TRANSPLANTS (Hansard, 18 May 1971)

§ Mr. Tam Dalyell (West Lothian)

I beg to move, That leave be given to bring in a Bill to implement the recommendations of the Committee chaired by Sir Hector MacLennan on the transplant of human organs. This Bill, which has all-party support, is to implement the recommendations of the Committee which reported in July, 1969, under the chairmanship of Sir Hector MacLennan, then the President of the Royal Society of Medicine, which advised on transplantation problems on the question of amending the Human Tissue Act, 1961.

The House knows perfectly well that any attempt to get Ten Minute Rule legislation at this season of the Parliamentary year is doomed to failure. Therefore, I had better declare that the real object of the Bill's sponsors and myself is to register the opinion that the MacLennan Committee's Report should not be left to accumulate dust in some pigeon hole in the Department of Health and Social Security but that the Government should come forward with their own proposals on the whole question of spare-part surgery during the next Session of Parliament and to ensure that this subject reaches the Secretary of State's in-tray.

On one thing at least the House can be agreed: that there is a very wide consensus that, with the surgical possibility of carrying out more and more organ transplants, the current situation is extremely unsatisfactory.

As of now a hospital often has to phone the relatives of a young man or woman who has been unexpectedly killed—perhaps in a road accident—and ask for permission to use the organs of their loved one at the point of maximum grief. Anyone who has been in a hospital and seen this being done cannot but be moved at the human emotion involved in the situation.

The House will readily understand that this is no time in a family's affairs to reach what is a very private, personal and, indeed, important decision. It is clear that the decision whether a person's organs should be given to what might loosely be called an organ bank rather than be cremated or buried should be taken in a cool moment, not in a moment 1083 of emergency. The present situation is unsatisfactory because no one thinks that road accidents or sudden death is something which comes to him; it happens only to other people. Therefore, we never get round to volunteering.

In terms of policy, we are confronted by two possibilities. Either a system of contracting out—that is, taking anyone's organs after clinical death has been established other than of those who have taken the trouble to object during their lifetime—or of contracting in—that is, volunteering during one's lifetime the use of one's organs—should they be needed. Both systems would assume a register of information on—dare I say to some of my hon. Friends and, indeed, hon. Gentlemen opposite after what the House has recently been discussing—a computerised register to which transplant teams could have easily available access.

The MacLennan Committee had a narrow majority. It is a Government-endorsed and Government-publicised voluntary system for which this Bill asks. It asks, inter alia, for the Government to try, in the first instance, to have a well publicised Government-sponsored campaign for a voluntary system. I am authorised to tell the House that the member of the MacLennan Committee who argued most strongly in favour of a system of contracting out, as they have in Scandinavia, Professor Roy Calne of Cambridge, has said that he would now accept a system of contracting in in the first instance.

In the summer of 1969, I was involved in an extensive survey of public attitudes, something which is perhaps more easily done by a Member of Parliament than by the Government Social Survey, because we can ask private and personal questions with some authority and with a hope of frank answers. I did this survey over 43 days in West Lothian of 1,000 families individually on their whole attitude to the question of human organs and transplant problems.

There were 208 "don't knows", including many who had reflected most deeply on the issues after the "Panorama" team had gone into the Report of the MacLennan Committee 1084 fairly deeply. There were 112 who were totally against, including some registered nurses who simply took the attitude that there were more important things to do in hernia operations end other simple operations rather than in spectacular surgery. There were 316 who were in favour of contracting in and 364 would have found contracting out to be acceptable.

I claim no more for these figures than that they are from people who are prepared to talk seriously about personal matters to their Member of Parliament in their own homes, and it represents a fairly accurate survey of public attitudes, at any rate in the industrial North. The results might be a bit different in London and the Home Counties and different again in rural areas like the Scottish Highlands.

Those who were for contracting out represented the largest single group, assuming that those against and the "don't knows" would mostly prefer volunteering. It should be assumed that the majority would go for contracting in. This is what the Bill asks for, with the support of Sir Hector MacLennan, the enthusiastic support of Sir Michael Woodruff and many other surgeons who are frustrated at the present system, under which they see their patients slipping away for the want of organs which are being buried and cremated.

In the words of Professor Woodruff: It is important to let the public see that a campaign to promote a system of contracting in has the support of the countries' leaders and is not just the notion of a few crackpot professors of surgery.