Craig Thomson (Dobell, Australian Labor Party) Share this | Hansard source

Over the last 10 years, organ donation rates in Australia have fluctuated at around 200 donors per year. To get straight to the point, Australia needs more donors. Last month, a young Australian man, 20-year-old Doujon Zammit, tragically succumbed to injuries sustained while holidaying in Greece. Doujon’s wish was for his organs to be donated, and he has provided the gift of life to four individuals who were in urgent need of organ transplants. The Zammit family, together with Transplant Australia, have established the Doujon Zammit-Transplant Australia Gift Fund to recognise Doujon’s donations and to honour his legacy. The fund will be used to raise awareness in the community of the need for organ and tissue donations and transplants.

Doujon’s father, Oliver, said his son had made it clear to his family that his wish was to be an organ donor and, although it was a difficult and emotional decision, they wanted to respect his wishes. Not only did they make a commendable decision to respect Doujon’s wishes and see through the donations but the Zammits have since also urged all families to discuss the issues concerning organ donation.

On the one hand, this country is internationally recognised for a strong record of successful organ transplantations—more than 30,000 Australians have received transplants in the last 60 years. But, on the other hand, we also have one of the world’s lowest rates of organ donations. Unfortunately, the demand far outweighs the supply, and the consequence is that substantial numbers of people die while waiting for suitable organs to become available. This is something we need to change.

As the former National Secretary of the Health Services Union, representing hospital and health workers throughout the country, I was able to see firsthand the lack of quality of life that many of those waiting for organ donations had to endure. For people with serious or life-threatening illnesses, organ or tissue transplantation may mean a second chance at life. It also means a much better quality of life. Improved survival rates now mean that most recipients of organs or tissues can look forward to a better quality of life. Anyone can choose to donate organs and tissues—there is no age limit on the donation of some organs and tissues. What is important is that, as families, we sit down and make sure, as the Zammits did, that they are fully aware of the wishes of the family member that their organs be donated.

While a person’s age and medical history will be considered in relation to their suitability for donation, he or she should not assume they are too old or not healthy enough. Organ donation can involve kidneys, heart, lungs, liver and pancreas, while tissue donation includes heart valves, bone tissue, skin tissue, corneas and bone marrow. In most cases, organ and tissue donation occurs after brain death. Brain death occurs when the brain stops functioning with no possibility of recovery. Organ donation is only considered after several tests are carried out by two appropriately qualified senior doctors to establish whether brain death has occurred. The way in which a person dies will generally determine what they are able to donate. In most cases organs such as the heart, lungs, liver, pancreas and kidneys can only be donated if a person has died in an intensive care unit under special circumstances. Less than one per cent of all people who die in hospital each year die this way. That ratio helps explain why the rate of suitable organ availability is so low.

But that is not the only explanation. The other explanation is that it is something that we do not talk about with our families before we are in these circumstances. When our families are in that pressured situation of having to decide what to do, to make those sorts of decisions, unless they have been clearly told—unless that discussion has actually happened with their family member, unless they know that when their loved one passes away in those circumstances their organs should be donated—the whole situation around a tragic death usually means that it is too difficult a decision to take. That is why it is so important that we make sure that we let our families know if we are prepared to donate our organs.

In some cases organ donation may be possible after a person’s heart has stopped beating, but this is extremely rare, and we get very few donations in relation to that particular situation. A greater number of people have the opportunity to donate tissue for transplantation, such as eye tissue, heart valves, bone tissue and skin tissue. This is because tissue donation does not require the same special circumstances as organs usually do for transplantation to be successful.

The Australian Organ and Tissue Donation and Transplantation Authority Bill 2008 being debated today will allow the establishment of the Australian Organ and Tissue Donation and Transplantation Authority. This organisation will provide national leadership to the organ and tissue sector to drive, implement and monitor national reform initiatives and programs aimed at increasing Australians’ access to life-saving and -transforming transplants. As we have heard in this debate, a higher rate of access to, and availability of, transplants is vital if we are to increase the rate at which recipients can truly have a second chance at life.

The new authority will be managed by a chief executive officer with direct accountability to the Commonwealth Minister for Health and Ageing. The CEO will be advised by the Australian Organ and Tissue Donation and Transplantation Advisory Council. It will comprise a chair and up to 15 members. Members will have expertise in a wide range of areas related to organ and tissue donation and transplantation, and also areas such as business and management, to assist the CEO to run the authority efficiently and effectively.

The authority will spearhead the government’s comprehensive, best practice reform package aimed at achieving a significant and lasting increase in the number of transplants for Australians. The functions of the CEO will include formulating, in writing, policies and protocols relating to organ or tissue donation and transplantation matters and declaring, in writing, standards and codes of practice relating to organ or tissue donation and transplantation matters. The CEO will also collect, analyse, interpret and disseminate information relating to organ and tissue donation and transplantation matters and support, encourage, conduct and evaluate training programs that are directed towards improving the skills and knowledge of people involved in organ or tissue donation and transplantation services. The CEO will also support, encourage, conduct and evaluate educational, promotional and community awareness programs relevant to organ or tissue donation and transplantation matters and conduct and evaluate research about organ or tissue donation and transplantation matters.

Some of the main objects of the new authority are to promote a coordinated and consistent approach to organ or tissue donation and transplantation matters, to improve access to organ or tissue donation and transplantation services, to improve the identification of potential organ or tissue donors, to minimise waiting times for potential organ and tissue recipients and to improve the management of waiting lists for potential organ or tissue recipients.

The large gap between demand and supply of organs and tissues has enormous personal costs for more than 1,800 Australians currently on organ transplant waiting lists at any one time, as well as significant economic costs for the country. As Australia’s population ages and more Australians are affected by lifestyle diseases such as obesity and diabetes, the demand for transplants will grow. In Australia we are now only second to Japan in terms of life expectancy, with a life expectancy of around 81 years. While we might be living longer, our bodies are not necessarily living younger as we age. The problems with age and with an ageing population mean that the issue of transplants will continue to grow and to be a problem in Australia if we are unable to address the big shortage in the supply of organs and tissues for transplantation in this country.

To address this issue, on 2 July this year the Prime Minister announced a national reform package to establish Australia as a world leader in best practice organ donation for transplantation and to achieve a significant and lasting increase in the number of transplants for Australians. These evidence based reforms have been designed using international and national best practice models which have a proven track record of maximising donation rates. The reform package was endorsed by the Council of Australian Governments on 3 July 2008. So this program does involve the states and has been endorsed by the state governments. Through that cooperation, it is a program perfectly suited to making sure that Australians can lift the rate of organ donation from the current rate of around 200 a year.

Think about the numbers that we have now: 200 donors a year on average over the last 10 years, yet at any one time 1,800 Australians are on the waiting lists. That is a deficit of more than 1,600. Unfortunately, many of those on the lists are not going to survive until organs become available. And those that are lucky enough to receive transplants will have had to wait for extended periods of time, fearing that, any day, their life may end because they cannot get access to organs. At the same time, their quality of life is dramatically affected because the organs for which they need a transplant are in such a poor state that they cannot function as they normally would if they were in good health. So this problem affects both the quality of life and the chance of life. It is absolutely important that we support this bill and encourage as many Australians as possible to make sure they become donors.

Even with this bill, it will be an enormous task to raise the number of organ donations per year from 200 to 1,800. This is a task that will not happen overnight, and it is one that needs a plan as to how we can make the improvement. It needs a plan that involves the state governments in terms of their role in our public health system. It needs a plan that is integrated. It needs a plan that sets out the way in which this can happen. It needs a plan that uses evidence based methods to make sure that if people find themselves in tragic circumstances they know that they have spoken with their family member and are prepared to honour that family member’s wishes. That will make sure that the donation of those organs takes place and that the lives that can be saved by such a donation are saved and that the quality of life that can be given to many Australians by such a donation is given to them.

Over the next four years, there will be $151.1 million spent on creating a nationally consistent, coordinated system of organ and tissue donation. The key features of that expenditure include $67 million over four years to fund dedicated organ donation specialist doctors and other staff in public and private hospitals, as well as $17 million over four years in new funding for hospitals to meet the additional staffing, bed and infrastructure costs associated with organ donation. That particular item is very important. All too often in health planning we lay some bricks and mortar and put particular programs in place but then do not make sure we have the staff so that programs can operate and function properly. It is crucial in this very important area that this plan makes sure that there will be enough staff for it to take place.

There will be $13.4 million over four years to continue national public awareness promotion and education. I have said a number of times during this speech that one of the key things is public awareness. As members of parliament we are in a unique position to influence and promote this very important issue. There are other significant measures in this bill, including enhanced professional education programs, consistent clinical protocols, clinical trigger checklists to help hospital staff appropriately identify potential donors and data collection for organ transplants in hospitals.

The new approach will be spearheaded by a national authority to be established by 1 January 2009, with funding of $46 million allocated to establish a coordinated, consistent national approach, including a network of organ and tissue donation agencies. Of this, $24.4 million over four years will fund the new authority’s operation and infrastructure. The authority is to drive, coordinate and be accountable for national organ and tissue donations and transplantation initiatives and will provide world-leading access to transplants and transplant outcomes.

This is a bill that all members of parliament will support. All members of parliament can go out and say: ‘We’re proud that we were part of passing this legislation. We’re proud that we played a role in helping those 1,800 people who are on waiting lists waiting perilously for the availability of transplant organs.’

Organ donation is a very difficult issue for families who are grieving. It is important as a government that we make sure we put in place the best systems to allow families in those very trying and difficult situations to make the right decision—to make sure that the organs of their loved ones, if they have expressed the view that they want to donate them, end up where they can do the most good. That is the purpose of this bill, that is why we have had so many speakers come out and support this particular bill and that is why this bill should be supported by the House. I commend the bill to the House.

Debate (on motion by Mr Raguse) adjourned.

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