Dáil Éireann debate -
Thursday, 27 May 1999

Vol. 505 No. 5

Written Answers. - Blood Transfusion Service.

Michael Ferris

Question:

50 Mr. Ferris asked the Minister for Health and Children if his attention has been drawn to the serious concerns expressed regarding the pro posed downgrading of the Blood Transfusion Service Board centre in Cork; if his attention has further been drawn to the serious concern expressed by more than 40 medical personnel at the Cork University Hospital regarding the implications of this move; the steps, if any, he will take to ensure that the full range of services is retained in an upgraded premises in Cork; and if he will make a statement on the matter. [13963/99]

Alan Shatter

Question:

90 Mr. Shatter asked the Minister for Health and Children the position concerning the future of the Blood Transfusion Service Board Centre at St. Finbarr's Hospital, Cork; and if his attention has been drawn to the concerns expressed by Cork doctors regarding the proposal to have polymerase chain reaction testing centralised at the new blood bank headquarters at St. James's Hospital. [14108/99]

Minister for Health and Children (Mr. Cowen)

I propose to take Questions Nos. 32, 50 and 90 together.

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.

As part of this process, the chief executive officer and the national medical director of the BTSB are consulting with international transfusion experts. Consultation is also taking place with BTSB staff, relevant hospitals and blood users to brief them on the emerging developments, fully explain the BTSB's enhanced blood safety programme and address the needs and concerns of medical and scientific staff. A meeting has already taken place with members and staff of the Southern Health Board. The BTSB has advised the Southern Health Board that the BTSB is committed to working with all hospitals to ensure that it meets their blood component needs in a speedy, efficient and cost-effective manner consistent with the essential requirement of blood safety. The BTSB has invited scientific and medical input from hospital consultants in Cork to inform its considerations. The newly appointed chairman of the BTSB has also offered an opportunity to the Southern Health Board to make a presentation. The board of the BTSB will consider the outcome of the current assessment at its meeting in July.

In response to a number of misleading statements that have appeared in the media recently, I want to assure you that the closure of the BTSB Cork centre is not on the agenda of the BTSB or my Department. All that is being considered is a possible change in one aspect of the Cork operation. There is no suggestion of any change in relation to the other scientific and technical services currently carried out at the Cork centre, such as blood grouping, components processing, compatibility testing and ante-natal screening.

With regard to claims that patients' lives will be put at risk as a result of the proposed changes in the BTSB Cork centre, the BTSB says that there is no evidence to suggest that life-saving operations in hospitals throughout the country would be affected by having one national testing centre. The BTSB point out that there are many acute hospitals in the country that are a considerable distance from a blood testing centre and this, of itself, does not pose a threat to patient safety. It has been suggested that the removal of testing operations from the Cork centre would delay the supply of blood components to hospitals in the region. The BTSB reject this and point out that, at any given time, 75 per cent of blood stocks are held by hospitals, with the remainder being stocked at the BTSB facilities in Cork and Dublin. There is no proposal to change this policy.