I was expecting the noble Baroness, Lady Thornton, to talk for a little longer, so I thank her very much.
I thank my noble friend Lord McColl for initiating this discussion on the role of the deceased’s loved ones under the proposed new system. This is an important issue that has rightly been the focus of much of the debate in the other place and here. My noble friends Lord McColl and Lord O’Shaughnessy rightly stress the issue of trust. As both my honourable friend the Member for Thurrock and the noble Lord, Lord O’Shaughnessy, have confirmed on a number of occasions, the family will remain at the heart of the new arrangements, as now. I believe this reassurance has also been given in correspondence to my noble friend and has been confirmed by NHS Blood and Transplant’s medical director and national clinical lead for organ donation. I am happy to give further clarification on this point.
The legislation sets the framework for consent to organ donation and reflects what we already know—that most people support donation and agree that the decision of the potential donor should be paramount. We have, however, always said that, as now, organs and tissues will not be taken without full consultation with persons in a qualifying relationship—that is, the deceased’s close family and friends. There will always be a personal discussion between the specialist nurses for organ donation and the family. This is NHS Blood and Transplant’s current policy and will not change under the new system.
In addition to this policy, the Bill as drafted allows for a person in a qualifying relationship to the deceased to provide information about the deceased’s wishes on donation of their organs and tissues. This is an important safeguard, to find out what the deceased would have wanted and the best way forward. I remind the House that healthcare professionals have a duty of care not only to the patient but to the family. Specialist nurses for organ donations are highly trained professionals from an intensive care or emergency medicine nursing background. When nurses join NHS Blood and Transplant, they initially receive extensive training over a six-month period. This covers supporting families to make end-of-life care decisions, including on organ donation. A key focus of the training is to enhance their skills in supporting acutely bereaved and grieving families.
11 am
In the light of the practical reality of the application of the Bill and the many medical processes and protocols that have been put in place since the Alder Hey scandal—which I know may still be a concern for some—and given that the Bill already allows the family to provide information if the deceased would not have wanted to donate their organs and tissues, it is not clear what my noble friend’s amendments will achieve. I say this to
him very respectfully. He may be concerned that donation will still go ahead if no family or friends are accessible but I can categorically confirm that this will not be the case. As my noble friend will know from his medical training, to enable a safe transplant doctors need someone’s medical, social and sexual history. Without such important information about the deceased, it would not be safe to proceed with a transplant and I wish put it on record that donation will not go ahead.
More detailed guidance about the role of the family will be included in the new code of practice, which will be developed by the Human Tissue Authority in formal consultation with stakeholders. This will include case studies and examples so that the public and healthcare professions can be clear that the family will continue to be involved in discussions about donation. The code will be laid before Parliament, so parliamentarians will have the opportunity to consider the guidance for healthcare professionals before the system comes into force if they wish. We expect healthcare professionals to act properly and in accordance with their relevant professional standards and guidance, part of which will be the new code In addition, as part of the information available to the public about the new system, NHS Blood and Transplant will set out its internal protocol in an easily digestible way so that the public have all the right information and feel reassured.
At Second Reading much reference was made to the letter my honourable friend in the other place, Jackie Doyle-Price, wrote to the Board of Deputies of British Jews, which further explains the role of the family under this proposed system. A copy of this letter was circulated to all noble Lords who spoke at Second Reading and has since been placed in the Libraries of both Houses. The Government are committed to introducing a new code of consent that is practical, ethical and enables the public to maintain trust in the system. The role of the family will be a key aspect of this. No family will be forced to agree to organ donation if they are strongly opposed to it.
One of my noble friend’s questions concerned Wales. Wales has seen a steady rise in donor numbers, from 52 in 2012-13 to a high of 74 in 2017-18. In 2017-18 Wales had the highest consent rate in the UK of 70%, compared to England, Scotland and Northern Ireland where consent rates were 66%, 57% and 66% respectively. We need to concern ourselves with the consent rate. A higher consent rate allows a bigger pool of available organs and can therefore lead to more high-quality transplants for patients who need them. Numbers, of course, will fluctuate. The family will continue to be at the heart of the new system; I put that firmly on the record.
The noble Baroness, Lady Randerson, raised the issue of what would happen if someone was not contactable by the NHS. The NHS staff will of course make every effort to identify the next of kin of any patient admitted to hospital in a serious condition. This starts with the ambulance service and can also involve the police. The specialist nurses at NHSBT will undertake further investigations such as contacting the GP, searching the organ donor register and contacting embassies and overseas record departments if the patient is not UK-born.