Select Committee on Public Accounts Minutes of Evidence

Examination of Witnesses (Questions 40 - 59)



  40. As far as you know it is pretty rare?
  (Mr Gorham) As far as I know but, having said that, we are expecting to solve that particular IT problem in the next few months.

  41. Good, because that clearly is part of being friendly to donors again.
  (Mr Gorham) It is and it is typically our regular donors who are coming back to us with problems like that and who are going to want to donate again. We need a good source of new donors but, equally, we need to retain our regular donors.

  42. I had a complaint some time ago that somebody had waited a long time and was getting very fed up so they were talking to the nursing staff and they were getting very fed up and they were saying that a lot of the blood is wasted and gets thrown away and some of it gets sold to Paris and God knows what. This was the sort of thing that was coming back from your staff to the donors, which may be totally untrue. Can you tell us what proportion of blood collected is in the end wasted, thrown away or whatever, either by the Service or, indeed, by the hospitals once it gets there?
  (Mr Gorham) There is a schematic on page ten of the Report, number seven, which actually tracks through. What that shows is that at the time something over 88 per cent of the blood was ultimately being transfused into patients. If I can just correct a number I gave the Chairman earlier, that has actually improved by about 0.2 of a per cent, and not 0.4 of a per cent, since this chart was prepared. Obviously we will continue to work to reduce the system of losses but they are not high. We did have a concern at the point where at the beginning of 1999 we suddenly got very high stocks after not having had very high stocks for a long time and we were concerned that our own wastage levels would go up as a result, and they did briefly, but, much to my admiration, the operational managers of the Service turned round the whole stock handling policy very, very quickly and we have now got the stock wastage within the NBS back to the previous level, and actually a little bit lower if you allow for the system loss that comes from leucodepletion. It is something that we take very, very seriously because, of course, we can actually manage with less donations if we do not waste donations. I cannot explain the stories you were being told. We certainly do not waste blood, that would be an appalling thing. I am not aware that we have ever sold it to Paris.

  43. Do you sell any of it abroad at all?
  (Mr Gorham) No. The only circumstances in which we would export blood would be if there was an approach to the British Government and the British Government felt that it was appropriate to support an international emergency or something like that. We do supply the British Forces. We occasionally help out our colleagues in Wales and Scotland and they would reciprocate with us if that was appropriate. At the moment it is more or less totally contained within the United Kingdom.

  44. So there is no income coming into the Service from this at all?
  (Mr Gorham) Not to my knowledge.

  45. I am speaking from memory—
  (Mr Gorham) Sorry. The one area that is different is the BPL, the Bio Products Laboratory who fractionate plasma products and they have always exported any surplus product that they have. The nature of what they do is that in order to get enough of particular products they then produce a surplus of other products and it has always been agreed that they should sell the surplus products and the income is used for the benefit of the NHS. That is entirely within the Income Generation Regulations to the NHS. I am sorry, I had not picked up the point you were making.

  Chairman: Can I just ask the witnesses to be a little briefer in reply.

Mr Williams

  46. Just as a matter of interest, where do private hospitals get their supplies of blood from?
  (Mr Gorham) From us.

  47. On what basis are they charged?
  (Mr Gorham) The same basis as the NHS.

  48. What is that?
  (Mr Gorham) It is not strictly speaking a charge, it is a handling charge. Essentially we recover our costs through the charges we make for supplying blood to hospitals.

  49. So it is the operational cost. That was a thought that occurred to me and I did not know the answer. I do not know the answer to the next one either, Mr Crisp, I hope that you do. Welcome here on your first appearance. I notice looking at the map that I happen to live in one of the only areas, other than Scotland, in the UK that is outside your empire, namely South Wales. Just as a matter of interest, and I do not want to explore the background to that, I remember the old arguments and so on, what processes exist to ensure that the standards in that area are exactly the same as in your area?
  (Mr Crisp) Across South Wales as well as England and Wales?

  50. Across South and Mid Wales.
  (Mr Crisp) Again, can I turn to Mr Gorham to answer?

  51. Yes, whoever can provide the answer.
  (Mr Gorham) Primarily in two ways. A lot of what we do in the Blood Services is subject to European Directives, so a lot of the standards are actually captured in European Directives, and then below that there is a UK organisation that sets guidelines for all of the four UK Services, so there are common standards.

  52. They are common guidelines, not necessarily common standards, or not necessarily common standards achieved. Is there a comparative system of operation?
  (Mr Gorham) We spend a lot of time discussing how we do things and looking at common standards. There are some of the same difficulties that I described earlier about actually doing internal comparisons because of historical differences, but we are all working towards the same standards and the four UK Services do talk to each other a lot.

  53. I only want to be reassured that there is no—
  (Mr Gorham) I could not possibly be parochial and say you should worry about being in South Wales.

  54. Your normal boundaries finish when you reach Wales, and always did, speaking as a previous Secretary of State for Wales, does this one-off North Wales situation create any sort of anomaly as far as you are concerned? Is it likely, in fact, that it will return, as before, to an all Wales structure? Will there be any possible benefits in that?
  (Mr Crisp) There are two or three points. One is just to build on what Mr Gorham said. In addition to the Blood Service meeting on a four country basis, so are we now just setting up a Health Service meeting on a four country basis, so I am about to start meeting with my new Welsh equivalent and Scottish equivalent and Northern Ireland equivalent so that we are able to pick up issues that cross boundaries. I am not anticipating that we would be wanting to change this, there does not seem to be an immediate pressure to change this particular arrangement as it sits. There are a number of things that run across different boundaries in different ways.

  55. So if my colleagues down in Wales in the Assembly wanted to ask questions along the lines of those today in relation to all Wales, you would have to attend as a witness as well, would you?
  (Mr Crisp) I have to say I assume that must be the case, but I do not know.

  56. I am not trying to trick you into anything. Put a note into the Committee about that, please.
  (Mr Crisp) I will respond to that, yes.[2]

  57. Okay, fine. As one who did not support the Assembly I am not arguing any particular line here, I am just interested in probing an anomaly when one exists. Can we switch back then to a bit of history and go back to the previous Chairman and the previous Deputy? Now, I am not clear quite why the previous Chairman was dismissed. What was it all about? Was it just about the restructuring or was there more to it than that?
  (Mr Crisp) I think, as I understand it, it was about a whole range of different issues. People were dissatisfied, the Service was losing confidence, the restructuring—

  58. Dismissal is most unusual. I have been on this Committee for the best part of ten years now and we come across very few actual dismissals.
  (Mr Crisp) Yes.

  59. If there were many factors, were there any factors involving risk to the public in any way? I ask you to consider your answer carefully.
  (Mr Crisp) Yes. I think again, I am afraid, I am going to have to come back to you on that to give you an answer on that.[3] That is not a question that I have actually asked myself so I am afraid I do not know the answer.

2   Note: See Evidence, Appendix 2, page 19 (PAC 2000-01/157). Back

3   Note: See Evidence, Appendix 2, page 19 (PAC 2000-01/157). Back

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