A panel of independent experts on blood transfusion has identified "serious management and organisational weaknesses" within the Irish Blood Transfusion Service (IBTS) despite radical reform of the agency after recent blood scandals.
The panel, which was charged with examining the merits of the IBTS's proposal to cease testing at its regional centre in Cork, stressed, however, that "no generalised lack of safety of the current Irish blood supply was detected" in the course of its review.
The panel, in a report published yesterday, said it "did perceive that many employees felt alienated and insecure, and morale was stated to be low. These perceptions suggest that leadership should work on confidence at all levels in efforts to restore employee co-operation, partnership and trust."
Calling for "a more balanced governance" of the IBTS, the panel said representatives and centre directors from Cork and Dublin did not participate equally at present.
The report laid particular emphasis on the absence of a unified computer system within the IBTS. Because of this failing, it said, it was possible that a donor permanently deferred by one centre might give blood, and have it entered into inventory, at the other.
"Correction of this deficiency is vital to the safety of the Irish blood system," it noted.
The panel's core recommendation of dual-site testing at the IBTS's Cork and Dublin centres was based on a number of reasons, including the need for a reliable back-up testing system.
Dual-site testing would also be "operationally cost-effective", the panel claimed. In addition, "the morale and involvement of the Munster medical community, as well as the centre staff, would be enhanced."
In making the recommendation, the panel noted: "There are no best international practices for testing. Each country . . . must look carefully at what policies best suit its circumstances".
Of the division between Cork and Dublin, the panel said their activities should be "integrated meaningfully into a single national blood system". However, this should take place with separate management structures.
That meant the re-establishment of a management structure in Cork "such that each centre director clearly be in charge of their centre".
In addition, the panel recommended that the IBTS headquarters should not be located at either regional centre, "thus dispelling any impression that either is the 'national centre' ".
On standards, the panel said a national quality system should be implemented throughout the IBTS. At present, it noted, only the Cork centre had International Organisation for Standardisation accreditation.
The panel added that the physical facilities at both centres should be of similar quality.
"The new Cork facility should be designed to support academic, educational and research activities and preferably be located in an academic environment.
"This recommendation should be given the highest priority by the IBTS."
In a swipe at the Minister for Health, Mr Martin, the panel also recommended "that future replacements of IBTS board members reflect balanced geographic representation, the interests of health boards and individuals with transfusion medicine experience . . ."
It added that a review of progress on its recommendations should take place after three years.
The panel emphasised that "within the time at its disposal for this review, no imminent danger to the public health was encountered. This general conclusion obtains even though significant management and organisational weaknesses were apparent."