TRANSPLANTS OF HUMAN ORGANS (Hansard, 2 February 1972)

§ 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 is not the occasion to go into the ethical, medical or legal aspects of this very complex subject of transplants. It is up to me to present a prima facie case in support of my request for leave to introduce this Bill.

The present position is that some 2,000 people between the ages of 15 and 55, who could be saved, die each year of kidney disease. In those cases, only one organ is diseased. Nothing else is wrong with them. Those 2,000 people have productive lives, except that they suffer from a kidney disease. That in itself is a fairly serious matter which warrants parliamentary discussion; these are people who could be saved. Society would go to a great deal of trouble to rescue them from disaster at sea, involving a great deal of expense on helicopters, or from any other form of disaster.

Another aspect of the present situation is the appalling state of affairs which now confronts our hospitals. A hospital has to telephone the next of kin at the moment of maximum grief to ask the terrible question, "Can we have the organs of your loved one?" It may be that there would be a very different answer either the day before or the following day. But I have spoken both to those who have regretted that they have said, "No", and to those who have regretted at this moment of grief that they have said, "Yes". Families are in no state to reach a rational decision on what is a very personal problem within an hour or two of hearing of an accident. The stark truth is that it is from accidents, and unexpected death involving young people, that surgeons obtain the organs that they need if they are to help save the lives of others.

There is something to be said for implementing the Maclennan Report in order to do away with this quick decision-making. After all, we all think that accidents happen not to ourselves but to other people. None of us expects to be 457 involved in an accident. Inevitably, there will be this surprise, and that is one reason why the House should give me leave to introduce my Bill. Families could make their decisions in a cooler moment

I must be quite frank with the House. The Maclennan Committee was divided about whether there should be a system of contracting in voluntarily or, as Professor Roy Calne, a constituent of the hon. Member for Cambridge (Mr. Lane), believes, a contracting-out system whereby everyone who has not taken a decision in his or her lifetime before being faced with an accident, may have his or her body touched; those contracting out, having met with an accident, can ensure that no part of it shall go to surgeons.

I admit that in asking the House for leave to introduce a Bill designed to implement the Maclennan Report, I am seeking the best of both worlds. I believe that we should have both a voluntary system of contracting into a central registry at Bristol, and a system of contracting out. At any rate, this would be the basis for an experiment. But, as with so many other matters dealing with transplants, it is up to this House to decide what it wants rather than for me to make any firm recommendation on this very difficult point in asking leave to introduce my Bill.

I wish to draw the attention of the Department to the fact that this is no radical proposal. Denmark, France, Italy, Sweden and Israel, and many other countries, have systems of contracting out and, consequently, have far more organs available for cases of the kind to which I have referred than we do in this country. The implementation of the Maclennan Report really is no great radical measure.

The surgeons who have to do this job are saying desperately, "We are now able to save only about 10 per cent. of those whom we could save." I suggest not immodestly that, when surgeons involved in transplants are united in wanting a Measure of this kind, the burden of proof is on the Department to say why it does not want it rather than on us to say why we do. I hope that the Department will take some opportunity to explain its attitude, if it is not prepared to facilitate the passage of this Bill.

458 Since I last introduced the Bill, the Bar Council has come forward with proposals for a new Organ Transplant Act. The supply of donors might be substantially increased by more satisfactory legal arrangements which commanded greater public confidence. This is neither the time nor the place to go into the details of what the Bar Council wants, but I believe that I am correct in saying that, since publication of the Brodrick Committee's Report, there has been a strong feeling among coronors that the law should be altered in the direction that the Maclennan Committee suggests.

It is no answer—I do not suppose that the Under-Secretary would say this—that, because we have this week set up a register in Bristol, therefore these problems are solved. Though I very much applaud what is happening there, it will make no difference to the total supply of organs.

Much of the discussion has been conducted in terms of what is good or bad for donors. I regret this. I should have hoped that a little more attention would be paid to the needs and requirements of recipients. Like many hon. Members, I have had drawn to my attention all too often terrible cases of parents who feel that 20-year-olds could have been saved and led a productive life had organs been available, thousands of which now either go up in flames or are buried, to rot away, underground.

I ask hon. Members who are doubtful about the proposal which I am putting forward to imagine a situation in which a relative, a son or daughter, could be kept alive, for a productive life, but for the want of one organ. In that situation what would they do? I think that most of us would be very clear that, however sad an accident might be, we would want for a member of our own family one of those parts which would be destroyed. This view has been accepted by many religious bodies, including the Roman Catholic Church. There is, in fact, a papal encyclical on this matter, as my hon. Friend the Member for Bothwell (Mr. James Hamilton) knows.

I have, somewhat awkwardly, to raise the question of cost. When it is a matter of saving human life or not, it is embarrassing to mention the cost. However, the Under-Secretary knows that in the 459 Health Sercice there are extremely complex questions of priority. Renal dialysis is exceedingly expensive. Many people who could be saved are not being saved. Transplantation is much less expensive and, therefore, should be rationally considered.

I can understand that the Government are worried about public attitudes. It may allay their fears, if I say that in the summer of 1969 I spent 43 days in West Lothian carrying out a serious survey of 1,000 homes asking about attitudes to contracting in and contracting out. Of the 1,000, 364 were definitely in favour of a contracting-out system, 312 would have gone for contracting in, 116 were totally against, and the balance, 208, had not made up their minds, though they included some who had thought a great deal about the subject after a television programme, "Panorama" had explained the issues at that time.

I do not think that the Department would find the British public nearly as antagonistic to what Sir Hector Maclennan and his surgeon colleagues have suggested as they might suppose. Therefore, I offer the Bill to the House in the certainty that it ought to be discussed and given a Second Reading.