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1.35 pm
Mr. Robert G. Hughes (Harrow, West): I congratulate my hon. Friend the Member for Hendon, South (Mr. Marshall) on introducing an important Bill. As my hon. Friend the Member for Carshalton and Wallington (Mr. Forman) said so eloquently, the Bill turns on an extremely tricky area. However, my hon. Friend the Member for Hendon, South produced some very good arguments in advocating why we should go down the road that is set out in the Bill. I congratulate him warmly on that. I am sure that many people throughout the country will have a great deal of sympathy with everything that he said.
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I echo what my hon. Friend the Member for Hendon, South said about the late Lord Finsberg, who initiated the Bill. The fact that it is a measure started by Geoffrey Finsberg is almost a reason in itself why we should support it. It would be a tremendous tribute to him. He had a long and distinguished career in politics, in local government, in the House and in another place. His tragic death has left a hole in all our lives. All of us in the Conservative party in London feel his loss enormously and remember what he did in rebuilding the fighting machine that the London Conservative party became in the 1970s. I pay a warm tribute to my late hon. Friend for all that he did, including initiating the Bill.
It is almost impossible to speak on the issues raised by the Bill without making an on-the-one-hand, on-the-other speech. We could, of course, go along automatically with what my hon. Friend the Member for Hendon, South said in introducing the Bill, but it is not quite as simple as that.
There are 6,000 people waiting for organ transplants, of whom 5,000 are waiting for kidneys. We are told that there is no lack of money and that there is clinical expertise. I know that from what I have been told by hospitals in my constituency, and especially by the Clementine Churchill hospital, which carries out private operations. The problem lies with the shortage of organ donors. It is a worldwide problem and a worldwide business. One hesitates to call anything in such a sensitive medical area a business, but we must recognise that it is one.
The falling number of road accident deaths has meant that not so many kidneys are being made available. Advances in neurological practice have also had an impact. I understand that we were able to attract a great many foreign-sourced kidneys into the United Kingdom because we had a much better and quicker ability than other countries to match kidneys.
The allowable timetable has, of course, increased with better technology being available to keep transplanted kidneys. However, we were able to say that within the allowable timetable we would be able to ensure that a kidney that had come from another part of Europe, or more especially from the United States, would be made use of. We were able to say, "We can definitely make use of this kidney if you get it on to a particular flight." The United States would not have been able to match the kidney with a possible recipient. Technological advances and an increasing ability to datamatch in the United States have meant that we have lost out.
There is a shortage of organs and it is not surprising that that has prompted a number of people, including some doctors and my hon. Friend the Member for Hendon, South, to propose a change in the law with a view to retrieving more organs from deceased persons.
I ask my hon. Friend, however, to imagine a doctor in a hospital trying to take organs against the wishes of a distraught parent of a young person killed in a road accident, or against those of a pregnant woman whose husband has just been killed. It would be absolutely horrendous to put such a proposition to grieving relatives at that difficult time. In both those instances, the dying people would probably have expressed no wish about what should happen to their organs when or if they died because they would not even have thought that they might die. One can see that such a proposition would cause
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I therefore wonder what would happen to the organ donor scheme. I understand that that is precisely what has damaged organ donor schemes in other European countries and we must take seriously the prospect that it could happen here. I do not seek to criticise doctors, but for understandable reasons, a doctor who believed that he could save a patient's sight, transform his way of life or even save his life might become over-anxious to get hold of a donated organ. Inevitably, the doctor would put more pressure on a dying person's family than would be suitable at such a difficult time. The doctor would not mean to do so, but doctors are only human and if they felt that an opportunity was available to them, they would try to take it.
As legislators, therefore, we must be extremely cautious in ensuring that that does not happen. Clause 1(3) is controversial as it removes the present provision for considering, in certain circumstances, the wishes of relatives. Clause 1(4) reinforces that provision by preventing anyone from prohibiting removal of any part of the body, except in specified circumstances. However, the Bill does not deal with the point that I made earlier: how an angry or grieving family could be prevented from prohibiting removal of an organ. That matter should be specifically addressed.
Before we allow ourselves to go down that route, we must deal with that matter because it would harm the cause of organ donation. Who would lay himself or his family open to such a provision if he believed that organ donation would become an automatic process, that control would be taken away from him, and that things that he did not want to happen would happen automatically in hospital in those circumstances?
It is a Government priority to maximise the supply of organs for transplantation and I am sure that relatives' refusal is a matter of concern which Ministers and the Department of Health are addressing. My noble Friend Lady Cumberlege, the Under-Secretary of State for Health, raised that point when the late Lord Finsberg presented the Bill in another place. A more fruitful course, however, would be to continue to promote organ donation through publicity and education, encouraging people to join the NHS organ donor register. We should also encourage them to discuss openly with their relatives their wishes and those of their family.
I hope that I am not robbing my hon. Friend the Minister of a point that he may wish to make later. He adds to my guilt that I do not have an organ donor card, as I see that he is studying his as he sits on the Front Bench. I notice that he has now quickly put it away, but it is a great credit to him that he has one and I must look into the matter for myself.
The Government have shown their commitment to increasing the supply of organs through a number of interesting initiatives in recent years. That has included television and other media publicity, organ consent boxes on driving licences, educating hospital staff about discussing donation with relatives and a reimbursement scheme for donating hospitals. All those are important and we have to get it as much as possible into the public consciousness that all those routes are open to people.
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The NHS organ donor register was launched in October 1994. I understand that already 4 million people have applied to join it. The register can be quickly accessed by transplant co-ordinators in hospitals and the families can then be consulted with sensitivity. The Department of Health continues to give considerable publicity to that register; we all should be pleased to note that, as the number on it increased, the number of refusals should therefore decrease. Currently, there are about 10 to 12 each week whose details were on the register--about half of the total number of donors--so it has had a significant impact.
In the Department of Health, as in any Government Department, such things are considered with a new perspective and perhaps with new thoughts. There may be new ways of doing it, but the fact that the total is about 10 to 12 each week is a tribute to the way in which the scheme was put together in the first place. I hope that we will be able to do even better. Therefore, rather than introduce a measure of compulsion, it is preferable that the Government should continue to promote organ donation through publicity and education and through encouraging people to join the register.
I should like comment on the study by the UK Transport Co-ordinators Association--[Hon. Members: "Transplant."] The UK Transplant Co-ordinators Association. I beg hon. Members' pardon. What did I say? I am not going to suggest that I cannot walk and chew gum at the same time, but I cannot read a paragraph and talk at the same time. I was trying to say that the UK Transplant Co-ordinators Association and clinicians confirm that it is almost unknown for relatives to refuse consent if they know that the deceased has expressed a wish to be a donor.
That is the crux of the debate. If there were evidence that people were overturning the express wish of their deceased relative, we would have to think again, but there is no such evidence. Refusal nearly always occurs when the deceased has not left instructions that he or she wishes to donate. The study that I referred to by UKTCA and MORI shows that the commonest reasons for refusal are claims that the deceased has said that he or she did not wish to donate, and the inability of relatives to agree in the absence of instructions. Unless a future survey along the same lines proves that things have changed and that a barrier is going up against the deceased person's wishes, we have to go the way we are going.
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