Frances Fitzgerald (Fine Gael)

I welcome the opportunity to speak on the Bill and welcome the Minister of State to the House. I commend Senator Quinn of the Independent Senators for placing the Bill before the House and for using his Private Members' time to discuss such a vital issue of life and death as the area of organ donation and transplantation.

We need more debate on this area as it can be a frightening area for people to think about. I agree a public awareness campaign is necessary, as well as further debate and discussion. It is a difficult issue to think about at any time, not just in a crisis situation. Research shows that when most people are consulted, they say they would be very happy to agree to be a donor and international research shows there is much good will and that donating is something people want to do. However, they do not always fill out the consent forms or tick the box on their driving licences.

A major 2006 international study found that presumed consent can give rise to a 25% to 30% increase in organ supply. This fact is quoted in the editorial in today's The Irish Times. Senator Quinn, by raising the issue here, has already generated media debate, as can be seen in today's editorial and letters page. The editorial stated:

Today some 600 patients in Ireland, many with seriously life-shortening conditions, are waiting for transplants of kidneys, hearts and other organs. Up to a third of those with cystic fibrosis awaiting lung transplants will die before a suitable donor becomes available.

As we know, many of these are young people. Our rate of donation is relatively high by international standards, but there is great scope for improvement.

I said earlier that many people are frightened about this issue. We need to provide detailed information on donation to the public. If we support Senator Quinn's Bill there will be questions, as Senator O'Toole said, with regard to how the procedures will be carried out in hospitals, the kind of work that will be done with the families and the type of counselling and support that will be available. These issues must all be discussed.

A letter in The Irish Times today relates to the Spanish situation, where there is presumed consent. The letter writer makes the point that the Spanish policy was developed by the establishment of a transplant authority independent of all hospitals and consultants and that it set up a system of transplant co-ordinators between hospitals whose role was to counsel the families of recently deceased people in an appropriate and sympathetic manner. This approach must be an important part of any change we make here. Also, financial costs to the hospitals were dealt with by the independent authority. Financial costs are a factor and must be considered. Organ donation rates increased by 50% on the introduction of the independent transplant authority. There has been significant change in organ donation in Spain, first because it did as Senator Quinn suggests regarding presumed consent and then it developed how the programme would be run. We must take those lessons on board.

Our debate is important. I regret it looks like the Government will not support this Bill, but I welcome the news that the Minister intends to introduce legislation. I hope it will lead to progress. Perhaps the best thinking from Senator Quinn's Bill will be taken on board by the Government. I am happy to support the general thrust of the Bill, namely, the idea that presumed consent to donate organs should exist and that if people do not wish to donate organs, they must withhold consent. This is common sense and we can learn from other countries. The objective behind this concept is to increase the amount of organs available for transplantation. Lives could be saved or improved dramatically by this measure. It is dreadful to think that people who die in accidents who would have been happy to donate their organs had not signed consent forms or it was not discussed with their families.

While I welcome the overall objectives of the Bill, I would like to make some observations and pose some questions. These matters are not insurmountable and could all be dealt with on Committee or Report Stage. I note in particular the concerns expressed by the Parents for Justice group. That group has been through a traumatic experience in terms of organ retention and is very concerned with regard to the removal and storage of organs. Those issues must and can be addressed. I wanted to mention the matter because they have e-mailed every Senator about it and we have to show sensitivity to their experiences. In regard to the issue of storage, for example, I am aware that a large proportion of donated organs are not used. Clearly, the issue of what happens to these organs must be addressed.

While I appreciate that the Bill respects parental authority and makes no effort to usurp it, I wonder whether the presumed opt-in should begin at a certain age. A family may not have considered opting out on behalf of a young child who died suddenly but there would be presumed consent in that instance. I am not completely sure about this issue but a debate which engages families is needed. We also need to raise public awareness on the implications of these proposals.

It will be important that good practices are followed in hospitals. Hospitals may be failing by omission in terms of not discussing the issues with families. Equally, a situation could arise as a result of insensitive handling. We need to have regard for Spain's emphasis on best practice when we deal with people facing these circumstances. Senator Quinn might also comment on how organ donation will be dealt with in cases of clinical death.

While I agree with the thrust of this Bill, any measure of informed consent should be supported by a framework which enables the maximum number possible of successful organ transplants. I support the advancement of the Bill to Committee Stage and have briefly outlined the areas which I would like to discuss further. I thank Senator Quinn for putting this matter on the political agenda and urge the Minister of State at the Department of Health and Children, Deputy Moloney, to respond positively. I hope we can bring about an increase in donations and greater public awareness of the issues involved.