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Professor John Dillon stated in his written statement that "All patients in Scotland have access to treatment with a direct acting antiviral regimen, irrespective of stage of disease or route of infection" and that no waiting lists for treatment exist in Scotland.

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In his written evidence, Dr Stephen Barclay noted that almost 90% of those infected with Hepatitis C in Scotland been identified and the majority of those had received treatment.

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In response to Professor Makris' concerns regarding patients who may have undergone Hepatitis C treatment solely directed by haemophilia centres, Dr Stephen Barclay stated that he had confirmed this practice did not take place in Scotland.

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Professor Chris Jones, DCMO, told the Inquiry: "The Welsh Government allocated additional resources to health boards for the new antiviral medications in 2015/16. Funding was allocated in line with anticipated health board treatment demand and there was no cap put on the number of patients that could be treated within any health board."

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Professor Chris Jones stated in his written evidence that in Wales there are currently no restrictions on treatment for Hepatitis C and currently no waiting lists for treatment.

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Monitoring of patients in Wales is dependent on the nature of the damage done by Hepatitis C prior to treatment. Professor Jones explained that patients are discharged if there is minimal liver damage, whereas those with advanced liver disease will be monitored by a hepatology clinic, including having regular scans.

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In his statement, Professor Chris Jones stated that an oversight group had been set up by the Welsh Government to oversee the elimination of Hepatitis across the 7 Welsh health boards through public awareness and improved access to testing.

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In his written statement, Professor Makris recommended that patients with an inherited bleeding disorder infected with Hepatitis C, including those who had
successfully cleared the virus, should be reviewed by a liver specialist at least once.

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In his written statement, Professor Makris recommended that patients with an inherited bleeding disorder who have cleared Hepatitis C should be seen by a consultant hepatologist and have blood tests, an ultrasound scan and a fibroscan.

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In his written statement, Professor Makris cited two studies demonstrating persisting liver damage in those who had been infected through blood products and successfully cleared Hepatitis C.

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In his written statement, Professor Makris recommended that patients with advanced fibrosis or cirrhosis are entered into a hepatocellular screening program, with six-monthly ultrasound scans and regular hepatology follow-up to detect early signs of liver failure. Those with an inherited bleeding disorder who have had Hepatitis C should be seen by a consultant hepatologist, rather than a more junior member of staff.

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An article by La Mura et al was published in "Blood Advances" titled "Residual burden of liver disease after HCV clearance in hemophilia: a word of caution in the era of gene therapy".

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An article by Isfordink et al was published in "Haemophilia" titled "Liver-related complications before and after successful treatment of chronic hepatitis C virus infection in people with inherited bleeding disorders".

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An article published in the "Journal of Hepatology" titled "EASL Recommendations on Treatment of Hepatitis C" described the optimal management of patients with acute and chronic HCV infections and included recommendations on appropriate follow up.

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The guidelines from the European Association for the Study of the Liver covered the various types of monitoring appropriate for individuals who have had a diagnosis of Hepatitis C.

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Describing the situation in Northern Ireland, Dr Joanne McClean noted that "HCV treatment has been predominantly delivered through specialist hepatology services".

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One witness ('Paul') described a contrast between his difficulty in accessing Hepatitis C treatment and that which he received for HIV.

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The Expert Report to the Infected Blood Inquiry: Palliative Care in Advanced Liver Disease noted the funding and commissioning of palliative care services varies throughout the UK.

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Rachael Watkins' mother was refused hospice and palliative care due to her hepatitis status.

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Alison Purseglove's husband, Ian, did not receive adequate palliative care: "The hospital was unprepared for the death and as a result it was, to my sadly expert eyes, extremely badly managed, protracted and distressing for both Ian and me."

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