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Orders of the Day

Human Organ Transplants Bill

As amended (in the Standing Committee), considered.

New Clause 6

Information about transplant operations

(1) The Secretary of State may make regulations requiring such persons as are specified in the regulations to supply to such authority as is so specified such information as may be so specified with respect to transplants that have been or are proposed to be carried out in Great Britain using organs removed from dead or living persons.

(2) Any such authority shall keep a record of information supplied to it in pursuance of the regulations made under this section. (3) Any person who without reasonable excuse fails to comply with those regulations is guilty of an offence and liable on summary conviction to a fine not exceeding level 3 on the standard scale ; and any person who, in purported compliance with those regulations, knowingly or recklessly supplies information which is false or misleading in a material respect is guilty of an offence and liable on summary conviction to a fine not exceeding level 5 on the standard scale.

(4) The power to make regulations under this section shall be exercisable by statutory instrument subject to annulment in pursuance of a resolution of either House of Parliament.'.-- [Mr. Freeman.] Brought up, and read the First time.

10.12 pm

The Parliamentary Under-Secretary of State for Health (Mr. Roger Freeman) : I beg to move, That the clause be now read a Second time

Mr. Speaker : With this, it will be convenient to discuss the following : New clause 1-- Register of Transplants --

It shall be the duty of every hospital which transplants human organs to keep a record of every such operation, its date, the derivation of the organ, tissue type, blood group, relationship with the recipient and the name of the surgeons and consultants involved, and such records should be forwarded to the Regional Health Authority within a calendar month of the transplant.'.

Sub-amendment (a) to new clause 1, at end insert

and the United Kingdom Transplant Service'.

Mr. Freeman : New clause 1, in the name of the hon. Lady for Peckham (Ms. Harman), seeks to establish the statutory recording of the details of all human organ transplant operations, involving either live or cadaver donors. It was tabled in a similar form in Standing Committee.

In Committee I said that we would come back at Report stage with a new clause to encapsulate the essence of the amendment. At that time we accepted the idea of making it a statutory requirement to record information concerning human organ transplants involving live donors. Since Committee stage, we have given further consideration to this matter and decided that it would be useful to have a complete record of transplants involving both live and cadaver donors. Leading representatives of the medical profession have also expressed to the chief medical officer their support for comprehensive mandatory records, and I know that some hon. Members are of the same opinion. New clause 6 sets out our proposals.

Proposed amendment (a) to new clause 1 would mean that the United Kingdom transplant service would also

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hold the statutory records. That is impracticable, since UKTS is not a statutory body. In our proposed new clause, the authority which will keep a record of the information will be specified in regulations under the Bill. We intend that the authority for this purpose shall be the health authorities. We will also specify the precise requirements of information to be supplied in regulations. The origins of the voluntary register to collect information about transplant operations go back far before the Human Organ Transplants Bill became necessary. Ministers agreed in principle to send out a health circular to initiate the register as long ago as 1986 and the medical profession also expressed their support for it. The arrangements to establish the voluntary register run by the United Kingdom transplant service were made before the decision was taken to include in the Bill the requirement to maintain a complete record. It will be some months before the regulations come into force and, until then, the voluntary register will provide information on transplants. That time will also offer a valuable opportunity to see how a system of collecting information on transplants works and to bring to light any possible problems.

When the regulations setting up a system of statutory records are ready to come into force, we shall discuss with the medical profession whether it thinks there is any reason to continue the voluntary register and, if so, in what form. In Committee, we made a commitment to come back with a new clause, and I hope that new clause 6 fulfils that commitment.

Ms. Harriet Harman (Peckham) : In Committee the Minister, in response to a new clause that we tabled, undertook to table a new clause today. I thank him for honouring that commitment.

We tabled new clause 1 tonight and the Government have tabled new clause 6. By my magnificent powers of deduction I believe that the Minister will not accept new clause 1, but will press new clause 6. New clause 1 has two advantages over new clause 6 ; the first is time, the second is specificity.

The Minister said that it will be a matter of months before the regulations come into force and that, until then, we shall have a voluntary register. He has said that, once we know how the voluntary register works, it will be possible to introduce the regulations. I am not satisfied that it should be in the lap of the gods as to when the regulations will be introduced to establish the register. I must press the Minister to give us some sort of maximum timetable for the introduction of those regulations. We are entitled to make such a request. He has not been sufficiently specific by just mentioning "months". I hope that he will tell us what the timetable should be--outside organisations interested in the Bill and in the register will demand nothing less.

New clause 1 would set up the register under statute. I do not believe there is any need for a long enabling clause that gives the Minister the ability to make regulations on all sorts of issues. Having talked to those organisations involved in the transplant programme, the Minister knows that there is a great deal of unanimity about the make-up and content of the register. I trust that the hon. Member for Newbury (Sir M. McNair-Wilson) will support me in that. We do not need to make a big meal out of this, as it is fairly obvious what we want on the register. The Minister

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need not bother himself with spending months examining the voluntary system and then drafting more regulations. If new clause 1 were accepted, the regulations would simply come into effect at the same time as the Bill. If new clause 1 were accepted, there would be no delay. We know what the specifics are, so we do not want to beat around the bush.

If the Minister insists on new clause 6, I would seek the minimum guarantee from him that all the points that are made in new clause 1 about what should be on the register are included in new clause 6. Such an undertaking would be helpful.

We are brimming with a lack of confidence in the Government's ability to get on with this, because we know that they are monstrously side-tracked with the impossible endeavour of trying to explain to the country the White Paper proposals. No one wants that White Paper, but the Government are trying to tell everyone that it is a terribly good idea. In the Department of Health, there is a political lack of impetus behind every other proposal. I do not want to see the Bill drift while Ministers slog up and down the country trying to persuade the people that the White Paper proposals are a good idea.

The Government's record on this issue is one of indecision and delay. The question of kidneys for sale arose as long ago as 1985 and the Government did nothing about it until a further kidney-for-sale scandal occurred at the end of last year and the beginning of this. Nearly four years had elapsed before the Government acted to make it an offence to sell kidneys. I am frightened that they may allow the establishment of the register to drift under the carpet with the legion of other issues while they remain frenetically concerned about the White Paper. Therefore, I ask the Minister to think again, accept our new clause 1 and take seriously any points made in its support, perhaps by the hon. Member for Newbury.

Sir Michael McNair-Wilson (Newbury) : I thank my hon. Friend the Parliamentary Under-Secretary for bringing forward new clause 6 and fulfilling a promise which he made, as the hon. Member for Peckham (Ms Harman) said, as a result of a clause tabled by the Opposition and me. However, my hon. Friend's introductory speech was too short for me to grasp the finer points of what he was saying. As I understand it, the new clause means that the Secretary of State may make regulations-- [Interruption.] Would it be possible for those making interruptions from a sedentary position to give me a chance to make a speech on this detailed point?

As I understand it, the new clause means that the Secretary of State may make regulations requiring persons unknown to supply to an unnamed authority information which is not detailed, and that body shall keep a record of information supplied according to the regulations.

I recognise that that is an attempt to summarise the clause, and if my hon. Friend tells me that I have misunderstood it I shall give way immediately. However, if I have not misunderstood what he said, it seems that the first difference between his clause and new clause 1 is that I can understand new clause 1 but I cannot understand new clause 6.

New clause 1 lays down a clear-cut duty and seems to contain most, if not all, of what any of us would want to see in a register of transplant operations. The

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Government's new clause is more obscure and is linked to an authority which dares not speak its name, or even to tell us where it will meet.

My hon. Friend seemed to imply that the authority was a regional health authority. If that is so, he will surely find that the Bill now becomes misleading. If in new clause 6 the authority referred to is a regional health authority, and in clause 2(3) another authority--as clause 2 (3) puts it,

"The Secretary of State may by regulations provide that the prohibition in subsection (1) above shall not apply in cases where-- (a) such authority as is specified in or constituted by the regulations is satisfied--"

I for one will find myself wondering which authority is which and how we shall know to which authority each clause refers. Will my hon. Friend clarify that point?

Mr. Freeman : It might be helpful to my hon. Friend if I described the authority under clause 2. This is the authority which will look at all live donations between non-genetically related individuals. That is its sole function, and I said in Committee that we would lay down the regulations. That authority deals only with whether the non-genetically related individuals should be permitted to have a transplant of a kidney, which is the only organ which can be transplanted from live patients.

I apologise if my hon. Friend could not hear what I was saying earlier. In new clause 6, we are dealing with a separate issue--the recording of live and cadaveric transplants. It is a recording of an event which has taken place. It is not prospective : it is historical. It is designed to meet the point that my hon. Friend and other members of the Committee raised. It is a comprehensive register of all transplants.

We have not reached a conclusion on whether the authority in question should be a regional or district health authority. Perhaps, if I catch your eye, Mr. Speaker, I shall develop that point at greater length at the end of this brief debate.

Sir Michael McNair-Wilson : I am grateful to my hon. Friend for shedding light on the authority, but anyone reading the Bill after tonight's debate will still find the word "authority" in the clause and in the new clause, yet different authorities are meant. How will my hon. Friend clarify that so that there is no doubt in anyone's mind? I read the Government's new clause as referring to the authority mentioned in clause 2, so the speech that I subsequently prepared no longer makes sense. No matter ; I have told my hon. Friend of my doubts and I am sure that I would not be the only person to draw the wrong conclusion from reading the word "authority" in the two versions.

I want to go a little further into why the new clause is worded as it is. As the hon. Member for Peckham asked, why is the statement to be voluntary- -

"The Secretary of State may make regulations"?

That is not mandatory. Why was it felt necessary to begin with that open statement when, as the hon. Lady rightly said, the request for a mandatory register has been circulating for at least four years, if not longer? I find myself wondering whether the truth is that the regulations have not yet been put together by the Department. I also find myself a little uneasy about the assurances that we have been given that this voluntary statement will be turned into a mandatory register at a later date. I have

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been sent a letter dated 6 June 1989 by Mr. Ross Taylor, president of the British Transplantation Society. Under the heading "Policing the Present Bill", he writes :

"Since 1985 when the original troubles were first reported the British Transplantation Society has been trying to create a mandatory Register of all transplant operations, whether public or private, and covering all organs. We have repeatedly been told by the Department of Health that a mandatory Register is not possible because it would require legislation and we are repeatedly told that it cannot be incorporated in this present Bill. We believe very strongly that it should be incorporated in the present Bill and we can see very little reason why anyone should object to making a record of their transplant activity. We have all the documentation, all the computer work and all the arrangements in hand to establish a Register, but we are told that it will have to be a voluntary Register. If it is voluntary we may well miss the very few transplant operations which are the particular ones that we need to record. The Royal College of Surgeons of England has jointly agreed with the British Transplantation Society to supervise this register, but I don't think I am divulging any confidences when I tell you that the President-Elect of that College feels very strongly indeed, and has said so on many occasions, that the Register should be mandatory." I agree with Mr. Taylor and with the president-elect. I hope from the nod that my hon. Friend the Minister is giving me that he, too, accepts that position. Although we are being asked to pass a clause which is not mandatory--I cannot understand why it should not be--I hope that we can have my hon. Friend's assurance that by this time next year the clause will have set up a mandatory register. 10.30 pm

If the clause does initiate the setting up of a register, who will keep it? I do not think that my hon. Friend the Minister told us that. Is the register to be made public in any way? Can hon. Members, for example, ask for a debate on the register? Will that be possible? Why should the register not be kept by the United Kingdom Transplant Service? The Minister says that it is not a statutory body, but it is the body which co-ordinates transplants in the United Kingdom. If not the United Kingdom Transplant Service, why not the British Transplantation Society? The president of the society is saying, "I have the equipment and the wherewithal."

It seems so obvious to me that that is the machinery that should be used to keep the register, to keep it within the hands of those who are most closely involved and who are most anxious that the ethics of transplantation should be maintained at the highest possible level. I have an article from the British Medical Journal of 1986, I think, which sets out recommendations on the use of living kidney donors in the United Kingdom by the British Transplantation Society. The recommendations could have been a model for any legislation that we have discussed in our deliberations.

I hope that my hon. Friend the Minister will give me a promise that the voluntary element in the clause will be translated into a mandatory register within 12 months. I hope also that he will seriously consider whether the United Kingdom Transplant Service or the British Transplantation Society should become the body to manage the register, to keep it up to date, and to be answerable for what goes into it.

Mr. Freeman : I hope that I can give all the assurances that my hon. Friend the Member for Newbury (Sir M. McNair-Wilson) has sought. New clause 6 is the Government's response to a system that I was asked in Committee to introduce on Report. It is a mandatory

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reporting system for health authorities covering all live and cadaveric organ donations. We shall introduce regulations--I am happy to respond to the hon. Member for Peckham (Ms. Harman), who asked for an assurance--under the new clause and under clause 2, which deals with non-genetically related live donations.

New clause 6 deals with the reporting system, and we shall introduce regulations as soon as possible--I hope that that will be before the end of the calendar year. The regulations will be debatable. We shall be specifying to whom the reports should be made. We still have not resolved whether it should be regional or district health authorities. We shall be specifying also what should be reported. I assure the hon. Member for Peckham that we shall bear in mind the text of new clause 1, which is specific on what should be reported.

The voluntary register is to be organised by the United Kingdom Transplant Service. It will be running for the balance of this year, for the six months prior to the coming into operation of the reporting mechanism under the regulations. For that period the voluntary register will be performing a valuable service. For the purposes of research, perhaps, clinicians will be more likely to turn to the voluntary register for greater detail than to the Department of Health. I am thinking of aggregate statistics that we might have from the regional and district health authorities under the reporting mechanism.

Sir Michael McNair-Wilson : Who will keep the voluntary register?

Mr. Freeman : We will not frustrate or stand in the way of the continuation of a voluntary register, which could proceed simultaneously with the separate reporting mechanism envisaged under new clause 6. I well appreciate the argument that the voluntary register might provide the research data that clinicians need. I shall now answer the points raised by the hon. Member for Peckham. I have dealt with the expected timing of the laying of regulations, which will be debatable. We need to consult the medical professions about what is specified in the reporting mechanism and to whom the report should be made. As to the hon. Lady's suggestion of a lack of impetus, I had hoped that she might congratulate the Government on their rapid progress. The Second Reading Committee was on Tuesday 16 May and now, in the first week of July, the House will--I hope--shortly be giving the Bill a Third Reading. I hope that we shall make rapid progress so that the other place can complete proceedings so quickly that the essential provisions of the Bill can come into force.

Sir Michael McNair-Wilson : I am sorry to delay the House--

Madam Deputy Speaker (Miss Betty Boothroyd) : Order. The hon. Gentleman has already spoken once, and under consideration I regret that I cannot allow him to speak again.

Question put and agreed to .

Clause read a Second time, and added to the Bill .

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New Clause 7


No proceedings for an offence under section 1 or 2 above shall be instituted in England and Wales except by or with the consent of the Director of Public Prosecutions.'.-- [Mr. Freeman.]

Brought up, and read the First time.

Mr. Freeman : I beg to move, That the clause be read a Second time.

I shall not detain the House. The new clause would ensure that prosecutions under clauses 1 and 2 of the Bill could go ahead in England and Wales only with the prior consent of the Director of Public Prosecutions. This is to prevent frivolous private prosecutions. A similar clause has been used previously in other Acts whose subject matter is emotive, such as the Surrogacy Arrangements Act 1985. I commend the new clause to the House.

Ms. Harman : By introducing the new clause at this stage the Minister is making it unduly restrictive. I quite understand that he does not want private prosecutions, and I support him on that. However, it does not mean that he needs to erect the hurdle of requiring the consent of the Director of Public Prosecutions. If he wanted to exclude private prosecutions, he should have simply done that. This new clause, together with his rejection of new clause 2, makes this an unenforceable statement of intent rather than a proper addition to the criminal law. I do not understand why he did not simply rule out private prosecutions rather than including the hurdle of the DPP--who, I understand, has plenty to do without having to take on this additional duty.

Mr. Freeman : The practical effect of excluding private prosecutions is, essentially, to put the matter into the hands of the DPP. I admit, although not a lawyer, that it was our intention to include this provision in the original draft of the Bill. I regret having to come to the House at this stage to seek its agreement to the new clause. It is not an afterthought ; it is a correction. Question put and agreed to.

Clause read a Second time and added to the Bill.

New Clause 2

Disciplinary offences

It shall automatically be deemed a disciplinary offence of serious misconduct if a doctor is guilty of an offence under this Act.'.-- [Ms. Harman.]

Brought up, and read the First time.

Ms. Harman : I beg to move, That the clause be read a Second time. New clause 2 simply says that if a doctor commits an offence under the Act it will constitute serious misconduct and so require the GMC to consider the matter as a disciplinary offence.

There is a history to this. In the past, the problem has been that, despite prima facie evidence that a doctor had been involved in such activities, the GMC was not prepared to take any action.

I know that in response the Minister will say that another statute says that if a doctor commits any criminal offence it is open to the GMC to look at the matter and take disciplinary action. We know that it has the power to look at it, but new clause 2 obliges it, at least on a prima facie basis, to consider an offence under the Act as a

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disciplinary offence of serious misconduct. Its failure to do so in the past has led to the need for the Bill. Had the GMC acted more swiftly and purposefully, we would not have needed the Bill in the first place.

Without new clause 2 it would be open to the GMC to say that a doctor has been prosecuted and found guilty under the legislation, but that he has been punished enough by the courts and by having his name in the paper so the matter will be left there and the doctor will be allowed to get on with the job.

The new clause makes an offence under the Act automatically a disciplinary matter. I cannot for the life of me see why the Minister should object to it. He is simply being a bit backward in coming forward on positive issues on the Bill. The Minister should get a grip on the issue. It is obvious that we need the new clause and the Minister should allow it to be included in the Bill.

Mr. Freeman : The hon. Member for Peckham (Ms. Harman) asks me to get a grip on the new clause. I hope that I have had a grip on the Bill during its proceedings. If a doctor is convicted under the Bill, which we hope will shortly become an Act, the hon. Lady wants automatically to instruct the GMC to disbar the doctor.

Ms. Harman : No, to look at it.

Mr. Freeman : The hon. Lady has offered no evidence that the GMC has expressed any lack of interest in the Bill or any intention not to investigate or debar those who are convicted. The reverse is true : the GMC has expressed its firm support for the Bill.

I said in Committee that I would be happy to look again at this, and I have done so. One of the values of our parliamentary proceedings is that we have time for reflection. I am clear that we should not breach the general principle that where disciplinary powers are given to a court or a council such as the GMC--which was given those powers by the Medical Act 1983--it should not at the same time be told that it must automatically take certain action on certain cases brought before it. That negates the whole purpose of setting up a body with discretion.

I am satisfied, as I hope that the House will be, that the new clause is not necessary. I ask the hon. Lady not to press it to a vote. There will be other occasions to debate the broader principles of how the GMC behaves, when I shall be happy to join the hon. Lady. The new clause raises wider issues and the hon. Lady has not made her case.

Ms. Harman : The Minister says that I have brought forward no evidence of the GMC's lack of interest. As I mentioned in moving the new clause, it spent four years doing nothing, even when the subject was a matter of public outcry. Its lack of interest is a matter of public record and concern. The Minister would not have had to bring the legislation before the House if the GMC had shown any interest before. The evidence of its lack of interest is the existence of the Bill, and that is lamentable.

The Minister says that I am asking that a doctor should automatically be debarred if found guilty of an offence under the Act. I am not. He should understand that an offence of serious misconduct requires the GMC to look at the matter for disciplinary purposes. A range of penalties is then open to it, ranging from debarring or suspending from practice right down to a polite letter telling him not to do it again. I am not putting forward automatic

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debarring ; I am just saying that the matter should be put under the GMC's nose so that it does not escape its attention in the way that it has done for the past five years. However, I shall not press the matter to a vote.

Question put and negatived.

Clause 2

Restriction on transplants between persons not genetically related

10.45 pm

Mr. Freeman : I beg to move amendment No. 3, in page 2, line 30, after children', insert

of his brothers and sisters of the whole or half blood or'.

Madam Deputy Speaker : With this it will be convenient to discuss the following amendments : No. 1, in page 2, line 31, at end insert and (e) his nephews and nieces of the whole or half blood.' No. 2, in page 2, line 44, at end insert--

(c) the person into whom the organ is to be transplanted is (i) the spouse of, or

ace (ii) related by marriage within the degrees laid down by subsection (2) above to the person from whom the organ is removed.'.Mr. Freeman : We accepted the principle of amendment No. 1 in Committee. It was not our intention to exclude nephews and nieces from the definition of genetic relations for the purposes of the Bill, and, as promised in Committee, we have tabled amendment No. 3, which will have the effect of including them in the definition. Amendment No. 2 was also tabled in Committee but was withdrawn by the hon. Member for Peckham (Ms. Harman). I was given to understand that the hon. Lady accepted my argument on why the statutory exclusions from the prohibitions of clause 2 should not be extended. However, as the amendment has been tabled again, I shall repeat my reasons for urging hon. Members to resist it.

Amendment No. 2 seeks to extend exemptions to prohibitions under clause 2 far beyond what is intended. The Bill already excludes genetically related people from scrutiny by the authority. A reason for that is that the existence of a close genetic relationship can be verified with a high degree of accuracy by laboratory testing. In this country, the vast majority of live transplants would be covered by that exemption, as close family members are both more likely to come forward to offer themselves as donors and to prove compatible, in the medical sense.

Under the Bill, the existence of a genetic relationship would be verified in each case in an objective way by such testing. Appropriate tests may have already been carried out in the process of trying to establish the compatibility of the donor and would-be recipient. In the case of relatives "in law" or people not related at all to the would-be recipient, the existence of some kind of relationship or personal tie is more difficult to establish. Unfortunately, we cannot rule out the possibility of non-genetic "relationships" being formed solely for the purpose of the operation or of pressure--economic or otherwise--being brought to bear upon a donor to submit to a transplant operation.

For those reasons, it is intended that the authority will consider the available evidence in each case where no genetic relationship has been established, before giving an independent decision on whether an offer of donation is altruistic. However, the fact that the authority will

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scrutinise all cases of live donation between non-related persons does not imply that unnecessary obstacles will be placed in the way of transplants between spouses or "in law" relations. I suggest that amendment No. 2 is contrary to the whole intention of clause 2. I urge the hon. Lady to reflect further and not to press it to a Division.

Ms. Harman : Long ago in the distant past, before I became a Member of Parliament, I wanted to be a parliamentary draftsman. Government amendment No. 3 has been introduced at this late stage because the Government become so confused by all the gobbledegook that they omit to say what they really mean. In this case, they omitted nephews and nieces from the definition because they were so busy referring to "brothers and sisters of the whole or half blood."

Helpfully, with my otherwise under-used parliamentary drafting skills--and certainly for free--I drafted amendment No. 1. But the Government prefer their gobbledegook, which is more complicated and will therefore provide more work for the lawyers. None the less, the definition has been restored, so I am grateful to the Minister for at least incorporating what would otherwise have been a significant omission.

The Minister reminds me that in Committee the intellectual brilliance of his arguments swayed me against my own amendment to include married people and people related by marriage. However, when it came to drafting my amendments, the force of his arguments escaped me. Now that he has made them again, I am happy to accept them, and I shall not press amendments Nos. 1 and 2.

Sir Michael McNair-Wilson : My hon. Friend the Minister referred to the authority in clause 2. He said that it is the body that will give consent to these various operations. Again, I am puzzled. Is he saying that the transplants that will take place have been notified to the authority referred to in new clause 6 and that they will be notified also to the authority referred in clause 2, so that two authorities work together? Are both authorities to keep a record of all these transplants? If not, one authority will be aware of all the transplants taking place within families and one will not. I cannot see how that is possible. Unless both authorities know what is going on, the authority that is meant to police the Bill cannot function. I should be grateful if my hon. Friend would clarify that point. Mr. C. J. Rudge, consultant transplant surgeon, has said : "I have considerable reservations about this second clause in the Bill. There are a number of situations in which the emotional relationship between a potential donor and recipient can be overwhelmingly in favour of allowing transplantation to proceed. I am thinking in particular of transplantation between husband and wife (or vice versa), between step- parents and their children"-- they are not referred to anywhere in the Bill --

"and even between individuals related by marriage. I can see nothing morally or ethically wrong for transplants in any of these categories to be carried out, and I have considerable anxieties that they are all made illegal by this Bill. There is no doubt that the number of cadaver kidneys becoming available in this country does not meet, and is never likely to meet, the requirements for the number of patients awaiting transplantation. Within my NHS practice I am currently carrying out a number of emotionally related

transplants--until now exclusively between husband and wife. I am very concerned that if these transplants are to be stopped then this would have a significantly detrimental effect on the dialysis and transplant programme within the NHS."

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Mr. Rudge referred to step-parents, about which no hon. Member has spoken yet. Can my hon. Friend the Minister say anything about step-parents being included in the legislation?

Mr. Freeman : Under clause 2, an authority will be established under regulations. It will comprise perhaps 12 members, perhaps under a medical chairman. Its purpose is to permit, or not permit, transplants between those who are not genetically related. It is a screening mechanism prior to the transplant. It relates only to live transplants. I can give my hon. Friend the assurance that we are not making ethical pronouncements about what is or is not acceptable. In Committee, I said that I could well understand that proposed transplants between spouses, who were not therefore genetically related--or, to use my hon. Friend's example, stepchildren--would be perfectly in order. It is important that we do not send a message that, if the proposed transplants were altruistic and the tissues matched, the House or the authority would frown on them. I hope that that answers my hon. Friend's question.

New clause 6 deals with the reporting mechanism ex post facto of all live and cadaver organ transplants. It is a separate issue. The reporting mechanism provides information and permits monitoring or "policing", as my hon. Friend said, of the intent and purposes of the Bill. The two are totally separate. The authority under clause 2 is a group of individuals, perhaps under a medical chairman. Under new clause 6, we are talking about authorities as being regional and district health authorities that gather and collect the information on transplants that have taken place.

Amendment agreed to.

Motion made, and Question, That the Bill be now read the Third time, put forthwith pursuant to Standing Order No. 75 (Third Reading), and agreed to.

Bill accordingly read the Third time, and passed.

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