Hansard

This is our third debate on organ donation this year. There can be no doubt that the Parliament—and, indeed, the Government—takes the issue seriously and has given it substantial prominence on the political agenda only two years after it approved the Human Tissue (Scotland) Act 2006, some provisions of which were designed to enhance the rate of donation.

During our debates, we have heard some well-reasoned and, sometimes, emotional speeches, which have put on record the cogent arguments for and against a system of so-called presumed consent to organ donation. The debate continues, and both of this year's excellent reports by the organ donation task force make it clear that there is no simple way to achieve an increase in organ donation. However, it is beyond dispute that there is an urgent need for more organs if we are to get anywhere near meeting the needs of the many people who await transplantation.

There also seems to be little doubt that, as Richard Simpson said, the number of people with end-stage organ disease will increase as our population ages and individuals suffer the long-term effects of the diabetes, obesity and excessive alcohol consumption that are prevalent in Scotland today. We must step up our efforts to alter lifestyles as a means of avoiding those diseases in the first place but, of course, the culture change will not happen overnight. Research must also continue into finding a cure for the many chronic conditions that lead, eventually, to organ failure and into the practicalities of viable organ generation within the laboratory.

In the meantime, transplantation is the only hope of saving the lives of many people whose organs can no longer perform their vital function, so we must consider every possible means of increasing the rate of organ donation and giving hope to those who are going through the pain and trauma of end-stage organ disease. Members should believe me that it is traumatic and deeply distressing to watch close friends or family members suffer the extreme breathlessness of respiratory or heart failure, or the severe pain of procedures such as sclerotherapy for the oesophageal varices that result from a failing liver.

I welcome the organ donation task force's latest report, which follows on from the one that we debated in March. The reports make it clear that the current system of organ donation is failing to meet the increasing demands that are placed upon it and that everything possible must be done to increase donation rates in the United Kingdom now within the existing legislation, which provides for opting in to donation. Initially, I was not clear about the intention of Richard Simpson's amendment but, having heard his explanation of it, I am inclined to agree with it, although the five years that the task force proposes seems a reasonable timescale for proper assessment of the efficacy of its proposals.

The factors that influence the rate of organ donation have been well rehearsed in our previous debates and the task force reports, and I have little to add. There is no doubt that there are many more people in Scotland who are willing to donate their organs than are on the donor register, and that it is largely inertia that stops them registering. As I have said in the Parliament before, it took me more than 10 years from my son's transplant to register myself, and I am not altogether sure that my husband and daughter are even on the register, although I know that both would want me to consent on their behalf should the situation ever arise.

Every opportunity to make organ donation easy should be taken up. Efforts should also be made to encourage people to think about what happens to their organs after death and to discuss the matter with their families. Unfortunately, in our society today, there seems to be a reluctance to acknowledge that death is an inevitable part of life, and it is seldom talked about in any depth. Our newspapers and other media are full of the fatal accidents that occur daily on our roads, but we do not often hear about the victims' contributions to saving the lives of others by the transplantation of their organs to which their bereaved families generously agree.

I agree with the BMA's assertion that improving organ donation infrastructure and increasing donor numbers are interdependent measures. To that end, we must somehow change our culture and create an environment in which donation becomes the normal choice. The task force has stressed the need to improve donor identification and referral and to enhance donor co-ordination and organ retrieval. The success of such efforts will depend on all parts of the NHS embracing organ donation as a usual, rather than an unusual, event.

The recommendations to improve organ donation infrastructure and to remove the barriers to donation should, if implemented across the country, go a long way towards achieving the UK target of almost doubling the rate of donation by 2013, without the need to resort to further legislative change. If the proposed infrastructure changes that the Government is addressing, which the cabinet secretary spelled out earlier, achieve the desired result, well and good, but if they do not, changing to an opt-out system with appropriate safeguards, which appears to be supported by more than 60 per cent of the population, will have to be considered again. I therefore very much welcome the task force's recommendation to review the situation in five years' time in the light of the progress that is made on implementing the recommendations.

I hope that between now and 2013, satisfactory progress will be made and sufficient organs will become available for the many people who currently await them or who may require them in the future. Any one of us or our friends and family members could find themselves in need of organ replacement. I believe that we are morally obliged to do the utmost to increase donor numbers, even if we ultimately have to move to an opt-out position.