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Mr. David Hinchliffe (Wakefield) (Lab): Over the years, I have met a number of families whose members have suffered from variant CJD. The view commonly held is that Governments have not been as open and frank about the problem as might have been hoped. I want to place on record my appreciation for the fact that the Secretary of State addressed that concern in his statement before Christmas and in his statement today. Those who have had to deal with this terrible problem in relation to family members will also appreciate the fact that the Government have been open and honest and have come to the House as soon as possible to give the information that has been available.
I want to press the Secretary of State on one point. He has referred to the fact that there will be some reliance on self-reporting by future blood donors about whether they have had transfusions since 1980. My experience of self-reporting in the NHS is that it is somewhat unreliable on occasions, and I would welcome his comments on whether we have the capacity in relation to electronic records to ensure that when there is no self-reporting of previous transfusions, that fact is comprehensively checked before individuals are allowed to donate.
Dr. Reid: I give my hon. Friend a straight answer: we do not have that capacity in relation to records; otherwise, we would not be relying on the normal method of self-reporting. It is not an entirely proactive dependency, because when people currently go to donate blood, they are screened in relation to a range of issues and materials, and that is when the questioning will take place. That leaves an outstanding question, as my hon. Friend says, as some people may not intentionally deceive but may be unable to remember, perhaps in relation to the circumstances of being operated on, or may be ignorant as to whether they received blood. I have therefore asked the expert group to consider further what might be done in that respect. All this information is considered on the balance of risk.
I make no apology for stressing once again that no proven, causal connection has yet been established between blood donation and the blood recipient, in relation to the transfer by blood of variant CJD. We are taking a highly precautionary approach, however, in relation both to being as open as possible when
information is given to us and disseminating it as quickly as possible, and in attempting to minimise any possibility of avenues remaining that we have not closed off.
Mr. Paul Burstow (Sutton and Cheam) (LD): First, may I thank the Secretary of State for his courtesy in allowing sight of the statement well in advance, which has provided a chance to reflect on the issues that he has brought to the House's attention? He has done that in a timely fashion, for which I am very grateful.
The Secretary of State says that he is taking a highly precautionary approach. Clearly, securing the supply of blood for transfusion is a key concern. Can he therefore amplify that part of his statement on supply, and tell us what measures he is taking now to safeguard it? What plans does he have, immediately and in the longer term, to increase the numbers of blood donors, not least because, at the moment, only about six in every 100 people in this country donate blood? Is the National Institute for Clinical Excellence to be involved in any way in undertaking work on the use of alternatives to transfusion, such as erythropoietin and the use of patients' own blood? Can he comment on the timeline that has been discussed in respect of making available US-sourced blood plasma for older children, which we hear will be by the end of the year? What about other at-risk groups, such as haemophiliacs?
Can the Secretary of State say what assessment has been made of the future availability and safety of non-UK sourced blood plasma? The right hon. Gentleman has referred to the report and work being done by the chief medical officer. Can he tell us when he expects the revised approach to the blood transfusion strategy to be published, and whether that strategy revision will include a more co-ordinated approach, involving the National Patient Safety Agency, in order to reduce risks? In particular, what plans does he have to deal with concern about the risk of the re-use of surgical instruments after brain biopsies, and is new guidance planned in respect of that, to deal not only with those cases in which vCJD has been diagnosed but in other cases?
I understand that the Department is currently undertaking work on a risk assessment of possible vCJD infection in large pools of plasma and the effects of dilution. Can the right hon. Gentleman tell us when that work will be concluded and when the results will be published?
Finally, can the Secretary of State say what support is offered to those affected donors to whom he has referred today, and to others who might be concerned? Will there be more than just leaflets and information? For example, will other services and support be offered in those cases in which it might seem appropriate?
The Secretary of State is absolutely right: blood is a precious resource; we must do everything possible to safeguard the supply in this country; and we must applaud those who give, and encourage more to do so.
Dr. Reid: On the question of whether support will be available, I certainly hope that it will be, not only from the National Blood Service but from NHS Direct and other parts of the NHS. As for the expert group, which is looking, almost incident by incident, at each of those
dependent on blood plasma, many cases need to be examined. Obviously, the risk in those cases is even less than the low risk that we have discussed today, because the nature of plasma is that it is a reservoir normally constituted from plasma from a range of people rather than from one person. Nevertheless, great efforts are being made by the expert incident group to examine that risk and to see how it can reassure itself and any recipients as quickly as possible. I cannot give him a finish date for that—he will understand that it is laborious even compared with some of the other laborious work in connection with this matter—but I am sure that it is being done as fast as possible and always in a manner that is commensurate with getting the information correct.The hon. Gentleman mentioned the question of stocks. As I said earlier, stocks are pretty healthy at present. The exclusions that I have mentioned today will, it is estimated—it is not a hard and fast number—reduce the number of blood donors by about 3.2 per cent. and the number of donations by about 3.6 per cent. In absolute numbers, that is about 52,000 people, who would give about 56,000 donations. That is comparable with the annual net reduction, and with extra publicity and extra effort, we can make sure that that stock is maintained.
In relation to the timeline on children, the only information that I can give the hon. Gentleman is what I said earlier: it will happen at the end of the year. We do not believe that any problem exists with the US-derived plasma that we have received. In common with the hon. Gentleman, I thank those who donate blood.
Mr. Tom Clarke (Coatbridge and Chryston) (Lab): I thank my right hon. Friend for his carefully considered and sensitive statement. In common with my hon. Friend the Member for Wakefield (Mr. Hinchliffe), I remind him about those of us who have families in our constituencies who have had to deal with the dreadful trauma of vCJD over a number of years, and who have now formed a network in Scotland, England, Wales and even Northern Ireland. Those families are only too happy to offer whatever experience they can and to be consulted by my right hon. Friend the Secretary of State and others. They, too, will greatly welcome what he has had to say about research and blood transfusions and his appeal that people should continue to make blood donations.
Dr. Reid: Yes, indeed. I know that my right hon. Friend has taken a great deal of interest in, and given a great deal of support to, those who have found themselves in difficult circumstances because of this issue. Of course, I have spoken already to our counterparts in Scotland—I spoke to the Minister there this morning. I may, however, have given the wrong impression—I understand that the Under-Secretary of State for Health, my hon. Friend the Member for Welwyn Hatfield (Miss Johnson), was unable to contact the Minister in Wales last night, but I know that our officials have been in close touch throughout. This is an issue that does not recognise national borders within the United Kingdom, and obviously, we will work closely together on the matter.
Lady Hermon (North Down) (UUP): For the benefit of those who may be alarmed by his statement, will the
Secretary of State comment on improvements in treatment of those with vCJD? Will he also reflect on the courageous decision of his hon. Friend the Member for Kilmarnock and Loudoun (Mr. Browne), who, as the then Minister responsible for health in the Northern Ireland Office, authorised a new technique for the treatment of a young man in Belfast whose condition then improved?
Dr. Reid: Yes indeed. I recall that case. While we are not entirely convinced that the treatment is truly effective, we did understand the anxiety that people would feel should there appear to be a form of treatment available that we were not testing, and we decided to carry out a pilot involving an English strategic health authority. This is a very difficult disease to come to terms with, and some of its implications are clear even from the screening technique mentioned by my hon. Friend the Member for Wakefield (Mr. Hinchliffe). There is, in fact, no test that can be applied before symptoms appear. Nevertheless, we continue to pursue treatments that might prove effective.
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