Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance) | Oireachtas source

I commend Deputy Fleming on proposing this motion on what is a tremendously important subject. I understand this is the first time it has been discussed in the Dáil. It has only been discussed on one previous occasion in the Oireachtas when Senator Feargal Quinn raised the matter in the Upper House. This is, therefore, a first for the Dáil and Deputy Fleming is to be commended on that. We are talking about organ donation which can be life changing for many people. While I am not an expert in this field, I have come across people who have been waiting many years for vital organ transplants. They have suffered considerably in the interim while awaiting transplants, and when they get them it utterly transforms their lives.

There are few things more worthy of debate here than a move to improve a situation that can change thousand of lives for the better. It is tremendous that we are talking about this subject and I hope that as a result of this debate the Government will take action to change the lives of so many people who could benefit from the proposals contained in this motion.

The motion proposes that we should have presumed consent, which is a no-brainer. Currently, however, if there are disputes within a family as well as uncertainty and delays, an adjudication of no consent is given. Where somebody or their family say they do not want to give consent, it is right that they should have that choice for whatever reason they choose. In other circumstances where it is less clear, however, it could make a significant difference if the consent was presumed and people had to make a conscious choice to opt out of organ donation. We should all support that.

In so far as I have acquainted myself with this subject, everybody with detailed knowledge of the issue will say that presumed consent is not enough. It is just the first step and we need to go further. The model in Europe is Spain where they have presumed consent which was introduced a number of years ago. In addition, the Spanish authorities discovered that even when presumed consent was introduced it did not make a significant difference to the level of organ donations. It was found that there were many other issues which caused problems in increasing the number of organ donations.

Deputy Tom Fleming's motion also rightly addresses these issues. In Spain, it no longer is simply described as "presumed consent" but now is described as "informed consent". In other words, in addition to having in place that system in which one is presumed to opt in, one also has a major education programme in respect of organ transplantation and its importance, as well as programmes in schools and so on, in which this issue is discussed by children, families and so on. In consequence, people are familiar with it and with the importance of organ donation for saving or transforming the lives of those in need of such organs.

While this aspect of the motion is important, the question of the system for managing organ donation also must be addressed. It is suggested that a system of regional donor co-ordinators is required or possibly even specialised donor nurses in hospitals who are trained in this area. This is to ensure the optimal retrieval of organs in situations in which a possibility might arise to talk to the families involved and to ensure the optimum level of organ retrieval. It also is suggested there should be an independent national donor office to co-ordinate at a national level, but that underneath such an office, the regional co-ordinators and possibly the specially trained donor nurses would operate in the hospitals. Another issue raised in this regard concerned the question of the air ambulance service and the limitations on it in the context of ensuring the rapid and efficient transport of organs to where they are needed. It is a resource issue to ensure the transport capability exists to get organs quickly to where they are needed. On all these fronts, the Government should consider what it can do to provide the requisite resources and back up a clinical and administrative system that can ensure the efficient retrieval of organs and their transportation to where they are needed.

In addition, there should be no question of any cuts. I believe there may have been some cuts to some organisations such as the Irish Kidney Association, which has done such tremendous work on this issue. However, I reiterate there should be no question of any cuts to voluntary organisations or NGOs that are working in this area. All the necessary resources should be provided to ensure the implementation of the best possible system in organ transplantation and donation. Consequently, the Government should take on board these suggestions made by Deputy Tom Fleming and the organisations that are pushing for these measures in order that they truly can offer a life-changing or lifesaving option to as many people as possible, many thousands of whom are currently waiting for such operations.

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