Public-private partnerships for UK cord blood banking

Philippa Brice

6 October 2014

A private cord blood banking company is to partner with an NHS Trust to deliver charitable and private umbilical cord blood banking services.

The company Precious Cells will provide the staff and equipment to collect and store stem cells from the umbilical cord blood of newborn babies to patients of Croydon Health Services NHS Trust. Parents will be offered the choice of making an altruistic donation of the cells to the NHS Cord Blood Bank without charge and for the use of others in medical need, or with that of Precious Cells for personal use at a charge of £2350 for thirty years’ storage.

The arrangement is said to be the ‘first of its kind for the NHS’; a similar partnership was announced between Virgin Health Bank and Cambridge University Hospitals NHS Trust in 2012, but this required payment from patients for a largely altruistic donation or a higher payment for private services.

Precious Cells Group chief executive Dr Husein Salem said that the partnership was intended to: “address the significant underfunding of UK stem cell banking and increase the number of stem cells banked from umbilical cord blood and tissue”.

A win-win situation?

Notably, the arrangement is via the company’s charitable arm, Precious Cells Miracle, and there be no charges to Croydon Health Services NHS Trust. They will also share some of the profits from private sales, expected to amount to £2 million over the first five years – which is indicative of the scale of potential returns for Precious Cells, who are said to be targeting multiple additional NHS trusts as new partners.

This announcement is in many senses good news for stem cell banking in the UK, which lags well behind many other countries in terms of the amount of cord blood stored for potential therapeutic and research use. Regenerative medicine is forging ahead and it is indeed likely that many new treatments using stem cells will become possible.

Already, for families where one member is in need of a stem cell transplant it may be appropriate to use cord blood from a new baby, a process termed directed donation. Private stem cell banking offers the future prospect of such a donation should the need arise, for a family member or the child themselves, although an individual’s own stem cells would not be suitable for therapeutic use in all cases. However, a well-stocked public stem cell bank can provide suitable tissue matched samples for all forms of treatment, as well as for on-going research.

Ethical issues

Whether a public-private partnership is good news for maternity patients, who could find themselves under direct or indirect pressure to agree to umbilical cord blood collection (whether for personal storage or donation) is less obvious. Private stem cell banking is expensive, but few prospective or new parents are likely to lightly dismiss what is described as protection against devastating and life-threatening diseases, especially if offered in the context of standard NHS services.

One testimonial on the Precious Cells website is from a mother who opted for the service after discovering during the pregnancy that her baby had a serious congenital heart defect; she says that they felt “helpless and out of control of our situation” but that banking the stem cells, whilst of no use for the heart problems, “was one way for us to feel as though we were able to do something to possibly help her should she need it sometime in the future”.

Perhaps the question is whether prospective parents and customers fully understand the relative values of public and private banking in terms of the risk that a member of their own family will both be in need of some form of stem cell transplant and be likely to benefit from a privately stored sample, which is at present small.

The official position of the UK’s Royal Colleges of Obstetricians and Gynaecologists (RCOG) and Midwives (RCM) remains that they support ‘medically directed and altruistic’ cord blood collection for public banking in the NHS or Anthony Nolan cord blood banks, i.e. not private banking. The NHS Cord Blood Bank cautions that private banking carries a ‘substantial cost and slim chances of ever needing it’.

Similarly, the American Medical Association states stresses that the ‘utility of umbilical cord blood stem cells is greater when the donation is to a public rather than private bank’ and to be encouraged, whereas ‘because of its cost, limited likelihood of use, and inaccessibility to others, private banking should not be recommended to low-risk families’.

However, with financial pressures on NHS Trusts in the UK already acute, many may not quibble for too long over nuanced issues of medical ethics and accept the option of a private partnership in order to fund other public medical services.