Blood donationBMJ 1996; 313 doi: http://dx.doi.org/10.1136/bmj.313.7054.428 (Published 17 August 1996) Cite this as: BMJ 1996;313:428
Britain's blood service is committed to spirit of altruism among donors
EDITOR,—Ann Oakley raises a moot academic point in her editorial about whether Titmuss's survey of people's reasons for donating blood needs to be repeated.1 Unfortunately, her superficially interesting hypothesis is undermined by its construction around a series of allegations that do not stand up to even minimal analysis.
Not all blood services are “in a mess.” The National Blood Service in Britain, which is recognised as among the finest and the safest in the world, goes from strength to strength, meeting hospitals' ever increasing demand for its products and services thanks to the increasing number of volunteer unpaid donors. Blood services worldwide have had to face the challenges of HIV infection and hepatitis C, and in Britain this has resulted in increasingly safe products. In common with most medical interventions, however, a blood transfusion is not free of risk. The decision to transfuse blood will remain what it has always been: a balanced judgment about the clinical risk of the alternatives to the patient.
The National Blood Authority has not recommended replacing the 14 blood centres with three zonal management teams. The document issued by the secretary of state, Stephen Dorrell, when he approved our proposals makes it clear that all blood centres are to remain open. The proposals are not a cost cutting exercise but rather a cohesive plan for the future that will improve quality, efficiency, and effectiveness to the benefit of patients and donors. There is no profit motive in the British blood supply; the amount of blood collected is determined by hospitals' need for red cells. Plasma based products for use in the NHS are made from the plasma separated from the red cells. Only if a surplus of such products remains after NHS demand has been satisfied is this surplus offered for sale abroad, at prices that only cover the cost of production. This has been practice for many years.
We are fortunate in Britain that the spirit of altruism that underpins our unpaid, volunteer donor base continues to prevail. It is a spirit to which the National Blood Service is committed. If Oakley is arguing for the increased input of donors' views in a service that depends on their gift, I do not necessarily disagree. She may wish to know that the service has already started such a process with, for example, the publication of a donors' charter and a range of other initiatives. It is a pity that she bases her contention on such a catalogue of false premises.