HC Deb 27 November 1995 vol 267 cc929-39 3.30 pm
The Secretary of State for Health (Mr. Stephen Dorrell)

With permission, Madam Speaker, I wish to make a statement about the organisation of the national blood service in England.

I have today accepted revised proposals from the National Blood Authority for the future of the blood service. The details of those changes are set out in a policy document, copies of which are available in the Vote Office.

The blood service is an essential part of the NHS. Modern medicine relies on the ready availability of blood and blood products, and the national blood service has an enviable reputation for providing a service that is safe, reliable and efficient. The changes that I am announcing today build on that reputation.

In this country, the blood service is based on a gift. Blood is given by voluntary donors, who neither seek nor receive payment. The blood service accepts two obligations in return. First, it accepts an obligation to provide donors with a service that is safe and convenient. Secondly, it accepts an obligation to ensure that their gift is used as effectively as possible.

The changes that I am announcing today will mean an improved service to donors. New information technology will mean that donor sessions are better planned; higher standards will be set for the premises that are used; and greater use of mobile units will allow for more local donor sessions. Those changes will be underwritten by the publication today of a blood donors charter, which will set out the standards that donors are entitled to expect, as well as a new complaints procedure to operate if those standards are not met.

Today's changes will also mean a better service to hospitals. Every hospital will continue to have its own blood bank. The blood service will continue to supply those hospital banks from its own network of 15 NBS blood banks. In addition, it will open two more facilities, in south Lincolnshire and central London. The addition of those two new facilities will, for the first time, allow the blood service to give every NHS hospital the assurance that emergency hospital supplies can be delivered within a maximum of two hours.

Furthermore, the blood service is increasing the resources that it commits to research and development. It has for the first time appointed a national co-ordinator of research and development, and it is developing centres of research excellence at Cambridge and Bristol. An extra £1 million will be devoted to ensuring that the latest developments in transfusion medicine are made available to hospital consultants.

It is important that every consultant whose practice relies on the effectiveness of the national blood service should be confident that it is able to meet his or her requirements. I have therefore decided to establish a national user group to monitor the service provided to hospitals by the blood service. It will report to me annually, and its reports will be published. I am delighted to inform the House that Professor Edward Gordon-Smith, professor of haematology at St. George's hospital, London, has agreed to be its first chairman.

As the House knows, I attach great importance to minimising unnecessary administrative and support costs in the NHS. When the National Blood Authority assumed responsibility in April 1994, the structure of the blood service reflected its history as the responsibility of 14 regional health authorities. There were 13 administrative centres, with computer systems that were not compatible with one another and considerable duplication of both administrative and specialist clinical support services. Those arrangements made it difficult to move blood stocks from one region of the country to another when the need arose.

The changes that I am announcing today will simplify those structures. A new computer system will allow blood stocks to be managed on a national basis, specialist clinical support services will be reorganised to make more effective use of the skills available and the administrative functions now carried out in 13 administrative centres will be concentrated at three centres in Leeds, Bristol and London. Those changes will release £7.5 million for patient care elsewhere in the NHS.

Furthermore, the organisation of processing and testing of blood supplies on a regional basis has led to a significant overcapacity and waste of resources. I have therefore accepted the NBA's proposals to concentrate processing and testing work in fewer centres. That work will cease in Lancaster by March 1996, in Oxford, Cambridge and Liverpool by December 1997, and in Plymouth by March 1998. Concentration of the work at the remaining centres will leave the blood service with sufficient capacity to meet projected demand, and will release a further £2.5 million for patient care elsewhere in the NHS.

The decisions that I have announced will be phased over the next three to four years, and will involve reductions in staffing levels over that period amounting to about 300 posts. That represents a 7 per cent. reduction over the period, and the management of the blood service will do everything possible to avoid compulsory redundancies.

Today's announcement brings to an end a period of substantial uncertainty in the national blood service. It is a reflection of the dedication and professionalism of the staff that they have maintained high standards of service throughout that period. These changes will bring significant service improvements to both donors and hospitals, while at the same time releasing a total of £10 million for improved patient care elsewhere in the NHS. I commend them to the House.

Ms Harriet Harman (Peckham)

We welcome the Secretary of State's recognition that the blood service must be based on a gift. I hope that he will tell us that he will ensure that we have no more commercial gimmicks from the National Blood Authority. We welcome the introduction of a blood donors charter, and hope that it will achieve better enforcement than other aspects of the patients charter; I also welcome the Secretary of State's announcement of a new national user group.

Does the right hon. Gentleman, however, recognise the dismay that will be caused by his announcement that he will press ahead with the plan to take blood processing and testing away from Liverpool, Cambridge, Oxford, Plymouth and Lancaster? Does he not realise that those who work in the blood transfusion service, those who donate their blood and the doctors who use that donated blood have all made clear their opposition to the plan? They believe, as we do, that it will make the service more expensive, and less able to respond quickly to the need for blood.

Does the right hon. Gentleman accept that, although he claims that the plan to withdraw testing and processing from those centres will cost the NBA less, it will be a false economy? It will cost the NHS as a whole more. It will cost more in increased travel costs, and in wastage: blood that had been taken and stored in case it was needed will be thrown away. Local centres have always responded quickly to specific local demand. The plans will not produce the savings that the Secretary of State has promised.

Does the right hon. Gentleman accept that the plans threaten the very viability of the work that will remain at the five centres? Once the testing and processing of donors' blood has been removed, and only the testing of patients' blood remains, unit costs in the five centres will rise, and the Secretary of State will come to the House to tell us that those centres are too expensive and must close altogether. Does he admit that that will be the next step? Why has he not learnt from his last effort at trying to save money on the blood service? The decision to buy cheaper blood bags from Australia led to the infection of patients and to the withdrawal of the bags. That decision lowered safety standards and cost more in the long term.

Does the Secretary of State accept that he has failed to convince doctors that his proposals will improve the quality or availability of the blood that is so vital to the national health service? Hundreds of doctors, as well as donors and those working in the service, have registered their opposition to the plans which the Secretary of State has said will go ahead. Clinicians in Liverpool and Oxford, in particular, have said that, far from improving the service, the plans will put lives at risk.

Why has the Secretary of State brushed those concerns aside? Does he not recognise that those who work in the blood service have helped to transform the way in which blood is collected, processed and tested? Therefore, their opposition to his plans is based not on resistance to change, but on the belief that the plans are totally wrong.

Does the Secretary of State realise that his handling of the plans has had a demoralising effect on the blood service, and that staff have drifted away? We have the worst of all possible worlds: a long period of consultation and uncertainty, followed by a decision that shows that the Secretary of State has not listened to those whom he consulted. With the proposed new computer system to which the Secretary of State referred at least 18 months from completion, it will not be possible to move the work to those centres that are not staffed adequately.

Is it not ironic that today's announcement coincides with yet another blood shortage? Will the Secretary of State confirm that blood is being brought from Scotland in order to deal with the shortage in London? As the Cambridge centre did not appear in the original proposals about which the Secretary of State consulted, what plans does he have to consult those involved with that centre, who have learnt today that it is to lose blood testing and processing work?

If the Government trample the views of those who work in and use the blood service, they will never get it right. If the Government look only at the balance sheet and not at the patient, they will never get it right. Is that not yet another reason why the British people do not trust the Government with their national health service?

Mr. Dorrell

It is incredible that the hon. Member for Peckham (Ms Harman), who usually chides the Government for not consulting enough, should now chide us for consulting for too long and then—to use her words—for "brushing the concerns aside". That is simply not true.

Clinicians from Liverpool, Oxford and elsewhere have expressed their concerns about whether the blood service would deliver the enhanced service that was described in the document and acknowledged as the ambition of the blood service. I listened to their views, and I responded by establishing the national user group—which the hon. Lady welcomed.

Clinicians working in the health service who rely upon the national blood service are concerned that that service should meet the standards that it set out in its document. I am grateful to the hon. Lady for recognising the importance of the national user group and of the donors charter, which sets out the standards that donors have a right to expect from the national blood service.

The hon. Lady took the side of those who argue that one cannot remove processing and testing work from blood centres without undermining their viability. Perhaps she has seen a copy of last week's British Medical Journal, in which Sally Davies, a widely respected consultant haematologist at the Central Middlesex hospital, argues the opposite case. She has experience gained from her own practice of doing precisely that which the hon. Lady says is impossible.

In the article, Ms Davies writes: Consultants at some teaching hospitals have suggested … that removing the processing and testing of blood from their sites will adversely affect their clinical services. The experience of teaching hospitals and specialist centres in London shows that this need not be the case. They are not my words, but those of a consultant haematologist who practises in the national health service.

The hon. Lady said that she was anxious to remove unnecessary costs. from the national health service. Why does she want us to protect a system which, as the document makes clear, provides overcapacity in processing and testing around the national blood service so that testing facilities are 48 per cent. overcapacity and grouping facilities are 59 per cent. overcapacity? Surely there are few better opportunities to use taxpayers' pounds to greater effect than to address overcapacity in a support service of the national blood service. That is why we are removing unnecessary overcapacity. It will not damage or undermine the viability and quality of the service that the national blood service provides.

It is true that, as a result of the consultation, we have changed the proposals for Cambridge to concentrate research functions—which we plan to expand—on the Cambridge facilities, and to ensure that the facilities at Brentwood are used to maintain the processing and testing capacity that we need. I have no doubt whatever that those decisions represent the use of the facilities at Brentwood, and the development of an opportunity for enhanced research and development at Cambridge. I hope that the hon. Member for Cambridge (Mrs. Campbell) will welcome that.

Dame Elaine Kellett-Bowman (Lancaster)

Will my right hon. Friend accept my considerable relief and that of the donors and the teams which serve them in Lancaster that they will receive an improved service? The rumour was that they would have to go to Manchester to donate. I never believed that was true, and I am delighted that that uncertainty has been cleared up. Will my right hon. Friend please thank the chairman of the National Blood Authority for the trouble he took to consult people? May I also cotton on to another point that he raised—improved facilities?

Madam Speaker

Order. The hon. Lady is very keen for other Members to ask questions. Perhaps I could now have one from her.

Dame Elaine Kellett-Bowman

If my right hon. Friend is aiming to improve premises, does he not agree that the facilities in Lancaster are not ideal, and that it would be infinitely to the advantage of donors and the teams which serve them if, in the fulness of time, he could provide a new purpose-built centre as part of phase 3 of the Lancaster royal infirmary? Then we really would be quids in, and it would be more convenient for everyone.

Mr. Dorrell

I shall certainly look at my hon. Friend's proposals for a specific improvement in facilities, but I can assure her that one of the benefits that will flow from the improved focus on the donors' perspective is that, around Lancaster, as in the rest of the country, we shall ensure that there are improvements in those facilities that do not match the standards that we expect when we encourage people to give blood.

My hon. Friend is absolutely right to stress that the statement represents an improvement and not a deterioration in the quality of the service that is provided to the donors on whom the national blood service relies, and an enhancement of the service to NHS hospitals. There will not be a diminution of blood donorship sessions, but an extension of local ready access to blood donorship. Every, existing blood service blood bank will be maintained, and the provision will be extended to two more.

There will also be the development of a higher profile for the research and development function of the national blood service. Finally, I agree with my hon. Friend that Sir Colin Walker has played an important and distinguished part in delivering those important changes.

Mr. Simon Hughes (Southwark and Bermondsey)

As the proposals at the end of the consultation were the same as those at the beginning, will the Secretary of State undertake to release all the evidence, so that the public can see whether the decision reflects the weight of evidence? Can he assure the House that no hospital will have its emergency services delayed longer than now? I heard the assurance that it is two hours per hospital. Will any hospitals be worse off?

Does the charter that the right hon. Gentleman has announced mean that there will be no huge profiteering by selling on blood supplies, as revealed earlier in the year, or is it all about Tony Hancock proposals, such as making sure people can have sugar in their tea?

Mr. Dorrell

First, the hon. Gentleman said that the proposals are the same as when they originally went to consultation. That is not true. I have referred already to changes in Cambridge, and some important new safeguards which were introduced as a result of the consultations. The hon. Gentleman asked for evidence. The evidence submitted to such a consultation is the property of the people who submit it; if they wish to publish it, that is entirely their right. I do not intend to publish it.

I give the hon. Gentleman the absolute assurance that no hospital will experience a diminution in the time taken to replenish its blood bank. I also give him the absolute assurance that there will be no change in the directive to the national blood service, which is that it does not make a profit out of the act of donation of human blood.

Mr. Douglas Hurd (Witney)

I am grateful to my right hon. Friend for the way in which he has handled this matter. Will he allay anxiety by assuring us that the Oxford hospitals—and, indeed, other hospitals—will continue to have the full and prompt range of services that they enjoy now? Will he further assure us that the Oxford blood centre and the other centres that will lose processing and testing will remain open and still have a worthwhile job to do?

Mr. Dorrell

I can certainly give my right hon. Friend both those assurances. Every hospital will continue to receive the same timely service that it receives now. The only change will be for those that experience improvements as a result of the development of the chain of national blood service blood banks announced today. The quality of service available to every national health service patient will continue to be built on the quality of reputation that the national blood service has built for itself. My right hon. Friend can have the absolute assurance that all 13 blood centres will continue to exist—what is changing is the processing and testing behind those blood centres.

Mrs. Anne Campbell (Cambridge)

The announcement today will be met with utter dismay in my constituency, especially as the consultation has been carried out in what I believe to have been a very unfair way. Cambridge has had no opportunity to evaluate the effects of the closure of the Cambridge centre on services in Cambridge.

Does the right hon. Gentleman appreciate the profound effect that that will have both on the liver transplant programme at Addenbrooke's hospital, and on the heart and heart-lung programmes at Papworth hospital? They are world-renowned centres of excellence in their fields, and both place a high demand on the transfusion service for blood and blood component supports. Does not the right hon. Gentleman feel that simply leaving a fridge of blood at the Cambridge site is ludicrous in the extreme?

Mr. Dorrell

I join the hon. Lady in recognising and applauding the excellence of the service at both Addenbrooke's and Papworth. I can give the consultants and, more importantly, the patients at those hospitals the assurance that the national blood service will continue to deliver all the things that they have grown used to, with the important addition of an improved research and development function—which will be located in the hon. Lady's constituency and at Bristol. I had hoped that the hon. Lady might welcome that.

Mr. Roger Sims (Chislehurst)

Will my right hon. Friend confirm that the demand for blood has increased steadily in recent years and continues to do so, and that it is therefore essential that there is an adequate number of donors? Will he assure the House that the reorganisation that he has announced today will not diminish the opportunities available to those who wish to give blood? To emphasise the importance of the service, would he care to set an example by giving a little ministerial blood?

Mr. Dorrell

I gave some ministerial blood last week, so I would not be welcome again this week.

My hon. Friend rightly placed importance on the act of donorship, on which the national blood service depends. That is why I placed stress on ensuring that we enhance the facilities available for blood donorship, that the act of donorship is properly respected, and that the arrangements made for donors are as convenient as possible. That is the purpose of the blood donors charter. I welcome the fact that that, at least, has been welcomed by the Opposition.

Mr. Peter L. Pike (Burnley)

The right hon. Gentleman will know that the Lancaster centre has been concerned throughout that the specialist services it provides could be put in jeopardy by his announcement this afternoon. Is that the position, or have there been changes to take account of its fears in that respect?

Mr. Dorrell

The changes that will be implemented at Lancaster are essentially the changes that were originally proposed: to maintain the blood centre, to stop processing and testing, and to ensure that the support services based at Lancaster take part in the national reorganisation that I have talked about. The effect will be to ensure that the specialist support services available from the national blood service respond to the demands made on them by NHS hospitals and are organised in such a way as to deliver the service as efficiently as possible.

Mr. Eric Pickles (Brentwood and Ongar)

I thank my right hon. Friend for listening to the staff and the many supporters of the blood processing unit at Brentwood. Does he agree that the one area of the country that will have a growth in population is East Anglia, and that the decision to retain the Brentwood processing plant will guarantee blood processing within the East Anglia area for all future needs?

On a general point, does my right hon. Friend agree that, before the reorganisation of the blood service, if there was -a shortage of blood in one part of the country and a glut in another, it was not possible to send blood where it was needed, and that sending blood from Scotland to London is therefore something that we should applaud rather than condemn?

Mr. Dorrell

My hon. Friend is quite right to stress the importance of regarding the blood that is contributed to the national blood service as a national resource, which we should be able to use as efficiently as possibly to meet national needs. That is one of the major purposes of the changes that I have announced.

As for Brentwood, my hon. Friend is right to stress the important role that it will now play in meeting the rising demand for blood in central London and in East Anglia. It is also important to underline the fact that the revised proposals for Brentwood allow the development of the research and development facility in Cambridge, whose function is an important part of the development of modern evidence-based medicine. That is an important part of the total package that I have announced.

Mr. Ken Eastham (Manchester, Blackley)

May I ask the Minister for some details about the chairman? Will the job be voluntary, fulltime or parttime? Will the user group be a quango run from Conservative central office, and what salary will the chairman receive, if any?

Mr. Dorrell

There will be no salary attached to the appointment; it will be done as part of Professor Gordon-Smith's commitment to the NHS, to ensure that the NHS delivers a continuing improvement in the service to its patients. Several consultants expressed concern during the consultation about the standards of delivery of the national blood service. The national user group responds to that concern by inviting representatives of the users of the national blood service to form a group to monitor the delivery of standards, and that group's reports will be published.

Sir Malcolm Thornton (Crosby)

I have listened very carefully to my right hon. Friend's statement. While I welcome the assurances that he has given about the service that will be provided, may I draw his attention to the regionally, nationally and internationally respected service provided by consultant haematologists in Liverpool? Has he taken into account in making his decision the fact that this could well jeopardise the wider research basis of developments in Merseyside, and will he consider that further if necessary?

Mr. Dorrell

I have certainly taken account of that view, of which I am well aware. As I said, there was an article in last Friday's British Medical Journal which demonstrated that, in the view of a senior and respected consultant haematologist, that argument does not hold water, and that it is possible to maintain high-quality clinical services, including research, without having a processing and testing base in the relevant blood centre. It is precisely in order to ensure that any concerns about the standards of service that are delivered are met that I have established the national user group to which I have referred.

I have also asked the medical director of the National Blood Authority to consult directly representatives of senior clinical opinion in Merseyside and in Oxford. She reported to me that, as a result of those consultations, she believes that all the clinical questions raised by that consultation were resolved. Of course, that is without prejudice to their right to maintain their opinions, but the clinical questions raised during that consultation have been resolved.

Mr. Dennis Skinner (Bolsover)

Does the Minister agree that his statement probably demonstrates more effectively than many just what makes this Government tick? They are prepared to play with the lives of millions of people throughout Britain by changing the whole system of dealing with blood in other parts of the country when advances in medical science mean that we need more blood. Why should anybody trust this Government to transfer blood from one part of the country to another, when they cannot even transfer water in the middle of November from one part of the country to another? As for this charter and this user group, God only knows what Tony Hancock would have done with that.

Mr. Dorrell

The hon. Gentleman obviously has to sort out his difficulties with his hon. Friend the Member for Peckham (Ms Harman) about the user group and the donors charter. But I did agree with one thing that he said—the changes that I have announced today show what makes this Government tick. To deliver high-quality service to donors and hospitals without waste and as efficiently as possible is what makes this Government tick, and I am very proud of it.

Mr. Barry Porter (Wirral, South)

There was obviously great consternation on Merseyside about the proposals and, to begin with, some serious objections were raised by some clinical people. I was grateful for the very detailed and, indeed, interminable negotiations. As I understood it, we were given an assurance that, unless professional opinion was in favour of the proposals, they would not go forward. Has that support been received?

Mr. Dorrell

That is precisely why I asked the medical director of the National Blood Authority to engage in face-to-face discussions with representatives of clinical opinion on Merseyside. As a result, people maintained their points of view, but no clinical questions raised were left unresolved. In such circumstances, I believe that, if there is the opportunity to improve services to both donors and patients, and at the same time release £10 million for services available elsewhere in the health service, it is my task as Secretary of State to take that opportunity.

Ms Angela Eagle (Wallasey)

But having a discussion with the director of medical services, who then takes a report to John Adey, the head of the NBA, does not signify the consent of clinical experts on Merseyside. I can tell the Secretary of State that there is no consent among clinical experts on Merseyside for this change. When my constituents in the Wirral and the population of the rest of Merseyside consider the results of this so-called consultation, they will realise that all that the right hon. Gentleman has done is go ahead with exactly what was proposed at the beginning, except for switching one of the most badly affected centres from Brentwood and Ongar to Cambridge—

Madam Speaker

Order. I have not yet heard a question from the hon. Lady. This is Question Time, so I must have a question to which the Minister can respond.

Ms Eagle

I began by asking the Minister whether he agreed that sending the medical director along to talk to clinical experts—this is a very important point in Merseyside—signalled that those experts agreed with the proposals. I can tell him that those experts do not agree.

Mr. Dorrell

What the medical director found when she talked to representatives of medical opinion on Merseyside, around Oxford, and, indeed, nationally—this is a national service—was that a number of clinicians had concerns about whether the blood service would be able to deliver the standards of service to which it was committing itself. It is because of that concern that I am setting up the national user group to monitor clinical standards, and to ensure that every NHS clinician who relies on the blood service has the assurance that it delivers the standards to which it commits itself. That is the assurance we can give. I believe that that resolves the clinical questions which arose during consultation.

Mr. Nigel Evans (Ribble Valley)

People who live in rural areas such as Ribble Valley have to travel further to give blood. Will my right hon. Friend give an assurance that the mobile units and the service they receive will not be reduced? A number of people in my constituency have blood belonging to rarer blood groups, and are therefore asked more often to give blood up at the Lancaster centre. Will my right hon. Friend give an assurance that they will be able to do so in future?

Mr. Dorrell

The answers to my hon. Friend's questions are yes, and yes. There will be no diminution of the local collection service. Indeed, in many parts of the country, it will be enhanced. All the existing blood centres will remain open, as both donor centres and blood banks.

Mr. Andrew Miller (Ellesmere Port and Neston)

Does the Secretary of State agree that, the smaller the number of processing centres, the greater the risk of cross-infection of blood products? Does he agree, therefore, with clinicians in Liverpool who believe that the closure of the service there has not taken into account all the issues that should be taken into account in the public interest?

Mr. Dorrell

If the hon. Gentleman's point had not been taken into account, I would agree that we had not taken account of everything that we should have taken account of. We have taken that point into account, and that is why, although the capacity is being reduced, we are continuing to plan for excess capacity—a safety margin—in every part of the country to accommodate precisely the uncertainty to which the hon. Gentleman refers. We are reducing overcapacity to release money to maintain patient care elsewhere in the NHS.

The hon. Gentleman asks whether it is true that we have taken account of the effect on the blood service of unforeseen circumstances in individual blood centres. The answer is yes.

Mr. David Congdon (Croydon, North-East)

I welcome my right hon. Friend's statement and his determination to achieve value for money in such an essential service, thus releasing £10 million for additional patient care. What will the benefits be of the two additional blood centres, one of which will be in London? Will he confirm that, despite the uncertainties that have been alleged by Opposition Members, the daily collection of blood is up by 6 per cent. on the 1993 figure?

Mr. Dorrell

It is true that the daily collection of blood has been meeting requirements, and has been on an upward trend. The two new national blood service blood banks will be established in south Lincolnshire and in central London, so that every NHS hospital has the assurance that its own blood bank can be replenished within two hours. That is a standard to which the national blood service should work. In parts of the country, the service occasionally falls below that standard. The investment of extra resources in the two new blood banks will provide an assurance to every NHS hospital in England.

Mr. Peter Kilfoyle (Liverpool, Walton)

Many of us believed that the Secretary of State would come to the issue with an open mind, and are bitterly disappointed that he has failed to do so. Does he recall a meeting with an all-party delegation of Merseyside Members of Parliament last month, at which the director was present? Does he recall that what she averred about the clinicians' position was flatly contradicted by Members of all parties? What has the Secretary of State done to satisfy himself—not the director, who had clearly made up her mind before she came to the meeting—about what the majority of clinicians believe should be done?

Mr. Dorrell

After that meeting, I asked the medical director to talk to all the leading clinicians on Merseyside and in Oxford to resolve the clinical questions that arose during the consultation.

Ms Eagle

They did not.

Mr. Dorrell

The hon. Lady says that they did not. The fact is that the medical director met senior clinicians on Merseyside and in Oxford. She addressed and resolved the clinical questions. Of course individual citizens are entitled to their views. My responsibility is to deliver national health service medical services to the highest standard possible and as efficiently as possible. That is the obligation which this statement discharges.

Mr. Michael Fabricant (Mid-Staffordshire)

As a regular donor of A Rh-positive blood, I welcome this statement, which is more than any Opposition Member has done. [Interruption.] Opposition Members do not seem to give blood or, if they do, no one has mentioned it. Is my right hon. Friend aware that many people feel that there have been difficulties when they move home in terms of records not being transferred from the old area into the new one—a problem that I have experienced? Will that problem be alleviated with a new national blood service?

Mr. Dorrell

Yes, my hon. Friend is absolutely right. The existing structure of the blood service introduces unnecessary and anomalous divisions between different parts of the country. The establishment of a national computer system will resolve that problem, and my hon. Friend's records will be able to move freely around the country.

Mr. Andrew Smith (Oxford, East)

This is a very sad day for Oxford and the other blood centres affected, and there has been a betrayal of the commitment and excellence of the staff in those centres. In addition, there has been a clear breach of the undertakings that were given, that the Government would proceed only with proposals which commanded clinical confidence. Does the Secretary of State accept that there are clinicians who remain opposed to the proposals? If things do not work out as the right hon. Gentleman expects, is he prepared to reconsider the matters before the functions are closed?

Mr. Dorrell

Better than that, Madam Speaker: I have set up a committee which is free to report if things do not work out as I have set out. If the user group reports that the service provided by the national blood service does not meet the needs of clinicians operating in the NHS, we will take the steps necessary to ensure that it does meet those standards. But since the management of the blood service believes that it can deliver an enhanced service for lower costs, I believe that the right thing for the Secretary of State for Health to do is to ensure that that higher quality of service is delivered, and to use the savings made to treat more patients in the NHS.