8 June 2022: Lister - C

Charles Lister left school and immediately started working in a junior civil servant role based within the local Jobcentre. It is imaginable that some of those accessing the services in that local office of a major department of Government might well have been some of his recent fellow school-leavers who had not walked out the school gates and straight into a job. Perhaps that new power dynamic was embryonic to a sense of status and being above the rest of society. And maybe this grew towards a sense of essential self-importance and automatic assumed greater knowledge befitting a Grade 7 and above civil servant by the time he got there.

The witness clarified that the main explanatory factor for Ministers not supporting any compensation or financial support was, in his view, due to the financial constraints prevalent at the time. They were so concerned about getting money into the NHS to cut down waiting times, that anything which might draw money away, such as a payment scheme for past NHS actions or inactions, was simply not an option, in their opinion. From this clarification we see another defensive trope in the making – ask Lord Penrose to explain it.

The purchase of a large US plasma collection company (Life Resources Inc.) was progressed by the DH with the witness taking the lead role. The aim was to secure essential sources of a vital commodity, blood. It turns out that one of the main drivers for taking this new turn (of the Government becoming owners of a private company), was the way the large pharmaceutical companies were buying up all the blood collection companies so they could secure supplies for themselves. The negotiations to purchase Life Resources Inc. was happening alongside the European Directive work, and the witness was heavily involved in this activity too.

Counsel then turned to the issue of vCJD. (Note, there are various references throughout the Inquiry to vCJD, nvCJD, or simply CJD. It seems the major use is vCJD, although this may be thought of as not the best term.) From having been so heavily involved in the BSE outbreak and subsequently giving evidence to that Public Inquiry, there was then a major revisit to this topic for the witness as the vCJD issue popped up in his blood policy leadership role. As with previous witnesses, the issues for vCJD were around food safety, difficulties with diagnosis, infectivity of the UK blood supply, and the question of telling people or not after some time how it was latterly known that a patient had been exposed to a blood treatment which may have included sourced material from a person who was subsequently discovered to have vCJD. This matter of implicated blood also linked to the potential for contaminated surgical instruments to be the means of the pathogen being passed on. The most difficult issue seems to have been the ethics, management, challenges, and practicalities of telling people of having been potentially exposed to vCJD.

Advice at the time leaned heavily towards the need to disclose, but with various caveats. It also bumped into the issues related to informed consent, confidentiality, and human rights. The legal advisors certainly had their busy times as these increasingly complex health issues arose.

The targeted use of Recombinant blood products was still developing when the witness came into the blood policy office where this was a responsibility. He had to become informed about the issues, including the pressure to find funds for these more expensive but safety-preferable products. The funding constraints meant that Recombinant could not be made available to everyone, certainly not from the start. This resulted in the targeting of Recombinant to children under 16 and previously untreated patients. These arrangements involved having patient representatives, including but not exclusively the Haemophilia Society, to inform and advise on these matters. Thus was far less common a practice back then compared to nowadays. Mr Lister already had a good relationship with the Haemophilia Society from previous engagements.

Counsel asked the witness to explain how documents were classified and the status of these for future access. There were papers held by individuals to help those people do their job. Registered files, however, were the official records; including minutes, reports, correspondence, notes. In the days of everything being hand-written, the files were very well kept, similarly for typed documents. However, as things moved to emails and other electronic communication channels, maintaining the quality and orderliness of files has become far more problematic. Destruction policies were meant to control how long a file was held before it was destroyed. The witness suggested that busy people may not have taken the time to properly record and file everything. It was not always clear who had the responsibility to archive specific document, for example, those held on shared files. Mr Lister felt that people just got out of the habit of keeping records of telephone communications.

The non-availability of documents related to Dr David Owen’s instructions to move towards blood self-sufficiency was next addressed. The witness tried to locate specific files that involved references to the allocated funding for self-sufficiency which had been on the instruction of Dr Owen. This involved a significant amount of money so they wanted to know what it was used for instead of the purpose designated by David Owen. Mr Lister’s earlier comment about where missing documents could have gone, including them being sent to lawyers, was not based on anything he could recall, but he did have a sense of being convinced of that explanation at the time.

Counsel asked about Lord Owen’s “private papers”. The witness could not tell what Lord Owen meant by that. It was reviewed that often Minister’s had their papers sent on to them once they left an office. The convention was for Government papers to remain confidential at times when there was a change of Government. It would be expected that any papers held that were of the status of Cabinet Papers, etc. would almost certainly be shredded during these changeover episodes. The witness could not say what he thought had happened to Lord Owen’s papers. He personally was only involved in shredding documents when he was a very junior civil servant, long before the time he was asked to locate the Owen papers. When first asked to look out the Owen papers, he did not anticipate it being an onerous task.