<fo:block>
        <xsl:attribute name="background-image">
         <xsl:value-of select="draft.jpg"/>

This attempts to insert the value of the child element
named "draft.jpg" as the attribute value. Because such an
element is unlikely to exist, the attribute will be empty.
Use
          <xsl:value-of select="'draft.jpg'"/>
instead.

This electronic transmission is strictly confidential

> to Smith & Nephew...
Could you get your employer at least to add some sort of
delimiter before the appendix?