11 November 2022: Psychology Panel - B

Questions from core participants:

On confidentiality within a multi-disciplinary context; they said the normal protocols apply of only passing on the content of conversations in a support session with the patient’s consent. The Chair asked England in particular since a generic practitioner would likely only have one such patient and so it was easy to identify them. She said she was a policy and strategy person so couldn’t say but tried to say something. She’ll take it back.

On the issue of the clinicians in the location where the psychological support was happening when that location and those clinicians were part of the problem; they said there were alternatives to meet the needs, such as meeting in a neutral location. Where trust has broken down, that is an important issue to address in itself.

On why England is carrying out a “gap analysis” since there are already piles of evidence from the Inquiry; she said she would have to find out. Further questions just directed at England were … on the specialist clinical illness pathway, on the modalities of psychosocial support, on the number of sessions £900 will buy, on the number of sessions available from IAPT, on the psychological support to bereaved family members from EIBBS, the answer was basically that she would have to go back to the DH. She did have a go at suggesting an answer to some parts of the tirade of targeted asks but not from a position of actually knowing the answer.

On England having options presented back in March 2020, including a service to support more serious needs for infected blood patients (which Counsel had the witness read out … killer) and which could happen despite Covid; she said that before anything could be put in place it would still involve further work, … yadda, yadda, yadda.

On the suitability of IAPT in England to meet the needs of infect blood patients; she said something about … (but it’s not worth typing anything).

On the issues of mistrust in the NHS in England being soluble by an IAPT approach; she said nothing but waffle.

On another matter the English witness didn’t know about; she again said something not worth listening to.

The Chair picked up with the England situation by asking about the role of the witnesses’ part of the process as recommending a service to the Inquiry. The witnesses’ answer trailed off to nothing as she realised she had nothing to say. The Chair tried again by giving the witness the answer in the question (about the resource issue of not having enough clinical psychologists), but the witness only just about grabbed it. So, then the Chair used his time to float some ideas to anyone who might be listening. It came out that some of the background work apparently going on was to have a resource to inform and teach people about the issues related to infected blood, but the witness could not give any details. The Chair was interested in who was taking this forward and what form it might take. He is surely not alone in this interest. It sounds like either money for a pal, or treading water so as to look like something was happening when actually nothing was happening. The number of times the witness from England said, “I don’t know” was becoming tiresome. Considering that the witness said she had passed her statement by the DH, the Chair was able to highlight the gaps in the responses. She still could not say, for example, what £900 would buy or how many people were accessing it. The Chair noted how useful it would be to compare the take up to see if people in England were getting (or willing to get through that method) the level of support they require. The Chair then focussed on the gap analysis. The other panel members didn’t really offer any supportive comments, while trying not to be seen to “stick the boot in” while the complete inadequacy of the English response to the psychological service needs was being shown to be as unsustainable as their “fall-guy” nominated witness was unable to answer the questions being put to her. It was a shambles from England, an utter shambles.

The panel were invited to make final comments. There was nothing substantive apart from welcoming the Inquiry’s role, recognising the role of patients and their representatives, and assuring people that ongoing funding for psychological support was anticipated. This did not apply to England, of course.

The Chair thanked the panel for their contributions and the chance to hear about the different approaches. He included the less well developed situation in England, the reasons why it had not developed, and “if it ever will”. That final phrase was yet another prime example of the Chair’s deadly subtlety.