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Dr. Brian Iddon (Bolton, South-East) (Lab): My concern is for the 15 or so individuals identified in the statement. Some have already contracted NHS blood transfusion-borne diseases such as hepatitis C, and others still require blood transfusions. Can my right hon. Friend assure us that that small number of people will continue to be monitored closely, and that if they require medical advice they will receive the best available from the NHS anywhere in the country?
Dr. Reid: Yes, I can. As my hon. Friend says, 15 recipients were identified. One is now deceased, although as far as we know there is no connection with vCJD. A further recipient has been discovered since then, in January. We do continue to monitor all those people closely. My hon. Friend is right: they deserve the support of the NHS, which must itself monitor their conditions. I promise him that that will happen.
Mr. Mark Francois (Rayleigh) (Con): The Secretary of State mentioned the importance of maintaining adequate stocks. In that context, may I raise an operational point? The right hon. Gentleman will know that the National Blood Service now employs call centres to remind donors to turn up for sessions. I understand, however, that problems have been caused when the message has not been passed on to teams going out to collect blood. When that happens, more donors turn up than the service would normally prepare for. That places tremendous strain on staff running the sessions, and also means that donors who are not covered by the new booked-appointment system must wait for an inordinate amount of time. Some become disillusioned and go home.
Next time the right hon. Gentleman has discussions with the chief executive of the NBS, will he raise that problem? If liaison between call centres and teams collecting blood is improved, staff will not be under such pressure, and donors—whom we all applaud—will not become disillusioned.
Dr. Reid: We are trying to modernise and improve the National Blood Service, along with every other part of
the NHS. In view of what I have said today, it is particularly important for us to maintain the utmost effectiveness in terms of logistics and such matters as collection, and I shall ensure that the hon. Gentleman's comments are brought to the attention of those in the blood service.
Mr. Dai Havard (Merthyr Tydfil and Rhymney) (Lab): As my right hon. Friend will know, I have been concerned for some time about the supply of blood and its security. I am also concerned about the quality of care and the use of blood for the largest group of recipients, cancer patients.
We had the same discussion last time my right hon. Friend made a statement. I know that NICE is considering the use of alternatives, and that it is also being considered by the All Wales Medicines Strategy Group; but will my right hon. Friend ensure that not just an incremental change but a step change is involved, and that alternatives are immediately used as the default for cancer patients when that is possible? If that happens, my right hon. Friend need not face a crisis in blood supply. However, I echo his call for people to give blood.
Dr. Reid: I know of my hon. Friend's interest. EPO, in particular, is an alternative to blood transfusion, especially for cancer patients suffering from anaemia following chemotherapy.
My hon. Friend has done a great deal of research, and I know of the benefits that he believes this will bring to cancer patients. I also know of the knock-on effects for future supplies of blood, and for the NHS generally in terms of potential savings and bed bays, which my hon. Friend has mentioned in the past.
My hon. Friend has made a strong case for EPO, but I know he will understand that that is only one side of the argument. Some argue that EPO may only be useful to a minority of cancer patients, and may not be effective enough to be used as a standard treatment in most cases. We have asked NICE to look into the matter. It will consult on the draft scope for its appraisal by June, and the final guidance is expected to be published by the end of next year. I hope that the appraisal will be objective, and will assess various points of view.
Mr. Roger Williams (Brecon and Radnorshire) (LD): As the Secretary of State will know, the BSE outbreak and the appearance of vCJD in humans has caused a great deal of financial cost and human sorrow. Part of the financial cost has been caused by the need to invoke the precautionary principle, which is always expensive, because we do not have the fundamental scientific knowledge about the infective agent, its transmission and the way in which it carries infection. Is the Secretary of State satisfied that we are investing enough in fundamental research? Is there a balance to be struck between that investment and the cost of invoking the precautionary principle?
Dr. Reid: The pursuit of knowledge in this as in every other area is costly. Taxation is a finite resource, and there is an almost infinite demand on it. The other night
I met some people whose children had cystic fibrosis, and then met others to discuss motor neurone disease. That illustrated the extent of the demand. I think, however, that we are investing as much in scientific research as is commensurate with need—some £500 million or £600 million. The Medical Research Council is investing another £500 million. We always want more, but we ascribe to this matter a degree of seriousness that is commensurate with the investigations that are taking place. That is why I have come to the House twice in the last four months to report on what some may consider relatively minor steps. Given the importance of the issue, I think it as well to be open and let all Members know what we are doing.
Mr. Henry Bellingham (North-West Norfolk) (Con): The Secretary of State said that he believed that blood transfusions should only be given in cases of clear clinical need. That struck me as a rather strange observation. Surely no blood transfusion should be given unless there is a clear clinical need. Is the Secretary of State saying that some transfusions have been unnecessary, or that medical technology is advancing?
Dr. Reid: I am saying that, although we have healthy stocks now, it is more important than ever for us to ensure that blood is being used efficiently. Indeed, the chief medical officer's strategy lately has been to inform all involved in blood transfusions that they should be given only when absolutely medically necessary. Blood is an extremely precious resource. I do not suggest for a moment that people are being comprehensively profligate in their use or expenditure of blood in operations, but we have shown in the past when seeking efficiency that we can cut down on the use of blood without cutting down on good medical practice.
Dr. Evan Harris (Oxford, West and Abingdon) (LD): I would like to ask the Secretary of State about the 15 patients who are potentially in a contactable group in respect of the risk of contracting CJD. How is he handling them? Are they on a confidential database from which they are not allowed to remove their names, as suggested by the CJD incidence panel report of October 2001? What was the result of the consultation that took place to a deadline of January 2002 on how that group was to be dealt with? What are the implications for that group in terms of being kept on a register? Indeed, what are the implications for the many more patients who are possibly exposed to a lower risk through pooled products? There do not appear to have been any further documents from the incidence panel following the consultation.
Dr. Reid: To put it simply, those people are being fully supported and fully informed. As I have said, 14 of the original 15 recipients identified are alive. An additional one was discovered in January. Five of those received leucodepleted red cells after 1999. The earliest transfusion involved in those cases was in 1993 and the latest one was in 2001. I mentioned during the previous statement that the National Blood Service was trying to trace all the patients concerned. It has now done so and the Health Protection Agency has arranged for them to be contacted.
Without going into any individual's details, I can tell the hon. Gentleman that, in conjunction with each recipient's doctor, the HPA intends to undertake a review of how the advice was communicated to each patient and to try to ensure that access is provided to expert counselling and to appropriate follow-up health checks. In response to the questions about the two reports that were published some two years before I became Secretary of State, I have to tell the hon. Gentleman honestly that I do not know the answer to his question, but I will write to him about that if I can.
Points of Order
1.22 pm
Clare Short (Birmingham, Ladywood) (Lab): On a point of order, Mr. Speaker. I rise to raise a point of order about a misleading report published today by the Select Committee on Defence entitled "Lessons of Iraq". Paragraph 358 of the report states:
- "It has also been suggested that DfID's"—
- "role in post-conflict planning was constrained by the attitude of the then Secretary of State towards the prospect of military action. Although our witness from DfID denied that this was the case, we remain to be convinced."
The reality is that DFID pressed the Ministry of Defence to prepare for its Geneva convention and Hague regulations responsibilities because, at the end of a conflict, in the absence of order, the occupying power has responsibility for immediate humanitarian needs. Those preparations were made and food and other supplies ordered and put in place shortly before military action began.
DFID also worked with the United Nations, the Red Cross, the World Bank, the International Monetary Fund, suitable non-governmental organisations and many countries that opposed the rush to war, so that we were fully prepared to support humanitarian relief as soon as there was order, and to support reconstruction efforts as soon as a UN mandate was put in place. Unfortunately, the UN and the United States State Department, which had made preparations for reconstruction, were pushed aside by the Pentagon, which took over the lead for reconstruction in Iraq—
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