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2.6 pm

Mr. Bernard Jenkin (Colchester, North): We are debating an important subject and I join other hon. Members in congratulating my hon. Friend the Member for Hendon, South (Mr. Marshall) on presenting an opportunity to debate it. I join my hon. Friend in paying tribute to our late friend Lord Finsberg who so ably represented the constituency of Hampstead and Highgate for many years. I was born in Highgate and I know that he was a good and able Member of Parliament who gave the House, his constituency and his country distinguished service.

I have listened to the debate with interest and it is obvious that there is much concern about the lack of organs for transplant. Organs become available only in the most distressing circumstances. In every culture, in every society, and in every age, people are reluctant to discuss some issues. In Victorian England, people did not talk about sex, but they did talk about death and money. In modern Britain, death is the taboo subject. We need only to consider how we approach the friends or relatives of those who are faced with imminent death to know how sensitively we feel that we need to behave.

The problem with the matter that we are debating is that people think it is about death. The only time relatives are formally approached is when they are confronted by the death of a loved one. To approach the problem from the angle of a change in legislation--effectively to ride roughshod over the understanding and sensitivities of relatives--is to go about it in the wrong way. We need to change the terms of the discussion. We must explain to relatives, perhaps at a propitious moment, which would be before they are confronted by the death of a loved one, that the issue is not about death but about giving life--and a better life--to others.

I carry a kidney donor card, which is now called an organ donor card because I have ticked the box to show that everything is up for grabs in the event of my death, but I have never been asked to consult the next of kin who appear on my card about what I want; nor have my next of kin ever been asked to record their understanding of what they think should happen to my body in the event

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of my death. We need not an amendment of the law to turn over people's sensitivities, but a public campaign to change the instructions on the card that we carry to give someone a better life.

The organ donor register should, for example, contain not only the wishes of the donor, but the pre-death consent of the next of kin as to what will happen in the event of the donor's death. We need to change what happens so that obtaining the consent of the potential donor and his next of kin is not the end of the matter; in the event of the donor's death, the relatives must know what they will face.

The trouble with the present arrangement is that, although we have achieved a great deal in getting people to carry organ donor cards, we have not prepared the relatives for the shock of what will confront them. A dead person's relatives are often not in the correct psychological state to deal with the fact that someone has died, let alone to choose what happens to the body. That is precisely the kind of decision that they are incapable of making unless they can be persuaded that they have already made that decision.

I beg hon. Members to think about tackling the problem from the opposite direction. A change in the law is inappropriate; persuasion is the answer. There are examples of how we can change by invocation how people behave and what is regarded as acceptable. Twenty years ago, people thought nothing of getting into a car when they were over the limit, to drive home from the pub. That was part of the game that they played with the police. Such behaviour has become wholly unacceptable. How did we achieve that change? It was done without changing the law, the method of enforcement or the penalties--it was done by invocation.

We need a much better campaign of invocation and education--and perhaps a change in the system of recording the wishes of organ donors and their relatives. In that way, people will be ready to give the necessary consent at the appropriate time. It is therefore with regret and considerable anxiety, but some certainty, that I oppose the Bill.

2.12 pm

Lady Olga Maitland (Sutton and Cheam): I greatly appreciate the fact that my hon. Friend the Member for Hendon, South (Mr. Marshall) has introduced the Bill. I had long been an admirer of Lord Finsberg. In fact, I was part of his campaign team when he was first elected to Parliament, and I had remained in touch ever since. It is very moving that one of his last acts was to introduce the original Bill.

The crux of the matter is that about 6,000 people are now waiting for an organ. In 25 per cent. of cases, the families of potential organ donors resist the request that their relatives' organs should be made available to give life. That fact led me to discuss the issue with my husband because, years ago, I had signed an organ donor card, and so had he. What I had not realised is that, in the event of my death, my husband, even knowing that I had signed the card, could--in his distress or after having second thoughts--override my wishes. That card was simply a worthless piece of paper.

When I write my will, I know that my wishes will be carried out on my behalf in the event of my death by the trustees, who are obliged by law not to deviate one jot.

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How is it that a will in the form of a card, which I have filled in and which states my express wishes--I want my organs, whatever use they might be, to be made available to give life to another person--can be overridden, yet my final will and testament will be adhered to by the law? When one considers the matter in that way, it is logical and sensible that the wishes of a donor, when written down on a piece of paper in the form of an explicit request, should have the same power as any request that I might make in my will.

Therefore, I hope that the Bill will come to fruition. I fear that, today, we may not be successful because of lack of parliamentary time, and I regret that. The issue is of fundamental importance, because I believe that it is my human right to be able to ensure that my wishes are carried out.

Some interesting research has shown that, where a person has made an explicit request, on the whole and mercifully, the family rarely override that wish--but they can. A wider issue is that when someone who has not made an explicit request dies, the family has a right to say, "No, I do not wish this to go ahead", and that happens in about 25 per cent. of cases. We should examine their reasons for doing that and not be too harsh. They often say that, in the trauma of grief, they feel that giving the body up for a donation is somehow extra surgery. Even if it makes no logical sense to think that, because the person is dead, such considerations can have great emotional power over grieving relatives. Sometimes, relatives say, "My relative has suffered enough--don't do any more." We have to bear in mind that fog of emotion and the time has come to try to clarify what people can do and whose wishes should be respected.

I totally endorse the Government's endeavours to publicise the organ donor scheme. I have looked down the list of all their initiatives and can only say that, although we have had years when the Government have worked hard and pumped money into a big publicity campaign, that does not happen every year or with the same energy. Sometimes, people come across their cards haphazardly--for example, I had not realised until today that I should have signed the section of my driving licence that provides for organ donor consent. How many people in the Chamber have signed the consent on their driving licence so that there is no shadow of doubt that that is their wish? It is a brilliant idea and it should be built on and publicised because, nowadays, there is barely a person in the land who does not carry a driving licence.

The Bill is so important that I wish it the very best passage, and if it does not pass all its stages right now, I very much hope that it will be picked up on another day. It means so much to me to know that, in the event of my death, someone, somewhere will benefit. It would also help the relatives to know that the spirit of their loved one, in a sense, continues in service in another being, and has made a better life for them. It eases the pain, the sharpness of death, to know that good is coming out of a tragedy.

I very much hope that we shall carry on in our endeavours to ensure that all our wishes are adhered to and that other people may benefit.

2.19 pm

The Parliamentary Under-Secretary of State for Health (Mr. John Horam): I join others in congratulating my hon. Friend the Member for Hendon,

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South (Mr. Marshall) on introducing the Bill. As we all know, he is a doughty campaigner on several health subjects--indeed, I would say relentless, considering the way in which he has pursued me concerning haemophiliacs. I noticed that he managed to get a well-contrived mention of the problems of haemophiliacs into his speech, which was otherwise about organ transplantation. His campaigning has been praiseworthy, although it is quite intimidating to be on the receiving end of some of his campaigns.

It is noteworthy that my hon. Friend the Member for Hendon, South has campaigned so much on health subjects when he is primarily an economist, and speaks also on economic matters. As a fellow economist, I am delighted by that, because it shows clearly that economists, who are often maligned, are also human beings. He will recall that one of the most famous of political economists, a Labour Member, was once called a desiccated calculating machine by another member of the Labour party. I do not wish to be disputatious about this, but it shows the low opinion in which economists are sometimes held. I am glad that my hon. Friend is striving manfully to present the other side of the coin.

My hon. Friend the Member for Hendon, South said, as have others, that the Bill is a replica of the Bill that was introduced by the late Lord Finsberg in 1995, which passed through the House of Lords but did not succeed in the House of Commons. Geoffrey Finsberg was my hon. Friend's neighbour in north London. There must be something about the air in north London that brings about--

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