Chamber
Plenary, 05 Mar 2008
05 Mar 2008 · S3 · Plenary
Item of business
Organ Donation Task Force Report
Mike Rumbles makes a good point, which was adequately covered in the task force's report. If we implement the task force's recommendations, as the cabinet secretary says that she will do, the situation will improve.
The task force claimed that it should be possible to achieve a 50 per cent increase in organ donation in the next five years. If that comes to pass and the task force's recommendations are implemented, many of our problems will be solved. We must do better, and we have the blueprint that will enable us to do better.
No doubt all members and the Presiding Officer will be pleased to learn that I do not intend to go over all the recommendations. However, I mention two aspects of the report that caused me concern. In the preamble to recommendation 5, the task force referred to evidence from the United States of America on the development of
"clinical indicators as a trigger for notification"
to transplant co-ordinators that a potential transplant donor is available. In such an approach the clinicians who look after patients are given a greater role in choosing suitable organ donors. In other words, clinicians spot the people who will die soon and pass the word to the authorities.
I acknowledge the benefit of such a system and the efficiencies that it would bring but I also envisage the pressure that it might place on the professionals who would need to initiate action while caring for a live person, albeit that the person had little hope of recovery. Clinicians might also worry about their relationships with patients' families. Therefore, I welcome the recommendation that there be further consultation with intensive care specialists and other people before we move down that road.
The task force did not make a recommendation, because the matter was outwith its remit, on whether transplant units are staffed and equipped to cope with the increase in work that will inevitably follow the success that we are all working to achieve. The task force reported that some units have been
"stretched … almost to breaking point"
by the modest improvements that have been made. It would be ironic if we greatly increased the flow of available organs only to have to bucket them because we did not have the manpower or the facilities to cope. The need for dedicated transplant teams with more members requires careful planning, especially under the exigencies of the European working time directive, which is slowly tightening its grip. I sincerely hope that the cabinet secretary will take the task force's concerns on board, even though it could make no formal recommendation in that regard.
Presumed consent is a controversial topic. An issue that unites Nicola Sturgeon, the BMA and Lord George Foulkes is worthy of consideration, so rare is such unity. In the past I have had no doubt that presumed consent offers the way forward. However, the proposal is controversial and risks dividing our community, so we must give it careful thought before we proceed down that route. I have read the task force's impressive report and I have witnessed how fragmented our service is. Given the potential for great improvement simply by organising the service a little better and by embarking on a publicity campaign, as the cabinet secretary described, we should hold off from initiating a system of presumed consent until all the task force's recommendations have been implemented. Perhaps take-up could be increased if we included consent forms in passport and driving licence application forms, for example.
Even if the recommendations do not achieve all that is promised for them, they have sensitised us to the need for a continuous supply of organs for transplantation. Perhaps implementing the recommendations will also make any future introduction of presumed consent less controversial than the idea is at present.
The time for talking is now over. Let us get on with implementing the recommendations.
The task force claimed that it should be possible to achieve a 50 per cent increase in organ donation in the next five years. If that comes to pass and the task force's recommendations are implemented, many of our problems will be solved. We must do better, and we have the blueprint that will enable us to do better.
No doubt all members and the Presiding Officer will be pleased to learn that I do not intend to go over all the recommendations. However, I mention two aspects of the report that caused me concern. In the preamble to recommendation 5, the task force referred to evidence from the United States of America on the development of
"clinical indicators as a trigger for notification"
to transplant co-ordinators that a potential transplant donor is available. In such an approach the clinicians who look after patients are given a greater role in choosing suitable organ donors. In other words, clinicians spot the people who will die soon and pass the word to the authorities.
I acknowledge the benefit of such a system and the efficiencies that it would bring but I also envisage the pressure that it might place on the professionals who would need to initiate action while caring for a live person, albeit that the person had little hope of recovery. Clinicians might also worry about their relationships with patients' families. Therefore, I welcome the recommendation that there be further consultation with intensive care specialists and other people before we move down that road.
The task force did not make a recommendation, because the matter was outwith its remit, on whether transplant units are staffed and equipped to cope with the increase in work that will inevitably follow the success that we are all working to achieve. The task force reported that some units have been
"stretched … almost to breaking point"
by the modest improvements that have been made. It would be ironic if we greatly increased the flow of available organs only to have to bucket them because we did not have the manpower or the facilities to cope. The need for dedicated transplant teams with more members requires careful planning, especially under the exigencies of the European working time directive, which is slowly tightening its grip. I sincerely hope that the cabinet secretary will take the task force's concerns on board, even though it could make no formal recommendation in that regard.
Presumed consent is a controversial topic. An issue that unites Nicola Sturgeon, the BMA and Lord George Foulkes is worthy of consideration, so rare is such unity. In the past I have had no doubt that presumed consent offers the way forward. However, the proposal is controversial and risks dividing our community, so we must give it careful thought before we proceed down that route. I have read the task force's impressive report and I have witnessed how fragmented our service is. Given the potential for great improvement simply by organising the service a little better and by embarking on a publicity campaign, as the cabinet secretary described, we should hold off from initiating a system of presumed consent until all the task force's recommendations have been implemented. Perhaps take-up could be increased if we included consent forms in passport and driving licence application forms, for example.
Even if the recommendations do not achieve all that is promised for them, they have sensitised us to the need for a continuous supply of organs for transplantation. Perhaps implementing the recommendations will also make any future introduction of presumed consent less controversial than the idea is at present.
The time for talking is now over. Let us get on with implementing the recommendations.
In the same item of business
The Deputy Presiding Officer (Alasdair Morgan):
SNP
The next item of business is a debate on the organ donation task force report.
The Deputy First Minister and Cabinet Secretary for Health and Wellbeing (Nicola Sturgeon):
SNP
I am delighted to open the debate. I fully expect it to be constructive and consensual. There are some real issues at stake, and this is a timely occasion fo...
Mike Rumbles (West Aberdeenshire and Kincardine) (LD):
LD
Does the cabinet secretary have any idea why that is the case? Is it because we do not implement the existing system well?
Nicola Sturgeon:
SNP
There are many reasons for the situation—some are understood and some are not. What the member cites is one of the reasons, so that makes the recommendations...
Margaret Curran (Glasgow Baillieston) (Lab):
Lab
I welcome the minister's speech. Labour wants to play a full and constructive part in the debate and we acknowledge the issues that she has laid out. This is...
Mike Rumbles:
LD
The member keeps using the term "presumed consent", as did the minister. George Foulkes has also used it. Does the member agree that we need to find a better...
Margaret Curran:
Lab
That is an interesting point; I know that Mike Rumbles made similar points during the recent members' business debate. I will argue strongly that we need to ...
Mary Scanlon (Highlands and Islands) (Con):
Con
As the Scottish Conservatives have agreed to a free vote on organ donation, the views that I will express are personal, rather than those of my party.Having ...
Ross Finnie (West of Scotland) (LD):
LD
I am not surprised by the consensus in the chamber on the essential need to increase the number of organ donors in Scotland. That said, there are other issue...
The Deputy Presiding Officer:
SNP
We move to the open debate.
Ian McKee (Lothians) (SNP):
SNP
I am sure that all members welcome the comprehensive review that has been produced by the UK organ donation task force and the Scottish Government's ready ac...
Mike Rumbles:
LD
Will the member explain why, when the number on the organ donation register in Scotland has reached the record level of 30 per cent—
The Deputy Presiding Officer:
SNP
Please speak into your microphone, Mr Rumbles.
Mike Rumbles:
LD
Although there is a record number of donors, the number of organ donation operations has reduced. The issue cannot be that we need more people on the registe...
Ian McKee:
SNP
Mike Rumbles makes a good point, which was adequately covered in the task force's report. If we implement the task force's recommendations, as the cabinet se...
George Foulkes (Lothians) (Lab):
Lab
As you know, Presiding Officer, from time to time I have been a little critical of some Scottish National Party ministers. At the outset, I warmly congratula...
Mary Scanlon:
Con
I thank the member for his comments on presumed consent, with which I said that I had difficulty. Does he also agree that if we change the language from pres...
George Foulkes:
Lab
Yes, we will have to look at the language in that regard, too.I spoke about assurances and safeguards, which, of course, form part of the debate. Assurances ...
Roseanna Cunningham (Perth) (SNP):
SNP
I am encouraged by the task force's straightforward assertion that there could be a 50 per cent increase in post mortem organ donation in the United Kingdom—...
Claire Baker (Mid Scotland and Fife) (Lab):
Lab
I am pleased to take part in the debate and to add to the support that has been expressed for the organ donation task force's recommendations, which could re...
Nanette Milne (North East Scotland) (Con):
Con
I am pleased to have been given the opportunity to speak in this debate, which follows on from the previously mentioned and excellent members' business debat...
John Farquhar Munro (Ross, Skye and Inverness West) (LD):
LD
I thank Lord Foulkes for giving us the opportunity to debate the matter again in Parliament—he should be congratulated—and I welcome the opportunity to contr...
Mike Rumbles:
LD
Will the member take an intervention?
John Farquhar Munro:
LD
I am just coming to an end—I think Mike Rumbles has a different agenda.Fortunately, political opinion is now swinging in the direction that the British Medic...
Kenneth Gibson (Cunninghame North) (SNP):
SNP
I am pleased to follow such a positive speech—one with which I wholly agree.The generosity of donors and their families enables nearly 3,000 people in the UK...
David Whitton (Strathkelvin and Bearsden) (Lab):
Lab
I had not originally intended to take part in the debate, but the more I thought about it the more I felt that I should. I hope that my reasons will become c...
Michael Matheson (Falkirk West) (SNP):
SNP
As other members do, I very much welcome the organ donation task force's report. I am particularly pleased that the Scottish Government has agreed to impleme...
Mike Rumbles (West Aberdeenshire and Kincardine) (LD):
LD
This has been another good debate on organ donation and transplants.Nicola Sturgeon said that the debate offered an initial opportunity to express our views ...
George Foulkes:
Lab
Mike Rumbles said that it is understandable that John Farquhar Munro did not speak for the Liberal Democrats. Mary Scanlon said that the Conservatives, like ...
Mike Rumbles:
LD
As my colleague Ross Finnie made absolutely clear, we will reflect on that very issue because the matter is of such importance.I am sure that all members are...