Above: Photo by ToeyToey/DepositPhotos.com
BitDepth#1354 for May 16, 2022
The Health Minister is correct to note that the blood donation system in TT is broken, but previous efforts to overhaul it haven’t worked because they haven’t delivered a value proposition for donors that’s better than the decades-old chit system.
It is also puzzling to hear of the minister’s plan for a “voluntary” blood donation system, because there is no formal system of renumeration existing for giving blood.
Blood is given voluntarily, but how it gets to the blood bank is often another matter entirely.
Desperate families coerce friends and relatives to donate blood and in truly dire circumstances, pay for blood donations, because critical surgeries often do not proceed until adequate blood is given for a patient.
On June 14, the planned introduction date of the new system, the Health Minister plans to put an end to the current system of blood donation, but there is no indication that he has consulted with stakeholders.
Without meaningful discussion, there is every likelihood that the Health Minister will preside over another debacle that will lead to even less blood being donated.
I can make this prediction partly because the last time the chit system was abolished, blood donations went into precipitous decline but also because the last 20 years of blood donations have given me a needle’s eye view of the process.
The chit system assigns a minor and transitory value to the donation of a pint of blood.
In practice, someone with a card recording multiple blood donations is entitled to draw on it for themselves or for someone in need.
Mr Deyalsingh has been trying to get rid of this system since 2018 and he has a point. Blood should not be a unit of barter in matters of life and death.
A patient in urgent need of a blood donation should not be put in the position of also having to find it.
The blood bank faces two core problems.
The first is the failure to develop a culture of blood or organ donation in Trinidad and Tobago.
The other is far more serious, because it cuts deeply into the very nature of blood donation as a transaction with the state.
The public health sector is designed to be an essential service offered to the public, largely without cost, and there is a pervasive sense in its sometimes antiseptic halls that the staff are doing patients a favour by treating their ailments.
Given that the alternative is facing a private health sector that sluices money out of bank accounts with the speed and efficiency of a vacuum, it’s easier to accept free service delivered sourly.
But in blood donation, the transaction is completely reversed.
The public health sector is put in the position of asking for a precious resource to be given without cost, and it has developed little capacity to operate as a supplicant.
The mobile blood donation service operated by the collapsed Friends of the Blood Bank sought to bridge that gap and did so quite effectively.
Most of the 22 pints of blood I’ve given was offered to workers at the mobile service and their approach was built around the delivery of an attractive customer experience.
Has there been any effort to engage with the small but committed group of donors who give blood regularly because it’s a civilised thing to do?
Such donors, particularly those with rare blood types, know that their blood, chit or not, has a limited timeline of usefulness for those who need it.
A blood bank is not a safe deposit box. For the system to function, there must be a continuous supply of fresh blood to make it viable.
The national target is 40,000 pints per year and the Health Ministry must dramatically change its approach to attract the 20,000 people it needs to donate blood twice a year if it hopes to correct a supply imbalance that delivers half of that.
The remaking of the customer engagement and service model at the Blood Bank will not be a trivial undertaking.
The Health Minister must begin by designing it as a parallel but separate business within the public health sector, supported by private sector marketing systems to win and retain customers.
Until that happens, the Health Ministry has nothing to offer in trade for a pint of blood.
While the chit system offered only illusory value for donating blood, it would be foolish to remove it without an overhaul of the way blood is won for medical purposes in Trinidad and Tobago
