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New NHS row over Welsh hospital supplies.

SURGICAL instruments whose use resulted in a threefold increase in haemorrhaging during tonsillectomy operations were supplied to Welsh hospitals by order of the Department of Health in England.

Assembly officials have confirmed that the NHS in Wales was not responsible for choosing the instruments, whose use has now been banned.

In future, instruments will be bought in line with specifications laid down by specialist surgeons in Wales.

There is a moratorium on all but emergency tonsillectomies in Wales until the New Year, and a backlog of thousands of patients waiting for operations has built up.

Cardiff ear nose and throat surgeon Alun Tomkinson identified the big increase in haemorrhaging after reviewing about 20,000 tonsillectomies that took place over a six-year period.

Disposable surgical instruments were used in Welsh hospitals from early 2001 after reusable instruments were banned because of a theoretical risk of transmitting variant CJD, the human version of BSE. Use of the disposable instruments was also suspended in December 2001 after concerns about haemorrhaging in operations.

Mr Tomkinson said: "My research paper on the issue hasn't yet been published, although it was important to take action immediately.

"It's easy to get the wrong impression about disposable instruments. If you compare them with the reusable instruments it is very difficult to tell the difference. Both are made from stainless steel, and the disposable ones probably look more impressive because they are new and shiny. They are extremely good copies.

"It's true that in England they have resumed operations with reusable instruments. There they have to warn patients they may risk contracting variant CJD if they have the operation. It's true that the risk is tiny, but it's not something any parent whose child is about to have their tonsils out wants to hear.

"I have been involved in this process and we have discovered what we regard as subtle design problems in some of the instruments we have examined.

"It's clearly important that we make sure the disposable instruments used in the future do not cause elevated levels of haemorrhaging. To that end, we have suggested a set of design specifications that will ensure the instruments are as safe as they can be."

A spokeswoman for the Welsh Assembly Government confirmed that the disposable instruments previously used had been bought through the NHS Purchasing and Supply Agency in England.

A spokeswoman for the Agency defended the way the contract was handled, saying: "The procurement process, which was carried out in line with EU requirements, was undertaken with the support of the British Association of Otorhinolaryngologists - head and neck surgeons - and consultation with their members was sought on an ongoing basis.

The spokeswoman added that price had been one of seven criteria used in choosing the five companies whose disposable instruments were bought under the contract.
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Publication:Wales On Sunday (Cardiff, Wales)
Date:Dec 1, 2002
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