the UK. The NHS was founded in 1948.

HIV - A virus that damages your immune system.

Hepatitis - Inflammation of the liver, usually caused by viral infections or liver damage caused by drinking alcohol.

Haemophilia - A medical condition which prevents the blood from clotting as normal, meaning small injuries can cause severe bleeding.

Rishi Sunak - A British politician who was the Prime Minister of the United Kingdom from 2022 to 2024.

John Locke - A 17th Century English philosopher, known as the "father of liberalism".

Thomas Hobbes - An English philosopher who is regarded as one of the founders of modern political theory.

William Beveridge - A British economist and politician, known for his role in designing the British welfare state.

Wild West - Used to describe the western USA during the 19th Century when settlers were moving into new areas. It was considered to be a lawless place.