Unnamed: 0
int64 0
47k
| index
int64 0
357
| q_a
stringlengths 22
51.4k
⌀ |
|---|---|---|
47,000 | 356 | QUESTION:
And there's a discussion about the
New England Journal of Medicine report.
Now, do you know whether this meeting, these
updates, were something that -- did Dr Hill come ba ck
and discuss them with Professor Stuart, to your
knowledge, or with you?
ANSWER:
I don't remember. This is Frank Boulton's note, is n't
163 it?
|
47,001 | 356 | QUESTION:
Yes.
ANSWER:
No, I don't even remember being -- anyone talking
about this meeting. No.
|
47,002 | 356 | QUESTION:
What about the issues that were raised? So the cas e
of the San Francisco baby which, as the Chair point s
out, was reported in December of 1982 in the MMWRs and
the issues flagged up by Jane Desforges in her
article, do you recall any conversation about those
issues if not about the meeting?
ANSWER:
I remember conversations about the doctors in
Birmingham, my colleagues being very concerned that
AIDS was going to be a problem in patients in the U K,
not necessarily only men with haemophilia but -- yo u
know, we transfused a lot of blood into people with
leukaemia. We were worried about them as well.
Yes, there was a big -- well, it was huge issue.
|
47,003 | 356 | QUESTION:
Was it -- when was it reasonably clear to you that
AIDS was probably being transmitted by blood and bl ood
products? Was it from these January 1983 reports?
ANSWER:
Yeah, difficult. Well, I suppose it was actually
from -- I mean, Chairman put me right on the MMWR.
I don't know whether I read that one. I read some of
them. But certainly by the time that -- the case o f
the baby came out, then that was pretty clear. The re
164 was still other theories around but I think they be gan
to fall away.
|
47,004 | 356 | QUESTION:
In your statement, you say that when HIV/AIDS becam e
a clinical issue, as co-directors we discussed our
approach and reached agreement. I'll try to find t he
reference to that in your statement. But what
I wanted to ask you was what did you mean by that?
Co-directors is you and Dr Hill, so this is presuma bly
after you have taken over in September of 1983 as
director. What was the approach and the agreement
that was reached?
ANSWER:
Sorry, that was from Archer or my current --
|
47,005 | 356 | QUESTION:
That was from your current statement. Forgive me,
I'll find the reference.
ANSWER:
Is that in relation to whether the men should be
looked after in the infectious diseases unit or --
|
47,006 | 356 | QUESTION:
I don't think so but let me find it,
Professor Franklin, rather than asking you in the
abstract.
ANSWER:
I think that would have been later, wouldn't it?
|
47,007 | 356 | QUESTION:
There are a few references I haven't noted down.
I may have to come back to that tomorrow morning,
Professor Franklin, when I have found the reference to
the specific discussions you had with Dr Hill.
Can I ask you about the other materials which
your statement suggests or your Archer evidence
suggests was influential on your approach and on yo ur
thinking.
You have referred in your statement to being
guided by the advice of others, in particular UKHCD O
and The Haemophilia Society, in terms of how to
respond to the AIDS crisis.
ANSWER:
I now know that wasn't The Haemophilia Society but,
yes, I mean, absolutely. It was late '83, wasn't i t,
the meeting we went to when Morag Chisholm raised t he
issue of cryo? Yes.
|
47,008 | 356 | QUESTION:
Yes, so 17 October 1983 was that meeting.
ANSWER:
Yes. I mean, I think that was when I came away and
thought, well, that's -- I can't remember -- I can' t
remember the discussion but I think that was -- we
came away with a view to carry on. And then there was
the next May, wasn't it, the letter from
Professor Bloom to -- on The Haemophilia Society
notepaper -- saying "carry on"?
So I think all the advice that I was getting
from people who I would have looked up to and expec ted
to give me definitive advice, that was where it cam e
from.
|
47,009 | 356 | QUESTION:
We'll take it in chronological stages. There's not
too much we need to look at.
166 The May '83 Haemophilia Society publication,
that was actually in '83.
ANSWER:
Oh, was it? Okay.
|
47,010 | 356 | QUESTION:
That's WITN4032008.
ANSWER:
I think I was aware of that at the time, even thoug h
I wasn't the co-director, because I think -- I mean ,
we had weekly meetings of everybody -- or maybe not --
maybe Frank wasn't there at every one of those beca use
he was mainly at the Children's Hospital, but I do
remember this.
|
47,011 | 356 | QUESTION:
This, as we know, was authored by -- as it says, it
was authored by Professor Bloom.
If we just go a little further down, please,
Henry, if we pick it up about halfway down, it says :
"Bearing this in mind [that's the investment in
BPL] it is important to consider the facts concerni ng
AIDS and haemophilia. The cause of AIDS is quite
unknown and it has not been proven to result from
transmission of a specific infective agent in blood
products."
Then it goes on to talk about the number of
cases being small:
"... we are unaware of any proven case in our
own haemophilia population."
And then towards the bottom of that paragraph:
167 "... whilst it would be wrong to be complacent
it would equally be counter-productive to alter our
treatment programmes radically. We should avoid
precipitate action and give those experts who are
responsible a chance continually to assess the
situation."
Was this, to some extent at least, influential
on your thinking?
ANSWER:
It sounds like wishful thinking now, doesn't it, bu t
I think it was, yes. I mean, the advice of the
experts -- I wasn't an expert. I wasn't an expert at
bone marrow transplants and I would have taken advi ce
from world experts in that as well. So yes, I mean
I think that seemed to be the advice. Well, it was
the advice -- clear, wasn't it?
|
47,012 | 356 | QUESTION:
There's reference there to being "unaware of any
proven case in our own haemophiliac population". W e
know from other materials that there was in fact
a case --
ANSWER:
That seems an economy of the truth, I would have sa id.
|
47,013 | 356 | QUESTION:
Do you recall when you first became aware of the
Cardiff case?
ANSWER:
Well, I think it was around about the same time as
this. I think it was quite well known. Wasn't the re
a Bristol one?
168 |
47,014 | 356 | QUESTION:
Yes.
ANSWER:
Was that before or after? I don't -- I have to say
I'm not sure.
|
47,015 | 356 | QUESTION:
Then if we go from May 1983, this
publication, to the UKHCDO meeting that you've
referred to -- Henry, it's PRSE004440, please.
Let me check that. PRSE0004440. I think
I omitted a zero.
We can see your name appearing. This is
17 October 1983. This would presumably have been y our
first meeting that you attended as director?
ANSWER:
Yes.
|
47,016 | 356 | QUESTION:
If we go, please, to page 10, this is the discussio n
that you've referred to already, Professor Franklin .
So Dr Morag Chisholm raising the question of revert ing
to cryoprecipitate. Professor Bloom's response:
"... no need for patients to stop using the
commercial concentrates because at present there wa s
no proof that the commercial concentrates were the
cause of AIDS."
It might be said that's a somewhat surprising
statement. Do you recall whether there was any
challenge to that by anybody?
ANSWER:
To be frank, I don't even know if I was in the room at
the time.
No, I don't have any recollection of this.
I mean, I've looked at it many times since. I thin k
170 you first showed it to Mark Winter. I remember goi ng
to the meeting and I think I said in my statement t hat
I remembered going, because it was the first time
I had been to a meeting where people with the
condition that the meeting was about (i.e. people w ith
haemophilia) were actually present and I think that
was a good thing, but also it was a novel thing, an d
I remember that. But no, I don't remember this.
|
47,017 | 356 | QUESTION:
The observation you make about it in your witness
statement, if we just go back to that, it's
WITN4032001, and it's page 72 of your statement, it 's
a sub-paragraph D in the first half of the page you
say:
"They recommended at the end of the 1983
meeting~...
That's the meeting we have just been looking at:
"... that patients did not switch from
concentrates to cryo."
Then you say this:
"I suspect that was taken not by vote but by the
sapiential authority of the senior figures and a la ck
of organised alternative opinion."
Can I ask you to elaborate on what you meant by
that?
ANSWER:
Well, sapiential authority is the authority that
171 vested in someone by their experience or knowledge,
I suppose, and I think, from reading the minute, it
just seemed to move effortlessly on to the -- the
senior figures in the UKHCDO decided that that wasn 't
the right thing. And there was -- if Dr Chisholm
disagreed, there's no evidence in the minute that
anyone else sided with her. I think that's what
I mean.
|
47,018 | 356 | QUESTION:
It may be difficult for you to answer this,
Professor Franklin, as I think you only attended th is
and then the 1984 AGM, but I do not know whether fr om
your discussions with Dr Hill or any other colleagu es
you have a view on the organisation of UKHCDO at th e
time. Was it effectively being -- were policies an d
recommendations being set by Professor Bloom and th e
other older, more experienced figures? Was there t oo
much deference?
ANSWER:
I think Mark Winter alluded to the fact that it wou ld
have been good to have had some more direct -- well ,
instruction or central advice rather than -- there' s
a lot of discussion in all of these notes about, yo u
know, individual directors should decide. Well, I was
an individual director but I wasn't very experience d,
and actually neither was Mark at that time, and
I think we both would have benefited from something
172 a bit more forthright as to what to do. Even wheth er
it was right or wrong, that would have been helpful .
I think I've come to be not that happy about the
UKHCDO, to be blunt, as someone who was in a very
large haemophilia centre that was not a reference
centre and a lot of the minutes and the notes that you
and your colleagues have provided come from subgrou ps
of the reference centres' directors. They containe d
far more useful information than the annual meeting of
the UKHCDO. I don't remember seeing those minutes.
I don't think those minutes were circulated to the
rank and file, if I can say. I think that was a sh ame
because they are far more useful than the two meeti ngs
I went to.
I don't remember why I only went to the first
two. It's unlikely that I found them so unhelpful
that I didn't want to go, but the fact is I didn't go
and usually, if there was something really good and
valuable in meetings, I would have attended. The
meeting of the AIDS group for the HCDO was again
reference centres' doctors, very interesting minute s.
They would have been very helpful. So I'm sorry we
didn't get to see them or the hepatitis ones, we
didn't get to see those.
So I do feel a bit sad on behalf of the patients
at the Queen Elizabeth Hospital that we didn't get
enough advice. You know, there was more to be had,
I think, and I think it would have been -- it was
never going to be easy but it would have been bette r.
So definitely -- sorry, to cut things short. If
there'd have been more advice, Mark Winter mentione d
the CMO -- pretty silent in all this. I don't thin k
it necessarily had to be the CMO but something
definitive as to what we should do.
|
47,019 | 357 | null |
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.