New recruit challenged establishment

Picture the scene. A young woman in a male-dominated profession confronts arguably the two most senior (male) employees in one…

Picture the scene. A young woman in a male-dominated profession confronts arguably the two most senior (male) employees in one of the State's largest health agencies over what she regards as its unsafe medical practices.

Imagine, moreover, her confronting the two at their headquarters within weeks of her taking up a new job, having arrived here from outside the jurisdiction.

Not a challenge many would relish.

Yet that is exactly what Dr Helena Daly did in August 1985 when she walked into Pelican House to tell the BTSB's national director, Dr Jack O'Riordan, a man regarded as one of the State's leading public healthcare professionals, and the board's senior technical officer, Mr Sean Hanratty, that they were failing to take the necessary steps to protect haemophiliacs from becoming infected with HIV.

READ MORE

It is no wonder that she still has vivid memories.

Describing the encounter yesterday on her first day of evidence, Dr Daly said she was "very surprised" by the reaction she received to her request that all products for haemophiliacs be heat-treated in order to minimise the risk of HIV transmission.

In relation to BTSB Factor 9, in particular, which has been blamed for the infection of seven haemophiliacs with HIV, she said she could not recall being given any technical reason as to why it could not be so treated.

In evidence to the tribunal, the blood bank has cited a fear over thrombogenicity as a reason for the board being slow to introduce heat-treatment.

But Dr Daly said she did not believe the issue was raised. She added that the thrombogenicity risk "was not a major issue" to treaters who regarded heat-treatment as a basic necessity in spite of potential negative side-effects.

The meeting was arranged on Dr Daly's request shortly after she took up a three-month locum position at St James's Hospital on July 1st, 1985.

She had taken temporary leave of absence from the Bristol Royal Infirmary in the UK where she had been employed since 1979, having graduated from UCD in 1975. While in Bristol she had direct experience of one of the first haemophiliac victims of AIDS, and she carried out a study of the case for the Lancet medical journal.

Her role at St James's was, in essence, to fill in for Prof Ian Temperley, director of the National Haemophilia Treatment Centre, while he was on sabbatical leave.

Of the Pelican House meeting, Dr Daly said she left feeling "very disturbed and very upset" and not convinced that she had conveyed to the board the necessity of heat-treating Factor 9.

She subsequently phoned Prof Temperley, with whom she had been liaising on the matter and who, she said, agreed wholeheartedly with her demand. Such was her exasperation with the board that she even travelled to see Prof Temperley in London, specifically to discuss a strategy for bringing the board round to their way of thinking.

The BTSB eventually agreed to heat-treat Factor 9, but only after the intervention of Prof Temperley. A start-up date of November 1st was agreed for such treatment. Dr Daly said this was a compromise date and was significant as it was subsequent to Prof Temperley's return, "and also after I had gone".

The intervention was undoubtedly a critical one and it raises the question as to how long the BTSB would have continued issuing untreated Factor 9, and at what cost to the lives of haemophiliacs, if Dr Daly had not acted when she did.

Certainly it does not reflect well on the relevant health professionals that it took someone effectively from outside the jurisdiction to bring about the change.

Dr Daly will continue her evidence today.