26 July 2022: Keel - A

The red coloured version of the Camilla Parker-Bowles hairstyle was looking a bit less perfected when the witness appeared on the screen. Gone was the white coat and the cross. Dressed in black, maybe she thought she was going to a funeral afterwards. Or maybe it was personally predictive given the grilling she received on Day 1.

Aileen Keel’s Day 2 of questioning started with the circumstances leading up to the announcement of the Scottish internal investigation at the turn of the Millennium. The advice to the Minister, Susan Deacon, was that the factor concentrates were “essential to their survival”. When it was put to the witness that this was a huge over-emphasis, at the risk of looking stupid the witness stuck to her position. It was a risk she was prepared to take despite the high likelihood of it happening. It happened. She went back to intercranial bleeds of severe haemophiliacs as justification. It was all she had, and even that was pathetic.

The Haemophilia Society continued to have the audacity to question the position being put forward by the witness. But Susan Deacon was minded to do more than follow the line. How dare the Minister have the audacity to question the position being put forward by the witness. Susan Deacon decided to hold an internal investigation into the claims being put forward by the Haemophilia Society. The witness could not recall if there were any other advocacy groups involved. When it became inevitable that there would be an inquiry, the first step was to hold a meeting with the Government lawyer, Ms Lynda Towers, and internal others. Next it was seen right to speak with Prof Ludlum and Prof Lowe. They confirmed their practice of informing patients. And that was it. That was the sum and substance of the investigation. So, she took at face value what the clinicians said. “That’s not much of an investigation”, suggested Counsel. Prof Keel tried to suggest she knew the Glasgow practice due to her experience of being there, but Counsel pointed out that the dates of the witness working there did not corroborate. Ms Keel had not gotten off to a comfortable start. It may have crossed her mind that it was going to be a long day.

She said that patient views were taken into account, citing how they received some letters from patients. It did not seem necessary to ask the Haemophilia Society who raised the initial concerns to explain what evidence they had. There had also been some media coverage of a Dundee man who had not been told the results of a test for over a year. The option of going through actual patient records was seen by the witness as being too much effort. Regardless of all this choreography to control the dance steps, the gleaned information had begun to raise some inconvenient concerns, but the witness simply questioned choice of words by those commenting on what was coming out (… or rather, what was not going to be allowed to come out).

While being questioned, the witness appeared to be making notes (… or maybe she was drafting her last will and testament). On the details from the time, the witness was devoid of recollection. She did say how the review of medical literature was carried out by an administrator, Ms Dora, who did not have any medical training. At best, Ms Dora was just an explora. When it was suggested that the whole exercise had been carried out with a pre-set agenda, and that that might be the prevailing view from the evidence as presented, the witness said she would disagree with that assessment. When asked if it was appropriate that her part of the Scottish Government undertake the investigation to make it more independent, given the closeness with, for example, the SNBTS, she said it was done properly. Will someone please tell the witness the hard fact of life that just because she says something, it doesn’t make it so.

The stated aim was to carry out the investigation in an open and transparent manner, yet key documents (such as Annex B to a Ministerial Briefing containing important information about evidence findings) were not sent to the Haemophilia Society. Again, the witness was left begging to differ with the assessment. Sadly, despite the etymology of begging it did not result in any accompanying humility by the witness. The detail of the report related to the emerging scientific evidence of HCV infectivity. She mentioned how when it came to new treatments, there had to be some period of time between the administration of a new treatment and being able to say with some certainty that either it works and/or that it does not cause side-effects. The Chair intervened to review what the witness had been saying and when he had done that, she complimented him on his summation. Unfortunately for her, she did not see how she had just agreed to a statement which incriminated herself. Dr Keel is suffering from the co-morbidities of arrogance and ineptitude.

The First Minister had responded to the investigation suggesting that an “open mind” be kept, which he worried would turn into an “open cheque book”. A hand-written note suggested that the investigation had been “a PR exercise”. It was written just nine days after the end of the investigation. The witness doggedly stuck to her guns that it was a genuine investigation. Does she still believe the Earth is flat, too?

A document was displayed which recorded a meeting involving Haemophilia Centre Directors with Health officials and Government lawyers. On a point raised by Ms Towers (lawyer), the response came from Prof Ludlum. The witness was asked if she accepted what Prof Ludlum had said, or if she knew for herself the data. She said it was the latter. (Yeah, right.) At the same meeting Prof Lowe asked about the need to check up on those who might have been infected under the leadership of their predecessors in Directors posts, but Ms Towers intervened to express concerns that it might be used in future litigation. The witness did not recall that part of the discussion (“belt”) but attempted to justify the thinking of the people involved (“braces”). However, despite trying use two fasteners, the trousers were still slipping down. Counsel asked the witness “as a medical professional” if it would be important to seek to contact and identify people who might be walking around with a viral infection. “It would be important, … but …”, began the witness as she went on to negate all the basic tenets of the medical profession. This writer is always red-flagged by a “Yes, but” response, and Prof Keel is not the exception but proves the rule.

A very telling internal email from the main author/investigator (Ms Dora) was full of frightening insights into how the whole exercise was carried out. She had not understood half of the papers from Prof Cash, she could not say anything satisfactory to the Haemophilia Society about testing, she asked for some help on saying things even though they might involve great dollops of hindsight, and more. In trying to respond, the witness was floundering all over the place. She was not so much a fish out of water, as she was a fish who had fallen into the deep fat fryer, well and truly battered.