25 July 2022: Keel - D

The assertion that factor concentrates were “the best available treatment” was explored with the witness. She tried to escape the inevitable conclusion of Cryoprecipitate being arguably the better best available treatment for most if not all patients. Counsel had handed the witness a spade and she obliged by digging her own grave in public. The fact she had to focus on people with severe haemophilia having an intercranial bleed as the justification example, was effectively game, set and match by this point. Counsel cast in the tied fly about informed consent and the witness took the bait hook, line, and sinker. Dr Keel must have a lot of family to go down with her because she just kept digging and digging. She tried to justify the medical-clinical difficulties, the judgement problems, the slowly emerging science, and more, and all this on the assertion/assumption that clinicians were telling patients of the risks in ways they could make informed choices for themselves in full knowledge of the facts, risks, and options. Counsel said the Inquiry would, the next day, move to questions about some of the things the witness had said in her justification. This will surely pose a challenge to the witness being compliant with the rule not to discuss the evidence she had given and would give. It could well be a lonely night to spend with her own thoughts in between the two days.

The questions shifted to those patients infected by transfusion incidents. Dr Keel spent a bit of time going over the old ground of how people ought not to be over-treated or treated unnecessarily. Counsel homed in on how people might have avoided infection if a surrogate testing regimen had been introduced earlier, as had been the case in other countries. “It was decided”, not to do it in this country said the witness (who, let’s remember, was the main decider). Due to the possibility of false positives which may have caused a donor to have to be told they might have been living in a way that put them at risk and they would not be able to donate blood, she said, “What would you say to this person?” With no due respect Dr Keel, what do you now say to a person who was infected by your blinkered decision – a decision focusing on convenience, compromise, and cost – who has been infected with your viruses and suffered years of losses and detriments? What would you say Aileen, what would you say? Say it.

Then she did say something, after another forensic Counsel question, but it was not something we wanted to hear. “I don’t think the stigma of HCV was anything like the stigma of HIV or the way HCV stigma was hyped”, she said, with no sense that she was talking out of not her mouth. If ever there was a good case for giving evidence by remote, this was it. It meant she could not see and hear the response to her crass insensitivity. Of course, even the description of this witness being “remote” lends itself to alternative applications. She was remote from the truth, remote from basic humanity, remote from self-awareness, remote from her medical oath, remote from the consequences of her actions (… so far, at least).

The circus act shifted as Counsel sent off the clowns and introduced the high-wire balancing act. The witness had to walk along the line as she was questioned about not paying compensation or financial support, while at the same time not appearing to minimise the difficulties caused by viral infection which justified support. The cognitive dissonance of holding and saying these two conflicting views at once brought about more wobble, including in the voice. So, not a good comedy act, not an acrobat, try lion-tamer Dr Keel.

Counsel was fishing when she asked Dr Keel for examples of the other groups who might have sought to jump on the compensation band-wagon after the HIV/HCV schemes. The fish took the bait by giving two examples; probably thinking she had out-smarted the angler. Counsel then asked if the witness knew whether either of these groups has tried to get a similar settlement, but the witness did not know; she was caught hook, line, and sinker.

In the round, or in the ring, the questioner was getting her hits to the head and body with virtually no capacity of the witness to defend herself. The Frank Dobson announcement of deciding not to pay HCV victims any compensation or payments, effectively bound Scotland, Wales, and Northern Ireland to follow suit. The Scottish Health Minister was Sam Galbraith. The briefing given to Mr Galbraith gleefully provided him with the line to take which was to maintain the “no way, no pay” mantra, just like Dr Keel and her ilk wanted.

Anne Robinson, she’s an Anne Robinson doppelganger. It only became obvious enough for recognising the visual connection when the Chair had a question for Dr Keel. She sat there in worried uncertainty, as Anne R in reverse, looking like she was about to be described as The Weakest Link. In effect she was (… goodbye). The question from the Chair was hypothetical and once again made her recognise how, if certain information had been given to a Minister, it would have been enough to change the line. But the question was not important (not yet, but surely the witnesses’ half-baked answer will be used against her tomorrow). The witness was not up to it, but despite this inadequacy her shortcomings contributed to hundreds of deaths and thousands of harms. Sleep well.