1 April 2022: Perry - D

"Viral inactivation" is itself a telling choice of words. Why not "viral removal"? Perhaps the virus is put to sleep rather than killed off by the process. If that is the case it raises a host of other questions, including the possibility of re-awakening, but that's possibly a topic for another time and place.

Dr Perry says viral inactivation became the top priority; and gradually became a phrase interchangeable with simply regerring to heat treatment. However, even if heat treatment was effective at dealing with viruses, it brought other problems, particularly inhibitors, since inhibitors were also considered a serious risk to patients. The original target for heat treatment was non-A-non-B, but when AIDS hit, it became the new focus and that pesky unidentified viral hepatitis had to take a back seat. AIDS also hastened the viral inactivation imperative. Too bad there was not the same pre-emptive urgency to deal with non-A-non-B.

Oops, we have a reference to "virgin haemophiliacs". And surprise, surprise, that reference related to studying 12 months of a product which in this case demonstrated how heat treatment had not resulted in any viral infections. As a non-clinical doctor, Dr Perry had a surprising level of influence on treatment decision-making for patients. I don't think Dr Perry is aware of the strong negative reaction patients have to the crassly unhelpful label of "virgin haemophiliacs".

At the same time as PFC made a request for 50 vials of English 8Y, the English bods wanted, reciprocally, that any new virgin patients it is given to be entered into their product trial. How many of us were among this group of "virgins" with which they are bartering, while we, the very patients involved, knew nothing about it. How sinister. As an unlicensed product, it had to be used in a named patient basis. How convenient that was. The 8Y received was perhaps favourably made available just to Edinburgh. In hindsight, says Dr Perry, it might have been better to spread the love wider. However, he said he could not be seen to be promoting an unlicensed product. Dr Perry thinks that any issue with this arrangement is really a matter for the UKHCDO (which was Chaired at the time by Glasgow's Prof Forbes). Sir Brian jumped in to pin down the witness away from his frequent attempts to distance himself from responsibility. For his part the witness responded by naming others who were possibly better placed than he was to make the key decisions and communicate information, thereby continuing to put distance between himself and the responsibility to act by filling that space with someone else. It reminds me of a very (un)working class secondary school in Glasgow where the Headmaster used to say the unofficial school motto was "It wisny me." Maybe Dr Perry is among its alumni.

Dr Perry, along with his peer, Dr Snape, were representatives on various strategic bodies. There were questions raised about a potential conflict of interest arising from their participation. These were high level, confidential, policy making groups which advised UK ministers on policy matters. They were chaired by the Chief Medical Officer or their Deputy. So it would be on a par with Chris Whitty or Jonathan Van Tam seeking expert advice to take to Sajid Javid. Scary. I wonder if the same demand for confidentiality exists with the SAGE group and the like. Dr Perry says he was never happy about the confidentiality constraint, or sure why it was in place. It stopped him passing on certain information which would have been useful to practitioners to know about. It also blocked the greater involvement of a more diverse range of experts to produce better outcomes. And interestingly, Prof Zuckerman was also in attendance. Double scary.

These meetings considered the matter of screening for the now named Hepatitis C, and occurred between 1989 to 1991. These confidentially bound group members were setting the (secret) agenda for the various Departments of Health. However, it created delays which some thought were holding back making progress on a key safety issue, which could have been taken unilaterally by any one of the partners, but the desire was to do so collectively. It meant there were various comparable countries who were ahead of the UK. Why could these countries resolve the issues which were apparent delaying the UK? Latterly, Dr Perry expressed his criticisms of the slow and secretive UK process, as presented at the Pen***e Inquiry ("Bin-quietly").

"I don't want to criticise the virologist, but ..." is a common introduction to then going on to doing the very thing you said you don't want to do. Is there no end to the buck-passing expertise of this man?

The "Better Blood Transfusion" strategy of the early 2000s was briefly explored by Counsel. Suddenly, Dr Perry became alive again as he felt the ground under him was firmer and less booby-trapped.

Then it was back to the hard stuff. The event attended by Dr Foster where Prof Ludlum gave a talk was re-opened. It was highlighted that among other things, Dr Perry had said it might have threatened their security; whatever that meant. Then there was the desire to control Dr Snape's evidence to the Lindsay Inquiry (again as previously raised with Dr Foster). Dr Perry flapped his way through an explanation for his desire to coordinate the content of Dr Snape's evidence. Eventually he had to resort to the security of referring Counsel to his statement which "is what it is". Banana skin time. ("Taxi and new underwear for Dr Perry, please.")

Finally, after the last break, to the questions from core participants through their Recognised Legal Representatives. Nothing to worry about, Doctor P.