7 June 2022: Rawlins - D
A written ministerial statement related to the Robert Francis report published online during the lunch break took all the focus away from the oral hearings. The report itself was yet awaited, having been sought for 80 days.
In the meantime, Counsel took the witness to the specific case of licencing approval for blood concentrates. He is (annoyingly) sitting back in the couch swinging his leg (not lead) while not recalling much. On the case of a licence request for a blood product, it seems to have been based on one doctor’s document, without reference to other material. It turns out this was not uncommon as a way for decisions on licencing to be made. On the issue of foreknowledge about the risks of viruses in blood, Sir Michael asked, “Did they know?” which took many people aback. The Chair had to intervene to state that the evidence of knowing was included in the application by the pharmaceutical companies. Counsel sought the view of the witness – based on his pivotal role – on what would have been reasonable checking of risks by those of his colleagues given the concerns that were swirling around at the time. It became increasingly obvious that not every step which could have been taken to protect patients was taken – far less than every step, in fact. The committee assumed that the Haemophilia Centre Directors knew what they were talking about, and so their views were very influential in how decisions were taken.
Our old friend, the Galbraith letter, made another appearance. As Counsel picked out the good bits, the witness sat with highly raised eyebrows awaiting the inevitable questions to follow. When asked, he said he expected the Department would have had access to the Galbraith letter and would expect its content to cause special attention to be paid to the viral risk issues. He was threading his answers about what he expected should have happened with observations about the seriousness of having haemophilia, seemingly in an attempt to mitigate what appears to have been a serious dereliction of duty by his colleagues. The process of “close surveillance” would have entailed senior doctors speaking with the clinicians involved in using any product to be investigated.
When faced by a statement he had made in writing, he could not explain why he had said it, and all but distanced himself from his own words. The thematic focus at that point was on the issue of heat treatment. In the space of a couple of minutes he had moved from saying heat treatment would have been the thing to do, regardless (or despite) the costs, to admitting how delays seemed to be justified by cost considerations. The witness clearly was influenced by Peter Jones, who had specific views on safety related to certain products.
With the witness appearing increasingly unsettled, another short break was called.
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