House of Commons Hansard Debates for 7 Feb 1997 (pt 20)

Mr. John Marshall: Very healthy air.

Mr. Horam: Or perhaps it is the electorate in north London who bring about this admirable concern for selfless health matters, if I may put it like that.

My hon. Friend the Member for Hendon, South took us on a fascinating tour of Europe. Uncharacteristically for him, given his views on European Union matters, he brought into play the strength of the arrangements in other European countries and said that we were a long way down the list of European countries when it came to the provision of dialysis. That is a fair point.

On a happier note, more people are alive with transplanted kidneys in the United Kingdom than in any European country--15,000. As my hon. Friend would be the first to say to me, given the wonderful performance of successive Conservative Governments, we are now leaders in Europe on economic matters; we are also, clearly, leaders in Europe on transplantation matters, which is the subject of his Bill. I should like to put my hon. Friend's point about our relatively poor performance in renal dialysis in that perspective--we are excellent on transplantation.

I must correct my hon. Friend's point about the percentage of relatives who refuse to allow organs to be removed for donation from people who have died in intensive care. He mentioned the figure of 50 per cent., which was picked up by one of my Conservative colleagues. We have different evidence. In 1989-90, an independent study showed that 30 per cent. of families consulted refused permission; in 1993, a study showed

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that relatives refused permission in 26 per cent. of cases. I am not sure where my hon. Friend found the figure of 50 per cent.; it does not appear to coincide with the information that we have. Our information is not specifically related to intensive care units, but concerns all cases where permission has been refused by the relatives.

Mr. John Marshall: The information was contained in one of the speeches in the debate instigated by the late Lord Finsberg.

Mr. Horam: I shall check on that if I may. I am not saying that my hon. Friend is wrong about intensive care units, but there is contradictory evidence about what happens generally when permission has been refused. I shall look into the point raised by my hon. Friend.

My hon. Friend the Member for Carshalton and Wallington (Mr. Forman) gave a characteristically balanced and rational appraisal of the situation and asked a significant question. Why does not the possession of a donor card automatically close the issue? Why is the card not enough to show clearly the wishes of the deceased with no further argument? The possession of a signed donor card satisfies the requirements of the Human Tissue Act 1961, which my hon. Friend the Member for Hendon, South (Mr. Marshall) proposes to amend, and under which organs may be taken without anyone being consulted. That requirement is fulfilled under existing legislation. However, the Human Tissue Act also requires it to be established that the deceased had not changed his or her mind after signing the card; the only sensible way to check up on that is to consult the family. That is the first reason why relatives have to be consulted.

As my hon. Friend the Member for Harrow, West (Mr. Hughes) suggested, I was consulting my donor card. I was checking on the point raised by my hon. Friend the Member for Carshalton and Wallington. The donor card states at the bottom:

"Let your relatives know your wishes."

In addition to carrying and signing the card, someone must let his relatives know his wishes. In that way, there can be no doubt that the wishes of the deceased remained as they were at the time of his signing the card and he has not resiled from them since.

My hon. Friend the Member for Finchley (Mr. Booth), who is no longer in the Chamber, mentioned that the donor should be of sound mind. We want to ensure that no one who signs a donor card is under a misapprehension about what it involves, as it is a significant thing to do.

My hon. Friend the Member for Harrow, West paid tribute to Lord Finsberg and raised an important point about the family. The relatives of the deceased will have memories and emotions of him or her. My hon. Friend made a telling point. One can imagine the situation where a young man has died in a car accident. His organs could be most usefully used in a transplant, but his relatives would be in shock; they would be particularly traumatised because he was young. It would be horrific if they made a decision and were then overruled so that organs were taken out of the young person against their wishes. If that happened, with all the tabloid publicity associated with such a gruesome incident, it would be a setback for voluntary organ donation, which we all support. We must address that problem. I am sure that my hon. Friend the Member for Hendon, South understands the problem and would not want to set back the cause of organ donation.

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My hon. Friend the Member for Harrow, West made the key point that, if a person has clearly said that he wishes his body to be used for organ transplantation after his death, permission is almost never refused by his relatives. In practice, under the current arrangements, the voluntary system works almost to maximum efficiency, which is crucial. I am glad that my hon. Friend raised that point.

My hon. Friend the Member for Finchley made an interesting point about the shortness and simplicity of the Bill. I agree: if all Bills were as short as this one, the House would be extremely grateful. My hon. Friend spoke of the Royal Titles Act 1876. Disraeli had a thing about shortness and simplicity: his Cabinet consisted of only 12 members, one of whom was the Master of the Horse, Lord Cardigan. So Disraeli clearly had things worked out in a way that we have perhaps gone back on since then.

The hon. Member for Doncaster, North (Mr. Hughes) made a characteristically forthright speech. I congratulate him on his maiden speech from the Opposition Dispatch Box. As is traditional in these cases, I wish him a long sojourn on the Opposition Front Bench. I am sure that he will hone his skills to perfection in the long years ahead of him. As he was substituting for my usual opponent, the hon. Member for Rother Valley (Mr. Barron), there was no change in the friendly Yorkshire tones in which the problem was aired. The hon. Member for Doncaster, North mentioned Jimmy Boyce, the Member of Parliament for Rotherham until his sad death. He was my pair and I was personally in contact with him literally a few days before he died--

It being half-past Two o'clock, the debate stood adjourned.

Debate to be resumed on Friday 14 February.