The Blood Transfusion Service Board and doctors treating haemophiliacs would have been aware in the mid-1970s that "skid row" types were queueing up in the US to get paid for their blood, which was used to make clotting agents for haemophiliacs, the tribunal heard.
The deputy medical director of the Irish Blood Transfusion Service (formerly the BTSB), Dr Emer Lawlor, said the reality of what was occurring, highlighted in two World in Action documentaries broadcast in 1975, would not have been news to the BTSB.
The programmes alleged that these paid donors, who included drug addicts and alcoholics, carried six to 13 times the risk of having hepatitis as volunteer donors. The programmes stated that Travenol/Baxter, the maker of Hemofil, which was distributed by the BTSB, would not allow filming inside one of its plasma centres in the US. One reason given was "unattractive donors".
Donors admitted they did not answer all questions asked by the centres truthfully. Dr Lawlor said this could still happen.
She said everybody was concerned about the risks in the mid-1970s but, in spite of them, people wanted to use factor concentrates as the benefits appeared to justify the risk.
Asked by counsel for the Irish Haemophilia Society, Mr John Trainor SC, if haemophiliacs ought to have been told of the risks involved and where the plasma was coming from, she said this was a matter for doctors, not the BTSB.
She added: "I think now you would tell. There has been a total shift in medical practice where people are informed and left to make up their minds about risks in a way that was not the case a quarter of a century ago".
Mr Trainor asked if she, as a consultant haematologist, would have been happy to have a patient on factor concentrates in 1975 knowing what was alleged in the programmes.
Dr Lawlor said if she had had a child with haemophilia she would have had the child on concentrates.
It then emerged that the programmes were broadcast in December 1975. Dr Lawlor said Mr Trainor was claiming the BTSB had not responded to the allegations made in them, but the BTSB had withdrawn Hemofil in August 1975 after a report in the Lancet by a British consultant, Dr John Craske, giving details of a hepatitis outbreak among haemophiliacs and linking it to Hemofil.
Mr Trainor said the product was later reintroduced and distributed for a mark-up by the BTSB, and the motivation for doing so had to be examined.