|Previous Section||Back to Table of Contents||Lords Hansard Home Page|
Baroness Andrews: The reduction of incidents of transfusion-related acute lung injury (TRALI) continues to be a high priority for the National Blood Service's (NBS), Blood and Tissue Safety Assurance Group. An NBS project team is carrying out an option appraisal to assess ways of reducing TRALI, working with the Department of Health's Economic and Operational Research Branch. Options under active consideration include sourcing fresh frozen plasma (FFP) exclusively from male donors and the use of an additive solution to reduce the volume of plasma used to suspend pooled platelets. Decisions will be taken later this year. In addition, the criteria in the NBS specification for imported FFP for neonates and children born after 1 January 1996 includes a preference for male donors.
Whether they are satisfied with the reporting of transfusion-related acute lung injury under the guidance of the Serious Hazards of Transfusion Scheme.[HL2519]
Baroness Andrews: In July 2002 the Department of Health published Health Service Circular 2002/009 Better Blood TransfusionAppropriate Use of Blood (www.doh.gov.uk/publications/coinh.html). The circular asks all National Health Service trusts to ensure participation in the Serious Hazards of Transfusion (SHOT) scheme by December 2002. We will be carrying out an audit to review the implementation of this guidance later this year. From the start of the current reporting year, participation in the SHOT scheme by NHS Trusts will be verified by means of a confidential personal identification number. SHOT also encourages awareness of reporting all adverse events, including transfusion-related acute lung injury (TRALI), by holding an annual educational symposium. The SHOT annual report is also widely circulated and available on the SHOT Website (www.SHOT.demon.co.uk).
The National Patient Safety Agency (NPSA) is also beginning to take forward and implement work on improving safety across the NHS including encouraging open and fair reporting of errors so that the NHS can learn from them. We will be looking to SHOT and the NPSA to help us take a more comprehensive approach to improving patient safety in the NHS.
In addition, the new European Blood Directive will, when implemented into UK law, make mandatory the notification by hospitals of "serious adverse reactions observed during or after transfusion which may be attributed to the quality and safety of blood and blood components". This will include TRALI.
In the light of the £88 million spent to secure safer products for haemophiliacs, and the £55 million to secure the supply of United States-sourced plasma for certain patients, whether they will consider an additional £9.6 million to supply a United States-sourced, virally-inactivated transfusion plasma for the 70,000 patients who undergo plasma transfusions each year.[HL2555]
Baroness Andrews: To date there is no evidence worldwide that variant Creutzfeldt-Jakob disease has ever been transmitted through blood. As a precautionary measure all fresh frozen plasma (FFP) produced by the United Kingdom blood services uses single unit plasma from UK blood donors which has been leucodepleted to remove the white cells which evidence suggests may carry the greatest risk of transmitting variant CJD. Although most UK FFP is not virally inactivated, high levels of safety are achieved by using single unit, as opposed to pooled plasma, by screening out potential high risk donors and by testing every unit of donated blood for the presence of infections such as HIV, hepatitis B, hepatitis C before it is released to hospitals.
The decision taken to import FFP from the United States for young babies and children born after 1 January 1996 will provide additional protection to the most vulnerable group who will not have been exposed to Bovine Spongiform Encephalopathy through the food chain. The National Blood Service is currently involved in negotiating for supplies of FFP for this group of patients and plans to have it available later this year. A commercially produced FFP product, sourced from the United States, is also available for the National Health Service to purchase.
The Government expert Advisory Committee on the Microbiological Safety of Blood and Tissue for Transplantation is continuing to keep this issue under review and there are currently no plans to allocate further funding.
The OFT report argues for abolition of entry controls on the grounds that there would be consequent benefits for consumers in terms of reduced prices, improved quality of services and better access. The Government strongly support these objectives. We want to improve access and choice (including improving out-of-hours access for NHS patients) so that more NHS patients can use the skills of community pharmacists, who are trained clinicians, for advice, information and services.
The OFT report also noted that in a more competitive environment problems could arise through the possible effect of deregulation on the ability of patients in some areas to access high quality pharmacy services, and that these problems could be addressed through targeted measures. It was not in the OFT's remit to examine how mechanisms such as the Essential Small Pharmacies Scheme could be developed to address a more competitive environment, and we therefore propose to examine these issues further before reaching a final decision on a balanced package which most effectively promotes competition, new entry and increased choice alongside our wider social and health objectives.
We therefore favour change to open up the market and improve quality and access without diminishing the crucial role that pharmacies play, especially in poorer and rural areas. The Government intend to come forward with proposals before the Summer Recess and will publish a progress report at the end of June. All changes will then be the subject of a full consultation.
The Parliamentary Under-Secretary of State, Department for Environment, Food and Rural Affairs (Lord Whitty): The UK has applied for the following transitional measures, to apply throughout the UK until the dates shown: the use of small (less than 50 kg/hour) incinerators which do not burn specified risk material (UK), until 30 December 2004; the use in animal feed of used cooking oils, until 30 October 2004; the separation at oleochemical plants which process tallow derived from category 2 and 3 material, until 30 October 2005; the rendering of mammalian blood at atmospheric pressure, until 30 December 2004; the collection and disposal of waste food from retail outlets, until 30 December 2005; and the feeding of processed animal protein from all fish to farmed fish, until 30 December 2003.
Lord Whitty: Council Directive 90/667/EEC (the Animal Waste Directive) already classifies shellfish and fish waste as an animal by-product and applies to all member states. The directive will be replaced by Regulation 1774/2002 (the Animal By-Products Regulation) which maintains the same principle. The regulation will be applying to all shellfish products which are not intended for human consumption.
The Sea Fish Industry Authority was consulted during negotiations on the regulation and a number of other fish and shellfish industries were sent the consultation document of 27 January 2003 on enforcing the regulation. As landfill is not currently a permitted disposal route for most shellfish waste, we have not asked the Commission for a transition period to allow that practice to continue.
Lord Whitty: Specific guidance is not provided to Ministers and officials on such matters, although advice on the rules and procedures relating to the operation of the Convention on International Trade in Endangered Species (CITES) is available on the DEFRA website at www.ukcites.gov.uk. It should be noted that a number of CITES species are traded quite legitimately for human consumption and it is the responsibility of the host's officials to ensure that such products are legally obtained from a sustainable source.
Lord Whitty: The question covered various policy areas spanning organisational units in more than one government department. It took longer than is usual to publish because we wanted to ensure that the answer given was full, accurate and up to date. There is nothing further to add to the previous Answer.
|Back to Table of Contents||Lords Hansard Home Page|