The former director of the National Haemophilia Treatment Centre acknowledged yesterday that the dire financial state of the health services in the late 1980s "coloured" his advice to the Blood Transfusion Service Board on the products it should select for haemophiliacs.
Prof Ian Temperley, on the final day of his evidence to the Lindsay tribunal, was explaining why he advised the board by letter in June 1988 that some balance would have to be struck between cost and the infection danger associated with blood products.
"The board should understand that in the present period of financial stringency the hospitals could not be expected to meet a doubling of the cost of concentrates in 1989," he wrote, before advising the board to order products from a company which wished to be indemnified against any infection its products might cause.
Prof Temperley said he was a big user of government money and always felt a sense of concern to do his best to ensure no "unnecessary expenditure" was incurred on blood products.
"I don't think anybody can say at any time that anybody in the National Haemophilia Centre ever was denied any treatment at any time whatsoever. I think it could be said I fought hard to ensure money was available for the products required," he said.
He added that 1987 was a particularly bleak one in terms of finance. The haematology centre was going to be closed down at St James's Hospital and that was a "dire" situation.
Asked by his counsel, Mr Brian McGovern SC, if this coloured the advice he was giving to the BTSB, he replied: "Well of course, because we were put to the pin of our collar at that time."
Prof Temperley said the bill for blood products at St James's, where the National Haemophilia Treatment Centre was based, was huge. "So there was constant pressure on the haematology unit to keep their prices down and not to expend too much money particularly at this time.
"Furthermore, there were stresses also from the fact that the Eastern Health Board and other health boards wouldn't pay for the factor 8 and 9 concentrates used for home therapy," he said. These bills were later paid by the Department of Health.
"This was a very difficult time financially and I felt that burden quite strongly," he added.
He stressed however, that when he wrote to the BTSB in June 1988 on products which should be selected, he looked at them first in terms of safety, before examining their cost.
Prof Temperley, who was appointed to the board of the Blood Transfusion Service in May 1987 after he complained to the Department about not being involved in decision-making on products to be used to treat haemophiliacs, said in hindsight he had "walked himself into it".
He said his advice to anybody in a similar position to his in the future would be to avoid membership of the BTSB. He said prior to 1987 he was "a fighter from outside" trying to ensure things were done by the BTSB. "I think once I joined I felt a sense of responsibility for both the BTSB and for the National Haemophilia Treatment Centre."