Professional rivalry or tension between staff at the BTSB's Dublin and Cork centres may have contributed to poor decision-making by the board on the HIV crisis, it emerged yesterday.
In a stark admission, the board's former chief medical consultant, Dr Vincent Barry, said he was not kept up to date by co-workers on key matters relating to the safety of blood products issued by Pelican House. His medical colleagues in Dublin had "not welcomed" his arrival in January 1986 from Cork where he had served as regional director for 10 years.
A Cork-Dublin division has been a feature of the BTSB down through the years and persists today over a Pelican House proposal to centralise blood testing in the capital. The Minister for Health, Mr Martin, is to decide shortly on whether to approve the controversial plan.
Yesterday Dr Barry explained that when he arrived at the BTSB's headquarters "there was no red carpet laid out". More importantly, he said, "not a great deal" was discussed with him despite the fact that he was the most senior officer with responsibility for product safety.
Dr Barry's arrival had coincided with the resignation of Dr Jack O'Riordan as the board's national director on December 31st, 1985.
Dr O'Riordan had served as director of both medical and administrative branches of the BTSB since it was formed 20 years earlier and his departure created a major decision-making vacuum. While it was not explicitly stated yesterday, it was clear his departure also gave rise to certain power struggles within the board, although it seemed Dr Barry did not want anything to do with them.
The retired official said he was very reluctant to take up the new post, which was offered to him without notice by Dr O'Riordan while they were sitting in a car together. Dr Barry said he did not want the job as he already had "hellish" commitments in Cork and believed he was "not a suitable person".
After some persuasion, however, he accepted the post on an interim basis until a proper appointment could be made.
While he served as chief medical consultant for up to two years, he stressed it was "in name only". He found it impossible to carry out his duties in Cork and attend board meetings in Dublin. As a result, he said, it was agreed in mid-1986, but not noted in board meeting minutes until October 1986, that Dr Terry Walsh, consultant haematologist to the board, would assume Dr Barry's duties in Pelican House.
The following year Dr Walsh formally succeeded Dr Barry as chief medical consultant, or national medical director, as the post came to be known.
This ad-hoc arrangement is to come under scrutiny in the coming days to establish exactly who within the BTSB was in charge of product safety in 1986-1987.
It already seems a confusion over roles may have contributed to system failures and a failure by the BTSB to recall an untreated Factor 9 product in June 1986 which had been linked to the infection of haemophiliacs.
Dr Barry admitted yesterday that he had only informed Cork University Hospital, the institution with which he was most closely associated, about the recall. He said he understood he had been relieved of his national duties at that stage.
The tribunal has already heard how the haemophilia treatment director for Galway, Prof Ernest Egan, only heard of the recall in August 1986 through a third party, and it is possible other haemophilia treaters were also left in the dark.
A total of seven haemophiliacs were infected with HIV through the locally-made Factor 9 product. Five of the patients have since died.
Of a Cork patient who tested positive in mid-1985, Dr Barry said he would have told Dr Walsh of this "immediately" after he had been informed by Dr Paula Cotter, a consultant in charge of haemophilia treatment in the area. He could not recall exactly when this was.
Dr Cotter is due to give evidence at a later sitting of the tribunal, and it is hoped she will be able to pinpoint the date in question.
If it emerges that she informed the board immediately after the positive test, as is likely, it will mean the board allowed a full year to elapse before recalling a product which it knew was unsafe, and then failed to ensure the recall was followed through.