Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein) | Oireachtas source

It is undeniable that the work of Oireachtas committees in the current Oireachtas has surpassed that in all previous sessions of the Dáil and the Seanad prior to 2011. That is my clear perception and understanding. In terms of quality and quantity, the work and product have improved, which is a tribute to the members of the committees, their respective chairpersons and secretariats, including Mr. Paul Kelly. There is more engagement than ever with citizens and groups representing citizens across many sectors and interests on many issues. On no committee is this more marked than the Joint Committee on Health and Children and I make no apology for saying this. I acknowledge and commend the role of the Chairman, Deputy Jerry Buttimer, and the secretariat.

Lest anyone think this is a back-slapping exercise - God forbid that I would be involved in such - the hard work of the committees is not always matched by the response from the Government to the many constructive and viable proposals that emerge from committees. There is a temptation on the part of the Government to see committees as useful devices to produce copious reports that can easily be shelved and, worse again, to keep Opposition Members busy. God forbid that that would be the subtext. I trust that will not be the case with our committee's report on organ donation because, as the Chairman acknowledges in the foreword, it is part of the Government's consultative process on its proposal to change the current practice of expressed, or opt-in, consent to one of opt-out consent to organ donation. I commend the report of the committee to the Minister and appeal to him to progress it. We have common cause and will all benefit.

Sinn Féin made a submission to the committee which I will briefly summarise. We need to address the question of organ donation and transplants in its entirety. There is a severe shortage of organs for transplant. There is also a severe deficit in the infrastructure for delivering transplants in terms of personnel, physical structures and funding. All of these shortfalls need to be addressed in a comprehensive manner. Speaking at the Oireachtas Joint Committee on Health and Children in April 2013, Dr. David Hickey, director of the national kidney and pancreas transplant programme, identified the three big gaps in the current system. They are a lack of organ donors, poor infrastructure in which transplant patients are housed and a shortage of transplant surgeons. He said these gaps must be filled by means of increased organ donation, investment and legislation.

Current Sinn Féin policy supports the presumed consent, or opt-out, rather than opt-in, system of organ donation. This reflects our desire to meet the need for greatly increased donations and transplants. That desire is shared by all, whatever a person's views on the best model of consent for organ donation. Having said that, debate on organ donation, including at the Joint Committee on Health and Children and in the Dáil, has increased knowledge of the issue and there is a new general awareness of the complexity of the opt-in and opt-out scenarios. It is far from being a black and white choice between opt-in and opt-out consent.

Underlying our position are a number of key principles that we believe should underpin the delivery of health services. We believe everyone has the right to enjoy the benefits of scientific progress and its application without discrimination. We believe it is necessary to use regulatory policy to protect the public good, including the safeguarding of public health and safety. Everyone has the right to participate in decisions affecting his or her health and to have his or her concerns heard. This means that individuals must be empowered to exercise control over their own health and participate in the decision-making process around health, law and policy. Importantly, people should not be subjected to medical or scientific intervention without their informed consent.

We recall the pain inflicted and injustice done to families in cases in which the organs of children were removed without parental knowledge, much less consent. On this basis, we believe a complete and comprehensive public consultation process should take place on the issue of organ donation.

We have called on the Irish Government, the British Government and the Northern Ireland Assembly to ensure that the principle of presumed consent, if adopted, would operate only with regard to organs available for donation to other patients and would not extend to reproductive organs, other tissues and organs for research. We have also argued that presumed consent would operate based on the idea that everybody carries a donor card and all persons who have the ability under the current "opt-in" policy to provide consent shall have the ability to dissent from presumed consent - that is, those who are over 16 and with legally recognised mental capacity. For children under 16 and those adults lacking legal capacity to consent, the next-of-kin should retain full control over consent, and the "opt-in" requirement should remain in place.

It should be the responsibility of the relevant health bodies to comprehensively inform the public of a presumed consent policy, if adopted, and an information booklet fully outlining the rights of potential donors and their families should be sent to every household and educational institution. This should include the ability to consent or dissent; how to officially register for and opt out of donating; the legal position regarding children; how organ donation works; how the new process will work in practice; and safeguards that will be put in place to protect the public. An all-lreland national register on withholding consent to organ donation should be established. I emphasise that this should be all-Ireland, as this is a practical area for real co-operation. This would be automatically accessible to the organ procurement services and managed by respective health departments.

We must address all aspects of this issue, most especially the need for greater resources to be devoted to organ transplantation by the Government. Even in these straitened economic times, I hope that will be an integral part of what the Government will do in moving this new approach forward. This would result in significant long-term savings for the State but, far more importantly, it would save and enhance more lives, which is the real objective we all share.

The position I have just outlined was reaffirmed by a resolution passed unanimously at the recent Sinn Féin Ard-Fheis in Wexford, which states:

In light of the continuing acute need for organ transplants and the unacceptably long waiting lists, the increased debate and public knowledge on this issue in the past year, and the wider recognition that changing to a soft opt-out system in relation to organ donation in Ireland has the potential to greatly increase our rate of organ donation, this Ard-Fheis reaffirms our call on the Irish Government to:Conduct an extensive consultation with stakeholders and the general public,

Publish legislation to introduce a soft opt-out system of organ donation,

Put the necessary resources and infrastructure in place to support the new system.

I have emphasised the point a couple of times already, and I strongly believe it is essential. It was very clear to us as members of the committee when those at the coalface dealing with transplants came before us and explained the reality of what they face and what they would face if we had a greater stream of willing donors but did not have the resources to cope with the increased opportunities this would present.

I acknowledge also the call from Cystic Fibrosis Ireland for early progress with speedy enactment of the human tissue Bill, a national online system to facilitate the change to an opt-out system, and the filling of the long-vacant cardio-thoracic transplant post in the Mater Hospital. I ask the Minister's colleague to note these points, as they are very significant. The post in the Mater Hospital in particular needs to be filled with urgency. Progress is being made and although it is not often that I have the basis to say the following sincerely, I acknowledge the Minister's proactiveness in this regard. The committee's report points the way forward and I commend my fellow members of the Oireachtas Joint Committee on Health and Children. I urge the Minister to endorse the report and move forward for the sake of the many whose lives can be saved and the many whose lives can be enhanced by organ transplantation.

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