25 July 2022: Keel - A

(Disclosure: Dr Keel comes to the Infected Blood Inquiry with a very negative repute in the eyes of the infected and affected community in Scotland. This prejudicial anticipation towards the witness should be stated for fairness – a similar consideration having never been reciprocated by Dr Keel. Wearing a white coat is surely more than coincidental, the received pronunciation is grating, eyebrows appear lifted too high, the coiffure seems to be forced too far towards (and beyond) stylish including the colour, and the crucifix is distractingly incongruous. Dr Keel had a pen in her hand so must have expected something noteworthy to come up. With that out the way, as a cathartic suppository, the scene was set.)

The main role of interest to the Inquiry is the witnesses’ time as Deputy Chief Medical Officer (DCMO) and Acting CMO in Scotland (for far too long). Most significantly, she trained as a haematologist which she described as a laboratory discipline. She was at Yorkhill Children’s Hospital working under the infamously pro-commercial product Dr Willoughby. The shadowy circumstances of his move to Australia were unknown to the witness (… cough-liar-cough). She immediately distanced herself from any blame of infecting so many children there since Dr W did all the meeting with patients and parents. All she did was administer the poison (… “it wasn’t me, I was just obeying orders” as they said during the Nuremberg Trials). She had also already developed her own security blanket of “I have no clear recollection”.

At Glasgow Royal Infirmary (GRI) she worked under Prof Forbes and then Prof Lowe. She mentioned the unusual situation at GRI because most of the doctors were not primarily trained as treating physicians, but were people interested in blood topics. So again, the patients were not patients, but were “useful material” subjects who existed to aid the advancement of academic reputations. (As a further potential conflict of interest disclosure, this writer was treated at both Yorkhill and GRI, although “has no clear recollection” of meeting the witness.)

She was encouraged by the Scottish Office to apply for the role as a medic/official. How telling. They clearly wanted someone who thought their way. The Penrose Inquiry only asked Dr Keel about the Look-back Exercise and nothing else about her time in post. Strange.

Specifically on blood policy, George Tucker was the Assistant Principle Secretary who led the team she mainly interacted with. Later it included … oh, she could not remember any person’s name who she worked closely with for all those years. How telling. As Counsel asked some quite general questions about her day-to-day work, the witness displayed a strange combination of not getting the point until Counsel had to opt for an easier question, and then a twee recollection with gouache phraseology.

When asked about the possibility of wrong advice being given to Ministers on the risks of blood infectivity, she denied this. This will surely turn out to have been a marker put down by Counsel, with that marker looking a lot like a banana skin ready to be slipped on. The decision on what was drawn to the attention of Ministers was primarily a decision of the policy people, not the medics. When asked how that decision was made, she said it was not really something written down or easy to define. How telling.

A note was displayed related to the issue of blood infectivity of Scottish National Blood Transfusion Service (SNBTS) outputs. Counsel sought to discover why each of the attendees were there. There was a Government lawyer present, but there was no question about why that person (Towers) was attending. Further straightforward questioning again required to be broken down for the witness. She was coming across as not quite as savvy as a medically-trained senior official would be expected to be. Maybe the problems with this witness were not down to the assumption of bad faith and psychopathology, but just another Paula Principle appointment of a thicko (well, thicker than the posh accent might pre-suppose) person, whose little knowledge was a dangerous thing and lack of smarts sadly did not go as far as being unable to cause devastating harm to hundreds of people.

The witness thought clinical consistency was desirable, but there was no sense, she said, of England causing Scotland to have to fall into line. “Since 1948, the Scottish NHS has always been distinct”, said Dr Keel. She then went on to describe the HCV Look-back, saying how the view was that it would never likely be possible to conduct this. Then an initiative from within Scotland proved a Look-back actually would be possible. But London continued to resist a Look-back. So, tell us Dr Keel, which is it? Were decisions based on evidence or preference? It cannot be both. How many decisions and lines to take were set on evidence (obviously not all of them), and how many on policy priorities, fear of spending money, ideologies, convenience, cover-up, etc?

The witness was asked about engagement with Prof Cash, and she thought she met him about half a dozen times a year. She gave her answer, inflecting her voice upwards, as if she was asking the teacher if she’d got the question right. She never herself actually attended a meeting of the UKHCDO. She did attend a coagulation working group, being especially welcomed by Prof Ludlum. She spoke about how blood policy at the time was surrounded by several “hot topics”, including AIDS. One person’s hot topic is another person’s chronic, life-limiting health crisis. That must be how people are fine with attending a bullfight (a misnomer if ever there was one), because they don’t have any empathy with the poor bull. More bull was likely to come after the first break.