Nigel Hawkes: Health Editor
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Greater effort and more money could increase organ transplants by 50 per cent without a change in the law, a task force set up by the Government says.
The group wants organ donation to be a usual rather than an unusual event, but has yet to consider whether a change in the law to “presumed consent” would help to achieve this.
Last weekend the Prime Minister indicated that he would agree to a system under which it would be assumed that everybody was willing to have organs removed after death unless they explicitly had said not.
Yesterday’s report does not address the issue, but examines how improvements could be made within the existing law, drawing on experience in Spain, where donor rates are nearly three times those here. Its recommendations include doubling the number of transplant co-ordinators, strengthening the network of retrieval teams, identifying potential donors sooner, mandatory training of critical care staff and promoting the idea of donation. Such changes, the task force believes, could lead to an extra 1,200 organ transplants each year.
Alan Johnson, the Health Secretary, backed all 14 recommendations made by the task force, chaired by Elisabeth Buggins, chairman of West Midlands Strategic Health Authority. The Department of Health said that work would begin immediately to implement the plans, with £11 million of funding next year and more to follow.
The task force has set up subcommittees to look at the issue of presumed consent, and will report in the summer.
Mr Johnson said yesterday he did not believe that Gordon Brown had prejudged the issue. “I think what he said was he was kicking off a national debate and he’s attracted by what happens in Spain, as am I. I find the ideas attractive but, and this is crucial, I don’t think politicians should say we believe presumed consent is right and that is what should happen.”
Peter Weissberg, of the British Heart Foundation, said: “The recommendations must be adopted in full. Half-hearted solutions won’t do.”
Among the potentially controversial recommendations is that co-ordinators who match donors and recipients should receive early notification of potential donors. This would involve doctors identifying patients who were dying, which some may feel could take precedence over keeping them alive.
Research suggests that 90 per cent of the public is in favour of organ donation, and almost 15 million people are on the NHS Organ Donor Register, the report says. But donation rates remain poor, partly because 40 per cent of relatives refuse consent. This proportion has increased in recent years, and yesterday Mr Johnson blamed the fuss over organ retention at Alder Hey Hospital in Liverpool for the change.
He did not mention that the fuss was orchestrated by his predecessor, Alan Milburn, and the Chief Medical Officer, Sir Liam Donaldson. As a result, the Human Tissue Act was passed in 2004, with consent as its guiding principle. To introduce presumed consent for organ donation, this recently established principle would have to be abandoned.
John Fabre, past president of the British Transplantation Society, said: “There is no conclusive evidence that presumed consent works.” The link with donation rates was “entirely unproven. Spain has a transplant coordination network of doctors and nurses in every hospital likely to have organ donors. It is almost certainly this, rather than presumed consent legislation, that is the main reason for Spain’s superior organ donation rates. Spain also has a much higher death rate from car accidents a major cause of death among organ donors.”
There were also “strong moral objections to presumed consent”, he said.
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