Noonan may testify at resumed blood inquiry

MR Michael Noonan must view the reopening this morning of the hepatitis C tribunal with trepidation, given his experiences with…

MR Michael Noonan must view the reopening this morning of the hepatitis C tribunal with trepidation, given his experiences with blood related controversies in the past year. The Minister for Health may even be called as a witness at the inquiry, which is expected to last a further three weeks.

Up to 1,100 women were infected with hepatitis C by anti D manufactured by the Blood Transfusion Service Board to prevent haemolytic (or blue baby) syndrome. The tribunal was set up to establish how this happened over almost two decades from the 1970s. So far, the victims are satisfied that this is being done.

There are no indications yet whether Mr Noonan intends to extend the inquiry to include the issuing of blood products possibly infected with HIV by the BTSB. A number of these product, made from donated blood, remains untraced.

The tribunal has heard evidence from 29 witnesses so far, concentrating on the role of the BTSB and its employees. Now the spotlight turns outwards and upwards as the tribunal enters more complex territory, looking at political and institutional responsibility.

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The tribunal's legal team is examining all documents, interviewing witnesses, and circularising other legal teams with statements of fact seeking their agreements. This process, adopted in the first stage, has been one of the main reasons, according to the tribunal chairman, Mr Justice Finlay, for the "expedition and clarity of proceedings".

The supervision of the BTSB and "the functional and statutory responsibilities of the Minister for Health, the Department of Health and the (health) boards" will now come under scrutiny. Questions will be asked about what occurred after the infection was made publicly known in 1994.

It is not known how far back the tribunal will go to ascertain which politicians and civil servants knew what and when. The infected plasma was taken from "Patient X" and used to make anti D in 1976 and a whole series of errors since have been catalogued.

The tribunal has the authority to call Mr Noonan, as well as his predecessors, including Mr Brendan Howlin, or statements may simply be sought from them.

The tribunal will need to look at the responsibility of the other agencies involved, including the actions of the National Drugs Advisory Board. It is clear there were breaches of the law relating to the Therapeutic Substances Act, 1932, without the Department doing anything about it. The BTSB manufactured anti D for 14 years without a licence.

During Mr Howlin's time as Minister a retrospective product authorisation was issued by the Department for the product for a five year period.

It will be difficult for the Department to dispute information contained in its own files and most of the evidence will entail presenting facts, and establishing who was aware of those facts.

The explanation of the role of the "Expert Group" established by Mr Howlin in 1994 in an effort then to find out what happened, and "the relevance of any evidence not available to the Expert Group" should prove interesting. In light of revelations at the tribunal, that group's report is now seen as seriously inadequate, and raises many more questions than it answered.

Dubious information was given to the group and significant facts were withheld. The group was told by a "number of staff of the BTSB" that a written report by a named Dublin consultant had explained a hepatitis outbreak among women who received anti D in 1977 as due to "environmental factors". But when contacted the consultant said he was unaware of any such report and the BTSB could not produce it.

A crucial file showing the BTSB knew from 1976 that the woman whose blood was being used - without her consent or knowledge - to make anti D had infective hepatitis, was not given to the expert group.

Mr Noonan and his junior Minister, Mr Brian O'Shea, insisted for a time that the information in this file was known to the Expert Group. The chairwoman of the Expert Group, Dr Miriam Hederman O'Brien, is likely to be called to give evidence.

The BTSB has so far offered no satisfactory explanation for its actions.

It is still not known why the BTSB went its own way in the manufacture of anti D, ignoring guidelines. It made up its own rules as it went along, and even those were broken.

The efficiency of the inquiry so far proves that tribunals can work. Much cynicism was created by the beef tribunal, but in this inquiry all sides appear to be in agreement about dealing with the issues quickly.

A pending general election means the timing of the final report is important for Mr Noonan and the Government. Mr Justice Finlay indicated last week it would be ready by the end of next month.