On 1st April 2021, the Inquiry heard evidence from Dr. Gary Benson, Consultant Haematologist, Northern Ireland Haemophilia Centre, Belfast City Hospital (BCH), from 2008 to the present day. Dr. Benson is also a Director for the NI Haemophilia Comprehensive Care Centre.
Inquiry Counsel questioned Dr. Benson on his employment history and medical training up to 2008, when he was appointed Registrar and Clinical Director of Blood Services at the Belfast City Hospital. He was asked to describe his previous role as a Specialist Registrar working under Dr. Anderson and Professor Ludlam in Edinburgh.
Inquiry Counsel questioned Dr. Benson on the facilities and staff morale at the Belfast Haemophilia Centre on his arrival in 2008. He explained although the department was small at that time with very few staff members, the staff were an excited and motivated team and had given him great support in making changes and improvements, such as the implementation of dedicated clinics. He said they had been very helpful in preparing a questionnaire to send out to patients on how to improve things at the Centre. However, there were things lacking, such as a Social Worker and a Psychologist. He was not aware why a Psychologist had not been appointed previously. He explained the situation has now greatly improved and the Centre now has four nurses, a Physiotherapist, Occupational Therapist and biomedical scientists. He went on to explain how patients and those affected could access the service.
Dr Benson was then questioned on the transition of care for adolescents and what this entailed. He spoke about the ‘ready, steady go’ system to prepare patients and their parents alike for the transition into adult care.
Dr. Benson spoke about patients’ access to out of hours care and access to blood products in emergency situations.
Dr. Benson explained to the Inquiry about routine management and how and when patients would be routinely assessed depending on their severity and blood disorder. Inquiry Counsel asked Dr. Benson to clarify the number of patients with bleeding disorders on his appointment in 2008 and the types of products used at the Centre. He explained to the Inquiry that the majority of patients were on Recombinant Factor VIII and that it had been the patient’s choice to change if the use of another product was suggested. He said he would discuss it with them first, ensuring that they were aware of the source and risk of the product and also discuss the treatment plan with them. He said there was never a written explanation given to the patient, but they were provided with the insert which provided detail on the product and their medical records were updated recording the change in product.
Inquiry Counsel questioned Dr. Benson on what tests were carried out on a regular basis. He provided a lengthy explanation on what tests were done routinely. He was also asked about testing for Parvovirus and whether there was a consent process for this. He confirmed the reason for the test would be explained to the patient, a letter would be sent to the patient’s GP and the record system would show that the test had been done.
Inquiry Counsel questioned Dr. Benson about the number of patients co-infected with HIV on his appointment at the Centre. He said most of the patients were co-infected. Dr. Benson said that no re-testing had occurred on his arrival at the Centre but that he had ‘refreshed’ information to patients on their first meetings with him.
Dr. Benson spoke about patients choosing to be treated at the BCH and not wanting to be treated at the Royal Victoria Hospital as they considered the hospital was responsible for their contamination. Dr. Benson said discussion was had about a joint clinic with the Royal Victoria, but it never went any further and did not happen.
Dr. Benson was questioned about providing information and advice on lifestyle to patients. He talked about how some patients had disengaged in their treatment through alcohol abuse and how they and their families had struggled with their mental health as a direct cause. He told the Inquiry how he had tried to encourage these patients and their families to seek psychological counselling. He explained the side effects from Pegylated Interferon and Ribavirin were debilitating causing mood change and flu-like symptoms.
Dr. Benson was further questioned about patients with cirrhosis and their access to fibroscans. Dr. Benson explained that today he would sign-post these patients to the hepatology team who would be happy to perform a fibroscan if needed, but that there were a cohort of patients who had not had fibroscans and who were living in fear of the infection returning. He explained how he is able to assure these patients through blood tests results but would refer them for a fibroscan if their tests revealed anything of concern.
Inquiry Counsel questioned Dr. Benson concerning the vCJD scare and the notification to patients. He explained how patients had become fearful from the first notification of vCJD and since the risk had not changed or increased since that time, the Trust had decided not to send a further notification in 2009.
Dr. Benson was questioned by Inquiry Counsel about medical records and access to these. He explained at length the way in which he had identified and helped families and widows of deceased relatives to search for records so as to qualify for financial funding from the Skipton Fund. He said he had found this very difficult and emotional.
Dr. Benson was questioned on his involvement with pharmaceutical companies. He explained that he was a member of the Drugs and Therapeutics Committee and that on occasions pharmaceutical companies had provided funding for family support days. He went on to explain that the Trust has its own policy. Dr. Benson explained of his involvement with research into new product development, Pharma Global Trial for a non-factor replacement product.
Dr. Benson spoke about the impact on patients and the profound effect on his clinical practice. He spoke fondly and emotionally of patients unfortunately no longer with us.
For a full transcript of the evidence of Dr. Gary Benson please visit https://www.infectedbloodinquiry.org.uk/evidence where you can read the transcript or watch the evidence via YouTube video.