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When I was working in the Midlands some years ago I often found myself talking with a wide range of people. Some were dealing with bereavement and others were excited about the prospect of a birth. It was very common to find ourselves speaking about the things that really matter in life, and time and time again people expressed the view that you cannot put a price on your health. I recall talking to a young couple who were expecting their first child. Somehow the common enough subject of the sex of their unborn child came up. As we chatted, it became clear that there was a bitter/sweet edge to their sense of anticipation. It turned out that there was haemophilia in the family. At one level the sex of the baby was irrelevant. The child was longed for and would be loved unconditionally. But at another level, they knew what the implications could be for a baby boy. All the protectiveness of parents was there for anyone to see. In the end, they had a little girl and you could feel the sense of relief. The anxiety could be put on the back burner until their daughter became pregnant. (I know haemophilia can affect girls, but is predominantly boys who are affected)

I also recall being with parents whose teenage son had suffered serious burns. The young man was in intensive care at the Burns Unit at Frenchay Hospital in Bristol. I also recall sitting alongside the parents of a youngster who had suffered major trauma after being knocked over by a car.

Plasma Products are used in the treatment of those with haemophilia and those who have suffered such traumatic events.

Let me illustrate what we are trying to get over by telling you a true story of my own. I don’t know if you are familiar with the River Nevis in Scotland that meanders through the glen on the southern side of Ben Nevis. If the Ben is shrouded in mist, then there is the alternative of a fabulous walk through Glen Nevis. Along the way, you have to cross the River Nevis to continue your walk. If you are not familiar with the walk, this is the bridge that faces you.

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Shall we say that it is an interesting experience crossing this swaying wire. There are all sorts of emotions that you experience as you face the challenge from exhilaration to fear. For some, fear stops them from even, venturing any further. But if you do proceed (without a fixed safety line to one of the ‘hand wires’ you use to try and steady yourself) the adrenalin soon starts pumping. You trust that those who constructed the bridge have used wire and fixtures that will not fail you. Then at least you only have to deal with the vagaries of your own sense of balance, common sense, healthy caution – oh yes and what the weather is doing especially the wind.

Now let me create an allegory.

You and a friend are on a walking holiday based in Fort William. You set off for a walk up Glen Nevis having made all reasonable provisions your safety. You come to the river crossing and decide to go over it to continue your walk further. Further up the trail disaster! Your friend stumbles and has a serious fall. You scramble down to him and it obvious that he is seriously injured. You recognise that his life is at risk. It is critical to get help as quickly as possible. You go to your friend’s rucksack to get the radio to call the emergency services. But when you try to make contact, your heart sinks. The radio must have been damaged in the fall. It is not working. There’s only one thing for it. You make your friend as comfortable as possible, especially making sure he is kept warm. Then you set off back down the track and over the bridge, which is now the critical part of the journey. As long as you can cross it safely, there is a chance that you can get the help your friend needs to him in time. But this time as you step out you are more aware that you must take care not to slip. And is the wind a bit stronger than earlier, or is that your imagination playing cruel tricks on you?

Just one thing though, unknown to you those responsible for the maintenance of the bridge have made changes to the fixtures that hold it in place. In an attempt to keep costs down they have used inferior products.

Plasma products are the ‘bridges’ that offer a range of patients hope and for some they are crucial for them to carry on living. The vast, vast majority of plasma product users like our casualty in the Glen do not bring their ill health on themselves. And when, like the ‘helper’ in the story facing the bridge for a second time, the patient turns to plasma products as their bridge to life they do so in the knowledge that all treatments carry a degree of risk[1], but in the hope that everything is done to minimise those risks.

If we transfer this allegory to the specifics of the haemophiliac who is bleeding. In these circumstances the wire bridge is the Factor VIII or Factor IX that is crucial for your future health. You need to feel that the doctors are prescribing a treatment that is as reliable as it can possibly be.

The sale of the Plasma Service in allegorical terms is the use of inferior fixtures to secure the bridge. By selling the Plasma Service the Government is knowingly compromising the health of tens of thousands of people. The footnote makes it clear that there are companies in the plasma industry who consciously put profit before people’s health. Lord Owen has confirmed that the blood supply on the open market is compromised and we would be unwise depend on the efficacy of its Inspectorate. His warnings have so far been ignored. The Government knows what it is doing but is pressing ahead with a sale that will expose patients to the increased risk linked to purchasing plasma on the open market.

So we have the plasma user (injured walker), the plasma product (the bridge) and those responsible for Public Health (those responsible for the maintenance of the bridge).

So where does this leave us. It could be argued that if the Government is transparent in what it is doing and makes it clear that the sale has recognised risks. If it consults with the public and gets informed approval for its actions then we all share responsibility for any consequences that might happen in the future.

However, the Government, which often claims that it values transparency, is not applying that principle to the sale. It is quite reasonable to conclude that having already look at the future of the Blood Service and deemed it unwise politically to sell that, has deliberately separated off the Plasma Service in the belief that a sale can go through unnoticed because the word ‘plasma’ does not have the same resonance in our psyche as the word ‘blood’. In this it is no different from the Clinton supporter who sold contaminated blood overseas, where as the CEO of the plasma company put it ‘there wouldn’t be too many awkward questions about the source of the plasma’. We already know that the Government doesn’t mind in a bit of duplicity[2].

Which brings me full circle to the couple waiting to find out if they were going to have a boy or girl, the parents watching on helplessly as their children were fighting for their lives. What do we say to them about the sale, or more importantly would the Government be saying to them. At the moment I think an accurate statement would be “We extend our sympathies to you but I’m afraid we are going to make the treatment your loved one needs more risk laden”

[1] We know this has happened. Haemophiliacs know this to their cost (see the Archer Report). An unknown pathogen, HIV, was rife in the prisons of Arkansas where blood was being collected by a company run by a supporter of Governor Bill Clinton. By the time HIV was first recognised the damage had been done. To make things even worse the company, which found its US market had disappeared knowingly sold the contaminated blood overseas. Secondly, our own UK plasma donations were made unsafe as a result of a relaxation in the regulations governing cattle feed. Unwittingly, the Spongiform Encephalopathy called Scrapie began its migration via cattle (BSE) to humans (vCJD). In both instances, we have to catch up with unknown factors in the blood supply.

[2] David Cameron who frequently says he values transparency in Government is the same person who defied the ruling of the Information Commissioner about the publication of the Risk Register concerning the Health & Social Care Bill. It would be interesting to know if the sale of the Plasma Service was considered in the Risk Register. There can be no doubt that if it was then the risks we are highlighting                 would have been included.

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