Anger at deliberate use of 'surplus'

The Nuffield Council of Bio-ethics, which examines ethical questions in biological research, came out this year against commercial dealings in human blood. "What is freely given by donors should not be used to make a profit," it concluded.

Although subsidising UK supplies by selling surplus blood and blood products was not ruled out, it did not address the question of what happens to those surpluses when sold.

For the donors, that is the heart of the matter. Pauline Swan, 44, from Oxford, said: "I don't think that any donor in this country would be giving up their time to make profits for somebody else abroad."

Until recently, most donors did not know they were. They are still not routinely asked whether they might object. Mrs Swan said she had only recently discovered where her blood went. "I've always assumed it's gone for use in this country."

But in the House of Commons last December, the Government admitted that sales had been taking place since before 1986 to recover costs.

As concern grew at this revelation, the National Blood Authority repeatedly stated: "Our charges are set at the level required to recover our costs. No profit is involved."

But the implications of the commercial sales operation were not explained to donors and many have been angered to discover an overseas mark-up.

Mrs Swan, a medical personnel worker, said she believed the assumption from donors was that surpluses would go to health professionals, not businessmen.

And Dr Paul Giangrande, a consultant haematologist, said the National Blood Authority was disingenuous in arguing that the alternative to sales was destroying blood. Any excess should be given free to countries who needed it, not those who could pay, he said.

Two-thirds of the world's 180,000 haemophiliacs receive no treatment and many of BPL's rival pharmaceutical companies donate supplies to developing nations through the World Federation of Haemophiliacs.

Sue Kilroe, 33, a founder of the Merseyside and North Wales Patients and Donors Association, added: "It's just totally unacceptable the way they are going about it."

Blood service insiders claim that as sales began around a decade ago, surpluses could not have occurred by chance and commercial gain must have been in mind when the blood was collected, even if only to satisfy the Department of Health's demands that the service is self-financing.

One service worker said: "In these circumstances, there was a duty to give prior warning to donors that by-products of their blood might be sold."

An NBA spokesman explained whole blood was very rarely used, but parts - red cells, platelets and plasma products - were used as appropriate. High demand in England and Wales for red blood cells has left plasma unused. If this was not sold, the NBA could not balance its books, as required by the Department of Health. But it did not believe people in Turkey would pay the full list price.

Turkey has to import blood products as it does not make them itself and regulations governing pharmaceutical products like Factor VIII mean they have to go through a licensed distributor, the spokesman said.

Asked why these arrangements had not been explained to donors, he asked: "Is there really a necessity to?"

Tessa Jowell, a Labour health spokeswoman, said: "I don't think there's necessarily any reason to assume that donors would object, but they ought to be told."