Stephen Donnelly (Wicklow, Fianna Fail) | Oireachtas source

I thank colleagues for their support for the Bill. It is great to see such a strong signal coming from Dáil Éireann and that there is cross-party support for the Bill. I thank Deputies for this constructive debate. Many good ideas have been raised, as have many reasonable questions, and I will try to cover some of them in the few minutes remaining.

I echo the comments of Deputy Joan Collins, in that we are focusing on the great benefits for many patients who are waiting for organs. However, it is important to acknowledge as we progress the Bill that this topic is a difficult one for many families whose loved ones - children or other relatives - have been donors through tragic circumstances. It is the most precious of gifts that any donor could give. Nonetheless, it is often done in the most unfortunate and difficult of circumstances.

Questions were raised about the treatment of organs, including incineration, abroad. I once again offer my sympathies to those families who, having experienced the tragedy of losing a child, then had to go through the distress of hearing that the organs of their children had been retained in ways they should not have been. Under the Bill, consent will be needed from families for arrangements relating to burial, cremation and the return of organs and tissue material relating to post-mortems. I wish to be clear - organs should never be incinerated. Those organs should not have been incinerated. What happened was unacceptable, and it is important that this was recognised in the HSE report into the incident.

This legislation will ensure human organs, tissues and bodies will be treated with the respect they should, and that all arrangements will be in line with the wishes of family members. That is essential.

Colleagues have made various requests and issues have been raised by some of the advocacy groups. I am looking at all of those. I will consider them with my Department officials. Where there is an opportunity to make amendments that improve the situation, I am very open to doing so on Committee Stage. Questions have been raised around compiling detailed information on organ donations, donors and other information that can help us improve donation rates. I am happy to share with colleagues that I allocated funding in 2021 and work is under way on that. Further work has been ongoing that will inform the ongoing policy decisions and considerations.

Colleagues very understandably raised the issue of resourcing and capacity. Resourcing and capacity are not covered within legislation, as they rarely would be. However, I fully accept and agree with the point that this Bill is one piece of what is required to increase transplants in this country. It is a very important piece and it is being supported for that reason, but we do need the resources in place as well. It is my intention they will be. To that effect, a strategic review of services is under way to identify where the gaps, shortages and opportunities are. I am expecting a report back by the end of March. That review will inform where we allocate future resources. A sum of €7 million has been added in recent years to the service, which is important.

Colleagues referenced ICU and, quite rightly, the need for ICU capacity. We have just had the biggest increase in ICU capacity ever. There has been an increase of about 25% in ICU beds since the start of Covid, because of Covid. That is part of the first phase of the increase. There will be another very substantial increase in the number of ICU beds. It will help facilitate transplants and a lot of other critical care in the coming months and years.

Colleagues asked questions around offences and oversight. HIQA, as the regulator, will be responsible for ensuring standards are met across the hospital systems. On the question of whether a contravention of the legislation will constitute an offence, I can confirm it will be an offence. The Bill provides that the standards can be set out in regulations. Obviously, those regulations will be in line with best practice. For egregious breaches of the regulations, the Bill provides for prosecution of a criminal offence, with a sanction of a class A fine, €5,000, imprisonment for up to three months, or both. The sanctions are very serious. However, the aim of the legislation, of course, is to raise standards across the system. HIQA will be central to that.

I have covered most of the issues raised. If there are others, I ask Deputies to contact me. My officials have been taking detailed notes of the various questions raised. Once again, I thank my officials and the officials in the Department of Justice, who have been working very closely to put this legislation together. I thank colleagues for all of their input. I thank again the healthcare workers who are working in this field every day, who are doing incredible work and who I know are happy to see this legislation. Finally, I thank the advocacy groups who have been looking for this for a long time. It is a good day and it is great to see such a powerful and united statement going out from Dáil Éireann that we are going to back this and we are going to make sure this service gets better and better for all of those hundreds of men, women and children who are waiting for a transplant.

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