I propose to take Questions Nos. 808 and 823 together.
Cord blood is a recognised source of stem cells. However, there are other sources of stem cells including bone marrow. The benefit of stem cells for a range of issues is being explored by scientists around the world. In these studies the use of stem cells have been derived from a variety of sources, not just cord blood. Thus, while cord blood receives significant attention, access to cord blood is not the sole route of access to the benefits of stem cells — either those currently proven or those which may emerge in the future. It is important to note that many benefits of stem cells currently discussed are at very early investigative stages and will require substantiation through clinical trials.
"Directed" harvesting of cord blood stem cells is currently facilitated in the public system. When clinically indicated by a consultant overseeing care, collection of cord blood for donation to an identified family member in high risk families is facilitated by HSE hospitals in collaboration with the Irish Blood Transfusion Service. In addition, where an identified clinical need arises, Ireland has access to cord blood stem cells through international stem cell banks and registries and this is also arranged by the Irish Blood Transfusion Service.
Hospitals and their maternity service teams face significant challenges in ensuring that a safe and high quality maternity care system is provided to mothers and their babies within available resources. "Undirected" harvesting of cord blood, or collection of cord blood for private use in low risk families is not provided publicly in Ireland at present.
The HSE has not issued any direction to hospitals prohibiting them from undertaking undirected harvesting of cord blood under contract with private companies. However, staff employed at hospitals operated or funded by the HSE cannot undertake the collection of cord blood on behalf of third party commercial entities, as this activity would not be covered under the Clinical Indemnity Scheme. A number of hospitals have advised their clinical staff about the indemnity issues arising in this regard.
It is open to hospitals wishing to accommodate staff who are directly employed by third party commercial companies to undertake the procurement of cord blood at hospitals operated or funded by the HSE, provided they ensure that a service level agreement is in place between the third party commercial entity and the hospital concerned.
The HSE will continue to ensure that evidence-based, safe, effective and high quality care is provided to patients and their families. To this end the HSE and my Department will keep the emergence of the clinical benefits of cord blood banking under review.