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Mr. Clarke: I give way to the hon. Gentleman, whose ten-minute Bill I hope I voted for in 1971.
Mr. Dalyell: The right hon. and learned Gentleman did vote for it. When I did a long survey over 42 days, it was almost pathetic to note that many people who had not given permission for some part of their loved ones to be used later regretted it. It was a matter of considerable sadness to them that they had not been able to help other people.
Mr. Clarke: I quite agree, which is why it is so much better for people to indicate their wishes during their lifetime or to make a presumption that they would have consented unless a relative is quite sure that they would not have. In fact, we waste many available organs: after making inquiries into many deaths, in only a small proportion of cases is it found that people persisted in objecting to the removal of a kidney or heart for a transplantation operation. I hope that the issue will be re-assessed during the Bill's passage through both Houses.
We all agree that it is not a partisan issue and we have all joined in congratulating the Government on presenting a Bill that provides us with an opportunity to deal with all transplantation and other human tissue issues in one piece of legislation, tidying up and clarifying the law. However, if we make no advance on our present law and practice in respect of the shortage of donor organs, we will regret having missed that opportunity. I hope that the House will encourage the Government to be more ambitious in their intentions and to press more ambitious amendments as the Bill proceeds. Otherwise, we will have a growing scandal of a steadily deteriorating position in which people are dying needlessly or having their lives destroyed by waiting for organs that never become available.
4.11 pm
Mr. Robert N. Wareing (Liverpool, West Derby) (Lab): I, too, welcome the Bill, as it signifies the Government's clear intention to clarify the law. I have some reservations about it on the grounds that it does not completely clarify the law and is less comprehensive than I would have liked.
Practice over the use of a patient's organs has varied from place to place, and the Bill attempts to put into statute what is already best practice. I certainly welcome that. However, because it is not comprehensive enough,
it needs to be examined carefully in Committee. I only hope that the Committee has enough time. The hon. Member for South Cambridgeshire (Mr. Lansley) is right that we must have enough time to examine the Bill carefully.The Bill has been introduced without following through what the chief medical officer said should happen in January 2001, which relates to my reservations. At the chief medical officer's summit on 11 January 2001, Professor Donaldson said that, after the publication of Royal Liverpool's children inquiry, the move forward on any necessary changes, including legislative changes, should be "all in one go". He also said that the Department had large research programmes and that there was "no way" that it would wish
- "to divert or suppress any research".
The chief medical officer's report of January 2001 was entitled, "The Removal, Retention and Use of Human Organs and Tissue from Post-Mortem Examination". What Professor Donaldson recommended was accepted:
- "As soon as possible, there should be a more fundamental and broader revision of the law, encompassing the taking, storage and use of human tissue from the living and the dead and introducing an independent system of regulatory control. To be comprehensive this should encompass aspects of Coroners' practice. It should shift the emphasis from 'retention' to 'donation' to signal a new relationship with the public and bereaved families."
I want to express my admiration for the excellent work of the staff of the Royal children's hospital, Liverpool—or Alder Hey, as it is better known—which is just across my constituency border. It has treated patients from all over the United Kingdom, and even from abroad, and its reputation will undoubtedly outlive its recent problems and shortcomings. It has for a long time had a unit devoted to assisting bereaved parents with the utmost compassion. In my view, it remains a world leader in the treatment of children.
Following inquiries into the events at Alder Hey, however, it became apparent, as my right hon. Friend the Member for Holborn and St. Pancras (Mr. Dobson) said, that the storage of human organs and tissue without consent was widespread. Both the hospital and university authorities—they have not been mentioned specifically in the debate so far—were culpable. There was no criminal sanction, but the existing law proved ambiguous. Parents were told at the time of their bereavement that all the organs had been returned to the bodies. That was untrue. The situation was horrendous, and, as has been said, in some cases the bereaved parents had to endure multiple
funerals. Even where consent was given, the parents had no idea that it meant the extraction of all organs, and that what they were burying were the mere shells of their loved ones. I hope that the proposed Human Tissue Authority will address that issue properly when drawing up a code of practice.I am a little worried about codes of practice. Will the code, which should certainly be very clear, be enforced in the manner of the highway code, for example? If it is not to be regarded by the health service in the way the highway code is regarded so far as transport matters are concerned, there should be clear legislative enactment of it. People ought to know that a criminal sanction will apply, should the code be offended against.
Some say that there should be a presumption of consent, but I am a little unhappy about that. In my view, the needs of research and medical training should never take precedence over the rights of bereaved relatives.
Dr. Evan Harris: I can reassure the hon. Gentleman that those Members who support the option of presumed consent—including a "soft" version, whereby relatives are consulted—propose that it apply not to organ use for teaching and research, or to children's organs, but only to life-saving transplantations.
Mr. Wareing: I welcome the hon. Gentleman's comments, which are in accord with my views on what should happen.
The right balance should be struck between the needs of society and the interests of parents. The right hon. and learned Member for Rushcliffe (Mr. Clarke) was present when we discussed this issue, but he was unable to interject and offer his wise comments. The Human Tissue Act 1961 certainly fails in respect of creating the right balance. Currently, medical education comes first, and the retention of organs is based on lack of objection, rather than on consent. That issue needs to be looked at very carefully when the Bill is gone through in detail in Committee.
Clause 24 deals with qualifying relationships in respect of who may give or refuse consent—I think the right hon. and learned Member for Rushcliffe wrongly referred to clause 35 in that regard. However, it is unclear what would happen if there was disagreement between two persons of equal ranking under the provisions. There could be religious objections of the type referred to by the right hon. and learned Gentleman, or the person might not have seen the deceased for many years, or even decades, and their views might stand in the way of what the deceased person might have wanted. It is possible that a majority of people will continue not to carry donor cards, and although I hope that situation will change it seems unlikely to do so significantly.
The Bill provides that a living child may give its consent if competent, but what exactly is meant by "competent"? How is one to discover whether a child is competent?
The Bill does not include provision for a decision to be made on behalf of mentally incapacitated living donors. Will that matter be addressed in Committee, or will the Government's mental health Bill include a suitable clause to cover such contingencies?
When news of the retention of organs broke, Alder Hey made an attempt to provide families with counselling, which was a good thing. However, the counsellors either were, or were assumed to be, connected with Alder Hey and thus not independent, so families were sometimes reluctant to take up the service. Should not counselling support be independent of the organisation at fault? Will the Minister consider tabling a new clause on that issue? Many bereaved parents—certainly in the Liverpool area—did not go to the hospital for counselling because they thought that the counsellors were in league with the people at fault over their loved ones.
We tend to ignore the international dimension of these matters. There are many differences of practice between states. Is not there a need for harmonisation, at least between the countries of the European Union? United Kingdom citizens should be covered when abroad. Spain has been mentioned, but I believe that in Austria all organs are stripped from a dead person. That has happened to British tourists, no doubt against the wishes of their bereaved relatives.
What is our current policy on the European convention on human rights and biomedicine? About two years ago, in their reply to my question on that subject, the Government seemed to be of the view that they were considering the convention, but I do not think that anything has happened since then. What is the current situation?
I hope that the Minister can answer my questions. The Bill deserves a Second Reading and I am sure that the whole House will support it, but it needs detailed consideration, and although I shall support the programme motion it is very restrictive.
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