Catherine Murphy (Kildare North, Independent) | Oireachtas source

I too thank Deputy Fleming for tabling this motion. As others have noted, when something of this kind is tabled it forces one to look at the situation and some of the things one finds are astonishing when one thinks one has an idea of how things are. I hope the motion will be supported by all sides tomorrow.

One aspect I find astonishing is that Ireland has never provided any legislative basis for organ donation. We are the only European country not to do so, which I find incredible. It is true that organ donation rates in Ireland are nowhere near the rates we need to cover comfortably all the scenarios that arise annually. At present donation rates can fluctuate wildly. There can be reasons for this, but in 2010 alone organ donation rates spontaneously dropped by 28%. Unfortunately those who were waiting for organ donations were particularly affected in that year but the list also builds up because there is a backlog of those who are well enough to stay on the list while at the same time there is a rapidly growing waiting list. Take, for example, one of the most common procedures in the transplant family - renal transplants. Since 2000, the number of people on waiting lists has risen by 413%, an astonishing rise, yet donation rates have fluctuated throughout the decade.

The move to an opt-out system as recommended by the motion is one we should consider for Ireland if it will increase donation rates but this should not be attempted if done in isolation. It is important to note that much of the medical and expert opinion in this country claims that improvements in clinical practice have far greater consequences for raising organ donation rates than a simple switch to an opt-out system would have. I am glad to see that the motion supports what the medical experts are saying in this respect. That is where we need to focus our attention because those people who are at the coalface and who see what works are the ones to whom we should pay attention.

Many of the experts who gave evidence at a recent health committee meeting told of how a move to an opt-out system would likely be beneficial to their work but some of them stressed that they would prefer a soft opt-out option because the family of a deceased relative would have the final say. Above all other concerns, what has been very clear is that clinical practice is the key element which needs to be properly resourced in order to achieve an increase in donation rates. That is something I urge the Government to take from this debate. Whatever system we eventually move to, and it is imperative that we change how we do things, we need to have, at the same time, a prominent public awareness campaign about donations. We need to tell people just how bad the situation is. People are very generous. Even if the system is not changed we must continue to remind people about donations.

We must also look at the resources given to organ donation services. Currently, as referred to, there is the National Organ Procurement Service, based in Beaumont Hospital, which has six transplant co-ordinators. That is all there is available nationally. We must look at putting transplant co-ordinators in all acute hospitals in the State, or at least regionally, a point recently made at the health committee. In the United Kingdom, which remains an opt-in system, donation rates have increased by 50% in the past five years, an outcome primarily put down to the deployment of 250 specialist co-ordinators throughout that country.

Money may have been spent unwisely in this country. Right now it costs €70,000 every year to keep a person on dialysis. We need to deal with prevention. Our diabetes rate is one cause of the problem. Other countries have impressive organ transport systems, with those in Scandinavian countries being a case in point. They cover 25 million people and extend as far as Greenland. Ireland has a very dedicated transport unit. We have seen situations where this did not work to the optimum, as in the case of Meadhbh McGivern from County Leitrim who, thankfully, did in the end get a donation and received her transplant. An organ donation register is important. There are significant advantages to having a list of pre-approved donors who are cross-matched. Many things can be done.

Again, I thank Deputy Fleming for tabling this motion. I acknowledge the work Joe Brolly, himself a live donor, is doing in terms of raising the profile. The GAA is a very good partner in ensuring this issue is brought to every town and village in the country.

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