The privatisation of blood donations
The proposed privatisation of NHS Blood and Transplant service, or parts of it, will instinctively make people shudder and we are right to be concerned about how commercial motives will change the service.
At Anthony Nolan, we know a lot about blood. We have provided stem cells for transplant to people with blood cancers and similar conditions since 1974. We set up the world’s first bone marrow donor register and have always worked closely with the NHS. In fact our fundraising enables us to support the cost to the NHS of acquiring cells for these life saving transplants.
With blood there are some pressing hurdles to overcome with privatisation. Firstly, what will be the impact on individuals when they are asked to donate blood when a company will make a profit from that donation? Will there be a move to allow payments to be made to donors, raising the overall costs and removing the philanthropy from the act of donation? NHSBT also often asks blood donors if they would also like to join the bone marrow register, an important channel for getting more people signed up. If privatised, what will be the commercial incentive to continue supporting this work?
Privatisation of something so essential also demands cast iron assurance of quality and safety standards through regulations and inspections. As a charity handling human tissues, we’re subject to a rigorous regulation regime, but we don’t have a profit motive that conflicts with that drive for quality and safety. Furthermore, if foreign companies are to bid for NHSBT, to what extent will we be increasing the acquisition of blood from territories where we don’t get to choose how often or how thoroughly laboratories and facilities are inspected, even if their regulations are harmonised with our own?
In the Big Society, the Government has a nugget of an idea that is wholesome and attractive but articulated only as an expression of values. As this idea has been translated into policy, there have been few examples of those values surviving the overriding impetus to deliver financial savings. If the government is minded to release control of NHSBT, surely this is an opportunity to get creative and come up with a Big Society solution that delivers on the values.
One route might be to turn NHSBT into a mutual or to create a charity or community interest company to deliver on the service – a landmark first investment from the Big Society Bank perhaps? Or if it is to be sold, maybe the Scottish or Welsh blood services might like to take a stake, reflecting the way foreign state-owned utilities have bought into our own in past privatisations.
Philip Blond, Director of the think tank ResPublica, has written about the “stifling duopoly of a centralised state and a laissez-faire free market” and in many ways he is right; there is a compelling argument for supporting a more diverse flora in the delivery of public services. It is harder though to see the argument for a rush to commercialisation, particularly when the commodity in question is blood gifted by selfless people for the benefit of strangers.
If NHSBT is to be reformed, let’s find a structure that keeps standards high, ensures people’s safety and preserves the nobility inherent in its central, vital function.
Henny Braund is Chief Executive for Anthony NolanTagged in: big society, blood donation, david cameron, nhs, private healthcare
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