Leading Article: NHS blood for private foreign patients

WOULD you donate your blood as freely to wealthy foreigners as you would to hard-pressed patients of the National Health Service? Probably the gut reaction of many people is that they would not. But the dispute provoked by the new Clydebank Hospital in Glasgow - a large private hospital set up by an American enterprise to treat mainly overseas patients - is not as simple as it looks.

The hospital has signed a contract for blood supplies with the Scottish transfusion service, under which it will pay around pounds 450,000 for testing, storage and handling by the NHS over the next two years. It will not pay for the blood itself.

Scots are much more generous with their blood than the traditional jokes would suggest, but supplies are tight in Britain as a whole, so fears have been aroused that precious NHS blood, freely donated, will seep away to the private sector, especially if the NHS can make a profit on the deal. Donors might also become less motivated if they thought they were supplying foreigners free.

The transfusion service replies that the contract gives the NHS priority in times of shortage and even enables it to recall supplies from the private sector when necessary. Moreover, arrangements such as this have long been standard practice for private hospitals throughout Britain, so no new principle is involved.

More persuasively, there is no obvious alternative. If private hospitals were to pay donors they would divert supplies from the NHS. If they were forced to buy abroad they might bring poorly controlled supplies into Britain. If the NHS were to start paying donors the whole basis on which the transfusion service has operated would change, and donors would be attracted from among the sick and addicted. Nor is there any way the NHS could separate donations for the private and public sectors.

Blood is donated to help the sick, not the rich or the poor, Britons or foreigners. To abandon that principle would be to enter ethically dubious territory. Provided the NHS charges for its services to the private sector, and safeguards its own patients, there is no reason to change present practice. Doubtful donors can tell themselves that the ethical basis of their generosity is unaffected, and that any money the NHS earns from their blood will also benefit NHS patients.