Kidney Transplant Bill [HL]

My Lords, there can rarely have been a week when the issue of transplantation has been more widely discussed. I certainly welcome that. To start with, I very much welcome the Prime Minister’s statement last weekend, followed by the committee’s report and, now, by the Bill before the House. I join others in thanking the noble Baroness, Lady Finlay, for introducing it and particularly for the time and energy she has spent discussing with us why she produced the Bill in this way, which those of us who discussed it with her found helpful. The balance of the debate has clearly been that most of us would like to get to a position, at whatever speed we get there, of presumed consent. In a sense, the issue before us is what route we take. At this stage of a debate most things have been said, so rather than repeat them straightforwardly I shall comment on three of the contributions. First, my noble friend Lord Rea set out the kind of infrastructure that is required regardless of whether one opts in or out, and he quoted this week’s committee report on the subject. We can get too caught up in the opt-out/opt-in argument. If we have the right kind of infrastructure, support and transplant co-ordinators in hospitals, it would make a great difference in the availability of organs. That was a helpful contribution. Secondly, the noble Lord, Lord Brooke, talked about the means of increasing the number of those signing donation cards. I have known Lynne Holt, the transplant co-ordinator of the Freeman Hospital in Newcastle, for 20 years, for the simple reason that she was the transplant co-ordinator when I had my transplant. Speaking on behalf of Transplant Sport UK—an organisation with which I have some association, in what I assure noble Lords is an entirely non-participatory capacity, as I was privileged to be the patron of the very successful Transplant Games in Edinburgh at the end of last year—she has pointed out that, whether we have opt-in or opt-out, the biggest impact that could be made to the availability of organs is for people not just to sign cards but to sign them and to speak to their next of kin and friends and say: ““This is what I want and I expect you as my next of kin to do everything you can to ensure that it happens””. That would make a bigger and more immediate impact than anything done through the legislative process. I very much hope that we start increasing the pressure for that kind of discussion within families and groups, so that people really understand that that is what someone who has signed a donor card absolutely wants. In response to my noble friend Lord Hughes, I have not had the benefit of a discussion with the Public Bill Office. If he says that it is not possible to extend the Bill beyond kidneys, I accept and understand that. What needs to be done—and I think this is what the noble Baroness was saying—is, if possible, to amend the legislation not to cover other organs but to extend the conversation about transplants. Even if there were no changes to the Bill, initiating such a discussion would be likely to lead to further discussion about other organs. That would be a helpful start to increasing discussions of this difficult process. Should the Bill, judged in that context, be seen as helpful? I understand why one or two people might take the view that it is not. Perhaps I may go through some of the points that have impressed me. The Bill is, first, an honest and real attempt to deal with the awful issue of people going abroad for organs. Such a practice is bad for those going abroad and very bad for those from whom they are getting the organs. A serious attempt to stop that is desperately important. Secondly, were it to go through, it would start the conversation with people about transplants. On that basis, I hope that it would increase the availability of organs. On these two grounds alone the Bill is to be welcomed. I hope it might be possible to make it clearer—though, as I say, it may not matter—that the Bill is the start of the discussion and not limit the discussion solely to one organ. I do not know whether the Government will be prepared to look favourably on the Bill. However, if they do not, I hope it is because they can see a route map in terms of developing discussions, trust and understanding which enable us to get to a position of presumed consent as quickly and realistically as possible. I am grateful to the noble Baroness, Lady Finlay, for introducing the debate; it has been a hopeful and helpful part of the discussion. I personally would support the Bill, and will do so if I have the chance. We look forward with interest to seeing whether the Government have even more ambitious schemes ahead.