Sir, - The proposal by the Blood Transfusion Service Board (BTSB) to abandon testing of blood products in the Cork BTSB unit and thereby effectively downgrade the Munster unit should be a cause for concern, not only to the people of Munster and surrounding Health Board areas but to the people of the whole country.
The Cork unit has served the country well as a back-up for the Dublin unit and has rescued it in times of blood shortage. It is respected and has good working relations with the medical community. Why run down something that has worked so well? Could internal (Dublin/Cork) disharmony within the BTSB be the underlying motive?
The arguments presented by members of the BTSB for a change to central testing in one unit in Dublin are flimsy, poorly thought out and appear, at best, spurious. Indeed, the lessons of the Hepatitis C scandal in the Dublin unit should teach us the wisdom of retaining a second centre in the country for back-up, cross-checks and balances, and quality control.
At present, all blood donations are tested by a serologic method in Dublin and Cork for potential infectious contaminants. Centralising such testing was not thought necessary before, so why now? In the future, a more modern form of testing by a molecular method, the polymerase chain reaction (PCR), will be in place. This is appropriate, but there is no valid reason why the Munster unit cannot test by this method. The expertise for performing PCR is already available in Cork. Automation and scaling up would, of course, be required for both units to perform PCR on all blood donations.
Surely cost cannot be the reason why the BTSB wish to remove testing from Cork? When judged against the multi-millions the Dublin BTSB has cost the Irish taxpayer for Hepatitis C, the value of retaining a second back-up testing centre is clear. Is the Cork unit to be sacrificed because the new BTSB building in Dublin has run seriously over budget? The BTSB has not disclosed a rigorous cost/ benefit analysis of retaining testing in Cork. In fact, capital expenditure should be minimal because the automated PCR machines can be rented or offered free by some biotech companies. The significant cost in PCR technology is the consumable reagents. The cost of consumables is the same in testing a given number of donations whether in Dublin or Cork or both.
Since downgrading the Cork unit will have such a negative impact and is so unnecessary, we are dismayed at the lack of rigour from the BTSB in a cost/benefit analysis of retaining the Cork unit in full capacity. The BTSB has claimed to be involved in a consultative process on the issue, but its members have already expressed their bias. In light of this, we have no confidence in their hollow reassurances. One of the lessons from Hepatitis C in Ireland is that the BTSB should listen and not ignore advice from the medical community. - Yours, etc., Prof Fergus Shanahan
Also signed by: Prof Paul Redmond; Mr Stephen Cusack; Mr Gerard O'Connor; Prof George Shorten; Mr Tom O'Connor; Mr Michael O'Shaughnessy; Dr T. N. Fogarty; Dr John McAdoo; Mr Eamonn A. Kiely; Mr John Curtin; Dr Fergus Walsh; Dr Mary Lehane; Dr Seamus M. Hart; Dr Mary Horgan; Mr George B. Mullan; Prof William O. Kirwan; Dr Roderick Galvin; Dr Derry Ryder; Dr Paule Cotter (chair, medical staff); Mr Thomas Aherne; Dr Charles P. Bredin; Dr John Buckley; Dr Peter Frodsham; Dr Liam MacFeely; Dr William Fennell; Dr Michael Hurley; Dr Tim O'Connor; Pro Barry Ferriss; Dr Peter Kearney; Dr Dermot Murnaghan; Dr Declan O'Brien; Dr Maurice Hurley; Dr John Burke; Dr Paul Finucane; Dr Rory O'Brien; Pro David Jenkins (Dean); Dr William F. Kealy; Dr Catherine Keohane; Dr John Hogan; Dr Seamus O'Cathail; Prof Philip Cleary; Dr Catherine Molloy (Chairman, SHB).
Cork University Hospital, Wilton, Cork