Melissa Parke (Fremantle, Australian Labor Party) Share this | Hansard source

I speak in support of the Australian Organ and Tissue Donation and Transplantation Authority Bill 2008, which, as its name suggests, will create a national authority to advance the cause of successful and life-changing tissue and organ transplantation procedures in Australia. Such procedures represent some of the most dramatic and miraculous kinds of medical intervention that we have available to us in the 21st century. Many of us in this place will know, or know of, someone who is the beneficiary of an organ or tissue transplant. Of course the Prime Minister is himself the beneficiary of a heart valve transplant, and I would like to say that, while the focus in this area of health service tends to be on organ transplants, the transplantation of tissue is also extremely important and perhaps underrecognised.

Earlier this year—in fact, it was on the first, and last, Friday sitting—I moved a motion on the issue of organ and tissue donation, to coincide with Organ Donor Awareness Week. All those who spoke to the motion did so with heartfelt recognition of the gravity of this issue. The enormous benefits of organ and tissue transplant procedures are well known to all, but the fact that approximately 150 Australians die each year waiting for a transplant is not so well known. This is a preventable tragedy.

On Monday night on ABC TV, at the end of Andrew Denton’s show Enough Rope, there was a woman who spoke of the profound effect that a kidney transplant had had on her life after she had spent more than 30 years managing diabetes and seven years on a transplant waiting list. She talked about receiving a phone call from the transplant coordinator at 6.45 one Saturday morning to tell her the good news, and of how she needed time to put the phone down and run along the hall screaming with joy and relief. She said that, within six hours of the transplant procedure, her new kidney was working to regulate the chemistry of her blood and had brought her blood sugar levels into the normal range.

It is only right that we, as parliamentarians, are moved forward in the reform task by the sense of hope and joy, the health, the relief of pain and the miraculous staving off of death that organ and tissue transplant procedures make possible. We are also moved by gratitude to those donors and families of deceased donors who make the decision to donate organs and tissue. And of course we are moved by our understanding of the pain and the frustration, and sometimes the despair, of those who wait and wait and wait on the transplant lists.

The nature of the health policy challenges which this bill seeks to address can be described in relatively straightforward terms. There are approximately 1,800 Australians waiting for an organ transplant right now—

A division having been called in the House of Representatives—

As I was saying, there are approximately 1,800 Australians waiting for an organ transplant right now. In each case, the prospect of a successful transplant offers, at the very least, a significant improvement in quality of life. In many cases, it offers life itself.

Last year, as other speakers have noted, there were 198 deceased organ donors, which resulted in 657 transplants. Both the number of people waiting for transplants and the number of donors have remained relatively stable in recent years. This means that we are not making headway into that backlog, and it is important to recognise the very reasonable possibility that the number of people requiring transplant procedures will increase as the age of the population increases, and particularly as the under-quantified size of Australia’s kidney disease problem becomes clearer.

By any international measure, Australia has an outstanding record for tissue and organ transplantation and we remain at the forefront of clinical practice outcomes in this area. More than 30,000 Australians have been the beneficiaries of life-changing transplant procedures since they became a standard treatment option. This reform package springs first from recognition of the undeniable benefits of organ and tissue transplantation and second from the recognition that the demand for such procedures is significantly in excess of the supply of tissue and organs.

In my electorate, at the Fremantle hospital there is a new, innovative and nation-leading initiative called the paired live kidney donation program, run by Dr Paolo Ferrari, which uses data matching and a fair amount of cleverly applied common sense to match compatible donors and recipients across family pairings. Kidney donation is in a special category because a successful transplant does not depend on the death of a compatible donor. But it is also an especially acute kind of frustration when, within a family, there are willing kidney donors who cannot assist a family member suffering from kidney disease or failure because of incompatibility. The paired live kidney donation program addresses this by cross-matching willing family donors from separate families to the organ recipients with whom they are compatible. This effectively allows an incompatible family member to achieve their desire of providing a kidney to their relative by means of a cross-trade that is supervised and approved by the Western Australian Minister for Health under amendments that were made last year to the Western Australian Human Tissue and Transplant Act. This program is an example of creative thinking and planning and it is precisely the kind of better and more effective program that this legislation will promote as part of a comprehensive effort to lift the number of successful organ and tissue transplant procedures in Australia. I commend the minister for her efforts in rapidly bringing forward this health reform to support such initiatives.

In the context of this legislation, I want to make special mention of kidney disease. As I have already said, there are approximately 1,800 people awaiting organ transplants in Australia and three quarters of those are in need of a kidney transplant. There is every reason to believe that the growth in the number of patients waiting for a kidney will accelerate. Indeed, as Kidney Health Australia and other organisations have worked so hard to emphasise, kidney disease is one of the silent and under-recognised health problems that we face in Australia. On some indications it may in fact be fair to regard kidney disease as a looming health iceberg, with only the tip of it currently on show and the bulk of the problem as yet out of sight.

We know from remarks earlier this month by Dr Tim Mathew, the medical director of Kidney Health Australia, that on average six new patients are accepted onto the Australian dialysis program each day in this country and that a person can lose up to 90 per cent of their kidney function before experiencing any symptoms. We also know that approximately two million Australians could be affected by early-stage kidney disease. One point I would like to emphasise is that Indigenous Australians are disproportionately affected by kidney disease—and, to compound this problem, Indigenous rates of organ donation are disproportionately low. I am aware that Royal Perth Hospital intends to address this particular health policy challenge in a research seminar this month.

It is clear that a renewed effort in this area of policy is something that both the heart and mind demands. We know that hospital based dialysis costs on average $83,000 per annum to provide dialysis for one patient. Yet, in those cases where a kidney transplant is appropriate, and where our donor/transplant system allows it, we know that a kidney transplant will cost approximately $65,000 per patient for the first year and only $11,000 a year thereafter. Every time a patient is set free from dialysis by a successful kidney transplant the cost to the health system drops by 85 per cent after the first year. It is a saving of approximately $70,000 per annum per patient that can be applied elsewhere in our health and hospital system.

Though it is not the only factor in lifting the number of transplant procedures, the issue of donor registration and family consent is a very important one. While administrative improvements like the coordinated identification of potential donors and the introduction of a clinical identification trigger into all emergency departments have the potential to increase the number of successful transplant procedures, we also need to lift the sheer number of those willing to donate upon death. Donor registration, where it is present in the case of a potential donor, is generally decisive in facilitating a prospective transplant. In those cases where a person has registered their wish to be a donor, that intention is honoured by their family in the overwhelming number of cases. In Western Australia in 2005, for example, all 30 of the registered donors considered as a source of organs or tissue had their wishes confirmed by their families. It is for this reason that organ donor registration is something that we need as a society to encourage and to facilitate to the greatest extent possible.

Raising the number of registered donors is a primary objective, and I welcome the commitment of funds under this legislation to seriously lifting community awareness and education on the issue of organ and tissue donation. By registering as a donor we can leave behind us one of the most profound legacies—we can bestow on someone else the gift of health, in many cases the gift of life. To anyone who may be listening to or reading this contribution, I join with my fellow parliamentarians in urging you to register as an organ donor and to let your family know of your intention to give such an important gift.

As I have noted previously in this place, the Western Australian agency for organ and tissue donation, Donate West, began a first-of-its-kind campaign earlier this year to promote donor registration. The ‘Don’t Waste Your Wish’ campaign, which featured in both print and television advertising, ran with the tagline ‘There are some wishes you can’t keep to yourself’. This addresses the fact that, while a very large proportion of Australians indicate in polling that they are happy to donate their organs, not enough are actually registering their intention and not enough are discussing their wishes with their families. I hope that a similar national campaign will help us become a country with a rate of organ and tissue transplant procedures that matches our already excellent record of conducting the procedures themselves, and that this will see a significant reduction in the transplant waiting list and a significant reduction in those who die waiting.

The imperative to lift the rate of donor registration in Australia, to create a national transplant network, to improve the in-hospital practice and staff resources and ultimately to increase the number of successful transplant procedures requires a multifaceted approach. It requires an appropriate coordinating structure and it requires new funding to make good on the recommendations to government contained in the report by the National Clinical Taskforce on Organ and Tissue Donation. That is what this bill delivers.

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