Mark Daly (Fianna Fail) | Oireachtas source

I suggest the legislation require the publication of the number of donations made by each hospital. We accept that there are quirks, but it should not come down to the fact that one hospital has an enthusiastic nurse or consultant and another does not. There should be a properly resourced system in place.

Will the position on the issue related to cardiac deaths change under the legislation? Does it need to be changed? Professor Egan referred to brain injury. Will that aspect be provided for in the legislation? Will there be clear guidance for consultants on how it will work or will things be left as they are? It would be helpful if they were. As Mr. Watt, Mr. Murphy and the other delegates are aware, the cost over a decade of people awaiting a transplant is nearly €10 billion, which is big money. How much would be saved if we were to put in place the system Professor Egan, Mr. Conroy and all others in the health service want? We would save millions of euro.

Croatia had a system of presumed consent for kidney transplants and so on, but it did not work. It realised that what was needed was nurses and a system for retrieving organs and transplanting them into people who needed them. That is how we will save the health system money and it should be the aim of every health committee. It is possible to achieve it through this legislation because people wait too long for a transplant under the current system. Does Professor Egan know the number of people who died having been taken off a transplant list because they had become too ill while waiting for a transplant? They died because the system was not working.

My driving licence has the code 115 noted on the back such that my niece will know to donate my organs when my time comes. I will have nothing else to give away. The roles of the committee and the delegates are so important because what matters is what works. The Spanish health service discovered that what worked was nurses who specialised in organ donation. What also works is knowledge, that is, a family knowing that their loved one wanted to be an organ donor. Carrying an organ donor card is one way to impart that knowledge, if one is lucky enough to find it. A person can also discuss the matter with his or her family. If the video of my stating I wish to give away my organs can be retrieved, that is fine.

The system being proposed will not work. The evidence shows - correct me if I am wrong - that 29.8% of families consent to donation without knowledge of their loved one's wishes or being asked to donate by a nurse. The families just offer to donate the organs, which is great. Some 57% give consent if they have no knowledge of their loved one's intentions but are asked to donate by a specialist nurse. That is why we need specialist nurses. That is why they were put in place in Spain. Some 93.9% of families who they know what their loved one's intentions are and are asked to donate consent to the donation. That is the success rate we want to achieve, but the legislation will not bring it about. All it will do is create an opt-out system that will tell the families of people among the 2% to 5% - it is 6% in Wales - who will choose to opt out that their loved one did not wish to be an organ donor. It is a negative measure.

Some 1 million people have indicated on their driving licence that they wish to be an organ donor. I twice asked the Minister for Transport, Tourism and Sport, Deputy Ross, whether he would give that information to the Department of Health. He initially told me that he would not do so, citing data protection concerns. I pointed out that the Department shared the information on persons' driving licences with eFlow, private clamping companies, car parking companies, the Garda, the Courts Service and approximately 15 other organisations, but he was not willing to share it with the Department of Health. He has changed his tune and claimed that the Department of Health does not want the information. The information that would help families to make the decision is often contained on a person's driving licence. It is held by the Department of Transport, Tourism and Sport, but the Department of Health does not want it. If it was handed over such that the family would be aware of their loved one's intentions and they were asked by a nurse to consider donation, it would increase the rate of organ donation to 93.9%. Much of what we can do is available to us, although hospitals need further resources for nurses, which is important. It is a systems failure. The committee should suggest the legislation require the Department of Health to receive the information. If the committee decides to approve the opt-out system, that information should also be available. In potential cases of organ donation, the staff should make one telephone call to discover whether the person had opted out and, if not, another to ascertain whether he or she had indicated on his or her driving licence that he or she wished to be an organ donor. I note Mr. Watt's observation that only 38% people in England indicated their wish to be a donor. However, every inch we can move people along to make that decision will make a difference. I ask that arising from this meeting the committee recommend that the information held on driving licences be utilised. It is available, but the Department of Health does not want it, even though it would help families. All it would take is a simple telephone call to the licensing authority under the Department of Transport, Tourism and Sport.