18 May 2022: Connor - C

Core participant questions for Dr Connor:

On the notification process, did all Haemophilia Centres participate: She never had feedback directly from individual hospitals, but only had connections with the UKHCDO.

On the umbrella notification approach for public health reasons, it was balanced against individual patient needs: She sees the process as being focused on meeting patient needs, and the generic approach would stop potentially frequent changes to notification status

The links from the HPA side was with GPs and UKHCDO, what about Centres: She did not have direct communications with the individual hospitals

On the services available for vCJD patients, should a list of specialist supports have been distributed: She recalled a review study which did not flag up any problems, but that did not include any haemophiliacs, and she received to feedback of people not receiving support if they needed it (but if you don’t know there is support either locally of at a specialist unit, then you can’t say you never got what you didn’t know was there).

On notification, were there any patients who were wrongly notified, such as those who had not received UK products: She was not aware of any.

On de-notification support, was support available: She said the list of services was still available to doctors so hopes that was still being used for those people who were de-notified.

On the cleaning of equipment, was the product from Prof Collinge ever supported by the HPA: She did not think it was brought up with them.

On endoscopy equipment, was it kept for all implicated patients or just the one: She believes it was the individual patient.

On people who received numerous blood transfusions, were they notified: She said the modelling tried to assess risk of exposure balanced against the consequences of not notifying people.

On whether everyone was contacted to be notified: She said it was a difficult process and some people could just not be traced.

The Chair asked about “what is risk?”, such that if the risk is unknown, what then is the risk being assessed? The witness was not really able to answer immediately. He spoke about the two main risk factors, “likelihood of it happening” and “seriousness if it does happen”. This is how lawyers would analyse it (and other specialisms for that matter). She reflected that the wording in the documents from back when they were written would not be acceptable now. For the Chair, even if the risk is very small as a likelihood, the seriousness if it does happen is enormous, and that is the over-riding consideration. The witness said the document went through lots of people, and was carefully considered, but would not be useful now. (Note, the two factors described by Sir Brian has been the accepted way of assessing risk for many years, so how did all these smart people at DH not know that or bring in the expertise?)

She was then asked by the Chair what she would cross out from the document. The witness waffled without being specific about what she would cross out. He suggested that maybe the word “small” (as in small risk) might have been erased. He noted how it could come across as paternalistic. The response was still all over the place. I don’t think she is trying to avoid the question; she just doesn’t get it. That should fill us with not much confidence about a senior medically trained civil servant leading a key population protection agency without the capacity to grasp the issues.

A different question was about the 50% return rate on requests for information on an important matter like vCJD. She thought there might have been a process of chasing up responses but could not say for sure. She also could not comment on how acceptable it was for so many not to respond. She thinks they might have responded if there had been an order from the DH to hospital managers. This was another answer of a fairly weak answer given the expected competencies which should have been there from a person with her responsibilities.

Dr Connor was grateful to contribute to the Inquiry. Her thoughts are with those affected. She thanked her colleagues, who included some very expert people who were “doing their best”. (There’s that phrase again!)

Sir Brian’s thanks to the witness was, shall we say, faint.

After a short break, the rest of the day will consist of a Counsel presentation on the CJD timeline.