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

I joint with the Chairman and other colleagues in welcoming each of the contributors. Like so much in life and death, this is not a straightforward issue by any measure. Dr. O'Rourke talked about the one-page system. It must be acknowledged that, irrespective of the different views on presumption or signing up, everybody is sincerely working towards the objective of improved donor availability and the consequent access for those in need. It is a matter of trying to find the appropriate response.

I would like to ask a few additional questions. Both Dr. Hickey and Professor Conlon referred to the Norwegian model. As regards the number of transplant surgeons, I note that in the third page of his presentation, Dr. Hickey spoke of a current situation involving four whole-time equivalents. Is that the actual number currently in situ for the kidney service, or is it the picture across the board? He indicated that if we were to exercise the European Working-Time Directive we would need 20 transplant surgeons to run our current service. Will he clarify if that is particular to the kidney transplant area or does it cover all transplant issues that arise?

I am taken with Dr. Hickey's argument for a single centre of excellence and expertise that would cover all the various areas of need. I note that we currently have a triplication of such facilities in Ireland, which obviously does not allow for that professional engagement on a continuous basis and all the other advantages that would occur.

I thank the witnesses for what they have said. At the end of the day, even if the presumed approach were to be legislated for, could the current capacity cope even if there was a significant increase? Clearly, that remains a matter for debate among Dr. Hickey and his colleagues. From what I can ascertain from what he and others have said, they simply could not cope with a significant increase in availability.

Professor Conlon referred to establishing a national organ procurement agency. I know that there are representatives of the procurement end of this who have made important and useful contributions. I cannot fail to note that we have only five transplant co-ordinators here - a fact which, compared to the figures in Northern Ireland and Britain, jumps off the page at me.

Professor Conlon indicated that the proper management of organ donation would have a greater impact and a more dramatic increase in organ availability than even the presumed idea that is coming into play. I understand the concerns outlined by Dr. Dwyer and his colleagues that presumed consent could lead to a decrease in organ donation. I am not so sure that would be the case, however. It would be alarming if it were. In that respect, it would offer a break in the current enthusiasm for the presumed approach which was well described here last week by a range of people, including living donors and recipients who gave powerful testimony. One young woman, just five weeks after a kidney donation, looked in better health than any of us gathered here today. It was wonderful.

Dr. O'Loughlin referred to a number of measures that should be taken to have a more certain outcome than the presumed approach. Is Dr. Hickey's view on a single centre of excellence shared across the board? The Intensive Care Society of Ireland's correspondence to the Minister speaks of particular measures but I presume they are only in the context of the current trilocation of activity.

Dr. Plant strongly emphasised that the organisation and infrastructure provided to deliver organ donation and transplant services is a more certain requirement now and with more definite positive outcomes.

I thank each of the witnesses for their respective contributions. The well-intentioned, non-professional case that is being presented by people like Mr. Brolly and others who have taken up this issue, is gaining significant momentum. It will have the support of influential organisations and other interests in the coming week. I am aware that this matter will be addressed further then. The contributions we have heard are timely and welcome. I thank the witnesses for them. When the Chair allows it, perhaps they can respond to the questions I have posed.