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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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A hospice was not able to carry out paracentesis for Jane Chapman due to lack of expertise and had to transfer her to a nearby hospital.

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A witness's husband was not given the opportunity to be drained of fluid build-up in his stomach.

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Dr Benjamin Hudson noted that palliative care in liver disease is a developing subspecialty.

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Dr Hazel Woodland was of the view that resourcing was a problem in palliative care and care for hepatology patients generally.

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Dr Fiona Finlay noted that access to palliative case differs depending upon which country the patient is located in the UK.

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Professor Charles Hay commented that end-of-life care is a specialised area of medicine and nursing, and its provision varies across the country.

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The Gordon-Smith family felt let down by the NHS when they learnt that TACE treatment was not successful and the cancer was spreading. There was no follow up from palliative care at that point.

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When Seamus Conway was admitted to the hospital, his family had to fight for the appropriate pain relief for him.

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Seamus Conway was not provided with adequate haemophilic care before he died.

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Debra Pollard, lead nurse specialist at the Royal Free Haemophilia and Thrombosis Centre, recalled her close liason with palliative care but due to stigma attached to HIV, palliative care and some hospices would initially refuse to accept HIV patients.

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Ken Milne was refused a place at Canterbury Hospice because he was HIV positive.

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Mark Newton was one of the first people in the UK to be infected with HIV. He found that he had no options for end of life care.

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Marie Curie Hospice told the family of Graham Fox to tell people he had lymphoma and not HIV or AIDs because of the stigma that was attached to it at the time.

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A witness described how "The hospital staff never discussed [my husband's] illness or life expectancy with me. There was very poor communication. I understand he was receiving palliative care in the last week of his life. This was never explained."

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In written evidence, Amanda Beesley described the poor care her husband Andrew received: "We found the treatment we received at St Michael's Hospice in Basingstoke appalling."

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