Paul Murphy (Dublin South West, RISE) | Oireachtas source

We welcome the Bill and its key provisions. The provisions to support and increase organ donation and transplant through a soft opt-out system of consent are welcome and should ensure many more organs become available for transplant. That is obviously very good news for the more than 500 people in Ireland who are on waiting lists for organ donation.

In 2021, there were 203 organ donations from 99 donors. About 250 organ transplants took place in 2022 from 190 donors. The 2022 figure includes kidney transplants from 33 living donors. The chief executive of Cystic Fibrosis Ireland, CFI, has said, "Transplant and donor rates in Ireland have the significant potential to be improved by this legislation if accompanied by the necessary resources and public awareness supports," It is vital we ensure that resources, public awareness campaigns and so on follow on from the Bill.

The truth is the Bill is long overdue. We are the last country in Europe to introduce a soft opt-out. A soft opt-out system of consent for organ donation was introduced in Wales 2015. Within four years, the rate of people donating increased from 50% to 77%. England introduced an opt-out system in 2020 and Scotland in 2021, and we hope that one will soon be in place in the North.

The Council of Europe transplant report of 2021 showed Ireland with a transplants per million population rate of 40.6, well below the rates achieved in countries like Spain, which is very close to 100, the UK, which is very close to 60, or Croatia, with a similar sized population, at 65.4 transplants per million population. It is the international norm to have legislation governing donation, organ donation and transplantation, and the Bill introduces Ireland's first legislative framework in this area. At last, Ireland will be brought into line with good international practice in regard to the governance practices relating to human tissue. It is clear the Bill is long overdue.

A key issue for organ transplants will be specialist transplant capacity. The Irish Kidney Association, IKA, recently commented that the increase in donors and transplants in 2022 is welcome but said the underpinning infrastructure is still fragile and referred to the November 2020 incident where organs donated were not used due to a lack of resources. It went on to say it awaited the recommendations of the investigation into this incident.

In November 2021, an organ transplant operation at the Mater hospital was cancelled because of a shortage of ICU beds. The organs became available and were delivered to the Mater hospital by ambulance. The transplant patient was put on standby and the procedure was due to go ahead later that day. However, the hospital's ICU beds were full, and despite a frantic check of other hospitals in Dublin, no ICU beds were available and the operation had to be cancelled. The IKA has also said recently that it is disappointing to see that levels of heart and lung transplants have not recovered to pre-Covid-19 activity levels and it will be interesting to understand the reasons for this.

The IKA has also called for more transparency around transplant waiting lists. It said we need more clarity about the reasons more transplant operations are not taking place in Ireland. In the UK, a detailed report is available on each step of the process that results in organ donation and transplantation. No such data are published in Ireland. The IKA, correctly, wants more transparency on the criteria for patients to be accepted or removed from transplant waiting list for heart, lung, liver, kidney and pancreas transplants. For example, in excess of 2,000 patients with end-stage kidney disease receive dialysis treatment in Ireland. However, 20% of these patients are on the transplant waiting list. We need more transparency in all of these issues.

Our ICU bed capacity is far below what we need and far below the EU average of ICU beds per capita. We need to almost double the number of beds in the public health system. There are currently about 300 ICU beds available in our hospitals. This needs to increase to about 600 beds to ensure we have the capacity that is needed. This Government, along with previous Governments, has failed to act on this deep lack of ICU bed capacity. The likely increase in organs available for transplant makes this even more urgent. We have a chronically underfunded public health service, whether that is accident and emergency departments, child and adolescent mental health services, CAMHS, or bed capacity. A lack of capacity and staff undermines the health service, leaves more than one in five of the population on some form of health waiting lists, and creates entirely avoidable risks to the health of so many for want of timely care.

I raise the case of Dáithí Mac Gabhann, a five-year-old boy from west Belfast who was born with hypoplastic left heart syndrome and has been waiting for a heart transplant for most of his life. He has also inspired a truly remarkable campaign. His parents, Máirtín and Seph, have done Trojan work on opt-out organ donation. They have raised awareness, broken down concerns and galvanised an entire community. The Donate for Dáithí campaign was so successful it succeeded in achieving that most unique of things, namely, cross-party support in Stormont for opt-out legislation. The law has been named Dáithí's law. Stormont has passed the legislation, but full implementation is being held up because there is no functioning Executive. The family has fought enough. They have banged on the door of the Secretary of State to demand he intervenes. They have secured a meeting with him for 1 February. The demand from the campaign is clear. The demand from Máirtín and Seph is clear. The demand from Dáithí Óg is clear, namely, that the Secretary of State step in and enact the necessary legislation to ensure Dáithí's law becomes a reality. I ask our Minister to intervene and write to the Secretary of State before 1 February to press Chris Heaton-Harris to hear Dáithí's call.

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