Blood transfusion safety ‘compromised’ by lack of investment

BLOOD transfusion safety could be compromised because of insufficient investment during the economic downturn, the Irish Blood Transfusion Service has warned.

“In the past there has not been enough investment in blood transfusion safety and the fear now is there will not be enough investment in the future,” medical and scientific director Dr William Murphy said yesterday, as its report for 2010 was published.

Chairwoman Katharine Bulbulia said the economic climate posed challenges for the blood bank and that the board would support the HSE in making difficult decisions.

Dr Murphy said he was concerned that blood transfusion improvements were costed as medicines, not disaster prevention steps.

“Investment should not be costed as simple health economic measures,” he said.

“I am not getting at the Health Service Executive, my issue is with the whole international community of health economics — that they are not thinking straight.

“When we introduced virus testing everybody said okay but it costs a lot more per quality adjusted life year saved than would normally be paid,” he said.

Dr Murphy said blood transfusions had contributed to the spread of HIV and there would have been a huge public outcry if there had been a transfusion associated spread of variant Creutzgeldt-Jacob Disease (vCJD).

“Measures to reduce risk should be considered more as measures to reduce civil risk, like the risk associated with aviation, road traffic or environmental hazards.”

Dr Murphy was worried that, as the decline in the economy continued, the problem of affordability of safety measures for the blood supply would become more intense.

Two months ago, the Health Information and Quality Authority (HIQA) said technology that could safe lives from blood transfusion vCJD was not “cost effective”.

HIQA estimated that the measure proposed by the Irish Blood Transfusion Service, initially costing about €11 million annually, could prevent two deaths from vCJD over 10 years.

Dr Murphy said he was not saying HIQA’s decision was wrong. He was more concerned that there was a publicly visible process, with the final decision made by an elected representative, in this case Health Minister James Reilly, and not a faceless individual.

“It is not my place to make a life or death decision — nobody votes for me, nor is it a decision for the Department of Health’s secretary general or chief medical officer. We are not publicly accountable.

“HIQA did say that the screening process was not cost effective compared to other healthcare interventions but blood transfusion is not a simple healthcare intervention — it’s a civil risk so you pay extra for safety and you don’t cost it in terms of quality life adjusted years,” he said.