National Blood Service

Tuesday 15th March 2011 Westminster Hall

13:30

[Jim Dobbin (Heywood and Middleton) (Lab/Co-op)]

Thank you, Mr Williams, for relieving me of my Chairman duties so punctually. It was a great relief to have a rest and a coffee before I opened this debate. I am pleased to see the Minister in her place, because this is a subject that she will understand from her time in the national health service. I requested this debate on the future of the National Blood Service to highlight the intentions of the Government to sell off “elements” of the service to the private sector. I understand that there have been some preparatory discussions with a number of contractors. That was revealed in a report in the Health Service Journal. Three possible contractors are Capita, DHL and TNT.

In the paperwork relating to this debate, Members may notice that I have an “R” after my name. I spent 34 years in the national health service. Although I specialised as a medical scientist in microbiology in the NHS, I spent some of my former years in the National Blood Service, particularly in emergency transfusion services, so I have some experience of the subject.

The NHS staff who deliver that service are highly skilled and highly trained and it is essential that they are. I notice that a number of my colleagues are here, and I am quite happy for them to get involved in this debate. I will only spend about 10 minutes talking on the subject.

The annual review of the National Blood Service—and it is its own review—highlights the efforts that have gone into offering a world-class service to the NHS. It is probably the best blood service in the whole of the globe. Thanks to its unique clinical knowledge and experience and the support that it receives from its many dedicated donors and families, many people who need blood and organs can be saved. In its annual review, the organisation has spent some time evaluating its system and performance. In other words, it has looked at itself in great depth and that has allowed it to achieve substantial savings and to lower the cost of a unit of blood. According to its annual review, a unit of blood has dropped from £140 to £130 and it should reduce further to £125 this year, which will mean a saving of £30 million a year to the NHS. That money can be reinvested in NHS front-line patient care.

The National Blood Service administers not just units of blood, but organ donation, tissue donation and work on stem cells. There have also been improvements in the delivery of organ donation procedures, including training additional specialist nurses and increasing the numbers of people who are prepared to contribute organs. User hospital trusts pay for the blood products and services. It is important that both hon. Members and the public understand that blood and tissue donors give their services for free.

[Andrew Stephenson (Pendle) (Con)]

I congratulate the hon. Gentleman on securing this important debate. May I ask him a question on the subject of reform? The National Blood Service is crying out for new donors. Should the fact that there is still an arbitrary ban on certain groups of society giving blood, such as gay men, be up for review or does he think that such a ban is okay?

[Jim Dobbin]

Everything should be up for review at the present time. I am quite sure that the National Blood Service is considering that matter as part of its review.

Donors give their services absolutely free to the national health service. The Department of Health funds the production of all the organisation’s services within its factories, processing centres and laboratories. The system has a record of sound financial control, of which the NHS should be proud. I was in the service when cleaning services were compulsorily tendered out to the private sector. If my memory is correct, that resulted in a reduction in the quality of service. We saw wards cleaned less frequently and an increase in hospital infections such as clostridium difficile, E. coli 0157 and methicillin-resistant Staphylococcus aureus. We have all seen the publicity that such infections have received. Privatisation would introduce an element of cost cutting in order to increase profit. Shortcuts, reduced training and a reduction in quality are all strong possibilities.

The public who donate their services for free will be discouraged from taking part if the profit motive is introduced. The demand for blood from those who have serious health conditions will not diminish, but the supply of donors is in danger of being reduced.

[Mr Gerry Sutcliffe (Bradford South) (Lab)]

I congratulate my hon. Friend on securing this debate. As I understand it, the National Blood Service is allowed to use the blue flashing light to transport blood to the most serious cases. Is it not the case that if the service were privatised, the private sector companies would transport the blood but would not be able to use the blue-light service because it is restricted at the moment?

[Jim Dobbin]

If that were the case, it would make it much more dangerous for those patients who were waiting to receive that blood or organ. I would not like to see that happening.

The National Blood Service has created a strategy for each of its departments as it strives to improve its service and, looking at the review in great detail, in my view, it is succeeding. It is aware of the current economic situation and the constraints that it is working within over the next few years. It is planning more developments in future years. The question that has to be asked is why sell off something that is working so well. I understand that scientific staff have been angry about these moves. They have blasted the Government plan and demand changes to the Health and Social Care Bill, which will let private companies cash in on lucrative Government contracts.

[Lisa Nandy (Wigan) (Lab)]

Does my hon. Friend share my concern about the staff who currently work in the National Blood Service? Many of them opt to work in such services because they believe in the public good and in the common good. Does he share my concern about the impact that privatisation will have on them?

[Jim Dobbin]

Yes. That is exactly right. Those staff, who are well trained specialists in their area, are very concerned about the damage that this proposal would do to the blood transfusion system and they are very angry about what is possibly going to happen. Of course, they also fear that donors will walk away. There are 1.4 million volunteer donors at the moment. They donate about 200,000 units every year, which is a huge amount of blood, and all of it is donated voluntarily. Privatisation of the blood service has been tried in New Zealand and it drove down the number of blood donors. It deterred them from making that contribution freely, because donors do not like to see their organs or blood as part of a private sector business.

Why should the private sector profit from blood that is given freely? There is no private sector organisation that has the expertise to provide the range of services—blood supplies, tissue, organs and specialist products, plus the specialist research expertise—that are provided by the NHS blood transfusion service.

[Jason McCartney (Colne Valley) (Con)]

I congratulate the hon. Gentleman on securing this important debate. He raised an important issue when he said that there are a number of reasons why people give blood. Personally, I gave blood at the Galpharm stadium in Huddersfield a couple of years ago because I was inspired by Adrian Sudbury, the journalist from The Huddersfield Daily Examiner. Before he died, he also inspired people to sign up to the bone marrow register maintained by the Anthony Nolan Trust. So there is a lot of good work going on and the hon. Gentleman has identified that. I hope that the Minister, in her deliberations, will think about the other roles that the National Blood Service plays. The hon. Gentleman quite rightly identified that the service is not only about giving blood but about giving tissue and other material. I thank him for making that point.

[Jim Dobbin]

I thank the hon. Gentleman very much. That was a very positive contribution, based on his own specific experience. There is a petition about this issue, there are now some 35,000 signatures on it, and it is building up all the time.

[Grahame M. Morris (Easington) (Lab)]

I also congratulate my hon. Friend on securing a very important debate about an issue that is of great concern among the public. I wanted to ask him about the lessons from overseas countries where blood transfusion services have been privatised and where it is standard to pay for donated materials. What lessons can we learn from those countries about the safety of supply?

[Jim Dobbin]

I referred earlier to another privatisation that took place in the health service, when cleaning was put out to tender. Of course, the quality of the service was reduced. That is exactly what I fear will happen with the blood service, because if someone is in the business of making money and making profit they take short cuts. It is as simple as that.

The petition that I was talking about is building up. In addition, 300 people got in touch to say how much they valued the blood service. For many of those people, their loved ones personally benefited from the altruism of a fellow human being.

The blood service began before the national health service, around the time of world war two, when the demand for the service originated. So the blood service is older than the NHS.

I am very concerned. The Government are saying that only elements of the NHS blood transfusion service are under discussion at the present time but that is a dangerous route to go down. I hope that the Minister will take this issue back to the Government and the Secretary of State, and ask for a review of this particular service that the public so dearly love. The other thing that I will say is that if someone is looking for a big society in action, the blood service is it.

13:44

[The Parliamentary Under-Secretary of State for Health (Anne Milton)]

Having not served under your chairmanship before, Mr Williams, I now find myself doing so twice in a day. It is a pleasure.

I congratulate the hon. Member for Heywood and Middleton (Jim Dobbin) on securing the debate and I pay tribute to his experience of this sector. I also echo the tributes that he paid to the staff who are part of such a fantastic organisation and who are one of the reasons why it has such a high reputation.

The debate is an important opportunity to discuss an issue that is not only important to the NHS and the public but which has been the subject of very unhelpful rumour and speculation. I become very disappointed when I see scare stories in the press that are not necessarily based on any foundation and that will only result in scaring people off donating blood, tissue or organs. Those stories are not helpful. I urge the hon. Gentleman and the other hon. Members sitting beside him that if they want to clarify the situation they should please feel free to contact me. That is much better than running scare stories, or a story getting out of hand, so that the issue becomes a disservice to the public we are all trying to serve.

Contrary to what some people have been saying publicly and indeed privately, there are no plans to privatise the blood service, which is part of NHS Blood and Transplant, or NHSBT. I can say categorically that we are not selling off the service. If I do nothing else in this debate, I want to knock that rumour on its head.

The Government have said previously that we will retain a single national system for blood with NHSBT at its helm and we stand by that statement. Under its current management team, NHSBT has done a great job and it continues to do so. It has maintained—indeed, greatly improved—the stability and security of the blood supply. It has also improved productivity in blood processing and testing by more than 50% in three years, which is a true achievement.

[Jim Dobbin]

I have a letter from Andrew Pearce, who is the head of donor advocacy in the NHS. The second paragraph says:

“The review is at an early stage and is likely to take a few months. Although we cannot rule out that the review might eventually suggest that some of our supporting activities should be market-tested, this is by no means certain.”

There is some doubt in that letter, which is from someone within the blood system itself, about whether market-testing is going on with a view to something else happening. People do not test something for the market if they are not intending to put it out to tender.

[Anne Milton]

I thank the hon. Gentleman for his intervention. What matters is that people get good value for money from the taxes that they pay. What also matters is that we do things effectively and efficiently, so we constantly market-test within NHS provision. We should do so. What matters to us is having a quality service. However, we are not selling off the blood service and we are not privatising it. As for performance, I am sure that the hon. Gentleman will agree that the performance of our blood service puts us in the top quartile compared with other European blood services. That is a fantastic achievement.

I reiterate the hon. Gentleman’s comments about what the improvements in the blood service mean. There has been a reduction in the price of a unit of blood, down by £15 from £140 in 2008-09 to £125 today. As he rightly pointed out, that reduction saves hospitals £30 million each year, which can be channelled straight back into patient care. Again, I pay tribute to the staff who have achieved that reduction.

It would be a huge oversight on my part if I did not also pay tribute to those who donate their blood for the benefit of others. I am pleased to learn that my hon. Friend the Member for Colne Valley (Jason McCartney) has donated blood himself. Every year, 1.4 million people donate blood, which means that 2 million units a year are donated in total. That equates to 7,000 new units of blood every day, or about five a minute. Statistics are wonderful when one is engaged in a debate such as this one; they show the scale of the donations that are made. Those donations have saved countless lives and continue to do so. Indeed, the altruistic donor system is one of the rocks that the NHS is built on and we will not do anything to jeopardise public confidence in it.

It would also be remiss of me not to mention organ donation. The one thing that we do not do often enough is to thank people who donate their organs and those of their loved ones, saving many lives in the process. We have made great improvements in organ donation, which is up by 28% since 2008, but we must continue to make improvements. I do not want anything, anyone or any public statement to jeopardise any of that. On the contrary, we want to carry out a review to help NHS Blood and Transplant to improve its operational efficiency even further and provide an even better service.

The blood service must be seen in the context of its role in the NHS. The hon. Member for Easington (Grahame M. Morris) mentioned courier services for getting blood around the place. We have been using courier services for many years—the previous Government did so as well—to deliver organs and tissue, and there is no question of putting the delivery of blood at risk.

[Grahame M. Morris]

Just for the record, it was my hon. Friend the Member for Bradford South (Mr Sutcliffe) who raised that issue, but it is one that I am concerned about.

Will the Minister address the new role of the economic regulator, Monitor, and the responsibilities that it will have regarding competition? Will its remit extend to the blood service?

[Anne Milton]

I apologise for confusing the hon. Gentleman with the Member who was sitting next to him. At least it gave me the opportunity to clarify the point. To ensure that I give the hon. Gentleman a precise answer, I will have to come back to him on Monitor because I do not have the information with me. I will happily do that after the debate.

The blood service is self-funding, in that it recovers the cost of collecting, testing and processing blood through the price paid by the NHS for each unit. The price of a unit is therefore directly related to the efficiency with which NHSBT conducts its operations; the one feeds into the other. If the cost of a unit of blood goes up, there is pressure on budgets, so the whole NHS has an interest in NHSBT being as efficient as possible and keeping the cost low. The £30 million that we have been able to put back in demonstrates that costs are being kept low, and more can be spent on patient care.

The review of NHSBT was announced in the report produced by the arm’s length bodies review in July 2010. The review is ongoing, and I cannot say what the outcome will be, but I would like to explain what the review is about, and in doing so, clarify what it is not about and hopefully reassure the hon. Member for Heywood and Middleton and all those who might share his concerns.

The review will identify opportunities both to help NHSBT further improve the efficiency of its operations, and to save money. Aspects of NHSBT’s activities covered by the review include IT, estates, testing, processing and logistics. NHSBT has recognised that those areas have room for improvement, in both developing services and increasing efficiency; such functions can often be carried out more efficiently. NHSBT already outsources some of its activities to private sector companies, for example facilities management, legal services and the call centre, so by exploring whether greater savings are possible, the review does nothing new. It simply takes a currently successful model, which has demonstrated that it can improve, and considers whether it would work if it were to be expanded.

As I said, we are looking to ensure maximum efficiency for NHSBT, and I am sure that the hon. Member for Heywood and Middleton agrees with that aim. We will do whatever works, and whatever can ensure a safe supply of blood to the NHS.

[Tom Blenkinsop (Middlesbrough South and East Cleveland) (Lab)]

Will the review of the British national blood service be subject to European competition law?

[Anne Milton]

I am pretty sure that it will, but I will check.

There have been suggestions that outsourcing some other functions might lead to donors declining to donate. We are absolutely clear that in exploring other opportunities, we will not put at risk any aspect of public health. I do not want donors or any Member here today to believe that this is privatisation of our highly respected National Blood Service.

[Jason McCartney]

I thank the Minister for clarifying that there will be no sell-off—no privatisation—of the National Blood Service. Some Opposition Members are concerned that if there was some privatisation there would be a drop in donations, which is something that no one in the House would wish. Hopefully, Members on both sides of the House can now pass on that information, so that there is confidence in the National Blood Service and we see an increase in donations. We welcome the efficiency measures as well.

[Anne Milton]

I thank my hon. Friend for reiterating that point. Blood is donated freely to the NHS to improve and save patients’ lives. Like any donation, it is a gift, and we want to maximise the opportunities for that gift. We do not want to do anything to discourage donors. I state categorically that the donor-facing aspects of blood donation are excluded from the review, which will ensure that the relationship between NHSBT and its donors is not compromised.

My hon. Friend the Member for Pendle (Andrew Stephenson) mentioned that people, in particular men who have had sex with men, are excluded from blood donation, and that issue is currently under consideration. I understand that there has been a lot of concern that the rules are outdated, and we will make an announcement on the issue at some point in the near future.

I feel that I have been repetitive, but I need to be to make the point, so I reiterate the Government’s support for, and belief in, a single national system for donated blood and organs, with NHSBT at its helm. That does not mean there is a blinkered belief that the system has already reached the peak of its potential; it would be remiss of the Government to think so. NHSBT, like all areas of public and private life, must continue to innovate and to challenge itself if it is to provide the best possible service. The current review is designed to explore how it can do that, to keep the price of blood—the cost to the NHS—as low as possible and to provide the high-quality blood service that donors and recipients deserve.

[Jim Dobbin]

I agree that we should continually look at research and at improving the system for the people of this country. I have no problem with that, except that I would like the service to remain within the NHS.

[Anne Milton]

In everything he does, the hon. Gentleman operates from a deep-seated belief in organisations such as the NHS, and he wants the best, not just for his constituents but for the people of this country. I therefore urge him, as I urge all Opposition Members, not to play politics with this issue, although I am sure that that is not his intention. If Opposition Members have any concerns, I urge them to discuss them with me; my door is open. It would be a tragedy if anyone did anything that reduced the number of donors coming forward. We are determined to ensure that that does not happen, but scare stories in the press can have that unintended consequence. We should not believe everything that we read in the newspapers.

Question put and agreed to.

13:58

Sitting adjourned.