Kidney Transplant Bill [HL]

My Lords, the noble Baroness, Lady Finlay of Llandaff, who is an admirable activist on a series of health-related causes, not only deserves our thanks and congratulations but has been serendipitous in her timing. I realise that there may be a ““post hoc ergo propter hoc”” issue to this, but the week preceding the Bill that we are debating today has seen: the Prime Minister coming out for presumed consent in the Sunday Telegraph; the wide reporting of his views on Monday—I am not quite sure whether they count as an initiative, but they certainly advertise the work of the task force that will report in the summer; Libby Purves in the Times on Tuesday; the first task force report—to which the noble Lord, Lord Rea, has been speaking—on the ancillary issues on Wednesday, which was welcomed by the BMA; a Times first leader; and Dr Stuttaford on Thursday. I am sure that there has been similar coverage elsewhere. All of us participating in the debate today also owe to the noble Baroness the briefing that we have received on the occasion of the Bill from interested parties. Only its ubiquity and familiarity to other noble Lords and noble Baronesses participating causes me not to mine it today, but I shall give one vivid illustration close to home of the crisis that the Bill seeks to address. In our debate, to which the noble Viscount, Lord Chandos, referred, on the Human Tissue Bill in 2004, our late and lamented colleague Lord Biffen spoke—and from the perspective of a dialysis patient. I happen to know that he was at that moment completing his autobiography. Anyone who read a long piece by him in Times2 a year or so back on the Home Guard in Somerset in World War II, in which he had participated, will know what a joy that autobiography would have been. At intervals between then in 2004 and his recent death, I asked him if he had found a publisher. I shall long be haunted by his reply that the fatigue and weariness from dialysis had robbed him of the energy to make the effort. That is an index of the kind of opportunity cost that we are discussing, and although it would be hyperbolic to say that we have collectively failed a great fellow parliamentarian and the best Leader of the House of Commons in living memory, it is a pointer to how important it is that we solve the transplant donation gap. The fact that refusals by relatives has gone up from 30 per cent to 40 per cent in the past decade is sad and even ominous. Although I am not going to draw heavily on the briefing that we have received, whether on statistics or otherwise, I must say that we are also in debt to the Chief Medical Officer, whom the noble Lord, Lord Rea, also quoted, prior to his 2007 call for the concise and lucid summary of the nine key facts on organ transplants, which he gave on page 27 of his annual report on the state of public health in 2006. They do not seem to have changed much, if at all, in the past couple of years, and I commend them as a synopsis of the issues. In the context of the speech of my noble friend Lady Verma, I cite his seventh key fact: "““Black and minority ethnic groups are in double jeopardy because they have more need of organs but a reduced pool of donors””." I understand the relevance of presumed consent and the BMA’s enthusiasm for it. I shall look forward to the task force’s second report on it in the summer, but my particular support for that agenda is that it will keep the spotlight on the total issue, as the Bill does today. In the mean time, I hope that the ramifications of this week’s first report will also be powerfully pursued. There is still too much ignorance, especially of the implications. While I would not go so far as the Chief Minister in a populous Indian state who insisted that all his Ministers mention HIV/AIDS in every speech they made wherever they spoke in the state, I can report the editor of a local paper in Northern Ireland telling me that he had moved from being the music correspondent on the Belfast Newsletter in protest at being asked to introduce a hostile reference to the Anglo-Irish agreement into every music criticism he wrote. The more that the Government can use such relevant—I stress, relevant—forms as we fill in every year to remind of us of the issue and to seek our written consent or dissent, the better. I applaud the BMA for the fact that its enthusiasm for presumed consent is balanced and tempered by its insistence that the opt-out option should also be highly visible. I should confess that I have always carried an organ donor card but that I would not at this moment know how I should go about putting myself on the national donor register, although I dare say that I could find out online. I shall quote one statistic if only to provide a particular illustration. In the presumed consent debate, one piece of evidence is the detailed regression analysis comparing 22 countries over 10 years, including determinants that might affect donation rates, which concluded that presumed consent countries have roughly 25 to 30 per cent higher donation rates than informed consent countries. As the noble Lord, Lord Rea, cited, it is well known that Spain has the highest donation rate. Those in your Lordships’ House who went last year to see Dame Diana Rigg at the Old Vic in a Spanish play translated from a much respected Spanish film will recall the opening scene of citizens in a hospital group being coached on how to be organ donors very shortly before a central figure is killed in a road accident. That very centrality is an index of the manner in which the issue has taken root in Spanish culture. I hope it is clear how supportive I am of the efforts of the noble Baroness, Lady Finlay, to maintain the momentum. It was a pleasure for me to follow the noble Lord, Lord Rea, who I see as a bassoonist: the more noise on the issue, the better, on whichever side of the arguments the noise comes. I take final encouragement from the fact that the BBC ““Today”” programme Christmas poll in 2003 on the Private Member’s Bill that listeners would most like to see, had, as its second choice, a Bill on the very issue we are debating today.