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Glyn Davies MP says there is no firm evidence that a change to 'presumed consent' on organ donation will make any difference - and some evidence that it may do harm.
The Welsh Government has launched a consultation paper on proposals for legislation on organ and tissue donation. The effect of the legislation, if passed, would be to fundamentally change the system of organ donation in Wales. Instead of potential donors joining a register to offer their organs for donation, everyone over 18 would be considered a donor unless they had joined a register to object. An absence of objection would be taken as considered approval. There needs to be compelling evidence that such change would result in more organs becoming available for transplant before moving forward with such a drastic step.
There is no disagreement about the desperate need for more organs to be donated. In the UK, around 1000 people die while awaiting a transplant, about 50 in Wales. However, there is no firm evidence that a change to 'presumed consent' will make any difference - and some evidence that it may do harm.
During the last decade, both as a member of the National Assembly for Wales and as an MP, I have taken an interest in this issue, knowing people in need of transplants and through campaigning for local renal dialysis provision. Throughout that period, supporters of presumed consent have championed Spain as an exemplar. It is true that organ donation has dramatically improved in Spain over the last 30 years, but closer examination tells a different story. Presumed consent legislation was passed into law in 1979, on the assumption that it would increase organ donation. However, in 1980 a royal decree stated that objection could be expressed in any way, without formal procedures. In practice, Spanish law is only theoretical presumed consent. There is no opt-out register. A donor's wishes are established by discussion with next of kin.
What was particularly interesting about the Spanish experience, was that the level of donation did not change for ten years - until in 1989, the government made several key policy changes, which led to a gradual increase over time to the outstandingly good current performance of today. Nothing to do with presumed consent.
During the final year of the last Labour Government, the then prime minister and the Chief Medical Officer advocated a change to presumed consent, and established a Department of Health Organ Donation Taskforce. I can do no better than quote from its conclusions. "the more the Taskforce examined the evidence, the less obvious the benefit, and the more multifaceted and multidimensional the issue of donor numbers was revealed to be." And also "The taskforce reached a clear consensus in their recommendations that an opt-out system should not be introduced." A similar conclusion was arrived at by a cross party Welsh Assembly Committee about the same time. The issue is nothing like as straightforward as advocates of presumed consent sometimes claim.
There is a desperate need to increase the availability of organs for transplant. We need to learn from international experience where great success has been achieved, such as the US and Spain. In particular the UK needs a comprehensive transplant coordination strategy. It does not need an ill thought through change in the law which appears superficially attractive but remains unproven.
Glyn Davies has been Conservative MP for Montgomeryshire since 2010, he is PPS to Wales secretary Cheryl Gillan
Dods Parliamentary Communications Ltd