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Dr Gunson wrote to all RTC directors reaffirming the 1 September 1991 start date but announcing that Dr Lloyd's "premature introduction of the test" could be used to extend the evaluation trial.

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Dr Lloyd responded to a "very colourful" letter from Professor Cash, stating his personal belief that starting HCV testing to the original schedule was the correct decision "even if it appears unpalatable to some".

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Mr Canavan wrote to Mike Malone-Lee: "As for HCV testing, I don't think anyone was under any illusions but that it was marginal in terms of cost benefit. But this is true of other NHS interventions. However the litigation factor, the introduction of testing elsewhere in Europe and the prospect of EC harmonisation of licensing requirements for blood products stacked up in favour of testing."

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Dr Mortimer suggested a confirmatory testing pilot during September and October 1991, which was accepted by the RTC directors.

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A draft letter from Dr Mortimer to all RTC directors in England and Wales identified the problems with confirmatory procedures to follow routine anti-HCV screening.

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Dr Gunson wrote to Dr Mortimer asking that Dr Mortimer consider several requests concerning anti-HCV testing.

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A letter from Professor Cash to Dr Gunson described the SNBTS management board meeting held on 11 and 12 June 1991 as a "near disaster".

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Dr Lloyd recorded that "My only regret is that we didn't introduce [HCV testing] earlier. The coordinating activity of the National Directorate appears to have provided us with a lowest common denominator approach rather than a best possible approach."

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John Canavan wrote for the attention of Baroness Hooper recommending that a "low key announcement" be released to mark the introduction of anti-HCV testing. He noted that "there may...be questions about why testing was not introduced earlier as it was in some other countries."

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Dr Donald Acheson criticised Peter Jones for going on record regarding suspected infections after using Armour produced Factor 8.

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Robert Christie produced a document documenting the fallout from Dr Jones' revelations and stated that his view was premature and speculative.

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A copy of the memo from Dr Peter Harris stated that infected batches of Factorate would be withdrawn due to the announcement that four patients had tested positive for HIV after receiving a batch of Factorate.

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Dr Jones wrote to Armour to say that, in particular, their product should not be given to "previously untreated seronegative patients" and that he was "particularly averse to its prescription for children."

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In a meeting with Armour officials, it was decided that unscreened product would not be distributed as long as or unless there were no other product to distribute.

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In an interoffice memo from Amour, Dr Christie stated that they had a meeting with the DHSS and that there was no evidence that the DHSS regarded Armour products and their current heat treatment method as unsatisfactory and no indication that the DHSS wished for them to withdraw batches of product from unscreened donor pools.

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At a meeting between the representatives of Rorer Healthcare and the DHSS, the DHSS accepted that the data on viral inactivation presented did look in favour of the heat treatment process. However due to two cases of seroconversion despite heat treatment the DHSS would look carefully to decide if it were necessary to make the company voluntarily withdraw the product.

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At the meeting between Rorer Healthcare and the DHSS they discussed two cases of seroconversion and discussed if they could hold it from breaking into the public domain for a little longer. They said Dr Hill did not intend to disclose the cases to the haemophilia centre directors unless it was absolutely essential but would have to inform the parents of the children.

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In a letter from Armour Dr P Harris stated that it should not be overlooked that there may be material in centres or in patients' homes that was not derived from donors tested for anti HTLV-III.

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In a memo, Dr Harris discussed his conversation with Dr Jones who told him that he did not wish to receive replacement material since it was his belief that their (Armour's) material was less safe in the hepatitis risk area. Dr Jones asked for the letter and this call to be confidential as he had recently had "his wrists slapped for public statements".

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In a letter to blood banks directors and haemophilia treatment centre coordinators Armour recommended that lots of HT Factorate concentrates derived from non-tested plasma should not be used and that they would arrange for centres to exchange any inventory of product manufactured from untested plasma at no cost to the centres.

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