28 June 2022: Bottomley - D

All that remained was for questions from core participants:

On her stated concern for not meeting infected and affected people; she said justice needed to be done and seen to be done, and people had to know Ministers were aware of the issues directly from the affected people themselves. The old ways of paternalistic doctors or paternalistic Governments did not readily allow for meeting people, whereas nowadays things are much more about engaging with people.

On the Territorial matter, particularly Scotland and the desire for unity; she said she wanted togetherness, especially on important matters. She was born in Dunoon.

On the links between the UK and the Territorial areas; she said there was a lot of exchange and goodwill, despite England being so much bigger. The lookback was first announced in Scotland and the English side followed it up by proposing a collective approach.

On any complaints from the Territorials about DH activity; she said there was no time she was complained to.

On legal cases across the nation; she said she did not know about Scottish or other cases.

On justifications for not wanting to make payments, such as the statement that haemophiliacs would have died without factor products; she said she always though many would have died without the new blood products but could not say how.

On maybe receiving a briefing explaining how blood products worked and the risks involved; she said she did not recall a specific document, but the situation was generally understood, for example, that some of the product came from abroad.

On a compensation for medical injuries private members bill (Harriet Harmon, Rosie Barnes); she said she could not think of All Souls super-brain William Waldegrave not giving this serious consideration. She has not changed her view on no-fault compensation arrangements which might turn the NHS into a version of the US system. In her mind there are already proper arrangements for redress for negligence. She is still not sure about ex gratia schemes either. Basically, she remains against any payments beyond proven negligence. She even re-hashed tired line of the costs coming out of the NHS budget.

On the Ognall case for a moral responsibility; she said she appreciated the suffering of people but saw it as her higher duty to keep as much money for patient care as possible, not endless legal action and payments for errors.

On the relatively small amount which was being sought at the time compared to the large overall NHS budget, was there a possible accusation of parsimony; she said “No” because so much was already happening which was drawing on NHS funds.

On the option of seeking contributions for harms from pharmaceutical industries; she said she did not recall any discussions or approaches involving them.

On her prior interest in mental health support, what about the provision of psychological support to infected people; she said she was not really aware of the need for this group of people. She quickly shifted to giving a mini-speech on the benefits of counselling services nowadays.

On there being any handover from David Mellor; she said there was none, which is typical of barristers (apparently), whereas she went to speak with William Waldegrave about his new role. Maybe it is a woman thing, she said.

On families of HIV and being aware of children being taken into care; she said she did not know of any cases, but hoped it had not happened.

On Hep C claims from Wales and legal advice on the distinction between HIV and HCV being insufficiently robust; she said it may be the view of one lawyer. The Government lawyers would have explored this.

On her view of a civil servant having not sufficiently researched the topic; she said she would have expected a briefing like one given to a Ministers, citing the detail expected to a House of Lords matter.

On the setting up of the Eileen Trust and the relatively swifter payments from DH; she said there was an awareness in the Macfarlane Trust of their role and the group it supported, so they did things more carefully/cautionsly

On the delay in setting up setting up the Eileen Trust; she said it was unsatisfactory and “they should have got a move on”

On the role of the CMO with reference to Ken Clarke’s evidence when he had said it was a Minister’s role to challenge the CMO; she said she expected the views of the CMO were more informed compared with those of a Minister, but it is important to question the experts to gain clarity and check understanding. “But Mr Clarke would challenge anybody, that’s his nature, that’s why he’s so successful”, interjected the Baroness, which was an unsolicited intervention.

On legal advice being requested but not coming in in time before there was a change of Minister; she said she expected any new Minister would be interested to see what their predecessor had sought advice on.

On the lookback exercise, including the delay in initiating it in the knowledge of there being no treatment, even though there were other strategies which could have been offered as helpful (as well as there being technical reasons for delay); she said she was generally in favour of telling people, not least because there was usually something that could be something to be given as advice to help them. At the time she was very surprised by the BMA response which was negative in a variety of ways and sought to not move forward with the lookback.

On the issue of justifying not telling people things; she said it was very frustrating, especially if the patient could pass an infection on. It seems like the medical fashion then was to not tell or test until there was a treatment available. She advocated for testing and telling people at the time, against the medical advice. Sir Brian interjected for clarification that it was an ethical issue.

On the views of considering replicating the Irish scheme; she said there may be documents about it, but she could not recall anything.

The Chair asked if she ever personally met any Trustee of the Macfarlane Trust. She does not think so and instead was relying on advice from others who had met them. He asked about the need for doctors to be as truthful as she knew she had to be under Inquiry oath. She recognised there were certain challenges in specific situations, but doctors must not be untruthful. They can be sympathetically direct rather than brutally direct. The Chair noticed how she took notes during  the time of giving evidence and asked if she did while a Minister. She said she did, it helped her concentrate. When asked what had happened to all the notes, she said they would have been boxed up and eventually thrown away, although she wished she had not since there was no source to go back to, for example, if she wanted to write about her experiences.

When asked if she had anything additional to say, the witness recognised the length of time which has passed, and despite the hard work to prepare a statement and get ready to appear in person, the Inquiry had allowed her to remember the great respect she had for political colleagues and supportive officials. She also acknowledged her respect for all those infected by contaminated blood and the difficulties they have endured. She hoped the Inquiry would be helpful for everyone. Finally, she mentioned how the Inquiry was located in the shadow of the London School of Economics which she had attended. Mrs Bottomley had various familial links to the LSE, including an eminent ancestor who had written the seminal book, “The Gift Relationship” about the system of voluntary donations of blood by the people of this country.

The Chair thanked the witness who, despite saying she was not a very interesting person, had been interesting to listen to. (Make of that what you will.)

Finally for today, while preparing to leave almost last again, this writer heard his name called and looked up to see a waving Inquiry Chairman across the room wishing him a good night. Thank you, Sir Brian, and a good night to you too.

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