Responsibility for the organisation and management of the national blood transfusion service rests with the Blood Transfusion Service Board. Following the report of the Finlay tribunal of inquiry, the BTSB is implementing a wide ranging programme of modernisation in order to adapt to emerging developments in transfusion medicine. A number of measures to further improve blood safety are being introduced this year at a cost of approximately £6.8 million. This has resulted in a unit price increase in red cells from £63 to £94. A new IT system is also being introduced at a cost of approximately £4 million. At the Cork centre, the BTSB recently completed the refurbishment of the components processing and compatibility testing laboratory at a cost of over £500,000.
Transfusion medicine is undergoing rapid change. New technologies and additional safety tests continue to emerge. The BTSB is continually assessing these developments to ensure that its practices are in line with best international standards consistent with efficiency and effectiveness. One such development is PCR testing which is being introduced on the advice of the medical consultants at the board following an evaluation of international best practice. PCR testing is the most sensitive way of detecting viruses in blood donations and requires high grade laboratories, expensive technology and expert technical support.
In February 1998, the board of the BTSB decided that, having regard to international practice, PCR testing at both the Dublin and Cork centres could not be justified. It was decided, therefore, that PCR testing for all donations would be carried out in the new national headquarters which is currently under construction. The implementation of this decision will involve testing blood samples from donations collected in all parts of the country at the new national headquarters. The proposal which is now being assessed by the BTSB is whether all serological testing, and not just PCR testing, should be performed at the national headquarters. The board of the BTSB has asked the chief executive officer and the national medical director to prepare a report on the practical implications for patient services of developing a single site for donation testing in Ireland. Among the issues being addressed are: how best to provide a transfusion service in the light of the rapidly changing environment in transfusion medicine; the application of accepted international standards of practice in leading centres and blood services; the achievement of the goal of supplying 100 per cent of blood components on time and without fail; the likelihood of a substantial reduction in the use of blood components given the alternatives to blood transfusion which are currently available on being developed; the concerns of health boards and hospitals, including their concerns about the substantial increase in the costs of BTSB products; the achievement of a service that is efficient and effective.