DESPITE the advice in 1994 of senior officials in his department that a tribunal of inquiry into the hepatitis C scandal be set up, the then Minister for Health, Mr Howlin, did not do so, Mr James Nugent SC, counsel for the tribunal, told yesterday's hearing. Instead, Mr Howlin had set up an expert group to look into the matter.
Mr Nugent said that "from the very start (February 1994), the officials in the Department, from assistant secretary down, advised the then Minister, Minister Howlin, that, in these circumstances, a tribunal of inquiry should have been set up."
"That, apparently, was not decided on," continued Mr Nugent, "the expert group was established instead." Mr Nugent said he felt this decision "not to establish a tribunal of inquiry at the outset" was something the current tribunal would have to look at "in the context of the supervision of the Department of Health where the Blood Transfusion Service Board (BTSB) was concerned "and the adequacy of how it dealt with the situation."
He said it was also clear the Department "knew" that the BTSB was not co operating with the expert group initially, though there was "a significant improvement" when the BTSB was reconstituted. However, in its work, the expert group was "hampered by the willingness or unwillingness of the members of (BTSB) staff" as to what information they would supply." As an instance of this ongoing "willingness or unwillingness" he said that "it was at this tribunal for the first time that the Department of Health ever became aware that Patient Y had tested positive for hepatitis C."
Mr Nugent also told the tribunal that the Department of Health representative on the BTSB, Dr Rosemary Boothman, did not inform the Department of anti D problems at Pelican House until officials there were told formally on February 17th, 1994, even though she had been aware for some time by then. "She saw her role as bringing the Department's expertise and viewpoint to the board of the BTSB and she has a definite view that her role was not to carry information from the BTSB to the Department," Mr Nugent said.
He also explained how the BTSB had misled the Department of Health in advising it that the Canadian Win Rho anti-D product, which was to replace its own withdrawn anti-D, had the approval of the Federal Drugs Administration in the US. This was not so, and did not come to light until April 1994 when Senator Mary Henry, who was attending a medical conference in the US, discovered the product did not have FDA approval.
She immediately informed the Minister, Mr Howlin and questioned the use of the Win Rho anti-D. It was decided to proceed with the product as it was applied intravenously, it was virally inactivated, and the BTSB had already been dealing with the Win Rho company, with a view to using it to replace its own anti-D.
Mr Nugent said the College of General Practitioners "were very aggrieved" no information was given to it about the anti-D infection before the announcement was made public. "That was, it appears," Mr Nugent said, "a concrete decision made by the Department." They felt it important to get "the true story out" without it leaking and perhaps "becoming distorted."
It was clear maternity hospitals and the masters of maternity hospitals "were not told." Also "there was a feeling that people were being kept apart," Mr Nugent said. Women in particular "felt they were being deliberately kept apart," and he recounted an incident involving Ms Jane O'Brien, chairwoman of Positive Action.
She appreciated the BTSB could not tell her who had been infected, but was anxious to contact such people. She asked the BTSB to pass on a letter from her to relevant people. The BTSB seemed to agree, but then said they could not do so as "it would breach confidence." Mr Nugent said: "it is hard to see how it could have breached confidentiality but, in any event, they declined to circulate her letter."