17/12/14 Senator Daly Speaks to the Seanad and Minister for Health Leo Varadkar on Organ Donation

Senator Daly:I welcome the Minister to the House. The issue I wish to raise is that of organ donation. As the Minister knows, the system in Ireland is not all it should be. For too long, we did not have organ donor co-ordinators. There are many staff working excellently in the field very much on a voluntary basis. We were to appoint 20 new staff in this area as part of the HSE’s service plan but there was only one line in the plan on organ donation. When one considers the number of people waiting for an organ donation and the cost to the Exchequer of organ donation, including the cost of dialysis for those in need of kidney transplants, one realises that if we had an improved system, there would be savings to the Exchequer over time.

We had the Seanad recalled the summer before last. The night before it happened, two HSE staff members were asked to move to the organ transplant office so that it could be announced in this Chamber that there was activity in the field. I welcome anything that results in activity and improvements in the field of organ donation. The appointment of 20 staff, which was to take place in August of this year, is also welcome. I hope to find out from the Minister what they are doing and what is his vision for organ donation in his term in the Department of Health.

The Minister has come from the Department of Transport, Tourism and Sport and I raised the following issue with that Department. We are collecting data from our driving licensing system, whereby people tick the box on whether they want to be organ donors, yet the Department of Transport, Tourism and Sport will not let the Department of Health access the information. It is a simple process of the Department of Transport, Tourism and Sport asking people, when people are applying for the driving licence card, if it is okay to share the information with the Department of Health and with doctors in the event of someone being suitable as an organ donor. It would make the decision for the family so much easier. We collect the data but it is not shared or is not available to be shared. Now that the Minister has spanned both Departments, perhaps he has a view on working with his colleagues in the Department of Transport, Tourism and Sport. I accept we are here to discuss the new staff in the organ donation section.

Minister Varadkar: I thank the Senator for raising the issue of the steps being taken to boost organ donation and transplantation rates in Ireland. I was very pleased that, in the face of difficult economic circumstances, the Government arranged for the HSE to allocate an additional €2.9 million to organ donation and transplantation in 2014. This additional investment is a clear demonstration of our commitment to this important issue. The extra allocation will facilitate the recruitment of 19 whole-time equivalent staff dedicated to organ donation and transplantation. These comprise four consultants, six organ donation nurse managers, five organ procurement co-ordinators and four quality officers. Four people are already employed in the new roles and others are at various stages of recruitment. All posts will be filled next year.

The consultant intensive care posts and the organ donor nurse managers being recruited will form a key element of the organ donation effort in each of the six hospital groups around the country. Having these people on the ground in hospitals will provide a major boost for organ donation. The consultants and nurse managers will work to foster a strong culture of organ donation, optimise conversion rates and champion educational strategies and training programmes that promote organ donation to health care professionals across each hospital group. These key personnel will have a particular focus on protecting the interests of donating families throughout the donation process. The consent of the next-of-kin will always be sought before organ donation and no organs will be removed without such consent.

We must do everything in our power to comfort, console and counsel families who find themselves in the most difficult of circumstances, having lost a loved one, while encouraging them to agree to donate the organs of their loved one. Ultimately, organ donation can bring great comfort to grieving families as well as representing a gift of life for others. In order to reduce the risks and maximise the benefits of transplantation, procurement and transplantation centres must operate an effective framework for quality and safety and this will be led by a dedicated team of quality managers. A quality manager has been appointed in each of the three transplant hospitals – the Mater, Beaumont and St. Vincent’s – and the recruitment of a fourth quality manager for the national organ procurement service is being progressed.

In line with international best practice, the national organ procurement service is being separated from the renal transplant service. In order to facilitate the separation of donor and recipient co-ordination, five organ procurement co-ordinators are being recruited. One is already in post, three are to start in early January and the fifth is to start in March.

In conclusion, I assure the House of my commitment to improving our organ donation and transplantation infrastructure. Organ donation and transplantation is an area of health care that brings so many benefits to the lives of patients and their families. I am confident this extra investment will facilitate an increase in the levels of organ donation and transplantation, to the benefit of patients and their families, while being a source of some comfort and consolation to the families and friends of the bereaved.

Senator Daly: I thank the Minister for his reply and I welcome the moves made in respect of organ donation and transplantation. We had a number of issues raised at the time of the Seanad recall about the crossover and infrastructural failures of the implementation of the EU directive on organ transplantation by the Minister’s predecessor. It was described by the head of the Spanish transplant authority as a system that would kill people because it was not streamlined. I am glad to see people being appointed.

While it is not the matter on the Adjournment, given the fact that the Minister had knowledge of both Departments, perhaps he can give his view on the matter I mentioned earlier, which is the greatest failure to have joined-up thinking. Can the Minister look into the ability of the organ donor co-ordinators to ask the driving licence authority whether the person had ticked the box? The decision is so traumatic that the fact that people know for certain that it was the wish of the loved one would make all the difference. I have an organ donor card in my wallet, as I am sure the Minister has, but this must be found for health care staff to know about it, unless it was discussed in advance.

Minister Varadkar:I had some conversations with my predecessor, when he was Minister for Health, but the issue we discussed was the symbol to appear on the new driving licence. For various reasons, mostly regulatory, we agreed that if someone agrees to donate organs it is reflected in a code on the driving licence. What Senator Daly says makes a lot of sense to me. I am due to meet the organ donation team in the new year and it is something I will put on the agenda for discussion. I imagine there are data protection issues but they could be dealt with because the person, when renewing a licence, could consent to the information being included on a registry. That would be the easiest for transplant nurses in hospitals to have the information online and have access to it. It is a good idea and I will follow up on it.

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