10 May 2022: Rejman - B

Dr Rejman must have had a strong coffee or two since he has come out for part 2 quite buoyant and emboldened.

Given the shady role of the UKHCDO, particularly the inner-circle “club”, then any person who attended their meetings was either deaf-blind, or part of the collusion. So, it comes as no surprise to hear Dr Rejman tell us how conscientious the Haemophilia Centre Directors were in always seeking the best for their patients. Then he goes straight into describing the efforts to “trial” new or improving treatments to get to the best product for their patients. Unlicenced products were common because they were at the “vanguard”. The idea that these new products could have produced a disbenefit was not a matter for concern, except for administrative reasons by the MCA section because licencing was their thing.

The attendance at meetings by officials was to show that the DH cared, was interested, and was listening. At one point Dr Rejman was on 23 different committees. It was quite hard to “keep the show on the road, so to speak” he says.

From behind a very broad teethy, beardy smile Dr Rejman explained how he was told about the HIV litigation on his first day on the job at the DH. He was told he would need to be involved. He was there to give advice to the legal people since it was quite a complex medical issue. He remembers there were about 900 or so individual claimants to respond to, after the group aspects of the claim. Overall, about 1,200 were infected, he thinks. Dr Rejman created a pro-forma document which when completed and collected together were then put on an early database table. He categorised people according to various conditions. It sounds like a prototype of a compensation framework. Most of this he did at home to get some peace from the office environment (that’s telling). So, was he taking personal data out of the security of the locked office, carrying it perhaps by public transport, and having it open on a desk at home where family and others could come across it?

“The Department would never use its own officials as expert witnesses,” according to Dr Rejman after he had been designated, inaccurately in his view, as an expert witness back in the day. At the time he was simply asked to comment on some documents to Counsel. It was an informal chit-chat which could have taken place in a pub, he says, yet somehow an administrator took a sufficiently detailed written note and wrote it up as minutes recording his “expert” view, apparently.

He assumes there was high-level coordination of the legal folks about responding to litigation evidence, for example in respect of different legal frameworks such as Scotland, but he was never involved in these.

In answering a question from Counsel, he mixed some scenario speculation with a “this is how it was back then” trope to explain away “informed consent”. Treatments were to let people have a normal life. He confidently asserted that patients would have been told what a treatment was, why it was being used, and invited questions. That was informed consent, with the patient probably not even remembering by the next day if they had been asked to sign something or not at the time. Somehow, he got to an awkward smiley description of a diabetic going into a cubicle in a toilet at work to take their insulin such that nobody at work would even know about their medical condition. Jenni simply pressed on in the face if his flapping. According to Dr Rejman, the doctors were all thoughtful people, who knew there were lots of alternative approaches to treatment, looking at the patient, explaining what they felt they should explain, because they knew their patients. So, nothing to see here, the doctors were all wonderful, move on please.

The doctors wanted the litigation to finish. Civil servants and lawyers attended meetings with these doctors who Dr Rejman had just told us would never do harm to their patients, with the pressure being for the Government to pay up so everything would go away. “The Haemophilia Directors wanted this closed down as quickly as possible.” Some doctors were being personally taken to court. Much to their frustration, the DH saw itself as defending a negligence claim and so would not automatically bow to pressure so settle. “The doctors felt they were being got at by the haemophiliacs because the Government wouldn’t pay up.” So, if the doctors were so concerned about their patients, why was all the focus on protecting their bank accounts and not protecting the lives and wellbeing of their patients?

According to Dr Rejman, there was no need to advocate for making payments due to the actual pain and suffering of patients because that was a given. He says the DH were well aware of the harms caused, just like the doctors themselves were. It begs the question, if the impacts on people were sufficiently known back in the 1980s, why did it nevertheless take so long for an Inquiry, let alone compensation?

More audible and visible sighs as Dr Rejman is asked about Government claims of having done everything possible to protect people, such that the Government were of the opinion the case can be defended because people did the best they could. The expert view of that position came from the best expert opinion at the time – the UKHCDO. No conflict of interest there then … really. It’s no different from people taking out individual action for negligence against a haemophilia clinician and the lawyers going to another haemophilia clinician for expert advice, when that person was doing the same things him or herself. No wonder it was so hard to get claims to progress. There were no truly independent expert opinions.

The delay in introducing screening tests might have been due to the potential misuse by people coming forward apparently to give blood, but actually to find out if they were infected. There was also some reference to issues over the possible inaccuracy of the tests.

A note in his own minute quoted a sum of £250,000 per victim and a total possible exposure of £300 million. He thinks this was something someone had worked out and told him rather than him being able to work it out. We assume the very same types of calculations are happening currently.