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Ms Harriet Harman (Peckham): We welcome the Secretary of State's recognition that the blood service must be based on a gift. I hope that he will tell us that he will ensure that we have no more commercial gimmicks from the National Blood Authority. We welcome the introduction of a blood donors charter, and hope that it will achieve better enforcement than other aspects of the patients charter; I also welcome the Secretary of State's announcement of a new national user group.
Does the right hon. Gentleman, however, recognise the dismay that will be caused by his announcement that he will press ahead with the plan to take blood processing and testing away from Liverpool, Cambridge, Oxford, Plymouth and Lancaster? Does he not realise that those who work in the blood transfusion service, those who donate their blood and the doctors who use that donated
blood have all made clear their opposition to the plan?
They believe, as we do, that it will make the service more expensive, and less able to respond quickly to the need for blood.
Does the right hon. Gentleman accept that, although he claims that the plan to withdraw testing and processing from those centres will cost the NBA less, it will be a false economy? It will cost the NHS as a whole more. It will cost more in increased travel costs, and in wastage: blood that had been taken and stored in case it was needed will be thrown away. Local centres have always responded quickly to specific local demand. The plans will not produce the savings that the Secretary of State has promised.
Does the right hon. Gentleman accept that the plans threaten the very viability of the work that will remain at the five centres? Once the testing and processing of donors' blood has been removed, and only the testing of patients' blood remains, unit costs in the five centres will rise, and the Secretary of State will come to the House to tell us that those centres are too expensive and must close altogether. Does he admit that that will be the next step?
Why has he not learnt from his last effort at trying to save money on the blood service? The decision to buy cheaper blood bags from Australia led to the infection of patients and to the withdrawal of the bags. That decision lowered safety standards and cost more in the long term.
Does the Secretary of State accept that he has failed to convince doctors that his proposals will improve the quality or availability of the blood that is so vital to the national health service? Hundreds of doctors, as well as donors and those working in the service, have registered their opposition to the plans which the Secretary of State has said will go ahead. Clinicians in Liverpool and Oxford, in particular, have said that, far from improving the service, the plans will put lives at risk.
Why has the Secretary of State brushed those concerns aside? Does he not recognise that those who work in the blood service have helped to transform the way in which blood is collected, processed and tested? Therefore, their opposition to his plans is based not on resistance to change, but on the belief that the plans are totally wrong.
Does the Secretary of State realise that his handling of the plans has had a demoralising effect on the blood service, and that staff have drifted away? We have the worst of all possible worlds: a long period of consultation and uncertainty, followed by a decision that shows that the Secretary of State has not listened to those whom he consulted. With the proposed new computer system to which the Secretary of State referred at least 18 months from completion, it will not be possible to move the work to those centres that are not staffed adequately.
Is it not ironic that today's announcement coincides with yet another blood shortage? Will the Secretary of State confirm that blood is being brought from Scotland in order to deal with the shortage in London? As the Cambridge centre did not appear in the original proposals about which the Secretary of State consulted, what plans does he have to consult those involved with that centre, who have learnt today that it is to lose blood testing and processing work?
If the Government trample the views of those who work in and use the blood service, they will never get it right. If the Government look only at the balance sheet and not
at the patient, they will never get it right. Is that not yet another reason why the British people do not trust the Government with their national health service?
Mr. Dorrell:
It is incredible that the hon. Member for Peckham (Ms Harman), who usually chides the Government for not consulting enough, should now chide us for consulting for too long and then--to use her words--for "brushing the concerns aside". That is simply not true.
Clinicians from Liverpool, Oxford and elsewhere have expressed their concerns about whether the blood service would deliver the enhanced service that was described in the document and acknowledged as the ambition of the blood service. I listened to their views, and I responded by establishing the national user group--which the hon. Lady welcomed.
Clinicians working in the health service who rely upon the national blood service are concerned that that service should meet the standards that it set out in its document. I am grateful to the hon. Lady for recognising the importance of the national user group and of the donors charter, which sets out the standards that donors have a right to expect from the national blood service.
The hon. Lady took the side of those who argue that one cannot remove processing and testing work from blood centres without undermining their viability. Perhaps she has seen a copy of last week's British Medical Journal, in which Sally Davies, a widely respected consultant haematologist at the Central Middlesex hospital, argues the opposite case. She has experience gained from her own practice of doing precisely that which the hon. Lady says is impossible.
In the article, Ms Davies writes:
The hon. Lady said that she was anxious to remove unnecessary costs from the national health service. Why does she want us to protect a system which, as the document makes clear, provides overcapacity in processing and testing around the national blood service so that testing facilities are 48 per cent. overcapacity and grouping facilities are 59 per cent. overcapacity? Surely there are few better opportunities to use taxpayers' pounds to greater effect than to address overcapacity in a support service of the national blood service. That is why we are removing unnecessary overcapacity. It will not damage or undermine the viability and quality of the service that the national blood service provides.
It is true that, as a result of the consultation, we have changed the proposals for Cambridge to concentrate research functions--which we plan to expand--on the Cambridge facilities, and to ensure that the facilities at Brentwood are used to maintain the processing and testing capacity that we need. I have no doubt whatever that those decisions represent the use of the facilities at Brentwood, and the development of an opportunity for enhanced research and development at Cambridge. I hope that the hon. Member for Cambridge (Mrs. Campbell) will welcome that.
Dame Elaine Kellett-Bowman (Lancaster):
Will my right hon. Friend accept my considerable relief and that
Madam Speaker:
Order. The hon. Lady is very keen for other Members to ask questions. Perhaps I could now have one from her.
Dame Elaine Kellett-Bowman:
If my right hon. Friend is aiming to improve premises, does he not agree that the facilities in Lancaster are not ideal, and that it would be infinitely to the advantage of donors and the teams which serve them if, in the fulness of time, he could provide a new purpose-built centre as part of phase 3 of the Lancaster royal infirmary? Then we really would be quids in, and it would be more convenient for everyone.
Mr. Dorrell:
I shall certainly look at my hon. Friend's proposals for a specific improvement in facilities, but I can assure her that one of the benefits that will flow from the improved focus on the donors' perspective is that, around Lancaster, as in the rest of the country, we shall ensure that there are improvements in those facilities that do not match the standards that we expect when we encourage people to give blood.
"Consultants at some teaching hospitals have suggested . . . that removing the processing and testing of blood from their sites will adversely affect their clinical services. The experience of teaching hospitals and specialist centres in London shows that this need not be the case."
They are not my words, but those of a consultant haematologist who practises in the national health service.
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