New blood report creates hope
The report by Growth Strategies, a copy of which was obtained by CBC News, suggests setting up an independent blood centre in New Brunswick when Canadian Blood Services relocates to Dartmouth next year could be cheaper than staying with the national agency.
"We've often felt that the blood service production centre here has been cost-efficient, effective and very safe and so we've been advocating for it to remain in the province as it would be the best way to serve the people of the province," said Dr. Andrea Garland, the past-president of the medical staff organization in Saint John.
The report says the annual costs of a operating a provincial service would be about $10 million, compared to Canadian Blood Services' estimated annual costs of $14 million.
That's contrary to a previous government report by another consultant, KPMG, which concluded a stand-alone agency would cost up $37 million a year to operate.
"We've often felt that there was probably an alternative to what the KPMG report had shown, you know, but I think it needs to be looked at and I think the province will probably look into this hopefully in a very favourable fashion."
The provincial government commissioned the KPMG report in August 2010 after Canadian Blood Services announced plans to consolidate services in Dartmouth, N.S. by 2012 and shut down the blood processing and delivery clinic in Saint John.
Although KPMG stopped short of endorsing any of the three options under review – staying with the national agency, creating a new agency, or partnering with another agency such as Héma-Québec - it ranked sticking with Canadian Blood Services the highest.
The report said New Brunswick physicians and blood bank technologists are satisfied with CBS and it said the agency has a strong international reputation.
Dr. Andrea Garland and other doctors have told CBC they're concerned that blood products coming from Dartmouth won't be able to reach New Brunswick patients in time and that lives could be lost.
Department of Health officials declined to comment on the latest report by Growth Strategies, or even confirm that it was commissioned by the government.
Larry Cain, the president of Growth Strategies, also declined to comment, referring all inquiries back to the department.
But the cover of the 25-page document dated Aug. 25, 2011 is entitled: "Advice to Minister: A Review of the Options as a Result of Canadian Blood Services' Decision to Relocate Blood Production Facilities from Saint John to Halifax."
Independent service would save money, improve safety
It suggests an independent service would save the province more than $10 million in the first three years, resulting in a payback of approximately 38 months.
"The KPMG analysis assumed no revenues to an independent blood services agency from the export of excess blood products," the Growth Strategies report states.
New Brunswick is one of the few provinces that collects more whole blood products than is required to meet the needs of the provincial health care system.
In 2009/10, the Saint John facility exported more than 11,000 units of blood products to other provinces, according to the report.
"By focusing on growth in the donor base in New Brunswick, we believe that Héma NB (the proposed working name for an independent blood production centre) could generate almost 20,000 units of excess red blood cells for export markets.
"Based on assumed revenues of $300 per unit, this has the potential to generate more than $6 million annually in export revenues for the agency," it states.
The report suggests having a provincially-run service would also improve patient safety by having a supply closer to demand and by providing fresher blood products.
It says delivery times to major New Brunswick hospitals, including the Saint John Regional Hospital, Moncton Hospital, George Dumont Hospital and Dr. Everett Chalmers Hospital, will increase "by a minimum of one to four hours as a result of the proposed consolidation.
"While the current shelf life of red blood cells is 42 days, current research and literature suggest that improved patient outcomes can be achieved via fresher blood products – less than 15 days old," it adds.
Other effective models
Growth Strategies contends KPMG based its analysis on the assumption an independent agency would operate like a smaller version of Canadian Blood Services, but be less efficient and not as safe.
"A number of comparably sized U.S. blood banks have been identified that deliver significantly lower costs of collection, production and distribution," the report states.
It points to the Nebraska Community Blood Bank, in Lincoln, Nebraska, which, it says, collects and processes similar volumes to those in New Brunswick.
The Nebraska blood bank has an average cost collected of $238 per unit, more than 47 per cent lower than CBS, the report states.
"NCBB generated approximately $11.8 million in revenue in 2010/11. Of those, more than 54 per cent were generated from the sale of products exported to a combination of other blood banks and hospitals in the United States."
NBCC has sole-source contracts in place with 10 hospitals in six counties. Two hospitals account for more than 90 per cent of products distributed, according to the report. It has four fixed collection sites, collects 50,000 units of blood a year, and delivers within a 75-kilometre radius.
The report suggests Héma NB should be established as a non-profit corporation, governed by an independent board of directors.
The company should be granted a sole source supply agreement with the provincial government, negotiate a series of export relationships with other blood service providers, and contract out the testing of blood samples to an accredited testing facility, it states.
Héma NB should also acquire any surplus assets from CBS, including the current production facility and any available equipment related to the collection, production and distribution of blood products, which could reduce the estimated capital investments and start up costs of $10.8 million, the report adds.
Canadian Blood Services has said it plans to have a stock holding unit for blood in Saint John, enough to meet day-to-day hospital needs. The agency also plans to have donor collection sites in Saint John and Moncton.
The health minister has said she is not prepared to give up the fight to keep the blood service operation in Saint John.