This blog is mainly about the governance and future of policing and crime services. (Police & Crime Commissioners feature quite a lot.) But there are also posts about the wider justice system. And because I am town councillor and political activist, local & national issues are covered a little, as well.

Thursday, November 1, 2012

Blood money (part two)

Previously, I have been raising concerns that the NHS blood & transplant service is in effect, subsidising profit making health care. My earlier blog post has been one of the top trending posts on this blog in the last month or so. You can read part one here.

I had a reply a couple of days ago to my challenge to the service. Here it is, reprinted in full:
Further to your conversation with our Customer Services team on 4 October and your subsequent email requesting further information from NHS Blood and Transplant (NHSBT) regarding the price of blood and the cost to private hospitals. 
I am writing to advise you that we are able to provide you with the following information in response to your request.  
I can confirm that NHSBT provides blood products for all patients equally, regardless of where they are being treated. The price of blood that is charged to all hospitals includes the costs that NHSBT need to recover for the collection, manufacturing, testing and issue of each blood component. However while the cost of routine deliveries to NHS hospitals are included in the price of blood, private hospitals are charged an additional fee for every delivery NHSBT makes to them. In addition many private hospitals have agreements with their local NHS hospital that if they order blood products for a patient that aren’t used they will then give the unused product to the local NHS hospital free of charge rather than letting it go to waste. 
Decisions about the price of blood are made by the National Commissioning Group (NCG) which consists of representation from the Department of Health, NHSBT, the National Blood Transfusion Committee (NBTC) and several Consultant Haematologists from NHS Hospitals. More information about this group including, previous meeting minutes can be found via the following link;
So, private hospitals are charged a delivery fee, but other than that they are receiving blood at the same price as the NHS.

In my view, this is equivalent to a subsidy since no commercial provider of blood products could afford to offer their services at cost price to all their customers. They would go out of business. This means that your blood and taxes are helping profit driven private health care services make bigger profits.

Do you find that acceptable?

If you are a donor, how does this make you feel?


For info, here is the email I sent them:
I have just had a useful phone conversation with a member of your team about the commercial mechanics arising out of the points you have made to me. She assured me that the unit cost you cite is what you require to run your organisation overall. In other words, you are not making a profit out of the blood that you collect. The unit cost is there to pay for all the processing and staff time (etc) that it takes to collect, store and ship the blood you have collected out of people like me. 
Firstly, have I understood this correctly?
To be absolutely clear, I think that any human being in need of blood should be able to get it. No question about that. However, blood is one of a number of items that any hospital needs in order to function. Other items include staff uniforms, medical drugs, equipment etc. Many of these (perhaps even most of these items) are provided by profit making companies who, not unreasonably, expect the NHS and Private hospitals to pay at more than cost price. If they didn’t, those supplying companies would go bust.
So therefore I am wondering how it is that you provide blood at cost price to both NHS and private hospitals. Because as it is cost price, you are in effect discounting from a market rate (one that you would have to charge were your organisation to be a profit making company like a private hospital) and consequently you are subsidising your customers – both NHS and private bodies. Moreover, you are subsidising them based upon the fact that blood is donated freely to you by me and people like me. So it like a double subsidy almost.
Now I would not have a problem with this, if I knew that all my freely donated blood was going towards free health care, where the unit cost charged was merely an accounting wheeze to spread scarce resources around the NHS fairly. Just like I put my time freely into the local community, I am happy to put my blood freely into a free NHS.
However, this is not the case. Because you charge private hospitals the same unit cost, I (and fellow donors) are effectively subsidising commercial organisations. It is the equivalent of me going to work an hour for free for a commercial organisation out which they would get a profit and I would get nothing.
Now I really, really wish we did not have commercialised health care. For me health is basic human right and I am happy to pay my taxes to contribute towards socialised healthcare free at the point of need etc provided according to need (not ability to pay). However the Government has determined that ‘market forces’ should now underpin how our health services should operate and suppliers must bid commercially for contracts to provide health care and so forth. So if we are in this profit driven world, we should really be IN this world.
I am not happy that my freely donated blood is effectively subsidising private hospitals. In my view, either they should organise their own blood supply (by establishing blood collection & storage systems) and manage all the costs involved in that, or they should pay you a proper market rate for the blood you provide to them. I would then be happy that your organisation would make a surplus which could then be ploughed back in my free NHS. 

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