November 14, 2008
Hundreds of Britons die on waiting list every year despite 16m donorsDavid Rose
Shortages of intensive-care staff, transplant co-ordinators and a lack of funds remain the biggest hurdle to improving organ donation rates, even in the event of the introduction of “presumed consent”, campaigners say.
In January the Prime Minister called for a national debate on changing the system, suggesting that thousands of lives would be saved if everyone was put on the donor register automatically if they did not opt out.
But the “opt-out” system would be unlikely to improve the situation, the UK-wide Organ Donation Taskforce will report next week. Only by increasing numbers of skilled NHS staff to liaise with patients and improving facilities will the Government address Britain’s poor transplant rates, it says.
Last year 482 people, including many young people, died while awaiting a transplant. Hundreds more died after being removed from the waiting list because they became too ill.
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At present, nearly 16 million people in the UK, a quarter of the population, are registered as donors, but bereaved families currently have the final say as to whether the organs of their loved ones can be used.
The Human Tissue Act of 2004 set strict rules on explicit voluntary consent after the Alder Hey Hospital in Liverpool, the Royal Bristol Infirmary and other hospitals were found to have removed thousands of organs from dead children without their parents’ knowledge.
But where a person’s wishes are not known, four in ten families currently say “no” to having a deceased relative’s organs removed, while the system is not always effective at picking up those on the donation register.
Britain’s organ donor rate is 13.2 people per million of population. while the EU average is 18.8 and Spain, which adopted presumed consent in 1979, has reached 34.
Mr Brown has suggested that, as in Spain, relatives should still be able to stop organs being harvested if they found the idea too painful – under so-called “soft” presumed consent.
But a review of evidence by the taskforce, believed to be the most comprehensive analysis of its kind, concludes that Spain’s success was far more to do with effective organisation of donor services and training than with legal differences. Pressure groups added that even a “soft” system could present a number of concerns, such as that doctors being too quick to pronounce a patient dead if their organs were suitable for harvesting.
The taskforce involved six separate committees and 70 experts, who consulted a sample of people considered representative of the UK population.
They heard that a system of presumed consent might present practical problems to the NHS and be considered divisive, with some members of the public suggesting that patients who opted out of donating their organs should not themselves be treated as priority cases for transplant.
In an earlier report in July, the taskforce made 14 recomendations with the aim of a creating a 50 per cent increase in organ donation in the UK within five years – resulting in an additional 1,200 transplants a year.
Tim Statham, chief executive of the National Kidney Federation, said the charity had argued in favour of presumed consent for nine years but “it isn’t a lack of donors that lies at the heart of this problem. There’s a shortage of transplant surgeons, lack of culture to encourage transplants.”
http://www.timesonline.co.uk/tol/life_and_style/health/article5151487.ece
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