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The Parliamentary Under-Secretary of State for Health (Ms Gisela Stuart): Before the right hon. and learned Gentleman concludes his speech, I should be grateful--the answer might help me to reply to the debate--if he clarified whether he is fully aware of the distinction between non-heart-beating donations, which, in the Leicester example, provide a broad window of 40 minutes in which kidneys can still be donated, and
elective ventilation, whereby a body is simply ventilated for no purpose other than to use it for transplant operations. We draw a clear distinction between the two and we oppose the latter. It would be helpful if he stated whether he sees the clear distinction between them that we perceive.
Mr. Clarke: Personally, I do not draw that distinction and I am not sure why either procedure should be made wholly illegal. The circumstances in which either procedure is carried out should be carefully governed, but I should prefer that to be done by the ethical code of the profession and the guidance of the Department. If the Department in its wisdom chooses to continue to issue guidance stating that elective ventilation should not be carried out within the health service, so be it. Foremost in my mind was the insertion of catheters in non-heart-beating patients, but I am not sure that, in the right circumstances, I would oppose elective ventilation. Certainly, that point does not provide an adequate reason not to clarify the law on the circumstances in which it is right to preserve organs while consent is being sought.
Mr. Peter Bottomley: The Minister's question is helpful. Perhaps the Department's view is based on an interpretation of the law. I do not think that it should necessarily be a burden on the Department to decide on the ethics of the situation; that matter is better left to the medical profession in association with public opinion. My right hon. and learned Friend's response should allow the Department to accept the Bill and thereby allow the responsibility to pass to the GMC and doctors in general.
Mr. Clarke: I am grateful for that intervention. If a practice is excluded by law, I am not certain that that was intended by Parliament in 1961. When the 1961 legislation was being debated, medical science was less advanced and I suspect that it is mere accident that doubt now hangs over procedures that have been developed since that time which enable organs to be preserved in the way that is now possible.
That is the full scope of my Bill. I am astounded by the modesty of my ambitions. The Bill deals with only a small part of the subject, but I do not apologise for that. The subject is an extremely large one to which I hope the House will again turn its attention in the not-too-distant future and as frequently as possible thereafter. Needless deaths are occurring. The entire medical profession wants to do more and the public are highly supportive, so I hope that the House will take a small step in the right direction by giving my Bill a Second Reading today.
1.5 pm
Mr. John Heppell (Nottingham, East): I had not intended to speak, but I introduced the Human Organ Transplants (Amendment) Bill of 1993, which related to presumed consent. I fully appreciate why the right hon. and learned Member for Rushcliffe (Mr. Clarke) has introduced his Bill. We are faced with a growing problem. Donor numbers are gradually decreasing while waiting lists grow longer. No sensible Government can sit back and wring their hands in these circumstances. We must consider practical measures to try to improve the situation, and the Bill is an attempt to do just that.
I have one or two reservations, which I probably would not have had when I introduced my Bill. First, we make assumptions about the number of people who are willing
to be donors, and I am not sure whether they are always correct. If my memory serves me correctly, the results of a survey in July 1999 seemed to show that more than 50 per cent. of the population were in favour of keeping the present system. If the results of a public opinion poll suggest that it is right not to change the system, that does not necessarily mean that that is the right approach. However, we must take into account the views of the general public.Something even more significant has happened since the 1999 poll was conducted--I refer to the events at Alder Hey. I know that those events are not related to the Bill. Research undertaken by the national health service shows that the Alder Hey scandal has not significantly altered the amount of organ donation that is taking place.
I am happy to donate all my organs, if any of them are of use to anybody by the time I go. I am willing for my organs to be used for medical research or scientific research once I have gone. I take the view--I am sure that it is shared by many Christians and people of other religions--that the body is merely a container and that, when I am dead, it does not matter what happens to my organs. So long as those concerned make sure that I am dead, it does not really matter what happens to my body afterwards.
The Alder Hey events, among other things, have made me realise that other people do not take my view, and that their views should be respected. I understand that NHS research shows that one in four families has a principled objection to transplants.
Mr. Eric Forth (Bromley and Chislehurst): Does the hon. Gentleman accept a reversal of the presumption? The Bill does not seek to do it, but I am following his argument. Would a reversal of the presumption of donation fulfil his requirements? If people who had an objection to donation carried a card saying, "Please do not use any of my organs", would that meet the problem that he is outlining?
Mr. Heppell: Not quite. I promise that I shall come on to that.
There are levels of revulsion about what is happening. I would have no problem with my body being used, but I have tried to put myself in the position of others. For example, if I knew that the organs of one of my children were being used for research, would I take the same view? I think that I would, but I think also that I would be the exception that proves the rule. I believe that most people would have some sort of revulsion about that. In some instances we are talking about natural revulsion.
I shall not dwell on the tragedy of the Marchioness because my right hon. Friend the Secretary of State has to deal with the matter. It was discovered that the hands of those who had died had been removed so that fingerprints could be taken to identify the bodies. I think that people have a natural revulsion to that, but I would not have it. I have learned that I need to be much more sensitive to the arguments about transplants than I have been in the past. I took the view that the presumption should be that people are willing to be donors. Even though there is a presumption that people are willing to donate, I would still like relatives to be consulted.
That is not just because of the extra sensitivities, but because of the practicalities of organ donation. I am worried about the right hon. and learned Member for Rushcliffe narrowing the definition of who can object to organ donation to someone's spouse, daughter, son or parents. In countries such as France, where organ donation went ahead despite the fact that people objected to it, that reduced organ donation. There was a groundswell of opinion. If someone objects and is not listened to, that can work against the number of donations. It is not just about being sensitive to people's wishes; it is also about the pure practicality of what increases the number of donors.
I am torn on whether to support the right hon. and learned Gentleman. I, too, am impressed by his modesty; indeed, I am impressed by his modesty about his modesty. The Minister will have to reassure me that the Government's plans on organ donation will improve the situation if I am to be persuaded not to support the right hon. and learned Gentleman.
1.11 pm
Mr. Eric Forth (Bromley and Chislehurst): I want to say briefly how strongly I support the Bill of my right hon. and learned Friend the Member for Rushcliffe (Mr. Clarke). I have only a couple of reservations. First, I should declare a kind of interest as, for most of my life, I have had only one kidney, so, possibly, I may stand to benefit more than most others from his proposals--although, fortunately, I have not yet had to.
Were I ever to come high in the ballot for private Members' Bills, this is exactly the sort of issue that I should seek to promote. I would probably make the mistake of going much further than my right hon. and learned Friend and, in my enthusiasm, jeopardise the chance of my Bill succeeding. I am sure that he is right to restrict the scope of his Bill to trying to ensure that, in a small but important way, any obstacles to organ donation are removed. That is one of the most important things that we can do, and is ideal territory for a private Member's Bill.
My right hon. and learned Friend has deliberately tried to ensure that his Bill is not controversial; even so, the hon. Member for Nottingham, East (Mr. Heppell) challenged it. In the context of its subject area, it must be seen as extremely modest. I am sure that it is right at this stage to seek to minimise any possible objections but, at the same time, to promote the cause of the availability of organs for transport.
It has always struck me as a great tragedy that, although we now have the capability, techniques and technology to save and improve the quality of lives in many different ways, that process is unnecessarily inhibited by a combination of our laws, people's attitudes and, as the hon. Member for Nottingham, East eloquently said, people's frequent reaction to the subject. The difficulty is that, very often, those who, under the existing provisions, can prevent the use of an organ for transplant do so at a time when their emotions are heightened. The odds are that they will react against the possibility, rather than have a more favourable disposition.
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