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De Kernoff and Dr Colvin stated in a paper for the Haemophilia Working Party that the acute NANBH, appeared generally mild, though might sometimes be fatal, but the chronic NANBH seemed "very possible that there may be serious long-term sequelae"

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In oral evidence given to the Inquiry, Dr Morris McClelland explained that he could not recall whether the SNBTS guidelines regarding surrogate testing were adhered to and he followed "National decision making" in reference to surrogate testing in Northern Ireland.

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Dr Scott in an internal minute written to Dr McIntyre believed "we should prevent the BTS from doing a full scale introduction" of surrogate testing.

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Dr Gunson completed a funding application for a multi-centre study into surrogate testing and ALT.

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A letter published in the The Lance by Dr Contreras and colleagues at the North London Blood Transfusion Centre commented that if "the true incidence of post-transfusion NANB hepatitis and its serious clinical sequelae are at a much lower level than reported from the USA, then screening of donations to reduce the incidence of NANB hepatitis may not be cost effective in the UK".

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The Council of Europe's Committee of Experts on Blood Transfusion and Immunohaematology, which included Dr Gunson, published a report addressing surrogate screening for NANBH.

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Dr Gunson sent the Council of Europe's Committee of Experts' report on Blood Transfusion and Immunohaematology, to Dr Smithies DHSS).

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Dr Harris summarised the views expressed at the meeting of the Advisory Committee on National Blood Transfusion Service that if testing was introduced it should be national; that research on baseline data would be carried out; and that the position would be monitored in the UK and abroad.

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Dr Contreras questioned the decision of Medicines Division to include a statement in commercial plasma packaging that products have been tested for ALT. Argued "screening plasma donations for ALT is totally absurd since any hypothetical benefit obtained by excluding donations with high ALT is lost by pooling".

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Dr Rotbalt wrote to Dr Contreras that commercial companies were free to make any testing on their donors, including ALT testing.

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Dr Contreras expressed further concerns in her letter to Dr Rotblat saying that inclusion of ALT testing information on commercial products may lead to these products considered superior against those not ALT tested, while there is no evidence for any difference.

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Dr Forrester suggested that the development to state that the donations had been tested for ALT commercial companies, could lead haemophilia clinicians and SNBTS directors to put pressure on the SHHD to agree to the introduction of surrogate screening.

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Dr Fraser expressed disappointment in a response to Professor Cash, particularly in light of his understanding that it had been agreed at the 10 June 1987 SNBTS Directors' meeting that there was "a need for synchrony with England and Wales."

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Professor Cash stated that the SNBTS did not wish and currently had no intention of introducing NANBH surrogate testing unilaterally

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There was disappointment about a letter published in the Lancet to which all the Scottish Directors were signatories on the subject of anti-HBc and ALT Screening of all donations and that unilateral action had been taken.

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Dr McIntyre expressed concern that the SNBTS might seek to introduce NANBH surrogate testing without specific funding and agreement from the SHHD.

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The Lancet published a letter in response from Dr Contreras and Dr Barbara, arguing that "Transfusion services must not bow to irrational pressure for measures whose efficacy is unproven".

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Professor Barbara accepted, when he gave evidence, that it was a premise of his and Professor Contreras's argument that NANBH infections were occasional and that they had the feeling that non-A, non-B was not as severe as hepatitis B. He further described his view of the value of surrogate testing being based on the limited number of post-transfusion hepatitis reports from clinicians.

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A memo from Dr J M Forrester to Dr McIntyre in relation to the Scottish Component of Research into Non-A, Non-B Hepatitis and Blood Transfusion Services outlined that there was a suggestion that the Scottish component of the study was being abandoned. It also referenced Dr Brian McClelland's view that "we had better simply institute screening".

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Minutes of Scottish National Blood Transfusion Service Directors' meeting suggested that previous minutes were incorrect and that the Edinburgh Transfusion Centre would participate in the multi-centre study for surrogate testing for NANB hepatitis.

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