Blue Jackie: Human Tissue (Organ Donation) Amendment Bill — Second Reading 
Blue Jackie: Human Tissue (Organ Donation) Amendment Bill — Second Reading 
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Dr JACKIE BLUE (National) 
: 
 I move  
That the Human Tissue (Organ Donation) Amendment Bill be now read a second time 
. This bill started for me 2 years ago. As a new MP I was approached by a constituent Andy Tookey who then lived in Auckland. He had been very keen to get and lobby for an organ donor register and together we devised and put together this bill. It was drawn up put in the ballot and actually drawn out very very quickly in only a matter of weeks. So I am very grateful to Andy for coming to me to talk about the issue of organ donation because it really raised an issue I had been unaware of until that time. 
Andy has a daughter who may yet need an organ donation at some time in the future. He raised the matter that there really was an issue of not enough organs being available for donation and there was a huge need out there. As I said I was grateful to Andy. We put the bill into the ballot. It got drawn out it wended its way through the first reading and it was supported all the way through to the Health Committee. Sadly it will not be supported after its second reading. None the less Andy is a great campaigner. He is not going to give up; neither am I. 
There is provision in the Government’s Human Tissue Bill such that if a future Government feels there is a need for an donor organ register then a register can be established without the need for regulation. So the door is open and the cause is not completely lost. There is still hope. But from now on the focus will be on how Organ Donation New Zealand which is the organisation that is being funded to retrieve organs for donation will step up to the mark because in the last few years organ donation in New Zealand has been steadily dropping. For instance from 2001 to 2004 the number of organ donations was between 38 and 40. It dropped to 29 in 2005 and in 2006 plummeted to 25 organs. So there has been a steady drop in the number of organs that have been available for donation. 
There has been a greater need for organ donation as a result of the diabetes and obesity problem we have in New Zealand. Of course the consequence of long-term chronic diabetes is end-stage renal failure. People with that problem are hooked up to a machine and receive quite expensive dialysis treatment. Their quality of life is poor and the only way they can get off the machine is through means of an organ donation. Also we have an estimated 200000 people who suffer from either hepatitis B or C. The complication of that disease can be end-stage liver failure and there is no way out of that problem. There is no dialysis treatment for liver failure; those people need an organ donation. So there is a greater need for organs but there are fewer organs being offered for donation. Also over the last few years since 2005—and I have looked at the statistics—the number of organ transplants has been dropping steadily. They may have increased in the last year; I do not have those figures to hand. 
Organ donations are not just for those illnesses. Originally we were just doing organ transplants for kidneys and livers but now we are doing them maybe for spleens hearts and lungs. A lot more illnesses have the option of organ transplant. Also the threshold to receive an organ donation has actually been lowered. Patients who are a lot sicker are now being accepted as eligible for organ donations. So there is a lot of need out there and currently it is not being met. That was the whole point of the register. It was to provide a mechanism for New Zealanders to indicate their wish to donate an organ after they die. Currently we just have an indication on a driver’s licence which is a “tick a box” system. It is not the informed consent that is universally accepted. There is no dispute over that and it is not acknowledged even in the intensive care situation. 
Concurrently we have fewer brain-dead patients in intensive care. That is due perhaps to fewer road deaths obviously because of the promotion of drink-driving campaigns and road safety generally. Also techniques have been developed in intensive care units where doctors do more aggressive procedures on those people who have been brought in with brain injuries such as craniectomy where they reduce the pressure on the brain. This means there are fewer people who can be termed brain-dead and therefore obviously they are not available for organ donation. 
New Zealand per capita has few intensive care unit beds compared with other countries in the world. It is also a factor that the fewer intensive care unit beds there are the fewer the patients who conceivably could be on machines. Their brains could be kept alive and their organs could be kept alive for possible donation. New Zealand at the last count had 69 intensive care unit beds per million people compared with France with 384 USA with 305 and Spain with 148. So we are well down in the number of intensive care beds that we have per capita and that could be a factor. 
So there are a lot of reasons why we need an organ donor register. There have been two previous reports from the Health Committee on this issue. These were done in 2002 and 2003 and both called for the establishment of an organ donor register. Even the Labour Party as part of its 2005 election manifesto said it would establish an organ donor register. One would have thought there was hope that this bill would pass. 
Hon Member 
: They obviously didn’t vote for it. 
Dr JACKIE BLUE 
: Yes absolutely. One would have thought it would go all the way. The statistics were compelling: donor rates were dropping the need was greater the threshold to go on the waiting list was lower and so on. With the diseases we face in our community such as obesity diabetes and the renal and liver problems it seems really amazing in the face of such huge demand the backing of the Government in its 2005 policy and the two previous Health Committee reports all backing a donor register that the bill should fail at this point. We were told by the Ministry of Health that there is no international evidence for a register. That did sway a number of members on the select committee and I was really quite disappointed in that summary of the situation. I have seen a steady stream of media reports of countries turning to legislation to improve donor rates. We in New Zealand need to reflect on the world situation. It might be that the ministry felt the evidence was not there but the reports I have seen are that the countries that initially turned away from a possible organ donor register are now coming back to that. Our lag time is a bit slower and we may be looking at this issue in another year or two. But certainly a lot of countries are turning to organ donor registers or are going from intent registers to consent registers. They have all had to face this issue and find their own solutions to a fall in organ donor rates in the face of increasing demand. We are not alone. This is a worldwide problem. 
In January 2006 the Australian Capital Territory issued a press release stating that its impressive increase in organ donations confirmed the importance of registering with the Australian Organ Donor Register. In September 2006 the UK Human Tissue Act came into effect to ensure that if a person registers his or her wish to donate organs then that wish takes precedence over objections. In April 2007 the Texans expanded their organ register into an online register. And in the same month there was a Canadian media report calling for the establishment of a national database network in the face of falling donations. There are many many examples of countries coming on board. In July 2007 it was Switzerland that was establishing an organ donor register. I just think that we have missed the boat and I am really disappointed because I think we will have to face this issue again in a year or two. I am the last person who would want to propose legislation for the sake of legislation or bureaucracy for the sake of bureaucracy. That is not what my party stands for. But I am really concerned that without an organ donor register the Government’s Human Tissue Bill in which the donation of organs is actually based on informed consent will fail in terms of increasing organ donor rates. 
There is no talk of a public publicity programme at this stage and there is no mechanism for individuals to register their wishes unless they wish to carry around an advanced directive or have something mentioned in their will. I think it will be just too hard for many New Zealanders. Any publicity campaign for organ donations will involve a call to action and there will be no call to action if there is no organ donor register. So I think basically that we will be re-looking at this issue in a year or two. Precious time will have been lost opportunities will have been lost and maybe people will have died because we did not have a register—or maybe not. I cannot prove that of course. 
I am very sad that this bill will not be passed. Maybe other parties will have a change of heart. That would be great. In summary I would like to think there will be support for an organ donor register and if there is not then a future Government will decide its fate. Thank you.