The Blood Transfusion Service Board was accused at the tribunal yesterday of not pressing ahead with the production of high-purity blood-clotting agents at home because it was more profitable to have them manufactured abroad.
The deputy medical director of the Irish Blood Transfusion Service, formerly the BTSB, Dr Emer Lawlor, rejected the suggestion, made by counsel for the Irish Haemophilia Society, Mr John Trainor SC. She said a supply of the product, Factor 8, was produced and used to successfully treat up to 15 patients.
Dr Lawlor said the BTSB was "misguided" and "unrealistic" in believing it could produce the clotting agent on a large scale.
"It was most unlikely that a small blood bank that was strapped for cash would suddenly be able to produce, if not gold out of lead, then gold out of straw," Dr Lawlor said.
A laboratory technologist was employed to make Factor 8 and was now working in another hospital. She would give her name to the tribunal and she could be called to give evidence.
The tribunal heard that until early 1984 the BTSB had concentrated on trying to produce Factor 8 at Pelican House. Then it began to look at having the product made by commercial companies overseas from Irish plasma collected by the BTSB.
Dr Lawlor said it considered this second option for some time before it got the go-ahead.
It was only when a haemophiliac was discovered to have AIDS at St James's Hospital, Dublin, in November 1984 that things began to move, she said. "It was a matter of waking up the Department of Health."
Mr Trainor put it to her that throughout this period it was clear that continued use of commercial concentrates carried some risk of HIV transmission. Dr Lawlor agreed.
"In a sense was it not almost a matter of time before somebody tested positive? It is a bit like playing Russian Roulette. If you play it long enough somebody is going to be shot?" he suggested.
Dr Lawlor said she believed it was felt "if it happened" it would happen on a small scale, "not that that is consoling for anybody", she said. "Perhaps it was really that if it hadn't happened in your own country people did not believe it was going to happen . . . It was inevitable but I think it came as a surprise and shock to everybody."
Counsel opened documents to the tribunal which showed three commercial companies were prepared to pay the BTSB from £13 to £15 per litre for Irish plasma in 1984 and would return free of charge packaged Factor 8 ready for use. One of the companies would also meet transportation costs.
He suggested that in a "bidding war" the price would more than likely increase and that the BTSB would make £180,000 in one year on supplying 12,000 litres of plasma, the amount required to meet its annual needs, if it took up one of the companies' offers.
"This was likely to be quite a lucrative proposal," Mr Trainor said. Dr Lawlor said a person from the BTSB with knowledge of the board's finances could answer this question. "It's not simply profit," she added.