Examination of Witnesses (Questions 40
- 59)
MONDAY 29 JANUARY 2001
MR NIGEL
CRISP AND
MR MARTIN
GORHAM
40. As far as you know it is pretty rare?
(Mr Gorham) As far as I know but, having said that,
we are expecting to solve that particular IT problem in the next
few months.
41. Good, because that clearly is part of being
friendly to donors again.
(Mr Gorham) It is and it is typically our regular
donors who are coming back to us with problems like that and who
are going to want to donate again. We need a good source of new
donors but, equally, we need to retain our regular donors.
42. I had a complaint some time ago that somebody
had waited a long time and was getting very fed up so they were
talking to the nursing staff and they were getting very fed up
and they were saying that a lot of the blood is wasted and gets
thrown away and some of it gets sold to Paris and God knows what.
This was the sort of thing that was coming back from your staff
to the donors, which may be totally untrue. Can you tell us what
proportion of blood collected is in the end wasted, thrown away
or whatever, either by the Service or, indeed, by the hospitals
once it gets there?
(Mr Gorham) There is a schematic on page ten of the
Report, number seven, which actually tracks through. What that
shows is that at the time something over 88 per cent of the blood
was ultimately being transfused into patients. If I can just correct
a number I gave the Chairman earlier, that has actually improved
by about 0.2 of a per cent, and not 0.4 of a per cent, since this
chart was prepared. Obviously we will continue to work to reduce
the system of losses but they are not high. We did have a concern
at the point where at the beginning of 1999 we suddenly got very
high stocks after not having had very high stocks for a long time
and we were concerned that our own wastage levels would go up
as a result, and they did briefly, but, much to my admiration,
the operational managers of the Service turned round the whole
stock handling policy very, very quickly and we have now got the
stock wastage within the NBS back to the previous level, and actually
a little bit lower if you allow for the system loss that comes
from leucodepletion. It is something that we take very, very seriously
because, of course, we can actually manage with less donations
if we do not waste donations. I cannot explain the stories you
were being told. We certainly do not waste blood, that would be
an appalling thing. I am not aware that we have ever sold it to
Paris.
43. Do you sell any of it abroad at all?
(Mr Gorham) No. The only circumstances in which we
would export blood would be if there was an approach to the British
Government and the British Government felt that it was appropriate
to support an international emergency or something like that.
We do supply the British Forces. We occasionally help out our
colleagues in Wales and Scotland and they would reciprocate with
us if that was appropriate. At the moment it is more or less totally
contained within the United Kingdom.
44. So there is no income coming into the Service
from this at all?
(Mr Gorham) Not to my knowledge.
45. I am speaking from memory—
(Mr Gorham) Sorry. The one area that is different
is the BPL, the Bio Products Laboratory who fractionate plasma
products and they have always exported any surplus product that
they have. The nature of what they do is that in order to get
enough of particular products they then produce a surplus of other
products and it has always been agreed that they should sell the
surplus products and the income is used for the benefit of the
NHS. That is entirely within the Income Generation Regulations
to the NHS. I am sorry, I had not picked up the point you were
making.
Chairman: Can I just ask the witnesses to be
a little briefer in reply.
Mr Williams
46. Just as a matter of interest, where do private
hospitals get their supplies of blood from?
(Mr Gorham) From us.
47. On what basis are they charged?
(Mr Gorham) The same basis as the NHS.
48. What is that?
(Mr Gorham) It is not strictly speaking a charge,
it is a handling charge. Essentially we recover our costs through
the charges we make for supplying blood to hospitals.
49. So it is the operational cost. That was
a thought that occurred to me and I did not know the answer. I
do not know the answer to the next one either, Mr Crisp, I hope
that you do. Welcome here on your first appearance. I notice looking
at the map that I happen to live in one of the only areas, other
than Scotland, in the UK that is outside your empire, namely South
Wales. Just as a matter of interest, and I do not want to explore
the background to that, I remember the old arguments and so on,
what processes exist to ensure that the standards in that area
are exactly the same as in your area?
(Mr Crisp) Across South Wales as well as England and
Wales?
50. Across South and Mid Wales.
(Mr Crisp) Again, can I turn to Mr Gorham to answer?
51. Yes, whoever can provide the answer.
(Mr Gorham) Primarily in two ways. A lot of what we
do in the Blood Services is subject to European Directives, so
a lot of the standards are actually captured in European Directives,
and then below that there is a UK organisation that sets guidelines
for all of the four UK Services, so there are common standards.
52. They are common guidelines, not necessarily
common standards, or not necessarily common standards achieved.
Is there a comparative system of operation?
(Mr Gorham) We spend a lot of time discussing how
we do things and looking at common standards. There are some of
the same difficulties that I described earlier about actually
doing internal comparisons because of historical differences,
but we are all working towards the same standards and the four
UK Services do talk to each other a lot.
53. I only want to be reassured that there is
no—
(Mr Gorham) I could not possibly be parochial and
say you should worry about being in South Wales.
54. Your normal boundaries finish when you reach
Wales, and always did, speaking as a previous Secretary of State
for Wales, does this one-off North Wales situation create any
sort of anomaly as far as you are concerned? Is it likely, in
fact, that it will return, as before, to an all Wales structure?
Will there be any possible benefits in that?
(Mr Crisp) There are two or three points. One is just
to build on what Mr Gorham said. In addition to the Blood Service
meeting on a four country basis, so are we now just setting up
a Health Service meeting on a four country basis, so I am about
to start meeting with my new Welsh equivalent and Scottish equivalent
and Northern Ireland equivalent so that we are able to pick up
issues that cross boundaries. I am not anticipating that we would
be wanting to change this, there does not seem to be an immediate
pressure to change this particular arrangement as it sits. There
are a number of things that run across different boundaries in
different ways.
55. So if my colleagues down in Wales in the
Assembly wanted to ask questions along the lines of those today
in relation to all Wales, you would have to attend as a witness
as well, would you?
(Mr Crisp) I have to say I assume that must be the
case, but I do not know.
56. I am not trying to trick you into anything.
Put a note into the Committee about that, please.
(Mr Crisp) I will respond to that, yes.[2]
57. Okay, fine. As one who did not support the
Assembly I am not arguing any particular line here, I am just
interested in probing an anomaly when one exists. Can we switch
back then to a bit of history and go back to the previous Chairman
and the previous Deputy? Now, I am not clear quite why the previous
Chairman was dismissed. What was it all about? Was it just about
the restructuring or was there more to it than that?
(Mr Crisp) I think, as I understand it, it was about
a whole range of different issues. People were dissatisfied, the
Service was losing confidence, the restructuring—
58. Dismissal is most unusual. I have been on
this Committee for the best part of ten years now and we come
across very few actual dismissals.
(Mr Crisp) Yes.
59. If there were many factors, were there any
factors involving risk to the public in any way? I ask you to
consider your answer carefully.
(Mr Crisp) Yes. I think again, I am afraid, I am going
to have to come back to you on that to give you an answer on that.[3]
That is not a question that I have actually asked myself so I
am afraid I do not know the answer.
2 Note: See Evidence, Appendix 2, page 19 (PAC
2000-01/157). Back
3
Note: See Evidence, Appendix 2, page 19 (PAC 2000-01/157). Back
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