Listener 8 March, 1980.

Keywords: Health; Social Policy;

Legislation passed in 1979 made it illegal to buy or sell human blood, except with the consent of the Minister of Health. Is this not another example of the government over-regulating life? Did not Gerald Ford, ex-president of the United States, part-pay his way through university by selling his blood? Given the miserable level of student bursaries, is the prohibition on selling human blood yet a further attempt to ensure that future New Zealand prime ministers will not have a university education?

After all is not blood like any other commodity, demanded by some who are willing to pay for their requirements? And if they are willing to pay enough, will there not be others who are willing to supply the blood? Payment for supplying blood is the main method in the United States and the Soviet Union– why is it not appropriate here? In the US blood is also supplied by expatients replacing what they had earlier used and by relatives of patients in return for lower hospital fees. But the principle of human blood as a marketable commodity remains. Why then should we get out of line with the super powers ?

If the last two paragraphs have left you a little uneasy, you will find thoughtful support in Richa!d Titmus’s The Gift Relationship (Allen & Unwin). Titmus who was Professor of Social Administration at the London School of Economics died in 1973, alas, but he left us some of the most thought-provoking ideas of the 1970s on social policy.

The book begins with a comparison of the supply of human blood in the US and Britain where, like New Zealand, blood is supplied by voluntary donors through a state-dominated service. He concluded that the resource cost of providing blood in the United States was about five to 15 times the cost in Britain. There were a number of reasons for this. Donors in the US are more likely to have hepatitis there the selling of their blood is a major source of income for alcoholics and other drug addicts. The British voluntary donor is more likely to be accurate about his health status than the paid American. Blood is perisHable and the American system of firms in competition is more wasteful than the British monolith.

Thus we might justify the legislation because it is cheaper for our health service to be supplied from voluntary rather than paid donations. However, it is dangerous to conclude that an action is good because it is cheaper to the government. On more than one occasion this column has drawn attention to the inefficiencies and inequities which have occurred from this practice.

Consider what would happen if, for instance, commercial firms were to come to New Zealand to purchase blood for export. (This may sound a bit macabre, but already it is happening in a number of third-world countries. ) Even if the agencies confined themselves to skid row (and university students) their activities would affect voluntary supply.. Titmus shows how the introduction of a commercial market reduces people’s willingness to donate blood since the action has been tarnished by commercialism.

Why do people donate blood without direct reward, at a cost of their own time and effort, to another with whom they have no direct contact? It is surely easier to be a Good Samaritan if you meet the needy on the road, or see him on the television screen-as in the case of Abbotsford to give but one recent example. Titmus surveyed a group of British blood donors and found them a relatively representative cross-section of the community as measured by socioeconomic class, age, or sex. (A recent New Zealand survey showed cigarette smokers were under-represented among donors. I leave you to speculate why. )

Donors gave a wide variety of answers as to why they gave blood, including the odd humorous response: ‘I get a good cup of tea’; ‘I go along to hold my husband’s hand’. However, the most important reason was altruism, the regard for the needs of others as a principle of action. Donors showed a high sense of awareness of belonging to a community and of social responsibility.

Thus the consequence of the legislation preventing the commercialisation of supplying blood is to maintain a means for us to express our commitment to the community we live in – Titmus’s final chapter is entitled ‘The Right to Give’.

It is useful to reflect on what other areas of human activity commerialisation could or has driven out other social values: voluntary help, sex and parenthood are some possibilities. In my view one of the problems of our welfare state is that, while it is firmly based upon the principles of altruism and community, it emphasises the collective giving and so tends to ignore the individual gift, the contribution we may make as a person to the needs of others, be they old, sick, struggling parents and so on.

This, of course, is not yet another demand to shrink our welfare state for good commercial reasons. Those who join that cacophony need to be reminded that the commercial market-place can be destructive to social behaviour , that people do things for reasons other than greed and self-advancement.

By making it illegal to buy and sell blood (without the Minister’s consent) the government is acknowledging that we are a community. By you giving your blood, you do the same.