National Blood Authority

HC Deb 08 April 1998 vol 310 cc353-64 3.32 pm

The Secretary of State for Health (Mr. Frank Dobson)

I wish to make a statement on the National Blood Authority.

Last summer, I received representations from local Members of Parliament and local doctors against the transfer from Liverpool of bulk processing and testing of blood. That had been approved by the previous Government, and was planned to be completed by 19 September 1997.

Having looked into what was happening, I decided to appoint Professor John Cash, then president of the Royal College of Physicians of Edinburgh and former director of the Scottish National Blood Transfusion Service, to conduct an independent review of the proposed transfer. Professor Cash's review was welcomed by the chairman of the National Blood Authority, Sir Colin Walker.

On 9 September, Professor Cash submitted to me an urgent interim report confirming that there had been a serious breakdown of trust between the National Blood Authority and many local people and clinicians in Liverpool. He also advised that the rationale of the original decision to move the service from Liverpool remained unproven, but that the rundown of the Liverpool centre had gone so far that, for reasons of patient safety, it should go ahead. He recommended that an independent user group should be set up to monitor the service, and that a new leader be appointed for the Liverpool blood centre. I accepted those interim recommendations, while bitterly regretting that the original transfer decision had gone so far that it was unsafe to stop it.

Professor Cash submitted a draft final report, which was passed to the National Blood Authority for comment. Points made by the NBA were considered by Professor Cash before he submitted his final report to me. Today I am publishing his final report, which presents a damning indictment of the NBA's treatment of the Liverpool blood centre and the clinicians it serves.

Professor Cash concluded: that, over the past three years, the blood transfusion service based in Liverpool had been very severely damaged; that the position at the centre remained far from satisfactory; that it would continue to under-perform unless further action was taken; and that there was a serious crisis and widespread loss of confidence in the National Blood Authority by Merseyside and north Wales clinicians, hospital blood bank medical and laboratory scientific officers and the general public.

In the light of what he discovered in Liverpool, with my agreement Professor Cash extended his review to consider certain aspects of the general performance of the National Blood Authority. He concluded that many of the concerns that had emerged in Merseyside and north Wales were also evident in Oxford and East Anglia. A number of issues of wider concern about the overall management of the blood service applied across the country. All the evidence pointed to a conclusion that the NBA was failing to maintain appropriate operational connections with many of its management teams.

Professor Cash also concluded that the chairman of the board had often, perhaps perforce, been too close to the day-to-day operational aspects of the national blood service, and on occasions appeared to have been misinformed or to have misunderstood briefing that he received. There appeared to be a disturbing isolation of NBA headquarters from operational realities. Instructions had been inappropriately researched and not subject to effective consultation.

Since 1995, the national blood service has been exposed to a central management structure and a command and control culture that seemed to have insufficient regard for the views of customers and staff, and the interface between patients and the service. Professor Cash also drew attention to shortcomings in the arrangements within the NHS Executive, the Department of Health and user groups for monitoring the performance of the blood service.

Having considered Professor Cash's report and other representations about the performance of the NBA, I called in Sir Colin Walker, the chairman of the National Blood Authority, to say that I was concerned about the overall performance of the authority, and that, as a general principle, I believed that those at the top of an organisation had to take responsibility for it. I explained that, in view of the extra difficulties that the blood service is likely to face, I was not confident, in the light of past performance, that it was in the interests of the NHS for him to remain as chairman of the NBA.

Discussions have subsequently taken place between my officials and solicitors acting on behalf of Sir Colin Walker. He has refused to resign, so today I have dismissed him. I have appointed in his place Mr. Mike Fogden, the chief executive of the Employment Service under the previous Government. Mr. Fogden's appointment was carried out with the agreement of Sir Len Peach, Commissioner for Public Appointments.

Professor Cash made a series of recommendations about the future of the blood service in Liverpool. While pointing out potential risks to patients, he does not rule out reversing all or some of the transfer of services to Manchester. He recommends that the performance be monitored closely, and the position reviewed after one year's operation.

Professor Cash strongly recommends that, in the meantime, an action plan should be developed by the blood service, the north-west region of the NHS and Liverpool university medical school to upgrade the services in the Liverpool centre by such possible measures as the establishment of a regional stem cell service and a regional tissue bank, arrangements for specialist registrar training in haematology and transfusion medicine, and reviewing the development of the zonal reagent unit.

Professor Cash said that the Liverpool centre should be upgraded physically; new management arrangements should be put in place; more effort should be put into attracting and retaining top-quality staff; better consultative services should be available for doctors in the area; and there should be a drive to recruit more donors. I accept all Professor Cash's recommendations.

I have already appointed a transition director, Professor Bellingham, who is working to ensure that confidence in the centre is rebuilt. I have also established an independent clinical user group. I said in September that I wanted to maintain and improve blood services for the people of Merseyside and north Wales, and that remains my goal.

The new chairman's first task will be to implement those recommendations and to consider urgently the broader changes that are clearly needed in the National Blood Authority.

During a major reorganisation of their work, the staff of the blood service have worked very hard and effectively to continue to deliver a secure service to the clinicians whom they supply with blood and blood products. They—and 2 million blood donors in England—have done us proud. Both donors and staff deserve a new and better lead from the top. Under this Government, they are going to get it.

Mr. Patrick Nicholls (Teignbridge)

I thank the Secretary of State for his courtesy in telephoning me earlier today to give me the outline of his statement, rather than delivering it within the usual time limits.

Does the Secretary of State agree that the most important aspect of his statement is a belief that the medical profession's and public's confidence in delivery of blood services should be restored? Will he take this opportunity to confirm that the original reforms were not driven merely by a desire to cut costs?

Is it not true that—with delivery of blood services increasing at about 4 per cent. per annum—proper delivery of services could have yielded savings, which were earmarked to go straight back into the national health service? Is it not a fact that the original reforms were underpinned by a belief that, if duplication and administration costs had been saved, an extra £10 million might have been available to plough back into delivering primary care services? The savings were never made.

Is it not implicit in the Secretary of State's statement that we are dealing not so much with a defect in the structure of the National Blood Authority, as currently constituted, as with a chronic defect in its management and leadership? The right hon. Gentleman himself mentioned operational connections and the management team. The defect must be in leadership and in the management team. If it was not such a defect, I have absolutely no doubt that the right hon. Gentleman would take action to deal with the real defect in service delivery—frankly, by going back to the drawing board, and starting all over again.

As I said, it is essential to restore the total confidence of the public and of the medical profession in the services provided by the NBA. Will the Secretary of State therefore reconsider two passages in his statement? First—referring to Professor Cash and his recommendations on the future of the blood service in Liverpool—the right hon. Gentleman said: While pointing out potential risks to patients, he does not rule out reversing all or some of the transfer of services to Manchester. He recommends that the performance be monitored closely and the position reviewed after one year's operation. Some paragraphs later, the Secretary of State went on:

I also want to reassure the people of Merseyside today that the safety and supply of their blood services is now and will continue to be maintained.

Those two statements seem to be contradictory. If the Secretary of State believes that there are substantial grounds—or any grounds—for thinking that services are not properly run, effectively managed or somehow unsafe, the entire matter will have to go straight back into the melting pot. If we are dealing with potentially unsafe practices, a year is far too long to wait for a review.

Implicit in the right hon. Gentleman's comments must be a belief that the basic structure is sound. If that is so, it must be entirely right for the practices of the new management—those of us who know Mike Fogden have great confidence in his ability to grip the situation—to be reviewed. If we are dealing with unsafe practices, they cannot possibly be left for a year.

I commend the right hon. Gentleman for his closing words on the reaction among user groups, blood donors and the Haemophilia Society. The fact that some user groups and donors felt pretty remote from the system, when their contribution to it is absolutely crucial, was one of the perceived defects of the previous management.

Bearing in mind the way in which the right hon. Gentleman presented his statement, I shall not comment on his condemnation of command and control cultures, tempting though that may be. On several occasions, he has been commendably frank in deploring the leaking of statements. It will not have escaped your notice, Madam Speaker, and I cannot believe that it has escaped the right hon. Gentleman's notice, that the words that he used in today's statement, which I welcome, bear an uncanny similarity to a report in today's Evening Standard to an extent that would stretch beyond credulity even the most naive person's belief in the theory of coincidence.

Mr. Dobson

I welcome the hon. Gentleman's welcome for the report. He is quite right in saying that, particularly on Merseyside, and generally, the confidence of clinicians who rely on the blood service for the blood supply to permit them to carry out the operations that they need to carry out, the confidence of patients on whom the clinicians carry out those operations, and the confidence of the donors on whom the blood service relies, must be our principal concern. I hope that the changes that I am in the process of making fulfil that; they are certainly intended to.

I thank the hon. Gentleman for his welcome of Mr. Mike Fogden's appointment. It is essential that all those connected with the National Blood Authority and the blood service get behind Mr. Fogden in bringing about the improvements that everyone wants.

I would not suggest for a minute that the blood service does not need reorganisation and certain structural changes to improve it. I agree with the hon. Gentleman that the biggest problem has been the management and leadership behind those changes. My own view is that we must, with all such things, try to keep structural change to a minimum. However, there are clearly faults in the reporting process in the national blood service through to the National Blood Authority, the National Health Service Executive and the Department of Health, so some minor structural and reporting changes may need to be made if we are to bring about the changes we want.

On the question of safety of blood supplies on Merseyside, my reluctant agreement to the transfer of the service from Liverpool to Manchester was based on the advice of Professor Cash that it would be less safe for patients if the Liverpool centre continued both processing and testing. So far, monitoring suggests that arrangements are safe. I expect them to remain safe; that is the object of the exercise. We need to see whether, on balance, after a year's operation, both the safety and the general effectiveness of the service on Merseyside would be substantially improved by the return of some or all of it from Manchester to Liverpool.

I say to the 2 million people who are blood donors, "We depend on you." Our service is virtually unique in the world, in that people freely give their blood for the benefit of others. It is up to those of us with any responsibility for the service to ensure that all their voluntary effort is put to best use, that none of it is wasted, and that the good will that they put into the system is not squandered by other people.

Mrs. Louise Ellman (Liverpool, Riverside)

I thank the Secretary of State for his strong statement and decisive action. His decision vindicates the very hard work of campaigners who fought so hard to preserve Liverpool's centre of excellence. I am delighted to hear today's news. Does he agree that the situation left in the National Blood Authority means that one centre in Manchester is conducting testing and processing on behalf of 7 million people and more than 35 hospitals throughout the entire north-west and some of north Wales? Will he assure the House that the monitoring that he will carry out over the next 12 months will not only take account of the specific needs of Liverpool and Merseyside, but will deal with the over-centralisation of the National Blood Authority, a process set in train by the previous Government on the pretext of rationalisation?

Mr. Dobson

I confirm that the only blood centre in the north-west that undertakes both processing and testing is now in Manchester. I have always had my doubts about the sense of that arrangement.

I too pay tribute to various people, including my hon. Friend herself and some of her colleagues on Merseyside, for their campaigning.

I must also pay tribute to the clinicians on Merseyside, who, whenever I was advised that everything was all right, got in touch with me to tell me that it was not. The National Blood Authority would come up with some new statement on what it intended to do and would tell me that the clinicians on Merseyside were satisfied. The clinicians would then tell me that they were not satisfied, and that was repeated several times. That is why I had little confidence in the people at the top of the National Blood Authority, and it is one of the reasons that at least the chairman has to go.

Mr. Simon Hughes (Southwark, North and Bermondsey)

I thank the Secretary of State for his statement and for the prompt work by Professor Cash. We endorse the decision to replace the chairman.

Given that Labour made pre-election pledges to reverse the decision to close the Liverpool blood centre; given that representations were on the Secretary of State's desk in May last year; and given that Professor Cash took only three weeks to write his interim report, why was the appointment of the inquiry delayed until August, by which time it was too late to reverse the Liverpool decision? Had it been appointed in May, it would not have been too late.

What is the implication of the Secretary of State's decision on the centres in Cambridge, Oxford and Plymouth, which were also closed under the previous Government? Does he agree that it would be better if the blood services were run regionally and made democratically accountable within the normal national health service structures?

Does today's announcement mean that the necessary funding will be made available to enable the National Blood Authority to do its job properly, that the authority will be service-driven and not cost-driven, that blood services will be available throughout the country when and where they are needed, and that they will be of the quality needed?

Mr. Dennis Skinner (Bolsover)

No matter what you say, you'll never satisfy him.

Mr. Dobson

My hon. Friend is right to say that the Liberals appear never to be satisfied. "Eternal dissatisfaction" is their motto.

We won the election on 1 May; I took office on 3 May, and received representations about the situation in Liverpool towards the end of May. I very properly started checking whether those representations were correct. I got all sorts of advice, went back time and again, and eventually decided that some of the advice I was getting was not worth a light. That is why I then appointed Professor Cash.

My understanding is that the rundown of services in Liverpool had been going on for the best part of two years. Some people who work in Liverpool had transferred to Manchester, and some had moved there. By that time, the situation was irreversible. There was no question of any delay on our part.

The situation is as follows: we are now taking steps to improve the blood service and to re-establish public confidence in it. I have asked Mr. Mike Fogden to take a close look at what is happening, on Merseyside and nationally, and to tell me what, in his judgment and in the judgment of others, is the best thing to do. I will then consider his advice very carefully, and take decisive action on what he recommends.

Mr. Robert N. Wareing (Liverpool, West Derby)

Does my right hon. Friend accept that his statement will be warmly welcomed by the people of Merseyside, whose views have been completely ignored by the National Blood Authority? Does he agree that we should commend for the work they have done not only hon. Members but all those in Liverpool and Merseyside—including the Liverpool Echo—who have campaigned against the decision? Will he do all he can to ensure that the status quo that existed before last year will be restored? Given the transportation difficulties between Manchester and Liverpool, the very idea of transferring the blood service from Liverpool to Manchester was one of crass stupidity.

Mr. Dobson

As I said last September and have repeated today, I bitterly regret that the advice I received from Professor Cash was that to keep the Liverpool blood service in the state in which we inherited it would endanger the safety of patients on Merseyside. That was why the transfer had to go ahead. The situation is being monitored closely, and one of the things I shall be asking Mike Fogden to do is come to me after the situation has been monitored for 12 months and give me a considered view on what should be done.

However, I shall not indulge in sleight of hand and try to deceive people on Merseyside. I am not saying today that I can guarantee that the service will come back from Manchester to Liverpool, because it may not. The issue will be looked at rationally and carefully, but the trouble is that the status quo is now different from when the previous Government took the original decision to move the service from Liverpool to Manchester.

Mr. Michael Fabricant (Lichfield)

The Secretary of State rightly paid tribute to the many hundreds of thousands of blood donors in this country—incidentally, I wonder whether he is a blood donor. As we approach the holiday season, when there is a shortage of blood, will he give an assurance to blood donors that there is no question of any danger to donors, either in Liverpool or in any other part of the country?

Mr. Dobson

There should not be any danger to donors from donating blood to the blood service. The only reason I do not donate blood is that the blood service will not take my blood, because I have had jaundice in the past.

Maria Eagle (Liverpool, Garston)

I warmly welcome my right hon. Friend's statement today—there will be dancing in the streets of Liverpool tonight. The matter has been one of great public concern and we have massive public meetings attended by thousands of people, who I know will warmly welcome this statement.

In view of the appalling findings of the Cash report, does my right hon. Friend believe that other senior managers at the National Blood Authority should also be considering their positions—especially Mr. John Adey, the chief executive? Will he reassure me and other Labour Members that Sir Colin Walker is not walking away from this with a financial settlement?

Mr. Dobson

Taking things in reverse order, he is getting no compensation whatever.

One of the things Mr. Mike Fogden will have to do in his job as the new chairman is look at the general responsibility of people other than his predecessor for the present state of organisation in the National Blood Authority. No doubt he will come to his own sensible and, I expect, tough-minded conclusions. However, I do not have the statutory authority either to appoint or to dismiss people who are employed by any part of the national health service.

Mr. Andrew Lansley (South Cambridgeshire)

The Secretary of State will be aware that I have constituents who work at the National Blood Authority site at Addenbrooke's hospital who will be directly affected by today's statement. Does he agree that it is absolutely right that the chairman should have the authority and the freedom to restructure his management team, given that distinct reservations have been expressed in Merseyside and elsewhere about the quality of administration and management in the NBA?

Following from what the hon. Member for Southwark, North and Bermondsey (Mr. Hughes) said, will the Secretary of State comment on Professor Cash's findings on the transfer of services from Cambridge, Oxford and Plymouth? Obviously, I am interested in Cambridge, but these are general matters.

Furthermore, does the Secretary of State recognise that these are testing times for the national blood service? The difficult issues on which he has made announcements in the past several weeks include the theoretical, but not proven, risk of new variant CJD in blood transfusions, and therefore the importance of ensuring that policies are followed rigorously throughout the service.

Finally, will the right hon. Gentleman assure those who work in the NBA that their position will be recognised as well as the greater customer focus, which I am sure the staff will find valuable in the future?

Mr. Dobson

I hope that, within the limitations of the law, the new chairman will have a free hand when considering and carrying out whatever measures he thinks necessary to re-establish public, staff and donor confidence in the blood service. The transfers involving Cambridge and, separately, Oxford were a lot further down the road, and had been completed long before we came to power. It would not be sensible for me to contemplate reversing them. The transfer from Plymouth to Bristol will not go ahead.

I accept the hon. Gentleman's point. These have been testing and trying times for people working in the blood service, who have been doing their job and managing to deliver safe blood supplies and blood products to the clinicians who need them, to the benefit of the patients who need them, at a time when the service has not been well managed—indeed, has been insensitively managed.

The staff have been subjected to the process of reorganisation, and it is immensely to their credit that they have managed to maintain the standards they have in extremely trying and difficult times. It was partly because I was not confident of the capacity of the leadership of the NBA that I needed to make the change, in view of the problems that might arise and the difficulties and scientific rigour that will have to be applied because of the possibility of the transfer of new variant CJD.

Mr. Derek Twigg (Halton)

May I also welcome my right hon. Friend's statement, and offer my support for the sacking of Colin Walker, which was the right decision?

My right hon. Friend will be aware that what happened in Liverpool directly affected areas such as mine. People in Widnes and Runcorn in north Cheshire, as well as in other parts of Cheshire, supported the Liverpool Members of Parliament and others in their campaign for the Liverpool transfusion centre.

Does my right hon. Friend share my amazement about the statement by the hon. Member for Teignbridge (Mr. Nicholls)? The Conservatives had all the information that my right hon. Friend has, but the difference is that he has done something about it and they did not. Some of their statements are crass, given that information about what was happening in the Liverpool transfusion service and the service as a whole was fed back at the time to Ministers in the previous Government. I really am amazed. Does he share that amazement?

Mr. Dobson

Very little amazes me about the previous Government. Obviously, I do not have access to their records, but I understand that my immediate predecessor shared many of my concerns. It seems a pity that he did not do something about it.

Dr. Evan Harris (Oxford, West and Abingdon)

I certainly associate myself with the remarks made by the hon. Member for Halton (Mr. Twigg) about the approach of the Conservative party. However, I cannot share the view of the hon. Member for Liverpool, Garston (Maria Eagle) that there will be dancing in the streets of Liverpool, given that the service is apparently not to be restored there.

As a former Oxford clinician, a current Oxford donor and, perhaps, a future Oxford patient, I must press the Secretary of State on whether there is any chance of a reversal of the move from Oxford. If the new chairman of the National Blood Authority decides that that would be in the best interests of donors, patients and clinicians, will he be allowed to recommend it, and will the Secretary of State fund it?

Finally, will the right hon. Gentleman comment on the statement in paragraph 13 of the report, of which he will be aware, that Professor Cash feels that the NBA press release approved by the Department of Health on 14 August, which stated that there were improved services in Oxford and Cambridge, was misleading? We have had a series of misleading statements in the services in Oxford and in other areas. There is a case for restoration of bulk processing and testing at Oxford and at Cambridge.

Mr. Dobson

I simply cannot raise false hopes, in line with the general Liberal Democrat approach to the world. The transfers affecting Oxford and Cambridge took place some time ago. If the new chairman comes to me and says that he has considered matters carefully and thinks that those decisions should be reversed, we shall have to consider seriously the proposition that he might put to us; but it would be raising false hopes to suggest that that will be the first thing on his mind. To reverse every damn thing that the previous Government did that was stupid would take all the time and money in the world, and we do not have it.

Mrs. Linda Gilroy (Plymouth, Sutton)

I warmly welcome my right hon. Friend's announcement that the proposal to transfer the blood service from Plymouth to Bristol, 125 miles away, will not now go ahead. That will be warmly welcomed, not just in Plymouth but throughout Devon and Cornwall. I urge my right hon. Friend, in the further review and in re-establishing confidence in the service, to take particular account of rural areas and areas such as mine, where holiday visitors put significant additional pressure on the blood service.

Mr. Dobson

I thank my hon. Friend for welcoming the decision on Plymouth. I hope that the Plymouth blood service will continue to prosper, provide a high quality service and enable the prompt delivery of blood supplies and blood products to whomever needs them in the south-west peninsula. That is the object of the exercise.

Mr. Peter L. Pike (Burnley)

My right hon. Friend will recall that I raised this issue several times in the House before the general election. What he has said today proves to us that what the staff told us at the time was correct, and what the chairman and chief management told us was not only incorrect but misleading. Will my right hon. Friend consider the situation at the third centre in the north-west, the Lancaster centre, which is of particular importance to the north of Lancashire and further up in the north-west? It was an excellent centre, but it was equally affected by the changes made at the same time in Liverpool.

Mr. Dobson

I endorse my hon. Friend's point. From time to time, the National Blood Authority sought publicity, saying what an excellent job it was doing, when the money would have been better spent recruiting more donors.

The closure of the Lancaster processing facility has been completed. I hope that all the monitoring arrangements are in place, and that we can ensure that people in north Lancashire are benefiting from a good-quality, safe blood service. That is the object of the exercise. I know that Mike Fogden will enter into his new task, not quite with an open mind, because his mind is full of a commitment to improve the service and re-establish public, donor and staff confidence in it, but with the object of ensuring that the best services are available throughout the country. No doubt he will come to me with whatever propositions he feels are necessary to deliver that in the future.

Miss Geraldine Smith (Morecambe and Lunesdale)

I welcome my right hon. Friend's statement and his decisive action. The Lancaster blood centre in my constituency was transferred to Manchester, despite sound arguments and a huge public campaign against it. Is there any possibility that that decision can be re-examined and reversed, because that would be welcomed by the people in my constituency and the neighbouring constituency of Lancaster and Wyre?

Mr. Dobson

I fully understand and sympathise with my hon. Friend's view. I am not in the habit of leading people on. If I were to suggest that there was a likelihood of bulk processing and testing being restored to Lancaster, I would be doing just that. It may be that, in the fulness of time, changes will be made—that may be one of the answers. However, it is not particularly likely at this time. I hope that, as a result of the change I have made and the changes that I confidently expect Mr. Fogden to make, people's confidence will be restored.

Some of these things are not easily reversible. I suspect—I do not know for sure—that some of the highly trained technical and scientific staff who worked in the Lancaster centre may have transferred their homes to Manchester and be working there, with their children going to schools in Manchester. We cannot just reverse things: it is not a simple thing to do. What is crucial is whether people in north Lancashire will be getting a top-quality service. If they are not, we will have to make some changes.

Mr. Tam Dalyell (Linlithgow)

May a Scot, who was involved with Professor John Cash in a previous incarnation, commend the Secretary of State for his good judgment in appointing him? I also commend my right hon. Friend for appointing Mike Fogden. As Dick Crossman's parliamentary private secretary, I can say that he is one of the few civil servants to have escaped unscathed and with flying colours in the Crossman diaries. I have two substantive questions. First, is there not a general problem of a shortage of laboratory scientific technicians and officers? Is that not a national problem? Secondly, the Secretary of State said: the chairman of the board had often, perhaps perforce"— I am not sure what that means— been too close to the day-to-day operational aspects of the NBS and on occasions appeared to have been either misinformed or misunderstood the briefing he received. Can my right hon. Friend expand on that? It is a mind-boggling statement. I hope that the Secretary of State is right, and the solicitors are wrong.

Mr. Dobson

That is Professor Cash's wording, not mine. He had interviews with all sorts of people involved, he looked at a great deal of the written material, and he came to that conclusion. As my hon. Friend has pointed out from his vast depth of knowledge, Professor Cash is a person of immense distinction. He did a brilliant job running the Scottish blood transfusion service, and has just ceased holding the eminent position of president of the Royal College of Physicians of Edinburgh—a title for which most people in this Chamber would be willing to give their right or left arm—

Mr. Nicholls

Including you?

Mr. Dobson

Oh, certainly. I would find that an immense distinction.

I am willing to accept Professor Cash's judgment in these matters. As for Mike Fogden, it is certainly true that anybody who comes totally unscathed out of the Crossman diaries is clearly a person of greater merit than I had thought before.

It has never been brought to my attention that there is a general shortage of scientific laboratory staff in the national health service. However, it is crucial that we continually and continuously recognise their immense contribution to a top-quality, science-based health service. Those people have been badgered about and messed around, and their lives have been changed because of management fashion. That is what makes people leave the service, and deters good people from joining it. That is why we have to make these changes.

Mr. Ben Chapman (Wirral, South)

I join my colleagues in welcoming my right hon. Friend's statement. However, the steps taken in relation to the blood transfusion service in Liverpool now seem to have been wholly mistaken, on the basis of misinformation, incompetence and poor management. I believe that, as my right hon. Friend the Secretary of State said, it was right that at least the chairman was dismissed. As he also said, it is right that others should consider their position.

These are not easy times for Merseyside, and they have not been for a long while. As we are trying to improve our image and fighting to retain jobs and services, we could do without negative decisions, especially when they are wholly unnecessary. I hope that my right hon. Friend will again join me in condemning the decision and its effect—albeit temporary, as I hope that all the services will be restored to Liverpool.

Mr. Dobson

When my hon. Friend has the opportunity to read Professor Cash's report, he will see that it mentions the need to consider the impact on the great city of Liverpool, and on Merseyside generally, of the transfer of any national body. The city has been run down, discarded and cast aside for far too long, and we must start reversing that process—I hope that what I have announced will be a minor contribution to that. As to people considering their position, I asked Sir Colin Walker to consider his—I think that he considered it safe, but he was wrong.