Crisis was ignored as the blood banks dried up

Reform of the system appears to have done more harm than good.

CRISIS, what crisis? could have been the motto of the National Blood Authority when it was created under the last Conservative government.

Blood stocks reached an all-time low, staff left in droves in the face of threatened centre closures and donors threatened to boycott the service in anger at changes being driven through in the name of efficiency. Thousands of bags of blood had to be withdrawn after their seals were found to be faulty; critics blamed cost-cutting.

But senior executives of the NBA remained adamant that their reorganisation of the service was successful and right.

The ad hoc arrangements of the old Blood Transfusion Service had served the country for nearly half a century until it was swept away on 1 April 1993. In its place came the National Blood Authority for England and Wales.

The 15 regional centres did not even use the same computer system and it was felt better co-ordination was needed. But it was how the new administration went about modernisation that provoked controversy. Under the chairman, Sir Colin Walker, and his chief executive, John Adey, who had previously run a private company which, among other things, supplied blood bags, a pounds 1m consultation process was put in train.

A management consultants' report proposed the closure of five of the 15 regional centres saving pounds 10m. Although blood collection would continue as normal, Liverpool, Lancaster, Oxford, Cambridge and Plymouth would rely on supplies from elsewhere.

Local campaigns were launched to save the threatened centres. Clinicians warned of the risks of not having blood banks close to hand.

In November 1995, Stephen Dorrell, the then secretary of state for health, announced a compromise. The five centres in question would retain some facilities, but the main work of processing and testing would be transferred. The uproar remained unabated. Staff warned that management had failed to understand the special nature of the blood service. Donors gave their blood voluntarily, and often expected it to be used locally. So when, for instance, The Independent revealed that the National Blood Authority was selling surplus blood products to countries such as Turkey at four times the British cost, some donors said they would not give blood again.

The NBA tried to reassure, but difficulties persisted. In November 1996, The Independent revealed that blood stocks had fallen to a record low of half the previously accepted minimum. One Liverpool haematologist said he would have cancelled his routine surgery had he known.