COMING to the end of his cross-examination of Mr Howlin yesterday morning, Mr James Nugent SC, for the tribunal, questioned the former Minister for Health's decision to leave so much responsibility for sorting out the hepatitis C scandal to the Blood Transfusion Service Board (BTSB) from February 1994.
Mr Nugent: "First of all you knew that the BTSB had taken blood from a patient with jaundice, is that right?"
Mr Howl in: "Yes, that was in the (expert group) report."
Mr Nugent: "Second of all you knew that the BTSB had got a warning that patient's blood might not have been appropriate to use in the summer of 1977?"
Mr Howlin: "Yes."
Mr Nugent: "I think, thirdly, you knew that Dr Walsh (former BTSB medical director) had got a letter alerting him to the problem in December 1991 and that he had done nothing about it?"
Mr Howlin: "Yes."
Mr Nugent: "I think you knew that your Department were alleging that the BTSB were giving unsatisfactory information, that it was hard to get the information?"
Mr Howlin: "I explained that in some detail, yes, by and large you are right.
Mr Nugent: "You also, I think, were aware that they had provided the Department and yourself with inaccurate information about the new product?"
Mr Howlin: "In terms of the (Federal Drugs Administration) approval...?"
Mr Nugent: "Yes ... and NDAB (National Drugs Advisory Board) agreement?"
Mr Howlin: "Yes."
Mr Nugent: "I think you said you were not aware at any stage that the recall campaign was not a complete success; is that right?"
Mr Howlin: "Yes."
Mr Nugent: "But you were aware that the BTSB had taken a stance in relation to the women getting together and circulating the letter, that you did not agree with their approval?" (The BTSB had decided not to circulate a letter to infected women from fellow victims.) Mr Howlin: "Yes.
Mr Nugent: "I think you were aware that the Positive Action people felt that the counselling provided by the BTSB had served to anger rather than have a therapeutic effect?"
Mr Howlin: "I actually discussed that with them and you are by and large right, but not totally right on that one."
Mr Nugent: "I think you were also aware that the Positive Action people were of the view that the administration of the expenses scheme fell short of what was desirable?"
Mr Howlin: "1 felt it was understandable that anyone looking for supports would find them inadequate, but by and large, I understand what you are saying."
Mr Nugent: "You were aware that the BTSB were not co-operating with the Expert Group?"
Mr Howlin: "That there was a slowness in initial stages, yes."
Mr Nugent: "I think you were aware, in effect, that the BTSB had lost the confidence of victims the Positive Action people?"
Mr Howlin: "That is a hard question to answer. I think there were huge reservations, yes.
Mr Nugent: "Given all that Minister, did it not occur to you that whatever solutions you had to supply to the problem, the BTSB should be removed as far as they could from the scene?"
Mr Howlin: "Well, if you have to look at the individual responses and look at the alternatives available and to decide on an individual case basis, which was the better?"
Mr Nugent: "But was not the weakness with that that you had to set up a system. No system could answer each individual's case?"
Mr Howlin responded that Mr Nugent was looking at things with the benefit of hindsight.
Mr Nugent put it to him that there should have been "flexibility" where decisions were made, from the beginning, that "as the knowledge increased they could be revisited and perhaps altered?"
Mr Howlin: "Many of them were."
Mr Nugent: "Well, not the main ones, not the involvement of the BTSB?"
Mr Howlin: "In what?"
Mr Nugent: "In everything. In counselling for example?"
Mr Howlin: "Alternatives were put in place."
Mr Nugent: "Again, only for people who had to have the courage to stand and say..."
Mr Howlin: "Anyone who did not want to go to the BTSB had an alternative ... I do not think there was a difficulty in making the decision that if they did not like the BTSB to go to an alternative.
Mr Nugent: "Surely the role of the Minister was not for them to have to stand up for their rights, but for the Minister to ensure that they got their rights?"
Mr Howlin replied that if looked again "at the totality of it - and look at what this Minister did" one would conclude that by and large "we did a good job". As examples he referred to his making the issue public. He had supported all the proposals "to put in the screening, the counselling, the supports, the ex gratia payments, the special hospitals, the designation of supports in hospitals and to provide that free to every body". While inadequate hindsight" what had been done with the "expertise available to us in a small country" was a very good job.