Transplantation of Human Organs (Hansard, 30 March 1993)

§ Mr. Tam Dalyell (Linlithgow)

I beg to move, That leave be given to bring in a Bill to implement the recommendations of the Committee chaired by the late Sir Hector Maclennan and the report on Medical Research and Health of the Advisory Council on Science and Technology relating to the transplant of human organs. The purpose of this Bill is to allow hospitals to take the organs of anyone, other than people who have contracted out during their lifetime, through the central computer at Bristol. If legislation along these lines were achieved, we should avoid very difficult personal decisions being made at the point of maximum grief. These decisions have to be taken quickly as organs begin to deteriorate within half an hour.

This goes back a long way. In the 1970s I attempted on eight occasions to introduce similar legislation. In those days it was supported by Miss Mervyn Pike, who was the chairman of the Conservative health committee, by Col. Sir Malcolm Stoddart-Scott, who was a doctor deeply involved in the subject, and by the late and not forgotten Dr. Anthony Trafford, a distinguished Conservative Member of Parliament and renal transplant surgeon.

I have among the sponsors today some of those in the House who know most about these matters, including my hon. Friends the Members for Strathkelvin and Bearsden (Mr. Galbraith), a professor of neuro-surgery, for Kirkcaldy (Dr. Moonie), who is a doctor, and other colleagues who have taken a deep interest in these delicate matters.

In the summer of 1969 I did a survey of 1,000 families in the then West Lothian constituency on the ground that people would talk more willingly to a known Member of Parliament than to pollsters. Of those surveyed, 364 would have gone for opting-out; 312 said yes to opting-out but preferred the voluntary or card system to be given a proper chance first, there were 208 "don't knows", and the balance of 116 were against, including three state registered nurses who wanted resources for simple operations such as hernias before transplant surgery.

Even at that time there was a good deal of support for the opting-out system which, with qualifications, has been recommended by the distinguished surgeon who was the father of the hon. Member for Caithness and Sutherland (Mr. Maclennan), one of the sponsors of my Bill. Even though it had the personal support of the right hon. Member for Old Bexley and Sidcup (Sir E. Heath), the legislation which I proposed then was objected to chiefly by Sir Keith Joseph, as he then was, and his Department.

I do not in any way belittle the seriousness of those who oppose the Bill because, as the Minister knows, I went to the Department of Health and he courteously gave me an interview and explained that a number of surgeons, held in high regard by the Department, were unhappy about the element of compulsion. So it does the case that I put forward no service to pretend that there is not some serious opposition.

On the other hand, there is strong and powerful medical support. What has prompted me to try the ten-minute Bill procedure is the report of the Government's own committee, the Advisory Council on Science and Technology, entitled "A Report on Medical Research and Health" published with the imprimatur of the Cabinet Office, which says: 159 Organ transplantation: Through progress in surgical techniques, reinforced by the development of effective immunosuppressants and antibiotics, effective transplantation of organs (kidney, hearts, liver, cornea) and cells (bone marrow) over the past forty years has been a major achievement of 20th century medicine. Kidney transportation is now the treatment of choice for end-stage renal failure, and bone marrow transplantation has become the preferred treatment for some forms of leukaemia and marrow aplasia. Apart from bone marrow transplantation, cellular transplantation is a relatively new concept but is likely to have an important role in the future as growth factors and new knowledge of cellular biology allow specialised cells to be grown and manipulated in vitro by genetic modification. Then we come to the crunch of the report: Although the technologies are available, the full benefits to patients which can be achieved are not being realised because of our shortage of organs for transplantation. While the number of transplants in the first half of 1992 significantly exceeded that in the same period of 1991, less than one fifth of possible recipients received kidney transplants. Since past measures to increase organ supply have failed, radical actions need to be considered. Dr. Peter Doyle, chairman of the council's medical research and health committee, is quoted in The Independent as saying that in 1991 not one single kidney transplant was achieved through the card system. A lot of us carry our cards, but in the whole year it apparently achieved precisely nothing.

So to the recommendation of the Government's own report: We recommend therefore that the health departments enhance the number of organs available and investigate mechanisms to introduce an opt-out system similar to those operating in Belgium, France and Austria. Action", it says: Health Departments to introduce an opt-out system for organ donation. This ten-minute Bill does not encapsulate anything that is out of the way or in any way maverick. It simply seeks to face up to what we all know, from our constituencies, are very sad cases of desperate need for some kind of matching tissue, tissue which far too often goes up in the incinerator of the crematorium. It is for these reasons—humane reasons and reasons of medicine—that I hope not only that the House will give a hearing to the Bill but, far more important, because we know that ten-minute Bills are kite-flyers, that some kind of action will be taken within the next 12 months to deal with an acute situation in which there is an ever greater shortage—it increased by 7 per cent. last year—of matching human organs.