Kidney Transplant Bill [HL]

My Lords, I am the first speaker to be able to thank the noble Baroness, Lady Finlay, for her initiative, concern and foresight in introducing this Bill today, and I pay tribute to the very clear exposition of her case. Before I make a few brief comments, I declare my interest as the president of Kidney Research UK, formerly known as the National Kidney Research Fund, having taken an interest in renal disease and renal failure since my father became one of the first patients to undertake haemodialysis in 1965. Watching the development of transplants, for which he was not suitable, over the past 40 years has been a matter of huge encouragement. Although life on dialysis is clearly a significant improvement on the alternative, it clearly leads to a much more constrained lifestyle than can be achieved following a successful transplant and, as the noble Baroness mentioned, those who have had a transplant can expect a far superior life-expectancy. More than three years ago, I introduced an amendment to the Human Tissue Bill, which was designed to enable a move towards a system of ““soft”” presumed consent in relation to organ transplants. It would have allowed doctors to use organs unless the person concerned had indicated a desire to opt out but would still have required doctors to consult relatives wherever possible. At that time, the then Minister, my noble friend Lord Warner, politely resisted the amendment but gave strong encouragement, saying that the Government recognised the vital importance of increasing the availability of organs for transplantation and indicating their openness to potential changes in the law, in parallel with further investment in IT, transplant co-ordinators and other resources. Since then and most recently, of course, there have been the Prime Minister’s very welcome comments of last weekend, as well as the report this week of the Organ Donation Taskforce. I enthusiastically welcome that report and see it as a significant step forward in the broad issue of organ transplantation. All those initiatives are very encouraging but, most importantly, we must turn words into action, as every year that passes with an inadequate supply of organs available for transplantation represents many hundreds of lives lost or lives made more difficult or less fulfilling due to the constraints of either haemo or peritoneal dialysis. Despite that, however, I am afraid that I shall probably give the Bill only the sort of broad moral support that I have been accustomed to receiving from the Government on any initiatives that I have taken, as I believe that it contains one or two specific problems, which in my view point towards the desirability of a broader, government-introduced course of action and legislation. Concerned though I naturally am about the problem of renal failure and its treatment, I feel critically that it would be invidious to legislate separately for presumed consent in relation to kidneys alone and not all organs. I listened carefully to what the noble Baroness said about the requirements for doctors to look at other organs, but I think that having specific legislation for one type of organ and not for others would be very problematic. I also recognise the ingenious suggestion in the Bill that presumed consent should refer to only one kidney out of two, which I understand is intended to address a number of issues, including religious ones. However, clearly it is not an approach that can be applied to all other organs. In short, we should recognise that the step towards soft presumed consent—or however we describe it—is a very big one, and therefore, for all the urgency of this matter, we must be very careful to deal with the matter properly and comprehensively. Perhaps I may take a fraction of a minute to make the obvious point that end-stage renal disease, which leads to the requirement for either transplant or dialysis, should and can be avoided or delayed. Therefore, at the same time as looking at the need to improve the supply of organs for transplantation in the area of renal medicine and all other areas, we must ensure that that in no way diminishes our focus on research and, critically in respect of renal disease, education, particularly in the most vulnerable parts of the community where there is a very high incidence among both the Asian and Afro-Caribbean communities. In conclusion, therefore, I very much welcome this Second Reading debate as an opportunity to intensify attention, and accelerate action, on increasing the availability of kidneys—and other organs—for transplantation. If, as I suspect, the formidable challenge faced by any Private Member’s Bill means that this Bill, amended as it obviously could be, does not go on to the statute book, there will be a heavy obligation on the Government to ensure that considered, comprehensive action that is needed, including any legislation, is implemented as soon as possible. I very much hope that if the Minister does not feel that she can use this Bill as a base for moving forward, she will be able to give your Lordships’ House the assurance that we will not, in three years’ time, still be discussing the need for action but seeing the benefits of action already taken.