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Dr Jones in his statement to the Inquiry could not explain the discrepancy in the age range for cryoprecipitate but it was trying to cover the youngest children.

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Dr Jones stated that if NHS concentrates had been manufactured to the same general standards of the commercial concentrates, they would have been used exclusively for home therapy in the UK.

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Dr Jones stated that clinicians were only reliant on commercial concentrates because there was insufficient NHS product.

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Dr Jones in his statement to the Inquiry noted that he increased testing and surveillance at the Newcastle Centre when the risk of AIDS for people with haemophilia was brought to his attention.

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Dr Hamilton, on behalf of Dr Jones attended a meeting at a Heathrow Airport hotel where AIDS was discussed, however Dr Jones does not recall discussing the meeting or taking specific action as a result of this meeting.

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Dr Jones decided that despite some risk regarding Factor concentrate at the time, the switch to cryoprecipitate was not made.

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Dr Jones noted that in response to the risk of AIDS in the early 80's, the Newcastle Centre took the following action: cryoprecipitate was reserved for children, factor concentrates continued to be used and non urgent surgery was put off.

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Dr Jones explained at the 3rd European Regional Congress of the Federation of Haemophilia in London that his policy was to treat under 6s with domestic cryoprecipitate while those above were treated with factor concentrates.

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By 1975, the use of commercial concentrate in the Northern Region had rapidly increased to 972,000 units; and by 1976, a great deal more commercial concentrate (1,649,240 units) was used than cryoprecipitate (676,050 units) and NHS concentrate (82,800 units) put together.

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The Newcastle Haemophilia Centre annual returns from 1976 to 1979 recorded that Hemofil was the main product used for the treatment of Haemophilia A

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The 1977 Newcastle Haemophilia Centre annual return recorded a very substantial increase in the use of Hemofil (2.3 million units, compared to 1.6 million units of NHS product).

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The annual retruns for Newcastle Haemophilia Centre recorded that 1978 Hemofil, Factorate and Koate were all in use, along with NHS concentrate.

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The individual records enclosed with the 1979 return for the Newcastle Haemophilia Centre demonstrated that a number of individuals were treated with multiple products rather than kept on a single product.

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It was reported that at the Newcasle Haemophilia centre approximately 180,000 units of commercial concentrate had been bought in the past year to make up "the deficit in BTS supplied VIII products for in-patient use" within the Northern Regional Haemophilia Service.

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It was clear, from a letter written by Dr Jones, that commercial concentrates were considered to be preferable for home therapy for reasons including "size of bottle, volume of fluid required for reconstitution, time of reconstitution, viscosity".

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In her statement, Anne Kirkman Collins stated that the Newcastle Haemophilia Centre preferred commercial Factor VIII product because: it was more easily soluble, some patients had allergic reactions to NHS Factor VIII and the presentation of commercial product was more appealing to the centre.

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Peter Hamilton outlined his intention to make a special clinical study of the problems of liver disease in haemophiliacs

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Dr Jones asked that everyone who used commercial concentrate record full batch details whenever it was used in the region and that he be notified of cases of jaundice

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In a confidential note, Dr Jones stated that an association between commercial concentrates and hepatitis had been proven. In Newcastle there had been 16 cases of jaundice over the past 18 months, of whom 15 had received commercial concentrate and 10 had been on home therapy.

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Dr Jones noted in a publication that all concentrates prepared from large donor pools carry a greater risk of serum hepatitis and possibly other disease transmission than cryoprecipitate. They should therefore be reserved for the treatment of severe haemophilia A in older children and adults.

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