Dáil debates

Thursday, 18 January 2018

Topical Issue Debate

Organ Donation

6:40 pm

Photo of Louise O'ReillyLouise O'Reilly (Dublin Fingal, Sinn Fein)
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The issue I want to raise was brought to my attention by a woman who lives in my constituency. Her name, which she has given me permission to use, is Nicola McKenna. I met Nicola when I was out canvassing and we had a chat. Although she is very unassuming about it, Nicola is quite an amazing person. She donated a kidney to one of her siblings so she is a living donor. It is such a wonderful thing to do. We have all been inspired by following Orla Tinsley on social media and while I know Ms Tinsley's situation is not exactly the same, to be able to donate a kidney to a sibling, a relative or a friend is a marvellous thing to do.

I am aware of the way the scheme operates as I previously asked a parliamentary question on it.

The reply reads:

The Policy for the Reimbursement of Expenses of Living Donors provides for the reimbursement of accommodation and travel expenses ... up to a maximum of €6,000. In addition, the scheme reimburses loss of earnings incurred by salaried/waged donors ... for up to 12 weeks after the donation, up to a maximum of €10,000.

The final part of the reply was the most disappointing. It states, "There are no plans to further alter the scheme."

Nicola does not work outside the home. She works incredibly hard looking after her children but she is not in formal paid employment. Therefore, she cannot benefit from this scheme, which reimburses the loss of earnings incurred by salaried or waged donors. She incurred significant expenses. People who work in the home do work even if it might not be in the formal economy. She was not able to do that work, but it still had to be done and her children still had to be cared for. As such, she incurred additional expenses while recuperating after doing what was a marvellous thing, yet she is not covered by the scheme.

I genuinely believe that this is an oversight. Given that the numbers involved are small, no one in the Department of Health or any other Department would deliberately seek to exclude these people. They simply fell through the net. Excluding people who do not work outside the home is unfair. We should be encouraging people to become living donors. I would encourage anyone to do it. I have only one sister but I would like to think that, if the situation required it, we would do that for each other. Touch wood, we will not need to.

This small anomaly is not the Department's intention but it needs to be rectified. When I raised it previously, I was disappointed with the response to my parliamentary question, given what the bottom part read. I am calling for a very minor alteration of the scheme in light of the fact that we are only discussing a small subset of an already small number of living donors. Consideration should be given to this.

6:50 pm

Photo of Catherine ByrneCatherine Byrne (Dublin South Central, Fine Gael)
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I will read my reply and then speak again on the issues raised by the Deputy. On behalf of the Minister, Deputy Harris, I thank the Deputy for raising this matter, as it gives me the opportunity to update the House. Most of my reply is probably information that the Deputy already has, but I will read it in any event.

Organ donation is one of the most selfless acts that one person can perform for another. Last year was a record year for organ transplantation, with 311 transplants carried out, well in excess of the previous high of 296. This included 192 kidney transplants. The kidney transplant figure included 51 living kidney transplants, itself a record for a year. I thank the families of deceased donors for their kindness in times of great distress. I also thank the living donors for their significant generosity in giving the opportunity of life-changing transplantation to their loved ones.

The Department of Health introduced a scheme to reimburse the expenses of living donors in 2014. The reimbursement scheme applies to persons who have been selected as potential donors by the living donor programme at Beaumont Hospital and to those who, under the clinical supervision of the national renal transplant programme in Beaumont, travel to the UK for a paired kidney donation.

In line with the European Union (Quality and Safety of Human Organs intended for Transplantation) Regulations 2012, a key principle of organ donation is that it should be voluntary and unpaid. However, it is recognised that most living donors incur some financial losses when donating a kidney. The living donor reimbursement scheme is based on the premise that any reimbursement granted does not provide a financial incentive or award to a potential donor. The scheme aims to minimise financial disincentives for such donors as far as is feasible. It provides for the reimbursement of any loss of earnings incurred by living kidney donors as well as of accommodation and travel expenses incurred as a direct result of their donations. Loss of earnings by salaried, waged and self-employed donors incurred from the time that the donation takes place up to 12 weeks post-donation are eligible for reimbursement. A maximum of €10,000 applies in respect of lost earnings. Reasonable travel and accommodation expenses incurred from when the person has been selected as a potential donor, during the inpatient stay when the donation takes place and for up to 12 weeks post-donation are also eligible for reimbursement. A maximum of €6,000 applies in that regard. Reimbursements under the scheme are exempt from income tax. A donor who is in receipt of a payment from the Department of Employment Affairs and Social Protection will continue to have that payment paid for a period of up to 12 weeks after the donation. The living donor reimbursement scheme acknowledges the great generosity of living kidney donors. It aims to cover some expenses of donors while retaining the voluntary ethos of donation.

In the case of people who do not work outside the home, the provisions in regard to travel and accommodation, as well as payments from the Department of Employment Affairs and Social Protection, apply. Further reimbursement is not provided under the scheme. I will revert on the Deputy's specific issues shortly.

Photo of Louise O'ReillyLouise O'Reilly (Dublin Fingal, Sinn Fein)
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That was disappointing. The Minister of State referred to the necessity of not providing a financial incentive or award to a potential donor. I have met the lady in question. Knowing that she would not be reimbursed for the additional cost did not in any way deter her from donating a kidney. Donating is a marvellous thing for someone to do.

A group of people are being discriminated against, and the Minister of State knows as well as I do that women are most likely disproportionately represented in that group. It is a discriminatory practice. While there may not be what would in industrial relations terms be called a de facto loss of earnings, an expense is incurred. Someone must be paid to do the work that Nicola was doing. I should stress that Nicola in no way sought any financial award for this. She gave a marvellous gift to her sibling freely. Following my conversation with her, I am of the view that while the scheme is discriminatory, that is not the Department's intention. There is an anomaly that can be addressed without creating any financial incentive. We are discussing people who could, for example, be caring at home for an elderly relative, children or a family member with special needs. They will have to spend money to get that work done.

It would not be unreasonable to extend the scheme. We are not discussing a large number of people, but a very small one. They are doing a marvellous thing. We all recognise how essential living donors are. There should be some movement on the Department's part in this regard because I do not believe that this anomaly was its intention.

Photo of Catherine ByrneCatherine Byrne (Dublin South Central, Fine Gael)
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The Deputy probably already had most of the information contained in my reply. I have listened to and understood her concerns. All I can do is relay most of them to the Minister.

As someone with a person in her family who passed away and donated every organ, I understand the difficulties and stresses people experience during what is a time when no one can really put anything together. Having to go to hospital and see someone on a machine, knowing that he or she will never leave again, is very stressful. Thank God, we have people who donate their loved ones' organs.

We must also be respectful of the people the Deputy mentioned, namely, those who stay at home, mind others and do not go to work. Unpaid work, at any rate.

Photo of Louise O'ReillyLouise O'Reilly (Dublin Fingal, Sinn Fein)
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It is an anomaly.

Photo of Catherine ByrneCatherine Byrne (Dublin South Central, Fine Gael)
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There were 51 living donors of kidneys last year. I have the statistics with me. Many people are willing to change their lifestyles for two or three months after donating a kidney to a loved one.

I will raise the issue with the Minister and ask him to reply directly to the Deputy. I cannot give her a commitment that an alteration will happen, but I understand her concerns.

Photo of Louise O'ReillyLouise O'Reilly (Dublin Fingal, Sinn Fein)
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I thank the Minister of State.

Photo of Catherine ByrneCatherine Byrne (Dublin South Central, Fine Gael)
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I thank the Deputy for her thoughtfulness on this issue. Perhaps it has been overlooked and we should re-examine it.

The Dáil adjourned at at 7.50 p.m. until 2 p.m. on Tuesday, 23 January 2018.