Query on screening test decision unexpected, says Department head

THE Secretary of the Department of Health, Mr Jerry O'Dwyer, was unable to explain why in 1991 there had been a three-month delay…

THE Secretary of the Department of Health, Mr Jerry O'Dwyer, was unable to explain why in 1991 there had been a three-month delay in telling the Blood Transfusion Service Board to introduce a hepatitis C screening test for donors.

On May 29th that year the Deapartment's chief medical officer, Dr Niall Tierney, decided the test should be introduced, but this decision was not conveyed to the BTSB until September 3rd, 1991.

The test itself was not introduced until October 1st.

Mr O'Dwyer, who was an assistant secretary in the Department's financial section at the time, told the tribunal he had not prepared for the question, that he had anticipated dealing with other events at the tribunal. "Have you made no effort to prepare?" asked the tribunal chairman, Mr Justice Finlay, "you're a practical person. You're the secretary of a department."

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Mr O'Dwyer was instructed by Mr Justice Finlay to make such preparation for today's hearing.

Earlier, Mr O'Dwyer disclosed to the tribunal that an amount of money had been set aside in the Department's contingency fund for 1991, to finance a possible hepatitis C screening test programme. Only "two or three" people in the Department at the time were aware of it.

Mr James Nugent SC, counsel for the tribunal, said there was no reference whatsoever to this fund in Mr O'Dwyer's statement to the tribunal, nor were there any corroborating documents supplied to the tribunal either. He put it to Mr O'Dwyer that this was "an extrordinary omission".

Mr Justice Finlay asked Mr O'Dwyer whether there was any supporting documentation concerning this funding. Mr O'Dwyer said it was possible there was no written record. "I wonder whether the Comptroller and Auditor General will be happy about that?" asked Mr Justice Finlay. Mr O'Dwyer said the Comptroller was only concerned about what was spent", and explained the money was part of a fund which it was considered "wise and prudent" for the Department to have.

He said he was prepared to check to see whether any documentation concerning the funding existed, and would also produce it at the hearing today. "You're secretary of a department and you've sworn an affidavit that all relevant documents have been produced to the tribunal," Mr Nugent said. Mar O'Dwyer said he believed every possible attempt" had been made to supply all information to the tribunal.

The exchange between Mr O'Dwyer, Mr Nugent, and Mr Justice Finlay occurred when Mr O'Dwyer mentioned the fund to counter suggestions from Mr Nugent that the Department was stalling on introducing a screening programme for hepatitis C in 1991 for cost reasons.

A letter to the Department from Mr Ted Keyes, chief executive officer at the BTSB, and dated February 26th, 1991, said they (BTSB) believed it was "imperative" to proceed with the screening of donors and requested the Department's approval to go ahead. Dated March 7th, a note to Mr O'Dwyer written on Mr Keyes's letter, described it as "another effort to push us into C testing quickly" t was written by Mr Frank Ahern a principal officer at the Department, who at the time was also an appointee of the Minister of Health's to the BTSB.

Mr O'Dwyer told the tribunal that Mr Ahern was not aware of the contingency fund available at the Department for a screening programme. He agreed that the BTSB could not introduce hepatitis C screening tests without funding from the Department or by being allowed to increase blood prices. As it happened, he explained, no funding was provided by the Department to the BTSB in 1991 for the screening programme. When introduced on October 1st it was funded by the BTSB itself.

In his evidence the chief medical officer at the Department of Health, Dr Niall Tierney, denied it was the case that he wanted to delay introducing the hepatitis C screening test programme "as long as possible". "Certainly not," he told Mr Rory Brady, counsel for the tribunal. He disagreed with Mr John Rogers, counsel for Positive Action and the McCole family, that the Department had "slavishly" followed Britain concerning the introduction of hepatitis C testing. The "key factor", he said, was improved tests.

He told Mr Brady that he delayed two months, until May 29th, 1991, before acting on information from Britain that they planned to introduce a hepatitis C screening programme because he wanted to consult a colleague, Dr James Walsh, on the matter.

Mr J.S. Metters, deputy chief medical officer at the Department of Health in Britain, had written in a letter dated March 26th, 1991, that Britain planned to introduce a hepatitis C screening programme from July 1st that year.

Patsy McGarry

Patsy McGarry

Patsy McGarry is a contributor to The Irish Times