Written - Organ donation system in Wales

Members will be aware that I have been determined to increase the number of organ donors in Wales in an effort to improve the health and quality of life for people who need a transplant.

Currently, the legal framework governing organ donation is the Human Tissue Act which came into effect in 2006.

This current system requires a patient to consent by opting into the organ donation system before death. Health professionals should still consult with relatives, where possible, to find out if the deceased had spoken about their wishes and to encourage them to be respected, In this current system a person may have registered their wish to donate organs on the UK Organ Donation Register but not have their wish respected. Currently in the UK, the refusal rates stand at 40%.

Organs are allocated on a clinical need basis across the UK by NHS Blood and Transplant and there is no intention to change this system.

The UK Organ Donation Taskforce report (2008) proposed reforms to the current system to identify and remove obstacles to organ donation within it. Whilst the recommendations will improve the current situation, a significant gap will still remain between the number of donor organs needed and the number of organs available for transplant.

The Organ Donation Taskforce report on Presumed Consent for Organ Donation recommended that an opt-out system should not be introduced in the UK at the present time.

The Health, Wellbeing and Local Government Committee held an inquiry into Presumed Consent for Organ Donation in 2008. Its report recommended that the Assembly should not, at this stage, seek a Legislative Competence Order, to allow the introduction of a system of presumed consent in Wales. The Committee also recommended that in any future detailed consideration of legislation to introduce presumed consent in Wales or in the UK a “soft” system should be used, where loved ones are consulted and their views are taken into account.

My response to the report stated that it would be premature to rule out seeking a Legislative Competence Order at this stage, although it did point out that the Committee did not oppose presumed consent in principle. The response accepted, in principle, that in any future detailed consideration of legislation that a ‘soft’ system be used, although the response did state that a decision would be made once there is a clear understanding of public opinion in Wales.

I have made clear that I am personally in favour of presumed consent as a way of increasing organ donation. However, I recognise that this is a sensitive and emotive subject. That is why I have wanted to spend time ensuring we gauged people’s views before coming to a conclusion.

The Welsh Assembly Government held Public Debates on this issue between October 2008 and January 2009. Following these debates, there was a clear public preference for either an opt-out system or a mandated choice system above sticking with the current one. There was also a preference for a soft rather than a hard opt out system. The report on the outcome of the debate formed the basis of a consultation paper.

On 8 May, I published the paper ‘Options for changes to the organ donation system in Wales’, launching a 12-week consultation period. It specifically asked the public if the Assembly Government should now move forward and propose a legislative change to introduce a soft opt-out system in Wales. The majority of responses supported a change to the organ donation system in Wales to a soft opt-out system. A report on the consultation has been published on the Assembly Government website.

Cabinet colleagues have agreed with my proposal to explore the possibility of introducing a soft opt out system for organ donation in Wales and that a bid for a Legislative Competence Order be submitted as part of the annual trawl for legislative items. This will take time to achieve so we must continue to do all we can to raise awareness of this issue and encourage people to sign up to the organ donation register.

Members will be aware that the Assembly Government has funded the Kidney Wales Foundation-led Donate Wales: Tell a Loved One campaign. The campaign has had considerable success in terms of helping to increase the numbers of people in Wales joining the Organ Donation Register.  Between 2007/08 and 2008/09, 60,000 more people in Wales joined the Register, bringing the total number to 810,000.

I have agreed additional funding of £13,000 in 2009/10 to help fund the Donate Wales ‘New Year Resolutions’ campaign, which aims to build on this success.

In addition, work continues on implementing the Organ Donation Taskforce recommendations.

All but one of the NHS organisations have appointed a clinical lead for organ donation and there is also now a network of transplant coordinators in all critical care units in Wales. I would expect the clinical leads and coordinators to have the skills to work with families at the most difficult time to help them through the decision.

Work is already underway on a new Welsh Assembly Government-funded £4.2million purpose-built Renal Transplant Centre at the University Hospital of Wales, Cardiff, which will increase current capacity and greatly improve the quality of life for renal patients.

My move to seek the power to introduce a legislative change will mean that Wales is leading the way in increasing organ donation rates.

I would encourage Members who may not have already signed up to the organ donation register to consider this. Members can find more information on this on the Donate Wales campaign website at www.donatewales.com