James Reilly (Dublin North, Fine Gael) | Oireachtas source

Following Deputy Catherine Byrne’s contribution, in some ways it would be best if it were left at that because I cannot think of a more eloquent way to end the debate. I thank her for her contribution.

I thank all Deputies for their contributions because the issue is a very important one that goes to the core of the values of society. It is fair to say all sides of the House are in agreement on the aim of increasing Ireland’s organ donation and transplantation rates and that any difference in approach is about how best to achieve this aim. The enormously positive impact an organ transplant can have on the life of a recipient and the lives of those around him or her cannot be overstated. Deputy Catherine Byrne has made this very clear. We all have a duty and responsibility to do everything we can to ensure as many people as possible benefit from the gift of life that is organ donation. I am aware that there are differences of opinion on the introduction of an opt-out system of organ donation. I respect these opinions and assure the House that the various viewpoints will be fully considered as my Department progresses the legislative proposals to give effect to the opt-out system of consent for organ donation. Many people have asked me to expedite the process. We hope to have the draft heads of the Bill later this year, with which we will go back to the committee.

I am also aware that a number of practical issues need to be addressed before the opt-out system is introduced, including the establishment and implementation of a register. These issues will be addressed in the coming months as the legislative proposals are drawn up and an implementation plan is developed. I wish to ensure the system of consent we put in place will be a pragmatic one that will operate effectively in hospitals throughout the country in a manner that will be sensitive to bereaved families. I also wish to ensure the next-of-kin of the deceased will continue to have an important role in the process of organ donation. Most people never give much thought to organ donation during their lives.

This is perfectly understandable, as it can be a difficult topic to consider about one's self or a loved one in normal times. However, the benefit of considering these issues in advance and making clear one's position to one's next-of-kin are that it can ensure that one's wishes are met. It also provides peace of mind to those left behind, who have the consolation of knowing and implementing those wishes. It is my intention to emphasise this point in any public awareness initiatives undertaken in conjunction with the introduction of an opt-out system of organ donation.

I hope the introduction of an opt-out system will focus people's minds on organ donation and encourage them to consider their options. At the end of the day I do not expect large numbers of people will choose to opt out. Irish people are known for their altruistic and generous nature and many people know of a person who has benefited from an organ transplant or who is awaiting the opportunity to avail of one. In most cases they will be anxious to help those in need if ever they find themselves in the unfortunate situation in which donating their organs becomes a possibility.

What those who are supportive of the introduction of an opt-out system and those who have reservations about its introduction have in common is that they all want to increase the number of organs that become available for transplantation and they want to ensure our organ donation and transplantation services are on a par with those of the most successful countries in the world. Success can be measured in a number of ways - for example, based on the number of organs donated, the number of organs transplanted successfully, and the quality and safety of the organ donation and transplantation services. Ireland has a reasonably high rate of organ donation, but we all agree that we need to improve our current figures. Last year was a record year for organ transplants, with 294 transplants performed as a result of the generosity of 86 deceased donors and 38 living donors. It was a particularly good year for lung transplants, with 32 such transplants being performed, which was more than twice the total for any previous year. I would also like to pay particular tribute to the 38 living kidney donors. Their generosity is an example to all of us. Last year's figure of 38 was a record, and we are hopeful that we can take steps to facilitate a continuation of this trend.

While all those involved in making 2013 a record year are to be congratulated, we need to build on this improvement in 2014. Last year Ireland had an organ donation rate of 18.7 per million, and I would like to see this rate rising to 22 per million in 2014. However, we must accept that this is an inexact science and the potential for transplantation depends on suitable donors being available, as well as on the aspects we can control in terms of identifying potential donors and following through successfully. It is important that we have robust systems in place to maximise the supply of organs, match up these organs effectively with potential recipients and carry out successful transplants. I am confident that with the allocation of an additional €2.9 million and the appointment of 19 whole-time-equivalent staff, involving consultants, network link nurses, organ procurement co-ordinators and quality officers, we can make this year's challenging target a reality. For the first time we will have dedicated teams who are experienced in counselling and dealing with bereaved families, rather than leaving it, as has been the case in the past, to sometimes very inexperienced senior house officers to approach families. Encouraging staff throughout the hospital network to focus more on recognising potential donors will be a major step forward. Experience in other countries shows that having specially trained staff speak to bereaved families helps to increase the number who confirm their consent for organ donation, as I mentioned.

The issue of a consultant cardio-thoracic surgeon was raised by Deputy Ó Caoláin. The post has been approved. If it was not advertised today, it will be next week. I hope the position will be filled in the coming months. It takes time to get people of such calibre into the system, as they have commitments elsewhere and must work out their contracts. I pay tribute to Dr. Jim Egan, whom some call Professor Jim Egan, who has done a sterling job and is driving our transplant service in the direction it needs to go. I am also very pleased to state that in recent weeks a new unit opened in the Mater hospital with facilities for heart and lung transplantation.

Increasing the number of donors is just one aspect of increasing our organ donation and transplantation rates. A key performance indicator is the conversion rate, which refers to the number of organs successfully transplanted from each donor, in line with the wishes of the donor and his or her next of kin. Generally, potential donors will be encouraged to donate multiple organs, although the conversion rate also depends on the nature of the organ, with kidneys having the highest conversion rate and hearts and pancreas having the lowest. Although we have not had a huge increase in donors in the past year, our conversion rate has improved hugely, with many more successful transplants.

I again thank the House for the opportunity to address it today on this important issue. I congratulate the Joint Committee on Health and Children, particularly its Chairman, Deputy Jerry Buttimer. As Deputy Ó Caoláin stated, our committees are working much more productively now than previously and they inform and have an impact on legislation. I very much value the work they do. There will always be political differences, different emphases and sometimes frank and downright disagreement, but in the main the work that the committee has done in this area, on the Protection of Life during Pregnancy Act and on tobacco will stand the test of time as a true testament to it, its members and its Chairman. I will take very seriously and examine the issues raised today as I continue to develop the legislative proposals which will implement the opt-out system of consent for organ donation.

Transplantation is an area of health care that brings many benefits to the lives of patients and their families. We all rightly agree that it needs to be improved and we all wish to see this happen. I assure the House that I will continue to work to enhance donation and transplantation rates to the benefit of patients and their families. We should all be very proud of the generosity of our people to one another. There is no greater gift than the gift of life. I thank everyone for their support to ensure this generosity is fully converted into a meaningful improvement in life for others.

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