Martin Browne (Tipperary, Sinn Fein) | Oireachtas source

I will not mention all the towns, just all the undertakers. This is an important Bill. It would have always been so given its nature and the matter of dignity, self-determination and of course the life-saving consequences of organ donation. The purpose of the Bill is brought into even sharper focus given the revelations we have become acquainted with involving the improper retention and disposal of organs. The Madden report of 2005 found that doctors stated that they did not tell parents about organ retention for the parents' own good. It went on to divulge how doctors at the time did not attach an emotional significance to the organs of a deceased child. Such instances warranted a full and proper examination of the system and a concerted effort to address this attitude and the rules that cover the retention of organs. While overdue, it is welcome that we are in a position to discuss this Stage of the Bill designed to address the shortcomings inherent in the system at the moment.

To start with, I will provide some background to what we are discussing today and the importance it signifies. At present organ donation and transplant rates are below average when compared to other EU states. We were in 18th place for transplants in 2020 and when it comes to deceased organ donations in 2020 we were at 17th place. Clearly more needs to be done and the introduction of the soft opt-out organ donation register is welcome. This means that a person must object in their lifetime, or their family can object after their passing if in their view the person would have objected. There are certain other criteria that would apply in other circumstances including consultation with the person's family, which differentiates between soft opt-in and a hard opt-in. This is welcome. However, for the application of this system to be successful, it is necessary that its administrative demands are met with resources to establish the register and deal with the process.

The Bill in isolation will not add to the number of organ transplants that will take place. It will be of no help to the 600 people on the transplant list. There is another point that has been made by the Irish Donor Network and the Irish Kidney Association which needs reflection in order to provide certainty and develop a system whereby this country can move up the organ donation and transplant scale. They say that without adequate resources and infrastructure this legislation will not result in additional donations. The Irish Kidney Association has pointed to an instance in 2021 when a transplant did not proceed at the Mater hospital because of the unavailability of an ICU bed. The Irish Donor Network made a similar point, saying that for significant organ donation, transplant and post-transplant care, resources need to be available to allow for additional beds for pre- and post-transplant care as well as operating theatres, public awareness, doctors and multidisciplinary staff including nurses, cytologists and microbiologists. Resourcing issues have contributed to poor practices in the past that have led to retention scandals. I will conclude my remarks by welcoming the progress made in this Bill. There are aspects that will need further attention and my colleagues have already addressed these matters. It is welcome to be able to discuss this Bill today.

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