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Mr. Darling: My hon. Friend is right to draw attention to the fact that the CSA has been significantly reformed in the past three years. That was necessary for the new system, but was desirable anyway. The chief executive, Doug Smith, has made huge changes in management and in structures. It is a tribute to the staff—as my hon. Friend the Member for Linlithgow (Mr. Dalyell) mentioned earlier—that so much hard work has been put into making substantial changes, including more face-to-face interviews and more time being taken to explain how calculations are made. As a result, compliance rates have increased. Most of our staff wanted to get ahead with the new system, but my hon. Friend is right to say that the worst thing to do would have been to press ahead with the system, especially when the information I had
suggested that Members of Parliament would have had cause for complaint had I done so. As I said to the hon. Member for Northavon, I accept full responsibility for the matter and the decision was right.
Mr. Andrew Lansley (South Cambridgeshire): Does the Secretary of State realise that his claim of accepting responsibility for the matter might ring more true if he had spent more time talking about what is happening in 2002 and his efforts to introduce the new system, rather than spending most of his statement talking about the events of 1993? Given that he has deferred the introduction of the new system, I put it to him that—as a member of a Government for whom management by targets is the order of the day—he should set a new target, even if it is not a definite commitment, to bring the new system into operation on a given date, so that he can be held to account as the responsible Minister for his performance against that target. The Secretary of State has twice been asked to set a further target date for implementation of the new system and has signally failed to do so. Why will he not give a target date?
Mr. Darling: The hon. Gentleman will remember from his previous job as an adviser to the previous Government that Governments get into awful difficulties if they fix targets, sometimes plucked out of the air, and may have cause to regret doing so afterwards. It is important to ensure that the testing process is completed. Once that is done, I intend to fix a date for starting on new cases. As I have said, I will come to the House to spell out how we propose to take on those new cases. I am very sorry if my mentioning 1993 brings back bad memories for the hon. Gentleman, although I fully understand why that might be the case.
Mrs. Joan Humble (Blackpool, North and Fleetwood): May I applaud my right hon. Friend for his determination to ensure that the new system for the CSA will succeed? We all agree with that aim. May I also reinforce the concerns of existing clients about the announcement that the introduction will be deferred? Many of my constituents who are absent parents are suffering real financial hardship. They come to see me regularly and look forward to the implementation of the new system, but are already concerned that they have no clear idea of when they will be brought on to it. When my right hon. Friend returns to the House with a timetable for implementation, as soon as he is reassured about the efficacy of the new computers, will he consider especially the needs of existing clients, many of whom are in serious difficulties?
Mr. Darling: I have a great deal of sympathy with what my hon. Friend has said. I am aware that it is felt that the present system does not take sufficient account of
the circumstances of many people, especially those who now have second families. Obviously it is too soon for me to say at this stage what the precise impact will be on existing cases in terms of the time taken.I simply repeat the following point, which I think my hon. Friend accepts. In 1993, there was cross-party support for the CSA and my recollection is that the then Opposition agreed with the then Government on introducing the thing quickly, but that proved utterly disastrous. As I have told the House on several occasions, the situation is regrettable, but it is better that we spend time getting the arrangements right, because in the long term that is the better way of helping both new and existing cases.
We should remember that the agency now deals with about 1.4 million children—we project that in four years' time it will be 1.7 million. It is very sad that that is the case, but it gives the House an idea of the number of individuals involved. We should remember that we are talking about individuals about whose well-being we need to be concerned.
Rob Marris (Wolverhampton, South-West): I congratulate my right hon. Friend on having the courage to make the announcement and to withdraw the system before it came in at half-cock and did not work. I also congratulate him on making his statement to the House first, rather than to the press, as has sometimes been done. I agree with my right hon. Friend that it would be wrong to implement a new system for the CSA until the IT is sorted out. After all, the Government are addressing years of underinvestment in his Department.
However, can my right hon. Friend assure the House that there are no other untoward delays in IT implementation elsewhere in his Department, whether in benefits or in pensions, or particularly in the Employment Service, where I believe that EDS is the lead contractor, as it is with the CSA?
Mr. Darling: In the Employment Service, as I believe my hon. Friend knows because he is a member of the departmental Select Committee, the jobpoints, which are now all successfully in place, are one example of quite a big IT project. That project was started under the Conservative Government—I say that to show that I, at least, am bipartisan—and has now been delivered successfully. There are other examples.
The Department for Work and Pensions has some of the biggest computer systems in the western world. The systems deal with 7 billion transactions every year. It is inevitable, therefore, that anything that the Department does will take time. It takes an awful lot of investment. But one thing on which I strongly agree with my hon. Friend is the need for that investment—every penny of which, to conclude on a very partisan note, has been opposed by the Conservative party.
Organ Donation (Presumed Consent and Safeguards)
4.43 pm
Mr. Tom Watson (West Bromwich, East): I beg to move,
- That leave be given to bring in a Bill to provide for the removal of organs for transplantation purposes, after death has been confirmed in a person aged 16 or over, except where a potential donor previously registered an objection or where a close relative objects; and for connected purposes.
I should like to quote from a letter from a Mr. Michael Newbold, who says that his wife
- "was in hospital with what was later diagnosed as a serious, rare and incurable heart condition . . . after more than 100 hospital admissions she was told her only hope of continued life was to have a heart transplant. She has now been on the list for 15 months, and no suitable organ has yet become available.
We know that fitness and good health is no guarantee that we will not eventually need a replacement for at least one of our organs. It could happen to any of us.
Of course, we are aware and saddened that transplant can only normally come as the result of the death of a fellow human being, but surely it is a good thing if another person benefits from that tragedy?"
In 1971, when even opting in was seen as controversial by some, contracting and opting out was raised in the House by the Father of the House, my hon. Friend the Member for Linlithgow (Mr. Dalyell). Thirty years on from his ten-minute Bill, the major medical advances in transplantation have made the Human Tissue Act 1961 even more outdated. The attempt that the right hon. and learned Member for Rushcliffe (Mr. Clarke) made last year to amend the Act through his Transplantation of Human Organs Bill is to be applauded.
We all have constituents whose lives have been touched by transplants. They are the miracle of modern medicine because, in death, they can bring the gift of life to others. Once considered to be perilous operations, they are now routine. Indeed, King's College hospital will have performed more than 2,000 liver transplants by the end of this month.
Public opinion has moved on, but although studies have repeatedly shown that up to three-quarters of the population would be willing to donate their organs after death, only 15 per cent. have signed up to the NHS organ donor register. In fact, with one of the lowest organ donor rates, we lag behind Europe. More than a dozen countries on the continent use some form of opt-out system and have far higher donation rates than in this country.
The system used in Belgium—rather than, for instance, that used in France—provides a good model for the United Kingdom. Belgium established a register of non-donors in 1987. Citizens can express their objection to organ or tissue donation at the town hall. By the end of 1995, nearly 2 per cent. of the native Belgian population had registered their objections to donation. It is mandatory that the register be checked before any organs are removed, and in practice relatives are still consulted. Countries that have a system of presumed consent also tend to have higher donation rates than those without.
As the hon. Member for Oxford, West and Abingdon (Dr. Harris) pointed out to the House in July 1998, there is well-documented and convincing evidence that when Belgium changed from contracting in to contracting out there was an increase in organ supply. In Antwerp, they kept the opt-in system, but had a big public education campaign. In Leuven, however, they adopted the new law. Over a three-year period the rate of donation in Antwerp stayed the same, whereas in Leuven it rose from 15 to 40 donors per year.
My hon. Friend the Secretary of State for Health has set the challenging target of doubling the number of individuals on the organ donor register to 16 million by 2010. That is a laudable aim, and I welcome any proposals to increase donation and bring life to others. In my region, The Birmingham Post has run a successful campaign, regularly printing donor cards and promoting the organ donor register to its readers in the west midlands. Ultimately, however, if we are significantly to increase the rate of organ donation we also need a change in the law and a positive change of emphasis towards organ donation, which this Bill on presumed consent would achieve.
Medical experts have suggested that a system of presumed consent would increase the rate of organ donation by at least 20 per cent. in this country, thus going a long way towards tackling the problems I outlined at the beginning.
I am grateful for the support of so many Members on both sides of the House—not least for their backing for early-day motion 527. I am also pleased that 40 Members have joined the NHS organ donor register in the last few weeks. We, as Members of Parliament, should be leading the way and encouraging as many of our constituents as possible to sign the register.
The Bill is also backed by the British Medical Association, many individual doctors, surgeons and patients' groups, and many of my constituents. While
opinion in the country is mixed, a clear majority now favour "soft" presumed consent, and they look to the House to lead rather than follow.It is time for a public debate on presumed consent. It is time to prevent any further widening of the gap between the number of organs available and the number needed for transplant. It is time to drag our organ donor laws into the 21st century. This Bill is about saving lives, and with the support of the House we can begin to address the chronic shortage of organs for transplant.
Bill ordered to be brought in by Mr. Tom Watson, Mr. Tam Dalyell, Mr. Kenneth Clarke, Mr. Parmjit Dhanda, Dr. Evan Harris, Dr. Ian Gibson, Dr. Nick Palmer, Mr. Peter Pike, Mr. Nicholas Soames, Mark Tami, Dr. Richard Taylor and Dr. Jenny Tonge.
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