It was the policy of the National Haemophilia Treatment Centre in Dublin to play down the risk of AIDS to patients in the early 1980s, it emerged yesterday.
The director of the centre, Prof Ian Temperley, in a letter to the head of the BTSB in November 1983, stated that this attitude was based on the knowledge that only 14 haemophiliacs had been diagnosed with AIDS in the US and only one in the UK.
In the letter setting out a suggested policy on the treatment of haemophiliacs to the late Dr Jack O'Riordan, former director of the BTSB, he said he would be grateful if the contents of his letter could be kept confidential.
He asked for Dr O'Riordan's comments on his proposals "so that erroneous or impractical lines of management" were not introduced.
There is no record of Dr O'Riordan replying to the letter, the tribunal heard.
Prof Temperley said the dangers of AIDS to haemophiliacs had sharpened "all our minds" and wrote as follows: "Theoretically all blood products used in the treatment of haemophilia are harbingers of AIDS and clinical practice has revealed that all products from whatever source produce hepatitis B and hepatitis non A, non-B [hepatitis C].
"With this in mind it is the policy of the National Haemophilia Treatment Centre to play down dangers of AIDS to haemophiliacs," he wrote.
"It is also important to appreciate that at least 50 per cent of Factor 8 concentrate used in this country is imported and that we could not adequately cope with management without use of commercial products.
"Finally, purified products are essential to cope with surgical procedures," he said.
He set out proposals for the care of persons with haemophilia and recommended that every attempt would be made to use freeze-dried cryoprecipitate made by the BTSB but that major operations and home treatment should be covered by commercial concentrate.
Counsel for the Irish Haemophilia Society, Mr John Trainor SC, cross-examining Dr Emer Lawlor, deputy medical director of the BTSB, said this was an ideal opportunity for Dr O'Riordan to suggest that the use of imported concentrates, causing infection abroad, be discontinued. Dr O'Riordan had heard at a Council of Europe meeting a few months earlier that concentrates should only be used when medically necessary.
Dr Lawlor replied that Prof Temperley had said in his letter that imported concentrates were necessary. She added that Dr O'Riordan was not a treating doctor and it would be "impertinent" of him to tell Prof Temperley how he should manage his patients.
She also said it would have made no "appreciable difference" to the outcome. Counsel said she didn't know this, to which Dr Lawlor said it would emerge later.
The tribunal was told that when Prof Temperley got no reply to his letter he proceeded with the issuing of a directive on how patients should be treated in December 1983.
Dr Lawlor said she thought it would have been a good idea if the letter had been replied to but she didn't know if it was or not. To further questions on the letter, Dr Lawlor said they would be better put to Prof Temperley, who will give evidence later.