Department stalled publicity attempt, says BTSB doctor

THE national director of the hepatitis C screening programme said she had been "stalled" by the Department of Health in trying to publicise a second source of antiD contamination.

Dr Joan Power, who was giving evidence yesterday to the tribunal of inquiry into the hepatitis C scandal, said she had to resort to implicit" means to publicise the matter.

Dr Power, who is BTSB regional director in Cork, said that by April 1994 (the year the screening programme was set up), it was clear that the vast majority of antiD women who had come forward for hepatitis C testing were "from the 1977 period".

This was not surprising as there had been such a focus on the 1977 contamination episode in all publicity surrounding the scandal. As a result, the infection was being seen as "an older generation of women's problem".

Younger women didn't perceive themselves as a target audience". Partly for this reason, but particularly because of new information received from the Middlesex Hospital in London, it was felt important that this information be disclosed.

On February 18th, 1994, a letter from the Middlesex Hospital confirmed that preliminary hepatitis C tests indicated batches of anti D made with donor Y's plasma were positive.

The anti D concerned had been given to women between 1991 and 1994. A letter on March 25th, 1994, said further tests had confirmed the earlier finding.

On April 8th, 1994, Mr Ted Keyes, then BTSB chief executive, wrote a letter on the matter to the then secretary at the Department of Health, Mr John Hurley. It was accompanied by the letter of March 25th from the Middlesex Hospital, and a draft of a letter the BTSB proposed sending to GPs informing them of the situation.

Mr Keyes said a representative rang him to say approval was not forthcoming for the draft letter. Ms Dolores Moran, a higher executive officer at the time, was the Department representative with whom he was constantly in touch.

"I am nearly certain it was Ms Moran who rang to tell me that letter was not being approved," he said.

On Tuesday Mr Brendan Howlin, who was Minister for Health at the time, told the tribunal hem had no recollection of seeing the letter "until now". In his evidence Mr John Burley said he could not recall seeing it at the time.

Dr Power said yesterday the only reason she was prepared to accept the Department's view of the letter at the time was "because I thought I could get around it".

She was aware the Department felt the scientific evidence linking donor Y's plasma and the infected anti D was not conclusive enough, but medically and ethically" she was "certain" of the connection.

Scientifically, it had been established "definitively" only in the last six months, she said.

Her way around the Department's refusal to allow circulation of the letter to GPs was "to give implicit information to colleagues throughout the country" at meetings. However, she "couldn't say it explicitly".

The first time she dealt with the matter publicly was in an article published in the Irish Doctor journal of March 1996, but to date there had been no public health information campaign highlighting the contamination of anti D batches used between 1991 and, 1994, although there had been an improvement in women from the period coming forward for testing.

However, it was also her conviction that many of these women had chosen not to come forward until treatment for hepatitis C improved.

She spoke of "informationally challenged" women who had not yet gone for testing and tended to regard infection through anti D as "a middle class women's problem".

She referred in particular to traveller women and the difficulty of tracing those who gave addresses at halting and caravan sites when they received the anti D.

There were also those women who received the anti D but later miscarried, and there were women who might have had babies in the past about which subsequent spouses would be unaware.