10th April 2002 - Board Minutes
Minutes of the Meeting of the Board of the Irish Blood Transfusion Services Wednesday 10th April, 2002 at 10.00 am
Chestnut Suite, Newpark Hotel, Kilkenny
Present: Mr Michael McLoone (Chairman)
Ms Valerie Mannix
Mr Tony McNamara
Dr Ann OConnor
Dr Liz Keane
Dr Gerry Crotty
Ms Maura McGrath
Dr Mary Horgan
Dr Karen Murphy
Apologies: Mr Pat Farrell
Dr Helen Enright
In Attendance: Mr Martin Hynes (CEO)
Dr William Murphy (NMD)
Mr Michael Healy (SEO)
Minutes of Meeting 13.03.2002
The Minutes of the Board meeting held on Wednesday 13th March 2002 were adopted on the proposal of Ms M McGrath, seconded by Mr T McNamara and signed by the Chairman.
Matters Arising
International Expert on the MAC
The CEO confirmed that the appointment of the International Expert to the MAC would now proceed.
Proposal to extend the overdraft to 31.12.02
The CEO noted that formal approval from the DOH&C has not yet been received for the overdraft.
Cost of Progesa System
The CEO briefed the Board on the ongoing costs of implementing the Progesa System. He noted that the ongoing costs of implementation are being scaled down.
It was agreed that a presentation would be given at the next Board meeting, outlining the various options open to the Board in implementing Progesa and the implications for the IBTS in selecting particular options.
CEOs Report
This was noted. The CEO briefed the Board on two cases before the High Court in recent times. It was noted that some witnesses gave information that had been previously covered by the Finlay Tribunal.
Review of Testing
It was agreed that a meeting between IBTS and SHB personnel and the expert group should take place before the review group schedule other meetings. It was agreed that the requests for information by the review group, should be dealt with by the Chairman, the CEO and NMD, at their meeting with the expert group, using their own discretion in responding to their requests. The Chairman suggested that he, the CEO and the NMD meet with their counterparts on the SHB and the review group at the earliest possible opportunity. It was noted that the review group will conduct their review in May 2002.
NAT Testing
The CEO reported that the SNBTS have agreed to continue NAT testing for the IBTS. He also noted that a revised contract had been received from Chiron and that it is expected that the contract will be finalised in the near future.
Organisational Development Programme
The CEO briefed the Board on the progress to date of the workings of the Change Group. It was noted that no timelines have as yet been agreed for the work of the Group. It is expected that the HR review will be completed by the end of May 2002.
Lessons of the Lindsay Tribunal
The CEO gave a presentation to the Board on the lessons to be learned from the Tribunal. He outlined events as they had occurred and some of the key lessons which had been learned. He noted that some of the period and the issues under review had been examined to some extent in the Finlay Tribunal of enquiry, the Hederman OBrien Report and the Bain Report.
Some of the key lessons outlined:
There was lethargy within the BTSB in the 1970s and early 1980s that should have been identified and acted upon at the time.
The trauma of the Tribunals needs to be explored and its effects on decision making understood.
The adversarial legal system may be a barrier to the easy/early settlement of (medical) negligence cases. Even at the Tribunal which was to be inquisitorial, there was a tendency for it to become adversarial. The opportunity for mediation in negligence cases might usefully be explored.
The paucity of records and the absence of key witnesses made it difficult to present a complete picture of all of the events of the 1970s and early 80s.
In responding to the Tribunals, decision making within the IBTS may have changed from a situation of lethargy to being overly pressurised.
Major decisions needed to be objectively and independently scrutinised by the Board in the first instance.
Clear policy proposals must be put to the Board by the Executive.
The decision making process from the Board down must be clear.
The need for greater critical evaluation of some key decisions such as NAT Testing and Pathogen Inactivation is required.
The mandate of the IBTS should be explicit
Committees/groups in which IBTS participates should have a clear purpose with clear reporting/communication lines
There is a need for clarity of roles, responsibilities and lines of communication.
The organisation structure must have checks and balances.
It was noted that the decision making process in the IBTS had significantly improved as a result of the lessons learned from previous reviews of its activities.
The Chairman thanked the CEO for his comprehensive presentation. It was felt important that the IBTS needs to improve its communication to the general public in showing the improvements that have taken place in its operations. However while blood transfusion is now very safe, it is not a zero risk business.
The Board members noted the importance of having a partnership with hospitals and clinicians to review and assess how well services are operating.
It was noted by Board members that a general theme of a lack of accountability, co-ordination, responsibility both internally and externally, was evident from the information provided in the briefing.
It was noted that the IBTS needs to continue to be rigorous in its operations in terms of Board governance, management processes and technical expertise.
The Board noted the many changes and improvements, both scientific and administrative which had taken place in all transfusion services in the post-AIDS era and the particular improvements in the IBTS arising from previous examinations of its activities.
It was agreed that the report by the CEO would be discussed and reviewed further by Senior Management and relevant Committees. It was felt that this shared analysis would inform the Change Management Programme in the IBTS and help the IBTS move forward in its business.
The Chairman requested a progress report on this item at the May 2002 Board Meeting.
Recipient Tracing Statistics 2001
This report was noted.
Minutes of Medical Advisory Committee 13th February 2002
Dr Ann OConnor, who had acted as Chairman for this meeting, gave a brief summary of the Minutes of the MAC 13/2/02.
It was noted that Bone Banking is not covered by the Statutory Instrument (SI). It was agreed that the SI would be looked at as part of the Change Management Programme.
It was agreed that the procedure for dealing with recommendations from the MAC would be examined. It was agreed that the IBTS Chairman, CEO, NMD, HRS Consulting and the Chairman of MAC, would meet to discuss the matter. It was suggested and agreed that any proposal with financial implications should be reviewed by the Director of Finance before coming to Board for approval. The Chairman suggested that the NMD would take responsibility for taking recommendations of the MAC to the Executive and the Board. He suggested that relevant sections of previous reports on IBTS operations might help in finding a workable solution on the matter.
In response to a question from the Chairman of MAC, the NMD informed the Board that a register had been set up for recording details of patients who had been transfused with blood from patients who had subsequently tested positive for vCJD. It was noted that there were no names on the Irish register.
Minutes of Finance Committee 6th March 2002
These were noted. The Executive will analyse the enterprise liability insurance in the IBTS and revert to the Committee on the matter.
Pension Review
It was agreed that a pensions expert would be employed at a cost of 3,000 to make a presentation to the Chairman and pensions group on the IBTS pension scheme and proposed changes. It was also agreed that this information would be made available to the Board.
Audit Committee
The Board agreed to defer the decision on the setting up of an Audit Committee, as it is expected that this proposal will form part of the HRS Consultants review.
Date of next meeting
It was agreed that the next meeting of the IBTS Board would take place in the NBC on Wednesday May 8th 2002 at 2pm.
Signed .. Date
Next Board Meeting to be held at 2.00pm on Wednesday 8th May 2002 at National Blood Centre.
