Organ Donation (Presumed Consent and Safeguards) (Hansard, 20 March 2002)

§ Mr. Tom Watson (West Bromwich, East)

I beg to move, That leave be given to bring in a Bill to provide for the removal of organs for transplantation purposes, after death has been confirmed in a person aged 16 or over, except where a potential donor previously registered an objection or where a close relative objects; and for connected purposes. By the end of this week, five people will have died unnecessarily on the waiting list for an organ transplant, and more than 200 lives will be needlessly lost this year because of a shortage of organ donors. The gap between the number of organs available and the number of people needing a transplant is widening. Since the House last debated presumed consent at the instigation of my hon. Friend the Member for Broxtowe (Dr. Palmer) in April 2000. the waiting list for organ transplants has risen by several hundred. Seven thousand people are now on the transplant waiting list and the queue is growing by the day. The sad truth is that one in 10 of those people waiting for a heart or lung transplant and 7 per cent. of those people waiting for a liver transplant will die, and many others will have lost their life before they even get on the waiting list.

I should like to quote from a letter from a Mr. Michael Newbold, who says that his wife was in hospital with what was later diagnosed as a serious, rare and incurable heart condition … after more than 100 hospital admissions she was told her only hope of continued life was to have a heart transplant. She has now been on the list for 15 months, and no suitable organ has yet become available. We know that fitness and good health is no guarantee that we will not eventually need a replacement for at least one of our organs. It could happen to any of us. Of course, we are aware and saddened that transplant can only normally come as the result of the death of a fellow human being, but surely it is a good thing if another person benefits from that tragedy? That is just one of thousands of cases, which demonstrates the urgent need for something to be done about the desperate need for more organ donors. The Bill would introduce an opt-out, rather than an opt-in, system, so that everyone would be a potential donor unless they registered their objections otherwise. A central computerised register of objectors would be established and would have to be consulted by doctors before transplant could go ahead. The system would have several additional safeguards. The deceased's close relatives would still be consulted in every single case and would have the ultimate veto over donation. The change would not apply to children under the age of 16, where explicit consent would still be sought in all cases.

In 1971, when even opting in was seen as controversial by some, contracting and opting out was raised in the House by the Father of the House, my hon. Friend the Member for Linlithgow (Mr. Dalyell). Thirty years on from his ten-minute Bill, the major medical advances in transplantation have made the Human Tissue Act 1961 even more outdated. The attempt that the right hon. and learned Member for Rushcliffe (Mr. Clarke) made last year to amend the Act through his Transplantation of Human Organs Bill is to be applauded.

326 We all have constituents whose lives have been touched by transplants. They are the miracle of modern medicine because, in death, they can bring the gift of life to others. Once considered to be perilous operations, they are now routine. Indeed, King's College hospital will have performed more than 2,000 liver transplants by the end of this month.

Public opinion has moved on, but although studies have repeatedly shown that up to three-quarters of the population would be willing to donate their organs after death, only 15 per cent. have signed up to the NHS organ donor register. In fact, with one of the lowest organ donor rates, we lag behind Europe. More than a dozen countries on the continent use some form of opt-out system and have far higher donation rates than in this country.

The system used in Belgium—rather than, for instance, that used in France—provides a good model for the United Kingdom. Belgium established a register of non-donors in 1987. Citizens can express their objection to organ or tissue donation at the town hall. By the end of 1995, nearly 2 per cent. of the native Belgian population had registered their objections to donation. It is mandatory that the register be checked before any organs are removed, and in practice relatives are still consulted. Countries that have a system of presumed consent also tend to have higher donation rates than those without.

As the hon. Member for Oxford, West and Abingdon (Dr. Harris) pointed out to the House in July 1998, there is well-documented and convincing evidence that when Belgium changed from contracting in to contracting out there was an increase in organ supply. In Antwerp, they kept the opt-in system, but had a big public education campaign. In Leuven, however, they adopted the new law. Over a three-year period the rate of donation in Antwerp stayed the same, whereas in Leuven it rose from 15 to 40 donors per year.

My hon. Friend the Secretary of State for Health has set the challenging target of doubling the number of individuals on the organ donor register to 16 million by 2010. That is a laudable aim, and I welcome any proposals to increase donation and bring life to others. In my region, The Birmingham Post has run a successful campaign, regularly printing donor cards and promoting the organ donor register to its readers in the west midlands. Ultimately, however, if we are significantly to increase the rate of organ donation we also need a change in the law and a positive change of emphasis towards organ donation, which this Bill on presumed consent would achieve.

Medical experts have suggested that a system of presumed consent would increase the rate of organ donation by at least 20 per cent. in this country, thus going a long way towards tackling the problems I outlined at the beginning.

I am grateful for the support of so many Members on both sides of the House—not least for their hacking for early-day motion 527. I am also pleased that 40 Members have joined the NHS organ donor register in the last few weeks. We, as Members of Parliament, should be leading the way and encouraging as many of our constituents as possible to sign the register.

The Bill is also backed by the British Medical Association, many individual doctors, surgeons and patients' groups, and many of my constituents. While 327 opinion in the country is mixed, a clear majority now favour "soft" presumed consent, and they look to the House to lead rather than follow.

It is time for a public debate on presumed consent. It is time to prevent any further widening of the gap between the number of organs available and the number needed for transplant. It is time to drag our organ donor laws into the 21st century. This Bill is about saving lives, and with the support of the House we can begin to address the chronic shortage of organs for transplant.

Question put and agreed to.

Bill ordered to be brought in by Mr. Tom Watson, Mr. Tam Dalyell, Mr. Kenneth Clarke, Mr. Parmjit Dhanda, Dr. Evan Harris, Dr. Ian Gibson, Dr. Nick Palmer, Mr. Peter Pike, Mr. Nicholas Soames, Mark Tami, Dr. Richard Taylor and Dr. Jenny Tonge.