Cord Blood Preservation

lazygal

Penny Dreadful wrote: »

Hospitals in other countries aren't working under the same staffing and budget constraints as the Irish ones are. Every extra task that takes only two minutes adds up.
The collection of the samples requires certain training and not everyone is trained to do it. So then you have either an additional training cost or the few people that can do it are under greater pressure to collect all samples. This pressure will inevitably lead to mistakes being made.
Allowing people who are not employees of the hospital access to patients has a lot of implications in terms of Garda vetting, insurance, confidentiality, etc.
The question can be asked is it ethical to spend the scarce resources on a procedure that may save the life of someone sometime or is it better and fairer to spend the resources on helping more people in the hear and now.
As I said I'm not advocating for the current position but I can understand it.

The point I have made is that stem cell treatment will save the life of someone with the particular illness that runs in my family. Its one of the few areas of illness where stem cells have been proven to work and negate the need for more invasive and risky treatment. There's no may save the life about it - it will save the life of my children if they develop this illness. And because of this me and my husband were willing to meet the economic costs of collecting and storing the cord blood. If there was a doubt about whether it was worth our while doing it I wouldn't have bothered asking. Is it ethical to have a blanket ban on something which has been proven to safe a life and which will reduce the costs of more invasive treatment in the future? I don't know what the answer is.

rovoagho

Tore wrote: »

I don't really want to go off topic, but tbh I don't think that 2 more minutes after hours spent on labour and giving birth would really significantly affect the budget of any country. If these same 2 minutes would potentially save even a single life in the future, then the cost would be by far lower than the benefit. Sorry but no, I can't understand this position.

As the OP clearly explained, it's not just about the 2 minutes, there are also training costs and safety implications. But lets focus on those 2 minutes anyway:

CUMH had 8500 deliveries in 2012, which would be 17000 minutes of time added to deliveries, or around 283 hours. That's a LOT of money, and that's just one hospital. And again, it doesn't include additional training costs and/or the risk of allowing additional people into the delivery room.

Me, I'd prefer to see that money spent on the reintroduction of anamoly scans, which have been removed from the standard process in Ireland. Other people would prefer other improvements.

I'd like to retain the cord blood for my babies too, and I'd be happy to pay the cost of it, but it's not as simple as you'd like to believe it is.

Penny Dreadful

Chattastrophe! wrote: »

What's the reasoning behind it being illegal to store it there?

Cost.

lazygal wrote: »

The point I have made is that stem cell treatment will save the life of someone with the particular illness that runs in my family. Its one of the few areas of illness where stem cells have been proven to work and negate the need for more invasive and risky treatment. There's no may save the life about it - it will save the life of my children if they develop this illness. And because of this me and my husband were willing to meet the economic costs of collecting and storing the cord blood. If there was a doubt about whether it was worth our while doing it I wouldn't have bothered asking. Is it ethical to have a blanket ban on something which has been proven to safe a life and which will reduce the costs of more invasive treatment in the future? I don't know what the answer is.

It will save a life in the case you've outlined. It may save 3 or 33 lives. The cost of providing the service may adversely affect the care given to 3333 lives due to the money being spent in one area over another. That is the thinking behind it.
The ethics of it come down to do doing the most good possible with the money available. This means that a smaller group of people may not get the service or facilities they wish for as a larger group of people will be treated for the same amount of money being spent elsewhere.
As I said before I am not saying the government is right in its blanket ban on this procedure and service but I can understand how the ban came about.

rovoagho wrote: »

As the OP clearly explained, it's not just about the 2 minutes, there are also training costs and safety implications. But lets focus on those 2 minutes anyway:

CUMH had 8500 deliveries in 2012, which would be 17000 minutes of time added to deliveries, or around 283 hours. That's a LOT of money, and that's just one hospital. And again, it doesn't include additional training costs and/or the risk of allowing additional people into the delivery room.

Me, I'd prefer to see that money spent on the reintroduction of anamoly scans, which have been removed from the standard process in Ireland. Other people would prefer other improvements.

I'd like to retain the cord blood for my babies too, and I'd be happy to pay the cost of it, but it's not as simple as you'd like to believe it is.

Thank you, that is exactly what I was getting at.

Tore

rovoagho wrote: »

As the OP clearly explained, it's not just about the 2 minutes, there are also training costs and safety implications. But lets focus on those 2 minutes anyway:

CUMH had 8500 deliveries in 2012, which would be 17000 minutes of time added to deliveries, or around 283 hours. That's a LOT of money, and that's just one hospital. And again, it doesn't include additional training costs and/or the risk of allowing additional people into the delivery room.

Me, I'd prefer to see that money spent on the reintroduction of anamoly scans, which have been removed from the standard process in Ireland. Other people would prefer other improvements.

I'd like to retain the cord blood for my babies too, and I'd be happy to pay the cost of it, but it's not as simple as you'd like to believe it is.

Let's focus on those 2 minutes then. I did not say a public hospital should offer the service for free for every single delivery. So your calculation is not accurate from my point of view. I just said that the public service should guarantee this service for free to anyone in the same situation of Lazygal where it is proven that this could save a life or even save additional costs for the public service in the future due to more invasive treatments as she already explained very well. The public service should also offer the service - not necessarily for free and so without any effect on the budget - to anyone who might want to preserve the cord blood. The amount paid could be used to provide the training (it's just a matter of taking a blood sample...so I am not sure what complicated training you think this might require...) or any other associated cost. I might be wrong guys, but I still do not see all the the issues you do. If you are not happy with the way the system currently works, well..you should then start thinking if who currently governs will deserve your vote again in the future, but I would not think another way is not possible...

Dingle_berry

The IBTS provide a small service to families with appropriate medical histories. It's part of their tissue bank, not the blood bank.
For other families the chances of someone needing cord blood stem cells is way less than 1%. After your teenage years, if you needed a transplant, you would need more than one unit/donation so a unit from your birth would be useless on its own.

Our healthcare is seriously understaffed. Holles st has the best midwife ratio and is still understaffed and over occupied. The time the midwife or consultant spends with you collecting cord blood is time they're not spending with the patient in the next room.

The chances of the cord blood donation being used are too small to justify the extra time and costs involved.

Penny Dreadful

Tore wrote: »

Let's focus on those 2 minutes then. I did not say a public hospital should offer the service for free for every single delivery. So your calculation is not accurate from my point of view. I just said that the public service should guarantee this service for free to anyone in the same situation of Lazygal where it is proven that this could save a life or even save additional costs for the public service in the future due to more invasive treatments as she already explained very well. The public service should also offer the service - not necessarily for free and so without any effect on the budget - to anyone who might want to preserve the cord blood. The amount paid could be used to provide the training (it's just a matter of taking a blood sample...so I am not sure what complicated training you think this might require...) or any other associated cost. I might be wrong guys, but I still do not see all the the issues you do. If you are not happy with the way the system currently works, well..you should then start thinking if who currently governs will deserve your vote again in the future, but I would not think another way is not possible...

It costs money to train people. It costs time to train people. Both of these things are in very short supply in the healthcare system. If the service was to be offered by someone who was not an employee of the hospital then it brings with it a host of issues around data protection, Garda vetting for access to patients, insurance, etc.
There are loads of things that I'm not happy about in terms of the health care system and how it works or doesn't work and that isn't only in relation to maternity services. However, if you take the current reports on midwife services all across the country but particularly in Portlaoise: 1 midwife was covering 70 births, its a better rate now but still way above internation best practice. I'd rather the money that is available or may become available was put into improving those levels over cord blood storage. I'd rather the money was spent on restoring the scans that women were given as standard practice before they were dropped in one of the many rounds of cuts.
In terms of other healthcare services, I'd rather the money was spent on cancer screening so catching cancers earlier than they do and so saving more lives in that way. I'd rather money was spent on improving and widening hospice care to those who are dying in acute general hospitals rather than in the comfort of their own home or a palliative care unit. I'd rather the money was spent on increasing the services available to children with severe disabilities so their parents don't have to rely almost entirely on organisations such as the Jack and Jill Foundation.

There are always choices to be made with the money available and I don't think enough people will be positively affected by the storage of cord blood to make the spend acceptable. Those who will be positively affected will of course feel differently as is understandable.

melusina

I had this done in Rotunda a year and half ago. I had to be a private patient to do it. There are 2 or 3 consultants trained for a procedure. Private company will store the stem cells then. Other staff was not really aware that this can be done but the consultants said they were doing a few a year.

Carrie6OD

Has anybody had any experience of this done in the Coombe? I would like to harvest umbilical cord stem cells for possible treatment of my MS in the future.