Andrew Doyle (Wicklow, Fine Gael)

I was somewhat surprised to note that the transfer of responsibility for the procurement of blood clotting and other biological products required primary legislation. However, the fact that it does offers an opportunity for Members to display at some level the ability to do something right and to do something which everyone is prepared to buy into. This buy-in is shared by all the experts, the end users, who are the most important, and all the various political hues in the House. It also allows us to save money at the same time. Such opportunities do not arise often. We should demonstrate that this is possible, achievable and doable.

More than 2,000 people require blood clotting products. In the past 20 years recombinant factor products have become the norm. They are genetically engineered in a laboratory.

The Lindsay tribunal resulted from a time when most blood clotting products were sourced from blood by-products, including plasma. Issues regarding the quality, the scrutiny by which these products were secured and procured and the way in which they got into the system arose.

Haemophilia and other blood disorders are serious conditions. However, they are manageable. I speak as someone who has lived with an endocrinological disorder for more than 20 years. This means every day a small amount of product keeps everything functioning perfectly. However, on a given day when I do not get it or on other occasions when episodes arise it is necessary to have access to a safe, secure product which can deal with it.

In the same way as a diabetic needs insulin, a haemophilic needs factor VIII. We take for granted the fact that there are only approximately 2,000 people in the country with the disorder. This results in a focused and specific tranche of medicine and medical technology. It must be properly scrutinised to ensure the sufferer has the comfort of knowing that they will get the product to deal with their needs at all times.

The move away from the Irish Blood Transfusion Service makes sense because the recombinant product is no longer sourced from blood products. Therefore, there is no longer a need for the Irish Blood Transfusion Service to be involved. Moving the operation to St. James's Hospital, home to the national centre for hereditary coagulation disorders and the haemophilia centre, makes perfect sense. St. James's Hospital is a large teaching and tertiary hospital. It has all the facilities needed. Most patients with the conditions in need of factor VIII and factor IX will be familiar with St. James's Hospital and its surroundings and will have built up a relationship there. My experience at St. Vincent's Hospital is similar: it becomes easy after a little time to get swift access. People tend to know if someone arrives in an emergency that must be dealt with straight away. In such cases, people will be treated notwithstanding the pressures in accident and emergency services etc. This is why the change is important.

It probably would have made sense to do this any time during the past ten years. However, like everything else, it has taken some time. We should not do this simply because it will save between €6 million and €8 million over four years. However, the fact that it does is a considerable help.

Perhaps we should examine this model when it comes to the delivery of health services in other areas. We should streamline services and create not independent silos rather centres of excellence for everything. This debate will probably resurface when it comes to the review of the national children's hospital and whether it should be co-located with a main national hospital or linked to the location of a new maternity hospital.

The Master of the National Maternity Hospital, Holles Street, the first female Master, has four children all of whom were born there. She stated that we do not live in a perfect world but an imperfect one. She was asked what happens if the normal rate of baby deliveries is 25 per day but, on a given day, some 40 babies are delivered. She said that they cope and that everyone works a good deal harder. When it comes to the location of the national children's hospital we should try to get the best available model given that it will be with us for the coming 60 to 80 years.

This small tranche of legislation demonstrates how common sense and buy-in from all stakeholders can be of benefit and, at the same time, save money, reassure the patient and deliver a better service. I commend the Bill to the House.

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