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Donors will not have to travel further. Already the majority of blood is donated at mobile centres and units. We have heard a lot of scare stories from the Opposition today. Those scare stories have been a disgrace, and may have led to donors being unwilling to continue providing blood--the very thing of which Opposition Members warned during the debate. Nor, for that matter, is there any threat to specialist services, which will continue to be provided under the proposals. Those services include, for example, platelets for the treatment of leukaemia.

I am grateful to have had the chance to speak in the debate. I wish that I had more time, but Opposition speakers spoke at some length. The Government's proposals are well thought out and there has been very wide consultation. The weight of expert opinion is behind the proposals, which provide a sensible way forward for the blood service of this country--a much loved British institution.

9.30 pm

Ms Tessa Jowell (Dulwich): Tonight's debate has shown clearly that the future of the blood service concerns hon Members on both sides of the House. It has also been an occasion on which hon. Members have had a chance to restate the enormous debt of gratitude we owe to the nation's 2 million blood donors and to the staff who collect, test and process the blood at 15 regional centres.

We have the safest blood service in the world. Our tradition of donors giving blood for nothing to help those in need is almost unique in world medicine. We have every reason to be proud of it. Richard Titmuss demonstrated 30 years ago that, on the grounds of efficiency, price and safety, the commercialised blood market was wasteful, inefficient and risky to patients. Nothing has changed. Our motion tonight reflects the public's outrage and its lack of confidence in the National Blood Authority. The proposed reorganisation of the blood service has attracted criticism from across the board. If the need for change is shown, that change should be brought about with the support and guidance of donors and those who work in the service, and not in the teeth of their opposition. The NBA's chief executive, John Adey, promised my hon. Friend the Member for Liverpool, Broadgreen (Mrs. Kennedy) that the Liverpool centre would not close unless its closure was supported by clinicians. I ask the Minister whether he can confirm that the Government stand by that pledge. Will he also confirm that the Oxford centre will stay open, given--as my hon. Friend the Member for Oxford, East (Mr. Smith) has made clear--the opposition to its closure from more than 100 eminent clinicians? Hon. Members from all parts of the House, and not least those hon. Members whose seats will be affected by closures, will no doubt want such assurances before they decide how to vote tonight.

The Opposition motion asks the Secretary of State to intervene directly, to visit all the centres currently threatened with closure and to review the National Blood Authority's proposals in the light of what he hears. These are reasonable requests in anybody's language. The Secretary of State must reach beyond the swelling bureaucracy of the National Blood Authority and speak directly to the staff and donors concerned.

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The loss of public confidence in the NBA stems directly from the false values which that bureaucracy is adopting. It offers a classic example of how simple virtues of public service have become distorted and lost in the new market culture. What was once a hard- working and lean branch of the NHS is now an independent organisation with its own agenda, a new hierarchy, a new layer of management and--it goes without saying--a new logo and corporate identity, which cost £46,000 and goodness knows how much management time. A health authority with all the pretensions of a macho commercial organisation is slowly suffocating a public service which is admired around the world. The National Blood Authority's chairman, Sir Colin Walker, has been quoted as saying that all publicity is good publicity for the NBA, however bad. In that case, let me congratulate him on a public relations triumph.

If the language of priorities is the religion of socialism, then competition is the totem pole of the market--any competition. One is not a macho bureaucracy if one does not introduce

competition--competition however unnecessary, competition however inefficient, competition however destructive. Competing is macho; simple public service is for wimps in this brave new corporate world.

The direct and immediate result of the new orthodoxy was this summer's blood bag fiasco, to which many hon. Members have referred. It was intolerable to the new macho managers that one

firm--Baxter's--was supplying all the blood bags to the national health service. The fact that the bags worked was completely irrelevant. So, for a claimed saving of £700,000, about 20 per cent. of the contract was withdrawn from Baxter's and given to Tuta instead. We all know what happened then--10,000 units of blood, each and every one the product of someone's selflessness, were poured down the drain. There are other examples of the NBA's commercial madness. It has entered into secret discussions about sponsorship of blood donor sessions with McVitie and Ribena. Donors want to give for the good of others and to repay the debt that many feel they owe for their own transfusions, but they do not want to be at the sharp end of a sales pitch.

The next initiative was to organise a donor recruitment drive in July, just when blood stocks are rightly kept low because of the small amount of surgery that is carried out in August.

On top of that, as other hon. Members have said, the authority has shown a contempt for the House and the Secretary of State by appointing 12 new members of staff to the reorganised organisation before it has been approved. The NBA then compounded its contempt by trying to gag its staff, warning them that if they tried to raise matters of concern with their Members of Parliament, they might be the subject of disciplinary action.

It is not difficult to state what the blood service needs to produce its best results, and I have four straightforward proposals which I challenge the Minister to adopt. All have come directly from my six visits to various blood centres. They have all come from staff and donors involved in the work of those centres.

First, steps need to be taken to reduce blood wastage by ensuring that all centres are brought up to the efficiency standards of the best. Secondly, the way in which blood

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is supplied to London needs to be reviewed. At present, some 40,000 to 60,000 units are imported to London, mostly to the two northern London blood centres. If the adjoining centres at Oxford and Cambridge were allowed to provide blood to the London hospitals on their side of London, it would ease the difficulty of matching supply and demand.

Thirdly, the authority should remove the new zonal tier of management. It costs nearly £2 million a year. The proposed organisation would be more unwieldy, with longer lines of communication and decision times, and flies against all the current theories of good management.

The Secretary of State said that he is a bureau-sceptic. Now is his chance to show some healthy scepticism in the bureaucracy that he has created.

Mr. Malone: Does the hon. Lady agree that the best thing for a bureau-sceptic is to get rid of 15 bureaucracies and replace them by only three?

Ms Jowell: The Secretary of State should listen to some of the excellent ideas for changing, developing and improving the service that he would hear if he took the time and trouble to go and talk directly to the staff.

We must also make it the practice that no plasma is sold without donors' permission. Many hon. Members have expressed concern about that this evening. What matters is not that surplus factor 8 is being sold to Europe and other countries but that Ministers have stated in the House that there will be no sale of factor 8 or other blood products until there is a surplus. We do not have a surplus of factor 8. We have a sufficiency only because we import it for various clinical reasons. Ministers should make the position clear to donors, because it is open to confusion and misinterpretation. It would be fatal if the impression were ever formed that donors are giving their blood so that it could be sold at a profit.

Hon. Members from both sides of the House have raised specific worries about their local centres. I would like to pay tribute to my hon. Friends the Members for Wallasey (Ms Eagle) and for Liverpool, Broadgreen (Mrs. Kennedy) for their sterling work in defence of the Liverpool blood centre and to my hon. Friend the Member for Oxford, East (Mr. Smith) who spoke so eloquently about the concerns of clinicians in Oxford about the threatened closure of the Oxford centre.

The Minister claims that the Labour party is scaremongering. The problem is that the Government always look for somebody else to blame. We are happy to share with the Minister the hundreds of letters from clinicians who are worried about standards of safety, and we hope that he will take their concerns seriously in considering the recommendations for the future.

The National Blood Authority and the Government seem to base their argument on two grounds. First, they argue that blood centres are currently working below capacity. The Bain report uses a calculation that bears no relation to reality and ignores the fact that machines have to be serviced; that they work five, not six, days a week; and that there are variations in the level of donation. A just-in-time service, as it is known, cannot possibly operate at full or near capacity all the time.

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We should not forget that new viral tests are already in use in the United States, France and Japan. If they are introduced in this country, another 28 per cent. of testing capacity will be needed. The Government have trotted out the capacity argument in respect of other parts of the health service. It was the capacity argument that led to the closure of acute beds and produced Bottomley wards--patients on trolleys in corridors for hours on end.

The second area of dispute focuses on projections of likely future demand for blood. Bain foresaw an annual increase of about 1 to 2 per cent. On that basis, the NBA decided to reduce the number of centres. However, the NBA itself, and Ministers, had forecast the growth in need at 4 per cent. and 5 per cent. respectively. In those circumstances, there must be doubts about the level of future need. It would be foolish in the extreme to risk exposing the service to shortages.

Tonight's debate gives the House a real opportunity to send a clear message to the Government and the National Blood Authority that the country does not want its precious donor-based blood service messed about by the new breed of macho managers. The giving of blood creates a unique ethical bond between donors, those who manage the service and the patients whose lives depend on it. It is difficult to imagine a relationship further removed from the marketplace or one where crass commercialisation is more out of place.

I ask all hon. Members, many of whom will themselves be donors or recipients, to join us in the Lobby and send a message of support to the people who give their blood and a message of comfort to those patients whose lives depend it.

9.44 pm

The Parliamentary Under-Secretary of State for Health (Mr. Tom Sackville): I shall not accede to the invitation of the hon. Memberfor Dulwich (Ms Jowell) but I congratulate her on this red letter day because, for once, the Labour party is devoting some time from its Supply days--half a day--to health. That is very welcome and also very rare.

Ms Jowell: Most of the health debates in this Session of Parliament have been held in Opposition time.

Mr. Sackville: Have we heard anything about Labour's health policies? Have we heard anything about how Labour will face up to the great opportunities and challenges of the NHS in the future? No. We have simply heard a series of recycled headlines--thoroughly misleading and damaging headlines--many of which were inspired by the Labour party in the first place.

The speech of the hon. Member for Newcastle upon Tyne, East (Mr. Brown), who opened the debate, consisted of one headline after another. He began on the question of selling blood and we were reminded of an article in Today dated 16 December 1994 entitled "Stop Selling Our Blood". That was Germany; he went on to Turkey with an article dated 9 January 1994 entitled "Donors Kebabed". We then heard about the crown on the National Blood Authority's logo, which was totally irrelevant. The headline there was

"Charles out for blood over vanishing crown".

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That completes the irrelevance.

Ms Jowell: The removal of the crown from the National Blood Authority's logo was not irrelevant to the people who came to Downing street this morning with the signatures of more than 3,000 people who object to the arbitrary removal of the crown--a logo that they were proud of--with no consultation whatever by the NBA.

Mr. Sackville: The hon. Member for Newcastle upon Tyne, East went on to talk about blood shortages. A headline on 30 March 1995 read: "Blood banks in new crisis".

Within six weeks, we had another headline in the Sunday Times about surpluses of blood--"Hospitals dumping surplus blood"--which just shows that one cannot win.

The hon. Member for Liverpool, Broadgreen (Mrs. Kennedy) made a number of sensible points about clinical consensus. Clearly, we shall do nothing which, in general clinical opinion, poses dangers to patients. Neither on this occasion nor at other times when we have debated this matter in the House--the hon. Lady and I have discussed this matter in an Adjournment debate--have we heard any evidence that the proposals, which are still before the Secretary of State, pose a danger to patients.

There are large towns and cities all over the country with hospitals that do not have blood processing, testing or transfusion facilities. I remind the hon. Lady that large cities with one or two acute hospitals, such as Leicester, Nottingham, Coventry, Middlesbrough, Sunderland, Durham, Hull and Bradford have never had processing or bulk testing facilities.

Mrs. Jane Kennedy: Will the Minister publish the responses from clinicians on Merseyside? If those are as he says and if the points that they make can be answered adequately, it will silence the criticism that we have made on that point. But if he will not publish those responses, not only will the clinicians continue to doubt what he says but so will hon. Members, the public and the donors who contribute to the service.

Mr. Sackville: Any of the people who submitted returns during the consultation are free to publish whatever they wrote, but those consultations were conducted on the basis that what was written was confidential and addressed to the NBA. No one is being prevented, however, from saying exactly what they think.

Since the survey was conducted there has been much communication between consultants in the hon. Lady's area and the NBA. Any of those consultants is free to provide evidence that there is some danger to patients in Liverpool, but, as far as I know, none has been forthcoming. It would be deeply insulting to the NBA and all those who have made the proposals to suggest that they would make any that would be dangerous to patients.

The location of processing and testing facilities is not fundamental. What matters is that there is an adequate network of such facilities across the country to provide those services to all hospitals. The hon. Lady is well aware that the blood banks kept at hospitals or at large transfusion centres which may not have access to processing and testing facilities in the future will still be able to benefit from a perfectly adequate service. There are a great many scare stories around and we must have some evidence before we take them seriously.

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The hon. and learned Member for Montgomery (Mr. Carlile) was particularly interested in the sale of factor 8 and other plasma-based blood products. I cannot help feeling that he is chasing a headline. The price of such products in Turkey or anywhere else is a sufficiently abstruse subject. As has been said to him repeatedly, if we sell such products when they are surplus to requirement it is not possible to control their end price in all markets. There is no mechanism for doing so.

Mr. Jenkin: I half wondered whether the complaint from those on the Liberal Benches was that the price obtained for blood products abroad was not high enough.

Mr. Sackville: If we have surplus products, we must get an acceptable price for them. If we failed to do so, we would be denying funds to the NBA which could be reinvested in the service. If we refused to sell those products, we would have to destroy them. That would be foolish, as several of my hon. Friends have already pointed out, with the support, I understand, of the Haemophilia Society.

Mr. Alex Carlile: I am grateful to the Minister for dealing with the points that I raised, but will he answer my question? Is there any reason why the Government should not insist that the contracts for the sale of factor 8 should include conditions that would avoid profiteering with it thereafter: yes or no?

Mr. Sackville: We are keen to hear the hon. and learned Gentleman's ideas on the subject. We do not wish to encourage profiteering by pharmaceutical middlemen. We are all ears to hear how the hon. and learned Gentleman would avoid that. For the moment we will stick to our policy of disposing of those blood products when they are surplus to requirement. They are high-quality pharmaceutical products for which there is a world market. If they are surplus here, we will sell them abroad.

The hon. and learned Gentleman also said that we have undermined donors' faith in the service. I refute that charge utterly. If anything has undermined their faith--there is no evidence that it has--it is the press campaign encouraged by Opposition Members. It is clear that that might have discouraged donors.

My hon. Friend the Member for Lancaster (Dame E. Kellett-Bowman) made several arguments. She said that it was important that donors should be able to donate locally, as now, and that the myth that had got around, which was part of the general black propaganda campaign, is entirely false. Specialist donors and other donors will be able to donate locally, as now.

My hon. Friend made a strong bid for a new blood centre. I am sure that the NBA will have heard that, and perhaps there will be a case for it. She reminded us of the need for an early decision about those matters. Obviously, the uncertainty has been very unsettling. My hon. Friend the Member for Brentwood and Ongar (Mr. Pickles) made several helpful comments. He was kind enough to thank me for my patience in listening to his eloquent pleas on behalf of Brentwood. I am sure that the NBA will have heard those pleas. I know that my hon. Friend has met representatives of the NBA several times and that those matters have been considered. He said--using several technical arguments--that he saw no reason

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to move facilities into Colindale or Cambridge. I understand his arguments, and assure him that they will be considered very carefully.

My hon. Friend the Member for Hendon, South (Mr. Marshall) reminded us of the fate of haemophiliacs who had had the misfortune to contract hepatitis C. I heard what he argued so eloquently. His arguments will all be considered, but I must tell him that there is a continuing policy that, where no negligence is proved, the Government do not pay compensation. However, I understand well what he said. The hon. Member for Wallasey (Ms Eagle) informed us that decisions have been taken in secret. I refute that absolutely. She also said that we have spoken, or that Bain has spoken, about commercialising the blood service. I refute that, but we need to have a blood service that is run along business lines and which does everything possible to improve quality throughout the system.

Mr. Andrew Smith: Will the Minister give way?

Mr. Sackville: I will not; I have only three minutes.

I also say to the hon. Member for Wallasey that what appeared in the Bain report is not policy; it is suggestions to the NBA. There is no reason to suppose that, simply because something appeared in the Bain report, it will become policy.

The cynical and underhand campaign that has gone on in the past year to disrupt the blood service has failed. It has not succeeded in deterring our donors, who have ignored all the headlines and scare stories, and have continued to give blood magnificently. The reality is not what has been communicated in various absurd headlines. The reality is that, in each of the past 10 months, the number of donations has been higher than in the equivalent month of last year. The NBA has succeeded in improving the use of the blood collected by better co-ordination of stock movements--a fundamental part of the new proposals--so supply has better matched demand and wastage has been sharply reduced. That is an important success.

Conservative Members have become used to the fairly systematic denigration of the NHS by the Labour party, but I believe that people are increasingly aware of the contrast between their experience and all that denigration, and increasingly discount what they hear from the Labour party.

The blood service should be exempt from all that because if such attempts to disrupt the service succeeded the consequences would be dire. We all know that if there was a sudden drop in donations, routine operations such as hip and knee replacements and non-emergency cardiac surgery would cease and rationing would start. It has been a disreputable campaign to disrupt the health service and the blood service that is vital to it. I reject the motion, which I think has flowed directly from that campaign. I hope that the House will treat it with the contempt that it deserves.

Mr. Dennis Turner (Wolverhampton, South-East) rose in his place, and claimed to move , That the Question be now put.

Question , That the Question be now put, put and agreed to.

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Question put accordingly, That the original words stand part of the Question:--

The House divided: Ayes 249, Noes 290

Division No. 218] [10.00 pm

AYES

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Abbott, Ms Diane

Adams, Mrs Irene

Ainger, Nick

Allen, Graham

Alton, David

Anderson, Donald (Swansea E)

Anderson, Ms Janet (Ros'dale)

Armstrong, Hilary

Ashdown, Rt Hon Paddy

Ashton, Joe

Austin-Walker, John

Banks, Tony (Newham NW)

Barnes, Harry

Barron, Kevin

Battle, John

Bayley, Hugh

Beckett, Rt Hon Margaret

Beith, Rt Hon A J

Bell, Stuart

Benn, Rt Hon Tony

Bennett, Andrew F

Benton, Joe

Bermingham, Gerald

Berry, Roger

Betts, Clive

Blair, Rt Hon Tony

Boateng, Paul

Bradley, Keith

Bray, Dr Jeremy

Brown, Gordon (Dunfermline E)

Brown, N (N'c'tle upon Tyne E)

Bruce, Malcolm (Gordon)

Byers, Stephen

Caborn, Richard

Callaghan, Jim

Campbell, Mrs Anne (C'bridge)

Campbell, Menzies (Fife NE)

Campbell, Ronnie (Blyth V)

Campbell-Savours, D N

Cann, Jamie

Carlile, Alexander (Montgomery)

Chisholm, Malcolm

Church, Judith

Clapham, Michael

Clark, Dr David (South Shields)

Clarke, Eric (Midlothian)

Clarke, Tom (Monklands W)

Clelland, David

Clwyd, Mrs Ann

Coffey, Ann

Cohen, Harry

Cook, Robin (Livingston)

Corbett, Robin

Corbyn, Jeremy

Corston, Jean

Cousins, Jim

Cox, Tom

Cummings, John

Cunliffe, Lawrence

Cunningham, Jim (Covy SE)

Dafis, Cynog

Dalyell, Tam

Darling, Alistair

Davies, Bryan (Oldham C'tral)

Davies, Chris (L'Boro & S'worth)

Davies, Rt Hon Denzil (Llanelli)

Davies, Ron (Caerphilly)

Denham, John

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