Report of the Health Committee

Background 2

Organ donation 2

Current system of registering organ donation wishes 2

Training and education for medical staff 3

Organ Donation New Zealand 4

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In November 2003 the Health Committee reported on petition 2002/25 of Andy Tookey

the petitioner’s request for the House to take action to address the organ donation shortage

in New Zealand. We noted our concerns about the current level of organ donation in New

Zealand and the inadequacies of the current system for recording donor preferences.

The Government response to our report did not support our recommendation that a

dedicated national organ donor register be established to replace the current system, which

is linked to the driver licensing system. The response suggested that we consider this issue

further.

To action this, we sought further information on a national organ donor register and

received a briefing from the Ministry of Health.

can be transplanted from brain-dead persons or a living donor. We note the Minister of

Health’s announcement of a plan to pay income support to living organ donors, who

would be compensated for income lost as a result of donating an organ. It is intended that

The ministry is reviewing the regulation of human tissue and tissue-based therapy,

including all uses of human tissue for both therapeutic and non-therapeutic purposes.

Organ donation is one matter covered by this review. We do not want the issue of organ

donation to wait while legislation is developed and would like to see it resolved

expeditiously.

At present, the Land Transport Safety Authority of New Zealand collects information on

those registering their wish to be organ donors after death as part of the driver licensing

process. The authority’s database has more than 1.1 million people registered as donors.

This donor information is available to designated health professionals 24 hours a day. The

ministry is not able to access this information, and it is normally accessed only if a family is

uncertain whether to consent to donation and the wishes of the person are not known by

the family.

BRIEFING ON A NATIONAL ORGAN DONOR REGISTER

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We consider that there are a number of difficulties with the current system of using the

driver licensing system to record the wishes of individuals in relation to organ donation.

Ideally, we would like to see a separate system that provides a central register that can be

readily updated, is linked to the Primary Health Organisation data system, and is flexible

enough to record specific wishes for organ use after death. The ministry is reviewing the

regulation of human tissue and tissue-based therapy. We consider that, in the interim, other

ways to enhance the existing indicative register should be explored, including registering

organ donation intentions at the time of issue or renewal of a driver’s licence.

1. We recommend to the Government that it proceed to investigate the option of an

indicative register that records organ donation wishes, independent of its review of the

regulation of human tissue and tissue-based therapy.

We consider it is essential that there are sufficient links between an indicative register of

organ donation intentions and hospitals, where these organs may be retrieved. We consider

it is important that intensive care units have computer access to information about

individuals’ wishes about organ use after death.

We noted in our previous report that appropriate training of medical staff is vital to

increasing donation rates and recommended that the Government fund ongoing education

for health professionals on organ donation. The Government’s response to the report

supported, in principle, increasing the availability of such education to ensure that all

professionals involved in organ donation receive such education within the next 3 years

and continuous complete national coverage is maintained in the face of the ongoing

turnover of personnel. The Government response also outlines the possibility of extending

education about organ donation to the medical school curriculum. We strongly support

these initiatives.

We consider that education is an important element in increasing the number of organ

donors. Education about the issues of organ donation will facilitate discussion among

family members about each other’s choice to donate or not to donate organs. Such

education would help to improve communication amongst family members and ensure, in

the event of death, that family members are clear about each other’s wishes in relation to

the donation of organs.

We are concerned about the legal implications of overriding an individual’s wish to offer

organ donation, because we note that medical specialists inevitably adhere to the family’s

instructions, regardless of a person’s indication on a driver’s licence.

We consider that it is essential to undertake research on public opinion to establish both

the level of awareness on this issue and whether people are willing to be organ donors.

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2. We recommend to the Government that it conduct random sample research to

gauge public awareness and attitudes towards all organ donation options and methods for

recording preferences.

We consider it imperative that funding for Organ Donation New Zealand is used to

facilitate community and family education. Organ Donation New Zealand, due to be

established in the 2004/05 financial year, will extend the current services of the National

Transplant Donor Coordination Office. The office is currently funded at $254,266 a year,

with additional funding for 2004/05 set at $212,500. In 2005/06 funding for Organ

Donation New Zealand will total $679,266. Organ Donation New Zealand will remain

under the auspices of the Auckland District Health Board, as is the National Transplant

Donor Coordination Office.

The ministry notes that extra staff will be appointed to Organ Donation New Zealand

before the end of 2004 and a work programme will be designed once a medical director has

been appointed. An advisory committee to Organ Donation New Zealand will be

established in March 2005.

3. We recommend to the Government that it review resources for Organ Donation

New Zealand and ensure that resources are allocated to community and family education.