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4.24 pm
Mr. David Wilshire (Spelthorne) (Con): Although the Bill is about more than organ donation, it is on that subject that I rise to speak. I do not speak as a party politician; this has to be free-vote territory. I speak simply as an individual whose awful experience may help others to clarify their approach to at least one of the difficult issues raised by the Bill.
At the outset, I want to make it clear that I have no objections at all, in principle, to the removal of parts of a dead body. In fact, I have carried a donor card for many years. However, I do have some concerns about consent, and they arise from the death of my daughter.
Twenty-two years ago, my 12-year-old daughter choked to death at school. Very shortly after that catastrophic event, I met some of her teachers and some of the staff at the hospital to which she had been taken. I was too distraught to turn my mind to organ donation, and I suspect that they were too kind to risk causing me further distress by raising the subject. As a result, no part of the body that was no longer of any use to Sarah could be used to help others. As the Father of the House predicted a few minutes ago, that is something that I deeply regret to this day.
When they hear me recount that story, people might believe that it is an argument in favour of presumed consent. However—and perhaps curiously to some people's minds—that experience has led me to become an opponent of presumed consent, and I want to try to explain to the House why that is so.
All hon. Members have probably received representations recently urging us to use the Bill to introduce some form of presumed consent for the removal of organs from a dead body unless someone has registered opposition to that course of action. I readily accept that there are powerful arguments in favour of that approach. Principal among them are the shortage of donor organs noted by my right hon. and learned Friend the Member for Rushcliffe (Mr. Clarke), and the many and growing opportunities to help people in need of organ transplants.
I accept that helping those people is an entirely worthy objective, and I hope that the entire House supports it. I certainly do, but I believe that we can achieve that objective by means other than through presumed consent. There are serious anxieties about presumed consent, and I have my doubts about whether it would solve all the problems that its supporters claim that it would solve. The potential abuse of presumed consent is a very real fear. Appropriate amendments to the Bill might resolve that problem, but we must also consider the impact of presumed consent on bereaved relatives.
If presumed consent had been in operation on that June evening so many years ago—and I take the point about its not applying to children made by the hon. Member for Oxford, West and Abingdon (Dr. Harris)—a doctor would have got on with what he judged needed to be done, or he would have had to check that I had no objections. If I had discovered later that, although I was in the hospital, no one had taken the trouble to consult me, I would have been outraged. Had I been invited to object rather than to agree, it is probable that I would have been made to feel guilty for the rest of my life if I had found the need to refuse.
Please believe me: the last thing that a person who is struggling to cope with the death of a daughter wants is additional and avoidable grief. That is why I oppose presumed consent. To my mind, something that has the capacity to add outrage and guilt to the hell that one goes through in those circumstances simply has to be wrong.
That said, I can readily understand why I might sound selfish to other people. I know that doctors are busy people, so why put obstacles in their way? It is not easy to ask permission from a bereaved family, so why make clinicians do something difficult and unpleasant?
Let me give my answers to those two questions. If there were ever a situation where the needs and wishes of patients and their families must come first, this is it. On such occasions, clinical convenience must always be a secondary issue. Presumed consent would not spare doctors the difficult task of raising the subject of organ donation with bereaved families—all it would do, as the hon. Member for Sutton and Cheam (Mr. Burstow) said, is alter the nature of that discussion. In my opinion, asking, "Do you wish to object?" is no easier than asking, "Please may we?", but to my mind, "Please may we?" is much kinder and much gentler.
Those who speak on any subject have a duty, if they oppose a certain way of achieving something desirable, to say what the alternative ways of achieving it are. In this case, I suggest "required request". Let me give the House a few examples of what I have in mind. We could
train, then require, GPs to raise the issue with their patients, especially when registering new patients, and they could record all those agreements on a central database. We could help, then require, hospital managers to add a question to their admission forms: I am sure that that would help. We could train, then require, hospital doctors, especially those who specialise in accident and emergency, to raise the subject gently with the bereaved. I would have been eternally grateful had they done that with me those 22 years ago.Before I conclude, I add a footnote about the events at Alder Hey hospital that triggered the drafting of the Bill. I, too, had constituents who were affected and a local hospital that was involved, and I therefore witnessed for myself the distress, grief and anger to which the Minister referred. Because of the death of my daughter and the post-mortem that followed, I, too, could have been personally involved. Had I been, the last thing I would have wanted—whatever the facts that may have been discovered—would be someone knocking on my door 20 years later and reopening a still very sore wound. I may sound like a coward, but some things that people demand that they know, I would rather not know. My hon. Friend the Member for South Cambridgeshire (Mr. Lansley) put it well when he said that there is a right not to know, as well as a right to know.
The Bill raises many more issues than those that I have mentioned. I readily accept that they are all important, that they are all difficult, and that none of them is party political. Using human tissue and organs can save the lives of others and is essential for medical research—that is why I support it—but we must not allow our enthusiasm to help others run away with us in the decisions that we take. Potential donors and their families must have equal consideration.
I realise that it is probably inevitable that I am on the side of the bereaved, and I feel no need to apologise for that. Even if others disagree with me, I hope that sharing Sarah's experience and my conclusions with the House may, in some small way, help this House to reach compassionate conclusions on all the intensely personal issues that are raised by the Bill.
4.35 pm
Mr. Tom Watson (West Bromwich, East) (Lab): This is a good Bill. As many hon. Members said, it is the result of a desire on both sides of the House to provide justice for the families of Alder Hey and Bristol. What better tribute could there be to the daughter of the hon. Member for Spelthorne (Mr. Wilshire) than that we can have an open debate about how we can advance compassion in medical science?
The hon. Member for Spelthorne made a powerful case for an opt-in system and advanced some creative ideas as to how we can improve the organ donor register. I should like to put it on record that I believe that the initiatives that the Government have taken in the past two years are excellent—not least, sending out licence reminders to 6 million people and encouraging electoral returning officers to add an opt-in system to people's voter registration forms. That obviously means that we can advance towards the target that the Minister discussed earlier, and 11 million people on the organ donor register must be welcome.
I would like to take this opportunity to advance the cause of presumed consent. Many Members have said that they believe in a system of weak consent. When I first approached the matter, I believed that if a deceased person's body could be used to save a life, then a hard form of presumed consent should be included in legislation. I must say that I have changed my view because of conversations with my constituents, which is true of my approach to many debates in the House.
One such constituent is David Nix, who is a great man. He runs the organ Donor Family Network and, having received a small grant from the Department of Health, he operates the organ donor bus. Week in, week out, he tours the country and has signed up tens of thousands of people to the organ donor register. David convinced me that families must be involved in the decision to donate organs. When I attended a ceremony in my constituency to honour the memory of Sarah Lewis, I met Sarah's parents, David and Katherine. At the time of their maximum grief, only a few months after her death, they took solace from knowing that Sarah's organs had saved many lives. That helped them in their grief and convinced me that, if we are to introduce a form of presumed consent, parents must be consulted and have the right to veto, and that all the issues must be dealt with sensitively.
Transplants are the wonder of modern medicine. I hope that the Bill results in robust legislation that stands the test of time like the Human Tissue Act 1961—I agree with the right hon. and learned Member for Rushcliffe (Mr. Clarke) that that was a good Act. When the legislation was debated in 1961, medical science had not developed ways to transplant spleens, kidneys, hearts and lungs and to conduct multiple transplant operations. The 1961 Act has stood the test of time, but it is right for us to take the time to consider the advances of the next 40 years. I hope that the Bill will allow for future advances such as xenotransplantation and stem cell research, and that will be an issue in Committee.
As the Minister in the debate in 1961 said, the test of the Bill will be whether we can build public confidence and convince people that organ donation is morally right. The 1961 Act succeeded. As has been said, most market research shows that at least three quarters of the British public believe in organ donation, and some surveys show that 90 per cent. of the population believe in organ donation. If nine out of 10 people in Britain support organ donation, it is obviously a problem that only 15 per cent. of people are on the organ donor register. As the Father of the House said, one way of addressing that gap is presumed consent.
I have read the Father of the House's contribution to the 1971 debate, and I have read the five further contributions that he made throughout the 1970s. Although it was not unexpected, I was sad to hear the announcement of his retirement at the end of this Parliament. As a new entrant in 2001, I had the benefit of his support and advice when I moved a ten-minute Bill on organ donation last year. He is renowned for yielding to no one in pursuing what he thinks is right, be it organ donation, the sinking of the General Belgrano
or, dare I say it, the decision of this House to enter Iraq. He will be sadly missed and I hope that he can still make a contribution after he leaves the House.The House does not have a great reputation for introducing legislation that meets the advances of medical science. The Corneal Grafting Bill was introduced by the then hon. Member for Tonbridge in 1952, but we had the technology to do corneal grafts in 1900. It took the House 52 years to pass an Act with a framework with which clinicians could engage. I would like to think that we will ensure that we do not make that mistake again.
During the course of my research for the debate, I came across a Select Committee report from 1828 and a debate on the Bill that became the Anatomy Act 1832, which dealt with body snatchers. The debates arose because colleges could not teach medicine without cadavers, so a black market for them existed. If the Government do not reduce the gap between the number of people who require organs and the number of organs available for transplant, we will create a black market again. I do not want us to lack the courage to act today and thus create an eBay body-snatcher culture of the kind that we have read about in the press in the past two weeks. I hope that we can be bold, and that those on both Front Benches may be convinced not to close the door entirely on presumed consent, while trying to be as sensitive as possible to the views of parents and loved ones.
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