Dr. David Hickey:

It is almost as hard as political life.

We should have all organ transplantation and procurement under one roof, as is done in Norway and most of the big European centres. Triplicating services is not a great idea. Consider the expertise that liver can bring to kidney and heart and lung can bring to pancreas. I do not have any idea where such a centre should be, but the issue should be addressed. It is a very cost-effective way of treating people and we should consider it seriously.

We should examine the model in Norway. We should develop a national centre for organ transplantation, and perhaps bone marrow could be included in that, because the personnel involved have a great deal of expertise in infections and immunosuppression. The new national centre should be located in a university hospital, independent of that hospital's board and CEO and answering only to the national organ donation and transplant office of the HSE and the Department of Health. This is essential if we are to stem the tide which is beginning to overflow us. To give an example of how serious the situation is, we have 65 patients who have been fully worked up with their donors for living donor transplantation. These are people who have taken time off work and gone to significant expense to donate a kidney to a loved one. However, we cannot give these people dates for their transplants. At the rate we are transplanting, they will have to wait two and a half to three years to get their living donor transplant. This means that in two years they will have to be re-evaluated and some of the organs concerned will have deteriorated and will no longer be transplantable. A person may have had a blood transfusion and become immunologically incompatible. We risk losing them. The other problem is that these patients are also on the deceased donor list. People who already have a living donor allocated end up getting a deceased donor and taking a kidney off someone else.

I thank the committee for the opportunity to bring our problems to the fore. I have no doubt that in two years' time we will be cutting the ribbon on a brand-new national organ transplant centre which will be a world leader in its field.