Meeting of the Parliament 29 November 2016
I am delighted that, for the first time, we are debating this hugely important issue in the chamber, and I am grateful for the great level of cross-party support that my motion on men who have sex with men being treated equally with regard to blood donations has had.
At our party’s autumn conference, the First Minister said that the key message that she wanted to promote above all else was inclusion, and my motion is about exactly that—equality and inclusion. Scotland has led the way on equality in recent years, and our party has an unblemished track record on promoting equal rights. In 2005, discrimination on the basis of sexual orientation and gender was banned; in 2009, same-sex couples were allowed to adopt children; and in 2014, we legalised same-sex marriage.
As the law stands, no men who have had sex with men in the previous 12 months, or women who have had sex with men who have had sex with men, may give blood within the 12-month deferral period. Those rules are archaic and have their origins in the 1980s, when little was known of the risk of HIV, the modes of contracting it or its prevalence in specific communities.
In last week’s debate on adoption, I spoke of close friends of mine who are in a same-sex marriage and who have just gone through the adoption process. How will those men, who are in a loving, monogamous relationship, explain to their child why they are being treated differently when it comes to giving blood? Shockingly, if their child ever needed a blood transfusion and they were a match, they would not be allowed to save their own child’s life in an emergency. In the name of equality, it is time to end the current discriminatory process and to base donor eligibility on risk, regardless of sexual orientation.
The current rules on blood donation make no reference to someone’s personal risk of being a carrier of HIV. A promiscuous straight person would be able to donate blood, while a monogamous gay or bisexual man would not. Scotland has a chance to address one major area where inequality still exists and, at the same time, to tackle the chronic lack of uptake in blood donation and the need for new donors to come forward to meet our demand for blood products. Over the past 10 years, there has been a 40 per cent drop in the number of people who give blood, and current figures suggest that only 4 per cent of people in the United Kingdom regularly donate, yet 6,000 blood transfusions are needed in the UK every day.
Stonewall Scotland believes that excluding thousands of gay and bisexual men who may safely be eligible to donate threatens the blood supply that one in four people will rely on at some point in their life. The fact is that the breakdown shows that the number of heterosexual people with HIV is rising, and the eligibility rules take no account of that. In addition, the regulation of men who have sex with men donating is based on self-declaration and it is incredibly simple to hide sexual activity in order to give blood.
Of course there must be stringent donor selection criteria that are aimed at protecting donors and recipients of blood transfusions—no one would ever argue otherwise—but those criteria should be based on participation in high-risk behaviour rather than sexual orientation.
The public need to have confidence in the transfusion system, and it is important to stress that all blood is screened to the highest level. That said, the fact that the statistics show that only one bag of blood has tested positive for HIV in the past four years puts what we are talking about in perspective.
We need to introduce a non-discriminatory risk assessment policy that will judge each individual equally, whether they are straight, bisexual or gay. The current rules were put in place in 2011, after the Advisory Committee on the Safety of Blood, Tissues and Organs—SaBTO—reviewed the donation rules. SaBTO recommended reducing the lifetime ban to a one-year deferment for men who have sex with men, and that recommendation was accepted.
Scotland needs to go further to ensure that all people can donate blood on the basis of their personal risk of blood-borne virus transmission, not their sexual orientation. Although health matters are devolved to the Scottish Parliament, blood donation policy has so far been in line with approaches in England and Wales, following the guidance provided by SaBTO.
In June 2016, an all-party parliamentary group at Westminster on blood donation began an inquiry into the current rules. That debate is happening alongside a review by SaBTO of the blood donor selection criteria. Stewart McDonald, the MP for Glasgow South, recently chaired an evidence-taking session at Westminster on the issue, and the APPG is due to make a recommendation early in 2017.
The Scottish National Blood Transfusion Service could determine its own policies and restrictions for men who have sex with men, but it would be unlikely to be willing to implement a policy that was contrary to the evidence-based guidance of the Advisory Committee on the Safety of Blood, Tissues and Organs. However, in 2011, the Northern Ireland Executive chose not to implement SaBTO’s proposed change to the deferral criteria for that group and maintained a ban. Wales, England and Scotland all moved to a 12-month deferral period after the last MSM sexual contact. Northern Ireland changed its criteria this year to fall into line with the rest of the United Kingdom, which sets a precedent for autonomy.
To highlight the great anomaly, gay men can join the bone marrow register and donate organs and stem cells. Everyone goes through the same health and suitability checks—sexuality does not matter one bit. Whatever a person’s age, health or sexual orientation, they can donate.
Argentina, Chile, Colombia, Costa Rica, Spain, Italy and Mexico are some of the countries that accept donations without basing eligibility on sexual orientation. Spain has a deferral period of at least six months after a change of partner for heterosexual and MSM donors, with permanent deferral for individuals who have multiple sexual partners. In Italy, a deferral period of four months applies to people who have multiple partners when they have had a change in regular partner.
It should be possible to ask donors more detailed questions about their sexual activity rather than just whether they have had sex with another man in the past year. We would thereby gain more accurate information on risk and make the blood supply safer, which is of paramount importance. Of course, the current law also affects transgender people who want to donate blood, as it means that any man who transitioned to being a woman is still classed as an MSM and is therefore not allowed to donate, even though it might be a number of years since they last identified as being an MSM. Lifting the ban on MSM donating blood and replacing it with a more equal, non-discriminatory risk assessment is fairer, particularly since one in three 16 to 24-year-olds do not identify as heterosexual.
The Scottish National Blood Transfusion Service recently published a document with an updated position on gay blood donation. That document recognises the principles of kindness and mutual trust that are expected between all blood donors and the blood transfusion service. However, the mutual trust that the service expects is not reflected in the selection and deferral criteria, which is evident from the fact that there is no consideration of the position of thousands of gay and bisexual men who are in committed relationships, where the risk of HIV transmission is negligible.
For the sake of equality, Scotland needs to go further to ensure that all people can donate blood on the basis of their personal risk of blood-borne virus transmission, not their sexual orientation. We need to introduce a non-discriminatory risk assessment policy that will judge each individual equally, whether they are straight, bisexual or gay. That would increase the number of much-needed donors throughout Scotland.
As I mentioned, my motion is about equality and inclusion. As my colleague Patrick Grady MP recently said at the first meeting of the APPG on blood donation, for many gay men, a 12-month deferral is, in effect, a lifetime deferral. Even if we shortened the deferral period to three months, it would still, without doubt, be a discriminatory measure against MSM couples who are in stable, loving relationships. That is not equal or inclusive. Let us go further, Scotland, and end that inequality now.
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