Health, House of Lords, Speeches

Health: Donor Organs (EUC Report)

Posted by LordSheikh

My Lords, I have taken a close interest in organ donation for a considerable time and I welcome the report of the European Union Committee. Inevitably, this is a matter of concern to the public and, as highlighted by the committee, is more complex than the simplistic terms in which it is often presented. The last opportunity that we had in this House to consider this issue was earlier this year when the noble Baroness, Lady Finlay, introduced the Kidney Transplant Bill.

Undeniably, there is a shortage of organs for transplant in all countries across the European Union. The European Commission’s communication of May 2007, which established a directive to define standards for the quality and safety of organ donation and transplantation across the European Union and an action plan, was, unquestionably, well intentioned. Around 7,500 people are waiting for an organ transplant in the United Kingdom, with almost 400 people each year dying while awaiting treatment. Across Europe, this is estimated at around 40,000 people, which, by any measure, is a large number. Tragically, this includes nearly 100 children each year. These figures do not include those who would ordinarily benefit from the procedures, which would run to many thousands more people. It is apparent that the scale of human suffering caused by the shortage of organs is profound, as many people face pain and ill health while on the waiting list.

The problem is not one of willingness to donate. The number of people willing to donate their organs far exceeds the number who have completed organ donor cards. Notwithstanding that, we donate, per million of the population, only one-third of the number of organs donated in Spain and around half of that in Austria, France, Belgium and the United States. Our donation rate lags well behind the average across the European Union. It is clear that we need to do more, but a system of presumed consent is not the answer.

As a consequence of family refusals, around 40 per cent of those who have an organ donor card do not donate their organs. The context, therefore, for organ donations in this country is a problem, fundamentally, of infrastructure and organisation rather than just a matter of presumed consent. That was the conclusion in the report published in January this year of the Government’s own Organ Donation Task Force. The target of increasing donation rates by 50 per cent in five years is worthy of support and I wish the task force well. Given that the Government accepted the recommendations, I hope that the Minister can provide an early indication of what progress has been made.

I am uncomfortable with the issue of presumed consent. The state does not own our bodies and it should not have the right to take organs after death. Organ donation must be achieved without causing offence or distress to the family of the deceased, and should be established on explicit consent. If we are to make progress, we need to enhance organ retrieval teams in hospitals and appoint more donor liaison nurses in order to improve the alignment between those who express a willingness to donate and those who ultimately provide their organs.

During our debate on the Kidney Transplant Bill, I recorded my concern at the very low level of organ donation among ethnic minority groups across the United Kingdom. Different religions take different approaches to organ donation, but none of the five major religions objects to the principle. More needs to be done to increase the numbers among minority ethnic groups who donate their organs. I should be grateful if the Minister could provide a specific answer to what is happening on this front.

The committee concludes robustly against the sale of organs, and I agree that the trafficking of organs is a major problem, particularly as it often affects the vulnerable and weak in the countries that bear the pain of this hideous behaviour. This is an issue that has a particular currency on the Indian sub-continent.

What impressed me most in the committee’s report was the evidence provided by Dr Rafael Matesanz, who has been responsible for a magnificent achievement in devising and implementing significant improvements in the supply of organ donations in Spain. I salute the expertise that he offered, and how the committee presented his coherent and beneficial evidence. We cannot escape the reality that the retrieval of a donated organ needs to take place within twelve hours of death. It is clear from the report that there is not sufficient infrastructure to enable the retrieval and use of organs to meet demand, even under a system of presumed consent. We do not have the organisation in this country to address the demand for organs, and that will not be resolved by introducing a system of presumed consent.

The European perspective is another area in which I should like to address some remarks. There is limited value in establishing a pan-European organ donation sharing system. In most cases, domestic demand far exceeds supply, and in only a very small number of cases would it be practicable. I agree that there is some advantage in the establishment of a number of minimum common standards, but that is probably the extent of the value-added that we can expect from the European Union in this area. I entirely agree with the committee’s rejection of a pan-European donor card. Given the excess of demand in all European countries, it is hard to imagine where the value-added could be found, let alone the problem of identity, which may restrict people’s engagement on a European level. The Government should do more to encourage people in this country to sign up to become organ donors, but that is unlikely to work across the Union.

In drawing my remarks to a close, I welcome the conclusions of the committee’s report and congratulate noble Lords who have done such thorough work in this important area. I particularly look forward to hearing from the Minister how the Government propose to increase public awareness of and participation in organ donation schemes; what progress we can expect in developing the infrastructure and organisation to cope with the increased supply that we all want to see; and what action they will take to ensure that effort is focused on those ethnic minority groups where at present there is a shortage in participation.

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