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Ms Stuart: Again?

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Mr. Swayne: Indeed. Florence Nightingale pointed out that reports do not implement themselves. Action must arise from the summit. I ask the Minister to assure us that the national consultative body that will be set up as a result of the summit will have an agenda. I shall suggest some items for it.

The first item is how to increase the number of people who make their organs available for transplant. One method is to use the electoral registration process, which some local authorities are already doing successfully.

The consultative group will have to consider presumed consent. I am not an advocate of presumed consent, and many of my hon. Friends have grave reservations about it. I have a philosophical reservation, just as I had a reservation about the motion that we considered on Monday, when we "deemed" something to have occurred in a Standing Committee that clearly had not happened. I have reservations about presuming that something has been done, when it clearly has not.

My hon. Friend the Member for Woodspring pointed out that presumed consent may make matters worse. Let us imagine the case of a close relative who might legitimately have expected to be asked whether the donor would have had any objections. If the relative was not asked, and an issue was subsequently made of it, we can imagine the tabloid treatment of the case and the damage that it might cause the organ donation programme. There are, therefore, dangers in the process. However, the proposals about presumed consent with safeguards that the BMA has put forward in its document deserve close examination. Those proposals do not differ much from existing practice, and a debate on that issue is worth having because it would raise the profile of the issue and perhaps generate a great many more organ donors.

I would also like the consultative group to review the work on elective ventilation. I make no secret of the fact that I am an enthusiast for elective ventilation. The programme was highly successful: Professor Feest's work doubled the availability of organs available for transplant during the time that he carried out elective ventilation. There are difficulties associated with the practice, and they are covered in the BMA's work. However, the programme was effective, and it was stopped because of the doubts about its legal position, to which my right hon. and learned Friend has drawn attention. That doubt could be clarified by a change in the law, and if that does not happen, we may be passing over a very effective way of increasing the number of organs available for donation. I would certainly ask the consultative group to review that work.

I would also like the consultative group to review the co-ordination and organisation of the transplant infrastructure. Many health professionals believe that the Department of Health's review of the United Kingdom Transplant Support Service Authority that took place in 1998 and 1999 was a missed opportunity. The Royal College of Surgeons has subsequently called for a national transplant service. We should like that case to be reviewed again.

In supporting this narrow but very important Bill, I also call for urgent action on the other fronts that I have mentioned. I remind the House that we have been waiting some time. At least in one respect we shall have to wait no longer, as a consequence of my right hon. and learned Friend's important Bill, which I commend to the House.

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1.32 pm

Mr. Barry Gardiner (Brent, North): I recall--indeed, I shall never forget--the occasion on which I went to record the death of the woman who had taken care of me for 20-odd years of my life. There was a question about my relationship to the deceased on the form that I had to fill in. In answering that question, I said that she had been my nanny. The registrar said, "I am terribly sorry. That is not a subsisting relationship. You will have to be the person who causes the body to be disposed of." I shall never forget that. All hon. Members, and all those who draw up official forms, would do well to remember that, in circumstances such as these, when we try to set up a procedure and put in place a form on which it is necessary to capture a relationship, it must be done with great sensitivity.

I do not believe that any hon. Member would say that the aims of the Bill introduced by the right hon. and learned Member for Rushcliffe (Mr. Clarke) are not sound and good. The Bill aims to ensure that more organs are made available for donation and, therefore, that more lives will be saved. That is entirely commendable.

If I may be so audacious as to say so, I think that the right hon. and learned Gentleman has shown his great experience in the House by producing such a brief and short Bill, which has as few traps as possible. The older and the wiser the head, the more one is capable of putting a case with extreme brevity, and the Bill certainly has done that.

Doctors, health care trusts and medical professionals have a grave responsibility towards the relatives of patients who have been in their care and people, like me, who are not relatives. On occasions, most notably at Alder Hey recently, they have shown contempt and a complete disregard for the nature of those relationships. Clearly, medical professionals had forgotten that the patient was a person or a child, and not a specimen, a cadaver or a series of organs that had to be disconnected and taken elsewhere.

My reservation about the Bill, I put it no stronger than that, is that it would reduce the need to consult the people who are extremely close to the patient--they may not be blood relationships or marital relationships--and it would enable hospitals and medical professionals not actively to strive to get the consent of those people who are most concerned and closest to the deceased.

I do not want to detain the House, as it has other business to deal with; I simply want to express that reservation in the wider hope that the filling in of forms generally--not merely for organ transplants--may be made more human.

1.38 pm

The Parliamentary Under-Secretary of State for Health (Ms Gisela Stuart): I am grateful to the right hon. and learned Member for Rushcliffe (Mr. Clarke) for putting these proposals before us today. He has explained that his intention is to clarify some aspects of the Human Tissue Act 1961, which he believes placed difficulties in the way of people who wanted to retrieve organs for transplantation. I congratulate him on drawing up a private Member's Bill which, unusually, even gained the support of the right hon. Member for Bromley and Chislehurst (Mr. Forth). That is rare. I was in the strange

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position of being in the House the second time that he has supported such a Bill. That is a recognition of the fact that it was narrowly drawn.

I should like to put the Bill in the context of the action that the Government are taking. The hon. Member for New Forest, West (Mr. Swayne) was rightly looking for action, and he again reminded us of Florence Nightingale--I hope that that was the last time, but perhaps I shall hear the same quote again in a few weeks.

The starting point must be the uniqueness of donation and transplantation, because a donation depends on the altruism of others. Repeated public surveys show that most people would be willing to donate organs. The number of available organs has decreased over the past 10 years, partly because of positive developments such as the reduction in the number of road traffic accidents and our increased ability to help people who suffer strokes in their 40s and 50s. All that has been very good. We need to improve people's understanding of the processes involved in asking about donation and what will be expected and accepted. People are facing bereavement; it is a stressful time. We need to educate the public so that Government campaigns or those supported by local organisations or national interest groups urge people to think about the issue before the event occurs. There is currently a great surge of interest and we expect to be able to double the number of names on the organ donor register before the end of the decade.

My hon. Friend the Member for Nottingham, East (Mr. Heppell) made it clear that we have to take the public's views into account, as this is not entirely a rational argument. We now have a dedicated telephone line for registering organ donations and information is available on websites.

We must make sure that no potential donation is lost because, for whatever reason, a family is not asked. There are pockets of resistance or squeamishness about donation within the health service that we need to overcome. We are putting in place a programme of training and support for those NHS staff who deal with bereaved parents. We shall also be making clear the importance of active support for donation throughout each trust and health authority, and that includes the wholehearted endorsement of management. This is known as the whole hospital approach. One of the first steps is a public commitment to donation by the whole organisation.

That has been taken up in my area of the west midlands, where all trust chief executives have agreed to implement a hospitalwide policy on organ donation. This means that hospitals in the west midlands have agreed to inform staff of the trust's policy and view of donation; to support staff when approaching relatives for donation; but also to challenge staff who are reluctant to approach the families concerned and to support transplant co-ordinators in their aim to promote a general hospitalwide consciousness regarding all issues in relation to organ and tissue donation. That is within the NHS.

On 27 February, the Government held an organ and tissue donation summit to consider all possible ways to increase organ and tissue donation, and to call on a wide range of organisations in the private and public sectors to help support donation. Examples include the national ITV companies running the "Year of the Promise". HTV and Meridian both adopted the NHS organ donor register as one of their "Promises". The Sun newspaper has twice run

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a major campaign promoting organ donation to its readers and encouraging them to join the NHS organ donor register.

There has also been less spectacular but consistent support from Sky, Littlewoods, the AA, the National Express Bus Company and Connex. In August, Boots, the high street chemist, started promoting organ donation via its in-store loyalty card, the Boots advantage card. Boots customers can now join the NHS organ donor register when applying for or renewing their advantage card. Similarly, the Goldfish credit card has offered its 1 million customers the opportunity, when applying for or renewing their credit card, simply to tick a box to join the NHS organ donor register. We have to admit that it is more likely that people will carry their credit cards than their organ donor cards, even if they have them. We have recognised the importance of increasing the number of people on the organ donor register, but we are also ensuring that the register is used. I hope that that satisfies hon. Members that the Government are proactive.

In many areas, there has been a debate on the draft consultation document. What are the Government doing as a result of that? We have made it clear that UK Transplant must lead the campaign to promote organ procurement throughout the NHS. We need to strengthen the transplant co-ordinators service. It has an important role, identifying likely donors, ensuring that consent is sought by the NHS trust and that, when organs are available, they go to the right people.

The Government are also committed to investing in innovative forms of organ donation, encouraging the development of non-heart-beating donation programmes and encouraging live donations. We have also promised to consider in the review of the Human Tissue Act 1961 how we might modernise the law on the process of gaining consent for organ and tissue donation.

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