LETTER : Saving money on blood transfusion

From Dr Colin Entwistle

Sir: If John Adey, the chief executive of the National Blood Authority (Letters, 14 October), is not proposing to close any blood centres, why did the NBA choose Option D from the alternatives set out by the consultants Bain & Co who were asked to look at the service? Option D states that "five or six centres could be closed". In September 1994, Mr Adey wrote to all Blood Transfusion Centre (BTS) directors denying that "we plan to close more centres in addition to those published", with the obvious implication. Mr Adey also wrote to the workforce representative at Brentwood and discussed "the proposed closure of Brentwood".

The proposals for reorganising the service came from eight working groups composed of a total of 44 blood service managers chosen from the 15 centres. Among these 44 managers, none came from Liverpool, Plymouth, Oxford or Lancaster and only two (on the "donors" committee) from Brentwood. By a curious coincidence the centres selected for downgrading amalgamation were Oxford, Liverpool, Plymouth, Brentwood and Lancaster; that selection being decided by a small inner strategy group only.

It is astonishing that Mr Adey now tries to argue that the aim of the proposals was not to save money.

Mr Adey claims that "donors have always indicated that the sale abroad of any surplus is preferable to the alternative, which is burning". A substantial minority of the few donors asked do not wish their blood to be sold even under these circumstances. I believe that all donors should be informed, prior to donation, of potential sales arising from their freely given blood so they have a chance to opt out. Informed consent is the basis of our voluntary system.

Yours sincerely,

Colin Entwistle

Oxford

17 October

The writer is the recently retired medical director of the Oxford Blood Transfusion Centre.