Key factor at the BTSB was money, or the lack of it

The deputy medical director of the Irish Blood Transfusion Service, Dr Emer Lawlor, completed her 12th day of evidence yesterday…

The deputy medical director of the Irish Blood Transfusion Service, Dr Emer Lawlor, completed her 12th day of evidence yesterday, her fifth under cross-examination - and the strain is beginning to show.

Counsel for the Irish Haemophilia Society, Mr John Trainor SC, offered his second apology to her in two days over certain questions he had put to her. And that questioning is far from over.

In the past week, she has covered the years between 1973 and 1983, addressing the issue of whether the Blood Transfusion Service Board (the predecessor of the IBTS) could have done more to prevent the infection of 105 haemophiliacs with HIV through contaminated blood products.

The infection of more than 100 other haemophiliacs with hepatitis C is not to be addressed under cross-examination until next week.

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Dr Lawlor's task is difficult given the fact that, throughout the period in question, she was either far removed from decisionmaking level or else not in the board at all. While she has had links with the board since the mid-1970s, she did not become a full-time member until 1996 and has had to rely primarily on documentation and research to build up a picture of the way the board operated.

She portrayed a board struggling to make ends meet under economic embargoes and a lack of expertise, and so cashstrapped that on occasions it sought funding from the Irish Goods Council and the EEC through its European Year of the Disabled initiative.

It was a board which, like blood banks worldwide, was struck by the "international medical tragedy" that was AIDS. The board may have acted slowly and suffered from indecision but it would have been powerless to prevent the vast majority of infections that had occurred.

However, Dr Lawlor's portrayal has been under attack all week from Mr Trainor who has offered a contrasting picture. His board had its eyes on the bottom line - profit. It was a board which developed questionable relationships with multinational drug companies, and which, when making decisions, chose the outcome that yielded the most revenue regardless of the risk.

It was a board which "ceased to care" about the safety of the products it was importing and profiting from despite giving the impression that it would stand over their safety. It was a board which, crucially, had plenty of time to react to the unfolding AIDS threat, but sat on its hands and allowed at least 60 per cent of haemophiliacs to become infected after 1983 when the board had sufficient knowledge to take action.

Whichever portrayal is closer to the truth, it seems a key factor to the board was money. From Dr Lawlor's viewpoint, the BTSB just didn't have enough. From Mr Trainor's view, it was either saving too much or making too much from haemophiliacs, primarily at their expense.

While the argument will continue in the coming weeks, already a number of disturbing findings have emerged, among them the seemingly close relationship between the BTSB's former national director, the late Dr Jack O'Riordan, and the pharmaceutical company Travenol. The tribunal has heard how Travenol paid for the official to attend a Las Vegas conference on the company's behalf. Moreover, Dr O'Riordan appeared to have joined Travenol sales representatives at social engagements and had a diploma collected on his behalf by one of them.

Dr Lawlor has revealed that a board member was investigated over his links with a drugs company. The tribunal will return to that subject next week along with the issue of the destruction of key BTSB documents covering a 20year period up to 1986.

The public hearings will resume at the Distillery Building on Church Street, Dublin, on Monday and it seems Dr Lawlor still has a long way to go.