Regina Doherty (Meath East, Fine Gael) | Oireachtas source

I welcome the opportunity to contribute to the debate on an issue which must be close to everyone's heart. As a member of the Oireachtas Joint Committee on Health and Children, I thank the individual organisations and lobby groups that made such valuable contributions to the committee's hearings on this matter during the past two weeks. I take this opportunity to acknowledge the excellent standards observed by and dedication of our transplant co-ordinators, surgeons and teams. I also wish to acknowledge the work of the transplant teams in our hospitals. Without their dedication and skill and the support of the patient groups, particularly in the context of promoting transplantation, donation and transplantation rates would be considerably lower than they are at present.

There is little doubt that an increase in access to organs suitable for transplantation would improve the prospects for survival, rehabilitation and quality of life of many more patients. Such an increase would also be beneficial to the health service as a whole and, ultimately, to the taxpayer. The proposed change to a soft opt-out model is a development I wholeheartedly support but only if it is part of a package of measures designed to improve organ donation and transplantation in Ireland. It would be wrong to represent an opt-out system as a panacea for improving donor and transplant rates without addressing the gaps and weaknesses in the existing system. Legislation and education alone are not enough. More resources are required in order to deal with the potential expansion in the service and a robust infrastructure must be put in place to ensure that discussions with families in respect of organ donation are carried out in the right way, at the right time and by the right people.

The principal question which must be addressed is how we might best achieve this. A variety of potential solutions have been advanced by different individuals, organisations and the health care profession. The evidence and experience relating to various jurisdictions suggest that a suite of measures might be used to significantly increase the level of organ donation. Such measures might include the appointment of an appropriate hospital-based specialist, educational measures directed at the public and the medical community, better access to intensive care beds and measures to improve organ donation after cardiac death.

The package of essential measures to accompany a change in donor law should contemplate a number of things, including the appointment of a network of donor co-ordinators being assigned to the major intensive care hospitals. These medical and nursing personnel will underpin the organ donation process by protecting the interests and welfare of those families which choose to donate organs in difficult circumstances. The national organ donation and transplant office should be given sufficient resources and status in order to allow it to undertake its functions. The office's existing level of resources is inadequate. A national online organ donor registry should be established in order to provide potential donors the opportunity to indicate if they wish to opt out of all or some forms of organ donation. For example, a person may wish to donate one organ but may be reluctant to donate others. The process should be allowed to facilitate such individuals. Specific measures to improve the rate of lung and heart transplantations are needed. A national organ procurement office, independent of all the hospitals, should be established in order to accommodate the transplant standards required under current EU directives. In addition and irrespective of the change to an opt-out model, greater support must be provided by the Government in respect of the annual public awareness campaigns relating to organ donation. Such campaigns must be undertaken in partnership with the patient groups.

Legislation is extremely important. However, I wish to strongly associate myself with the view expressed by others to the effect that, in the absence of robust organisational and infrastructural development to support this endeavour, any legislative framework is unlikely to achieve its maximum potential in increasing donations. It is incumbent on the Government to ensure that there is a dedicated IT system in place and that this will be accompanied by the necessary strategic infrastructure. Above all, without national monitoring there can be no measuring of the system when it is implemented.

I am humbled by the wonderful families which make the very unselfish decision to donate their loved ones' organs in very difficult and traumatic circumstances. Without those families, we would not even be engaging in this debate and countless numbers of people would not be able to continue to lead healthy and fulfilling lives. I am happy to support the motion.

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