Tories unlikely to stop Bill prohibiting paid plasma, but why are they even trying?
2012 protest in Thunder Bay against the closure of CBS’ plasma clinic. Health Canada claims — without any evidence — that self sustainability in blood products in impossible under a volunteer system, but we’ll never know if CBS continues to downsize its operations.
The Ontario Tories recently have appeared to be distancing themselves from some of the more unpopular positions adopted by the party under Tim Hudak.
Voting for second reading of an Act intended to close the door on paid collection of blood and blood components by the private sector, the Tories none-the-less seem incapable of parking their ideology at the door as Bill 21 finds its way into committee.
For two days the committee is conducting hearings into the legislation, seeing a parade of mostly private sector lobbyists lined up on one side and mostly family and survivors of Canada’s last tainted blood scandal on the other. Each presentation was limited to five minutes, followed by three minutes for each party to ask questions. In the case of the Tories, that three minutes was frequently used to make their own case that somehow we can’t do anything in this province without the involvement of private corporations.
David Harvey, a lawyer who represented patient groups at the 1990s Krever Inquiry, made the point the legislative committee was trying to come to a decision in just two days of public hearings over an issue that took Justice Horace Krever four years to resolve. By contrast, the Krever Inquiry included 247 days of public hearings by 474 witnesses, testimony and submissions filling 50,000 pages and another 100,000 pages of exhibits. Even former Premier Mike Harris admitted the Krever report was “detailed, it was exhaustive and it was complete.”
Yet the Tories appear to be siding with the private lobbyists as they toy with the idea of reversing one of Krever’s key recommendations – that paid collection of blood and blood components be banned except in rare circumstances.
During our own presentation before the committee, the Chair had to urge Tory MPP Bill Walker to ask his question as the three minutes ticked off the clock with little opportunity to respond. The Tories had done the same thing with Antonia Swann, a Senior Health Economist with the Ministry of Community and Social Services. Swann is well-known as the partner of James Kreppner, the infected patient activist who died of complications related to HIV and hepatitis C in 2009.
Matthew Herder and Francoise Baylis, medical ethicists at Dalhousie University, point out that the basis for the Tory arguments are unsubstantiated statements presented as fact by Health Canada and repeated by others.
Writing in Impact Ethics in 2013, the two assert that there isn’t any supporting evidence to the idea that compensating plasma donors are critical to ensuring sufficient supply of plasma products. Often repeated by Canadian Blood Services, the two also state that there is similarly no evidence to support the idea that self-sufficiency in plasma products is not operationally or economically feasible within a volunteer model.
“With policy laundering, we can expect to see these unsubstantiated statements presented as facts in subsequent documents that will reference back to these original assertions,” they write. “And yet there are no facts or evidence to substantiate this policy preference for paid plasma collection.”
The Dalhousie University academics point out that Health Canada “does not know that a high-quality, well-resourced volunteer plasma donation program would not succeed.”
As we pointed out to the committee, not only has CBS not attempted to bridge the gap between volunteer and paid donation in plasma derived medicinal products, but has actively been downsizing the volunteer collections system in recent years, leading to the lowest hospital inventories in six years.
Had CBS maintained that infrastructure, it could have been transitioning surplus plasma no longer needed for transfusion into sustainable manufacture into these products.
While no evidence exists to suggest paid donation would help make Canada’s blood supply more sustainable – there is evidence to the contrary.
Both CBS and Canadian Plasma Resources – the private for-profit company that wanted to set up paid collection clinics in Ontario – admitted that a second private parallel system would have an impact on public voluntary collections. CPR estimated it to be 6.6 per cent, CBS at 8 per cent. Given the existing short supply, this would have left hospitals to cancel surgeries without blood inventory.
A New Zealand study suggested the impact of paid donation on the public system could be much higher – 11 per cent of those surveyed saying they would definitely cease donating if payment were involved, and another 41 per cent saying they would definitely discontinue donating if profits were to be made from their blood.
While CBS and others continue to maintain that paid donation sources are safe, they ignore the fact that pharmaceutical recalls significantly increased from 2004-2010, and that recalls of vaccines and immunoglobulins made from mixed paid and unpaid sources were higher than any other drugs in their class.
Lucy Reynolds, a research fellow at the London School of Hygiene and Tropical Medicine, notes in an April 2013 paper for Open Democracy that almost all suppliers of plasma products in the UK “have a track record of avoidable quality problems, in many cases resulting in deaths or serious chronic illness such as HIV.”
So why would we want to increase risk by collecting plasma from sources where the risk is likely to be much higher?
We don’t know how the Tories will vote on third reading of this Bill. They could properly claim that they are doing their due diligence as the official opposition, but that may be a stretch given Tory MPPs Bill Walker and Gila Martow’s dogmatic performance at the committee on Monday. Clearly they had chosen who they want to listen to, and who they didn’t.
Ultimately the government has the numbers to pass this Bill, and they will likely have the additional support of the New Democrats.
The Tories? A vote against it would be meaningless beyond showing themselves to be off-side once again with the interests of most Ontarians.
About the Author
Rick Janson writes DiaBlogue, a project of the OPSEU Health Care Divisional Council. The Council represents more than 45,000 professional and support staff in Ontario’s Health Care System.
Reprinted with permission from DiaBlogue
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