Pauline Tully (Cavan-Monaghan, Sinn Fein) | Oireachtas source

I broadly welcome the Bill, although there is a small number of issues that need to be addressed. I commend the Minister on bringing this forward. In terms of organ donation and transplantation, Ireland, according to the Global Observatory on Donation and Transplantation, GODT, currently ranks 28th in organ donation rates out of 72 countries worldwide. Rates of organ donation are 18 per million population in Ireland compared with 25 per million population in Britain.

I welcome this Bill will introduce an opt-out model like that in Britain, replacing the opt-in model that currently exists. A recent study published in the journal Anaesthesia in May 2020 compared deceased organ donor rates in Wales, which introduced an opt-out system in 2015, with England, which only introduced it in 2020. In the three years between 2015 and 2018, the rate of consent in Wales was double that which was seen in England and donor numbers rose rapidly. One organ donor can potentially save seven lives. There are also benefits to recipient families and Irish society in general, including the Irish health system and the wider economy in promoting transplantation and working towards the most effective organ donor system possible.

In 2021, there were 669 people here who were reported to be on the overall transplant waiting list and there were 31 deaths reported of those waiting for a transplant. An opt-out system, I believe, will give more opportunities to those who are in need of organ donation and will reduce the number of people dying while waiting for a transplant. The Bill, with choice and consent at its core, respects individual human rights, personal autonomy and religious beliefs. It retains the right of anybody who believes that it interferes with any of these to be able to opt out and this is important. It also requires consultation with the person's family and that, too, is important.

While I support the Bill, I have concerns about the administrative burden if it is not properly resourced. There is a need for significant investment in essential infrastructure, transplant surgeons, trained support staff and enhanced bereavement supports to substantially increase transplantation rates. Enhanced public awareness and education are also essential.

Another aspect of this Bill strives to address concerns raised in the report by Dr. Deirdre Madden on post-mortem practice and procedures. The Madden report came about on the back of a number of serious revelations about the retention of organs at a number of hospitals and that a number of children's organs which had been retained without their parents' consent or knowledge were also sent abroad for incineration. Again, this was without their consent or knowledge.

One of my constituents was in contact with me recently. Her son, Tadhg, was stillborn in June 2016 at almost 38 weeks gestation. A year and five months after burying Tadhg, she was contacted by the morgue in Drogheda asking her if she wanted her baby's brain and left lung. She had no idea that her son's organs had been retained and she did not get the organs back until March 2022, which was five years and nine months after his funeral. The family reopened his grave to bury the rest of their son. Can you imagine how difficult it is to lose a baby in the first place? Then, the hurt was revisited on them all over again when they were confronted with the fact that part of their baby son was removed and retained.

I acknowledge that it is common practice to remove organs during a post mortem and to retain these organs for further tests, but surely families should be informed if this is the case. This family still does not know why their baby son's organs were retained. The sad part is that they are not the only family that this happened to, and this was not mentioned in the post mortem report. It seems that one pathologist in particular was responsible for quite a number of these post mortems. The families concerned deserve answers from him or from the health service. This Bill must ensure that something like that cannot happen again.

Another issue that was brought to my attention was that of families that have been negatively impacted by the delay in the carrying out of post mortems. Many hospitals, particularly in Dublin, do not carry out post mortems. Some only carry out a post mortem if the person passes away in the care of the hospital. This means that there is enormous pressure on the mortuary in Dublin city. One family from Cavan whose family member passed away suddenly in Dublin on a Wednesday evening had to wait until the following Tuesday for the post mortem to take place and then have his body released to them for burial. That was extremely difficult on them. This is another example of the lack of workforce planning which is evident across many sectors of society and particularly in relation to medical personnel. The staff in the mortuary in Dublin city were trying their best but they were inundated with work and were trying to cope with deaths which occurred in several hospitals as well as in the community.

Once again, I broadly welcome this Bill with the caveat that a number of issues still need to be resolved. I commend the Minister on his work, and I especially praise the families who have been so horrifically impacted and who have battled to have safeguards put in place so that no other families will have to go through what they went through.

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