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Mr. Stephen O'Brien:
That is an important area and I am sure that what the Minister is saying is giving considerable reassurance to both the hon. Member for
Taunton (Mr. Browne) and his constituent, my namesake, whom I am pleased to acknowledge. The experience in Spain is important. Has the Minister asked people from Spain who have been through the process over a number of years to advise the Department on how this important initiative will be designed and implemented?
Ann Keen: We are taking advice from all areas and I am confident that that would be guaranteed. That is always the right process where best practice is being delivered.
There should be close and defined collaboration between these teams, clinical staff and trust donation champions. Electronic online donor registration and organ offering systems should be developed. A UK-wide network of dedicated organ retrieval teams should be established to ensure timely, high-quality organ removal from all heart-beating and non-heart-beating donors.
The organ donation organisation should be responsible for commissioning the retrieval teams and for audit and performance management. All clinical staff likely to be involved in the treatment of potential organ donors should receive mandatory training in the principles of donation. There should also be regular update training.
Appropriate ways should be identified of personally and publicly recognising individual organ donors, where desired. These approaches may include national memorials, local initiatives and personal follow-up to donor families. I join the hon. Member for Taunton in paying tribute to all our citizens—and their families—who have so bravely given in order to give life, especially when one takes life for granted so many times in our daily lives. To be part of the giving age is very important. There is an urgent requirement to identify and implement the most effective methods through which organ donations and the “gift of life” can be promoted to the general public, and specifically to the black and minority ethnic population.
Laura Moffatt: Does the Minister agree that an essential part of the negotiation as regards people from black and ethnic minority groups is to understand the faith issues that may or may not be involved? I congratulate those who are very keen to ensure that people understand that there are no objections to transplantation from either the Muslim or Hindu faiths.
Ann Keen: I thank my hon. Friend for that intervention. Of course, the taskforce was able to gain much knowledge during the consultation period, although one cannot gain enough of it on such an important topic. It is about education and awareness and, most of all, about providing real reassurance about possible outcomes.
Research should be commissioned through Department of Health research and development funding. The Department of Health and the Ministry of Justice should develop formal guidelines for coroners concerning organ donation. The taskforce believes that its recommendations, if implemented, could increase organ donation rates by at least 50 per cent. by 2013. We have accepted all the taskforce’s recommendations and made extra funding of £11 million available for implementation for 2008-09. Significantly more will follow in future
years. An additional £4.5 million made available over the two years between 2008 and 2010 will fund a major publicity campaign to raise public awareness and help encourage people to register on the organ donation register.
We have also strengthened the leadership structures by appointing Chris Rudge as the first ever national clinical director for transplantation. Mr. Rudge has been tasked with driving forward the implementation of the taskforce recommendations and championing change and innovation. A programme delivery board has been established to ensure implementation work is co-ordinated and the board is overseen by the NHS medical director, Professor Sir Bruce Keogh. All the major stakeholders with a role in implementation, such as NHS Blood and Transplant and professional organisations, are represented.
I am pleased to report to the House that, one year on from the publication of the taskforce’s recommendations, there are already good signs of progress. Donation and transplantation rates are up compared with the same time last year. In January this year, the number of people on the organ donation register reached 16 million people, representing 26 per cent. of the UK population.
Following two recruitment campaigns, 39 new donor transplant co-ordinators have been recruited, and a third campaign was launched in February with the aim of recruiting a further 20 new staff. We anticipate that a total of 265 staff, including donor transplant co-ordinators and office administrative support staff, will be in post by 2010-11. The national health service has a huge role to play, and is already taking action. At least 48 clinical donation champions are now in post, with more being appointed every week. It is anticipated that every acute trust will have a clinical donor champion in place by March next year. The champions will help to ensure that local policies supporting organ donation are developed and implemented. NHS Blood and Transplant has started reimbursing trusts for donation activity. That will remove some of the current financial disincentives within the NHS.
All Members will agree that it is vital that we fully optimise the opportunities for people to donate, that relatives and friends have confidence in our transplant services, and that more people agree to donation. Research shows that the majority of people in the UK support transplantation. Organ donation in this country operates on the basis of explicit consent. If, before they die, the deceased person consented to donation, their organs may lawfully be removed for transplantation. If there was no such indication, relatives are asked about the wishes of the deceased and whether they consent to donation. The Bill aims to change the basis of organ donation to a presumed consent or opt-out system, in the belief that that would lead to a significant increase in the number of organs available for transplantation.
The Government’s view is that the arguments in favour of moving towards a system of presumed consent, as opposed to retaining current arrangements, are finely balanced. We therefore welcome this opportunity for all Members to debate fully the principle of presumed consent and the practicalities of introducing such a system in the United Kingdom. Members may recall that the other place considered the issue of presumed consent in its 2008 report on increasing the supply of
donor organs within the European Union. The other place recommended that the Government’s top priority in seeking to raise UK organ donation rates should be to implement the reorganisation of organ donation and transplant services. It also recommended that before a decision is taken about presumed consent, the Government should implement national and local education programmes to improve public understanding of the issue. If at a later stage a decision is taken to switch to presumed consent, the other place advised that that should not be implemented until considerable progress has been made in strengthening organ donation services.
Mr. Chope: Does the Minister accept that a lot of public concern is centred, for instance, around stories about the Falun Gong? There was an article in the Journal of the Royal Society of Medicine in March 2007 entitled, “The Falun Gong, organ transplantation, the holocaust and ourselves”. The contents of such articles are enough to deter a lot of people from wanting to have their organs transplanted.
Ann Keen: The hon. Gentleman raises the issue of misleading, disgraceful articles, and it would be a wonder that we made any progress if they were taken seriously. However, the British public have good common sense. With the right approach of taking the matter in stages, and the correct training and balance within our national health service and education service in general, the British people will treat such articles with the contempt that they deserve.
It would be helpful to the debate if I also reminded Members that the Organ Donation Taskforce has recently considered presumed consent in considerable detail. It carried out an in-depth analysis of the issues around an opt-out system, setting up six expert working groups to report on specific areas—clinical, communications, cultural, ethics, legal and practical. The taskforce commissioned an initial analysis of the cost of setting up a new consent system, a systematic review from the university of York of international literature on presumed consent systems across the world, a comprehensive series of deliberative events in seven regions across the UK, and one-to-one interviews with leaders of 17 different faith and belief groups. In addition, the taskforce—
2.30 pm
The debate stood adjourned (Standing Order No. 11(2) ) .
Ordered, That the debate be resumed on Friday 19 June.
Business without Debate
Employers’ Liability Insurance Bureau Bill
Motion made, That the Bill be now read a Second time.
Bill to be read a Second time on Friday 26 June.
Pharmaceutical Labelling (Warning of Cognitive Function Impairment) Bill
Motion made, That the Bill be now read a Second time.
Bill to be read a Second time on Friday 26 June.
Scottish Banknotes (Acceptability in United Kingdom) Bill
Resumption of adjourned debate on Question (6 March), That the Bill be now read a Second time.
Mr. Stephen O'Brien (Eddisbury) (Con): I beg to move, That the Bill be now read a Second time.
Mr. Deputy Speaker (Sir Alan Haselhurst): Does the hon. Gentleman speak with the authority of the Member in charge of the Bill?
Mr. O'Brien: Yes, Mr. Deputy Speaker.
Debate to be resumed on Friday 20 March.
Mr. Andrew Dismore (Hendon) (Lab): On a point of order, Mr. Deputy Speaker. Is there any way of recording in Hansard that my Employers’ Liability Insurance Bureau Bill was objected to by the hon. Member for Christchurch (Mr. Chope)?
Mr. Deputy Speaker: The official record will show that there was an objection.
Use of the Chamber (United Kingdom Youth Parliament)
Resumption of adjourned debate on Question (12 March),
That this House welcomes the work of the United Kingdom Youth Parliament in providing young people with an opportunity to engage with the political process and bring about social change; notes that many hon. Members from all parts of the House are actively involved in the work of the UK Youth Parliament; and accordingly resolves that the UK Youth Parliament should be allowed for this year alone to hold its 2009 annual meeting in the Chamber of this House.
Debate to be resumed on Monday 16 March.
West Sussex Primary Care Trust (Review)
Motion made, and Question proposed, That this House do now adjourn. —(Mr. Spellar.)
2.31 pm
Laura Moffatt (Crawley) (Lab): I am delighted to have secured the debate.
It strikes terror in the hearts of most of our constituents, and certainly in the hearts of Members of Parliament, when they hear that there are to be health service reviews in their areas. In Crawley, we have been in the unfortunate position of being subjected to our fifth review since the early 1990s. It is without doubt a difficult experience, but the purpose of this debate is to demonstrate that we can do things decently, and ensure that reviews truly represent the views of not only local people, but local commissions and health experts. I firmly believe that the recommendations of the West Sussex primary care trust review of health services in the north-east of the county, which produced a report in January, will be implemented over the next year or so.
I mentioned that Crawley’s health services had been reviewed several times. In 1998, they were reviewed by a citizens’ panel. There was a consultation involving Mid Downs community health council in 1999, and West Sussex health authority organised a further consultation in the same year. The independent Bagnell review, which began in 2000, continued for two years. In the years leading up to 2005, we underwent a further review in the form of the fit for the future consultation conducted by West Sussex primary care trust.
I want to make clear that I am not opposed to the reviewing of health services. They are unrecognisable in comparison with their condition at the time when I was nursing. Until three weeks before the general election, I was still giving people bedpans. The health service has transformed itself since then, with the help of fantastic, dedicated staff—a third more staff, along with three times as much money. That has helped to ensure that our health service is something of which we can be justly proud. Last year we celebrated its 60th anniversary with fantastic events around the country.
Many Members of Parliament may find it easier to say “Please leave things as they are.” People become fearful and anxious about reviews, and many things may flow from that, including quite a difficult life for Members of Parliament. However, I became convinced that our health services needed to be reviewed. I suspect that most Members took a very different view.
I was convinced of the need for such reviews not only because I was a nurse in the service for 25 years, but because I understood that my constituents deserved better. Many of the decisions went against the views we in Crawley held, and were difficult to take. The way to overcome that is to have a new process, and that is what I want to concentrate on this afternoon. The way in which a review is undertaken can utterly change how recommendations are received at the end of the process.
All the people who took part in all the reviews undertaken in the last decade or so—the clinicians and the residents of Crawley—made a fantastic contribution. They were committed in their views, and they understood what was being asked of them, but I believe the process let them down in the end. They became confrontational;
it looked like a “them and us” process. It is very sad to see constituents who just want improved services for their area in conflict with their local health services. I believe the north-east review by West Sussex PCT has avoided that this time, and we should congratulate it on that. If further reconfigurations and reviews of service have to be undertaken, I hope that the best practice of the north-east review will be used as an example of how to conduct business within the service—how to include our communities and give people a voice within the service, and allow clinicians the opportunity to put their point of view, and sit down around the table and discuss any proposals in detail.
One reason why the process was so different was that we were quickly told that there would be an independent review by the panel chairman, who was Sir Graeme Catto, the president of the General Medical Council and an eminent clinician in his own right. He was appointed to the post, and quickly grasped the subject of the health services under review—those in the north-east of the county of West Sussex—in order to understand how they were working. Therefore, he quickly got up to speed with how things were. He started to talk to all sorts of people—including Members of Parliament, clinicians and local people. He then set up a panel of very good people to listen to the views of local people. Importantly, at that point a stakeholder group—comprising many people—was set up and invited to many meetings, to hear and share evidence with the panel, and to look very closely at particular services. I cite the example of the children’s services in and around my constituency, which are vital, especially for those families with children with long-term conditions who need constant care and attention. Improving the pathway of care for those children, and their ability to access services more quickly, was vital. We did not just spend a couple of hours trying to decide how best to do that. One of our local GPs, and a leading expert on children’s services—someone who has taken a lead in making sure we have good well-being programmes in Crawley—undertook to examine those services, which included lots of people contributing their views. What we have now is a proper programme for improvement, which I believe will transform children’s services. That was just one strand of the work undertaken in the review.
I remember that in previous reviews there was talk of closing the paediatric unit, and we were all out on the streets marching in protest. We were incredibly cross that the proposal had been put to us with little or no care by the local health chiefs. This time, we spent a lot of time sitting down together—some 50 or 60 people were involved, including some parents of children with long-term conditions. We were all given an opportunity to contribute to a discussion about how best to improve children’s services. That is now firmly part of the north-east review recommendation and something to which we can sign up.
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