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Fourth Day Hearing Transcript

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Fourth Day Hearing TranscriptDay,day

    Thursday, 14th June 2007

    THE RIGHT HONOURABLE LORD JENKIN ................. 1

    JENNY WILLOTT (called) ........................... 25

    ALAN BURGESS (called) ............................ 46

    LAURA BURGESS (called) ........................... 63

    THE REVEREND PREBENDARY ALAN TANNER .............. 71

     1 Thursday, 14th June 2007

     2 (9.30 am)

     3 THE CHAIRMAN: We seem to be complete. Mobile phones turned

     4 off. Our first witness is Lord Jenkin.

     5 THE RIGHT HONOURABLE LORD JENKIN (called)

     6 THE CHAIRMAN: Thank you very much for coming, Lord Jenkin.

     7 We have your statement, so we can take that as read,

     8 I take it.

     9 A. It seemed to be rather a waste of time to read it all

     10 out to you.

     11 THE CHAIRMAN: Yes, indeed. You became Secretary of State

     12 in 1979 and went through to 1981 when you were moved to

     13 another department?

     14 A. Yes, September 1981, yes.

     15 THE CHAIRMAN: And I think your Minister of State was

     16 Dr Gerard Vaughan?

     17 A. Yes.

     18 THE CHAIRMAN: And you were content to leave the day-to-day

     19 administration in relation to health to him?

     20 A. Some issues on health. He is a doctor.

     21 THE CHAIRMAN: Yes.

     22 A. And he knew a lot more of course about the medical

     23 aspects than I ever would and particularly he was

     24 knowledgeable about this subject. And I was, therefore,

     25 very happy to delegate to him the day-to-day conduct of

     1

     1 the department's affairs on this matter provided he kept

     2 me in touch with anything important, and particularly if

     3 there were going to be any parliamentary repercussions,

     4 parliamentary questions or whatever, and I met him from

     5 time to time and we went through the papers.

     6 I did ask my private secretary to make sure that all

     7 the important papers did come across my desk and they

     8 were in my red box and I was able to skim through them.

     9 But generally very happy to leave that to Dr Vaughan, as

     10 he then was. He later became Sir Gerard.

     11 THE CHAIRMAN: Sadly he cannot give evidence.

     12 A. No, he was much missed.

     13 THE CHAIRMAN: We appreciate this was quite a long time ago.

     14 If you tell us there is something you cannot remember we

     15 fully understand. But could you help us, how often did

     16 issues relating to infected blood come across your desk

     17 then, was it something that was happening ongoing or was

     18 it just occasionally?

     19 A. The answer is it was of course an ongoing problem and

     20 with certainly an ongoing concern by the medical

     21 officers and others in the department, but that did not

     22 necessarily mean that I was dealing with it on a daily

     23 basis. On the contrary, my recollection is very clearly

     24 that from time to time, which might have perhaps been

     25 once or twice a month, some particular development or

     2

     1 some particular paper would be put in my box.

     2 THE CHAIRMAN: Relating to infected blood?

     3 A. Relating to the subject.

     4 THE CHAIRMAN: Yes, I see.

     5 A. There were lots of other papers.

     6 THE CHAIRMAN: Of course.

     7 A. And I would therefore perhaps then feel it necessary to

     8 have a brief word with Gerry Vaughan to see whether he

     9 was happy to continue to deal with that and was dealing

     10 with it satisfactorily. And I got the impression that

     11 with the concern of the department, which was undoubted,

     12 because it was then seen to be quite a serious

     13 problem -- perhaps not as serious as it subsequently

     14 turned out to be --

     15 THE CHAIRMAN: Of course.

     16 A. But not a happy story, and we were very concerned to try

     17 and make sure that the Blood Transfusion Service could

     18 be relied upon again, because at that point there was

     19 I think quite a shadow hanging over the BTS.

     20 THE CHAIRMAN: Yes, I see. Clearly the first thing we are

     21 trying to get a picture of was how high profile this was

     22 in the department. So it did come to the desks of

     23 senior ministers, you said something like twice a month

     24 in your case?

     25 A. I am sorry, you have already recognised it was rather

     3

     1 a long time ago.

     2 THE CHAIRMAN: Yes, of course.

     3 A. But that is the impression that I remember, but I do

     4 remember (a) it was a continuing concern and there was

     5 members of the Chief Medical Officer's staff who were

     6 certainly involved in this on a continuing basis, and

     7 they were consulting ministers as necessary and keeping

     8 us informed so that we would not be caught by surprise.

     9 THE CHAIRMAN: Yes, I see. You were aware then about

     10 infected blood from -- you were saying, were you?

     11 A. No, you are quite right. I had been told that the Blood

     12 Transfusion Service was not self-sufficient and that

     13 they had to buy what was generally referred to as blood

     14 products, had to buy them from other sources, and one of

     15 them certainly was the United States. At that stage

     16 I had no idea where it was coming from in the United

     17 States. I assumed they had a source which they could

     18 rely on.

     19 THE CHAIRMAN: Yes, I see. But were you aware so far as you

     20 remember whether it was known that the infected blood

     21 was substantially the blood coming from America?

     22 A. I think we had become aware that that was probable.

     23 I think the source by then had been identified and,

     24 therefore, must have been turned off, nobody would

     25 continue to import blood products they knew to be

     4

     1 contaminated, but I don't think at that stage there was

     2 any awareness about the contamination relating to HIV or

     3 what has subsequently become known as Hepatitis C.

     4 THE CHAIRMAN: Not even Hepatitis C?

     5 A. No, I don't think -- I have since seen -- we can perhaps

     6 come to this -- the papers which demonstrates that the

     7 department was certainly very well aware of what was at

     8 that stage being called non-A, non-B hepatitis, but as

     9 I have always understood at that stage it was regarded

     10 as a very minor condition and perhaps not many sufferers

     11 would ever in fact have any symptoms at all. They now

     12 know it is different.

     13 THE CHAIRMAN: Of course. There was no clear awareness of

     14 infection relating to HIV as far as you remember?

     15 A. That all arrived later. My successor, Norman Fowler,

     16 now Lord Fowler, he had to pick up the baton on HIV

     17 because it had become then a major international

     18 scourge, and he devoted a huge amount of time to that,

     19 and of course it then became apparent that some of the

     20 sufferers of HIV had had contaminated blood.

     21 THE CHAIRMAN: You have mentioned the question of

     22 self-sufficiency in this country. Were you aware of the

     23 debate which had taken place earlier as to the

     24 importance of self-sufficiency?

     25 A. I don't think at that stage it was regarded as an

     5

     1 important factor. If the NHS, if the Blood Transfusion

     2 Service could get an acceptable blood product from

     3 another source, it was felt that that was a way of

     4 keeping the NHS supplied with blood.

     5 THE CHAIRMAN: Yes, I see.

     6 A. I don't think there was at that stage a policy of

     7 seeking to become self-sufficient.

     8 THE CHAIRMAN: I don't know whether -- I am sorry to press

     9 you on matters which, as you say, are a long time ago.

     10 I wonder whether I could evoke any memories. On the one

     11 side of the debate it seems to have been said: we ought

     12 to be self-sufficient partly because of the danger of

     13 infected products from abroad and partly officials seem

     14 to have been concerned about the savings in money,

     15 because the imported products were expensive.

     16 A. Yes, I think there was an awareness that there needed to

     17 be an enhanced programme of attracting volunteers to

     18 give blood, and I think the Blood Transfusion Service

     19 over the years has had a remarkably fine record --

     20 THE CHAIRMAN: Indeed.

     21 A. -- in securing blood supplies, but I think it was only

     22 later -- I don't recollect there being -- maybe my

     23 memory is at fault but I don't recollect there being at

     24 that stage a strong policy imperative that this country

     25 should become self-sufficient.

     6

     1 THE CHAIRMAN: Nor of anyone saying on the other side of the

     2 argument: we must be careful of overriding clinical

     3 freedom?

     4 A. Well, that is always an argument to which ministers have

     5 to pay very close regard, but I don't think any doctor

     6 would claim the freedom to administer contaminated

     7 blood --

     8 THE CHAIRMAN: Indeed.

     9 A. -- would be part of his professional duty.

     10 THE CHAIRMAN: Of course. I wonder whether you could help

     11 us on this because we have not had any evidence on it at

     12 the moment. For a product to be sold or administered in

     13 this country requires a licence under the Medicines Act?

     14 A. I believe so, yes.

     15 THE CHAIRMAN: And the licensing authority is the Secretary

     16 of State. But I think we have rather gathered from the

     17 documents that the Secretary of State, as you say, would

     18 be at the mercy of expert committees and that it was in

     19 fact really then at committee level. Can you remember

     20 anything about that?

     21 A. No, I think one had occasional arguments about new drugs

     22 and so on, things that are now handled by NICE, but

     23 these are always highly technical questions with very

     24 considerable medical expertise necessary to make

     25 a judgment, and it may well be that Sir Gerard Vaughan

     7

     1 would have had some understanding but certainly I would

     2 not have had. I am not a scientist and I am not

     3 a doctor and I would rely entirely on the advice of the

     4 Chief Medical Officer and his staff, and my recollection

     5 is that I was very well served by them. They had an

     6 excellent team. And I had very good relations with them

     7 and I think it was very important that that should be

     8 so.

     9 THE CHAIRMAN: Certainly. But -- again if you do not

     10 remember please say so -- there seems to have been

     11 a discussion at one point as to whether the risky

     12 products should be admitted because we were not

     13 self-sufficient at the cost of denying some people

     14 treatment.

     15 A. I have no recollection of that but I would say that it

     16 certainly would not have surprised me that that would be

     17 so, because one was aware that some contaminated blood

     18 products had been acquired from overseas and clearly it

     19 was desirable to make sure that that should never happen

     20 again.

     21 THE CHAIRMAN: Yes. Just one other matter, if I may.

     22 During your period as Secretary of State it seems that

     23 there had been an increase in the products of blood

     24 transfusions in this country, an increase in the supply

     25 of plasma, but that the laboratory at Elstree wasn't

     8

     1 capable of manufacturing that amount. And then in

     2 1979 -- I think you took office in about May, did you?

     3 A. June, I think.

     4 THE CHAIRMAN: June, was it?

     5 A. Yes. When we won the election.

     6 THE CHAIRMAN: And it was just about that time, I think,

     7 that it was discovered that Elstree was defective in

     8 hygiene.

     9 A. Yes. Now I do remember -- in a sense you have reminded

     10 me of this -- there was a considerable amount of

     11 discussion about whether the laboratory at Elstree

     12 should continue to perform this duty, and indeed my

     13 recollection is that subsequently it was closed down.

     14 Certainly this role was transferred to other

     15 laboratories no doubt in universities and elsewhere.

     16 I am afraid I have no recollection of the details but it

     17 certainly was an argument, was a matter for discussion.

     18 THE CHAIRMAN: The problem being at that time there was

     19 really no other facility certainly in England although

     20 there was probably one in Scotland. You do not remember

     21 that?

     22 A. I'm afraid I don't because I think what was felt was

     23 that Elstree had, as it were, out-run its limitations of

     24 what it could do and that it was necessary to build up

     25 some other facility for testing blood, and of course in

     9

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