A doctor who treated hepatitis C-infected haemophiliacs has contradicted the evidence of a witness to the tribunal who said he was not informed for six years that he had tested positive for the virus.
Dr Anne Tobin said she was "absolutely clear" she had discussions about hepatitis C in the period 1993-1994 with the patient, identified by the pseudonym Albert, in the context of his positive status.
Albert had claimed that he received no details of his test results in check-ups throughout that period and discovered he was hepatitis C positive only in June 1999.
But Dr Tobin said she had a "very vivid recollection" of writing and drawing diagrams for him, illustrating the consequences of hepatitis C. She recalled he was a quiet person and was finding it difficult to cope with his situation.
The tribunal has already heard evidence from Prof Ian Temperley, medical director of the National Haemophilia Treatment Centre, that it was possible for patients to obliterate news they did not like.
Dr Tobin, who in 1992 launched the State's first treatment programme for hepatitis C-positive haemophiliacs at St James's Hospital, Dublin, said she had repeatedly asked Albert to contact her with a view to being treated with interferon, a naturally produced product which fought infection. A former lecturer at Trinity College Dublin, Dr Tobin said she set up the treatment programme following the receipt of an "unrestricted" educational grant from a pharmaceutical company that supplied interferon. At the time, there was "very little" information about the effectiveness of the protein on haemophiliacs infected with hepatitis C, despite the fact that it was the only available treatment for the virus.
The NHTC had more than 150 hepatitis C positive patients at that time and they "urgently" needed to be looked at, she said. A total of 30 had been put on interferon by May 1994.
Only five were effectively "cured", counsel for the Irish Haemophilia Society, Mr Martin Hayden SC, informed the tribunal. This was less than the international average success rate of about 25 per cent of treated patients.
In relation to patients who were not "cured", Dr Tobin said that while the reduction in viral activity, brought about through the treatment, might have been only transient it was not without benefit. Later, Prof Sean McCann, president of the Irish Haematology Society, described how facilities for haemophiliacs were "awful" and "pathetic" in the 1970s when he began practising.
He said he had approached the tribunal, and sought to make a submission, because the profession was extremely upset at the reporting of it. In 1976, he said, there were only four consultant haematologists in Dublin, including one laboratory-based doctor, compared to 40 in the University of Minnesota Hospital where he had trained.
Prof Temperley and other doctors fought an "uphill battle" against the Department of Health to institute improvements. The tribunal heard the number of haematology posts increased to 11 by 1996 and 17 by 1999. Counsel for the Department, Mr Ian Brennan SC, told Prof McCann that the Department was set on implementing a recommendation of Comhairle na nOspideal to increase the number of posts to 39 by 2003.
Prof McCann replied: "I hope you are right".
