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

I commend the member for Canberra for her motion on organ donation, and I support it wholeheartedly. I have spoken about this issue several times in this place. Indeed, it was the subject of my very first notice of motion, in February 2008 and, like a number of my colleagues, I continue to regard it as a matter of great importance.

The health problems that require organ transplant are often life threatening, and the gap that exists between the availability of organ and tissue material and those whose health problems can only be solved by transplant of such material is far too high. No great leap of discovery or innovation in medical science is required to make real progress in this area—we simply need to increase the number of people who are prepared to donate organs upon their death and we need to improve the clinical infrastructure and administrative coordination that will support a lift in transplant rates. The health benefits that follow a successful transplant are obvious; and the social and health benefits are similarly profound.

Australia is a country that is rightly proud of its leading record in a number of areas, but that is not to say that there are not areas in which Australia underperforms and, unfortunately, we must acknowledge that organ donation is one of those areas. Of course, as the member for Canberra rightly notes, this Labor government has already made significant strides in this area. In the first year of government, we established the national Organ and Tissue Donation and Transplantation Authority with the mandate and resources needed to begin delivering on the recommendations contained in the February 2008 report by the National Clinical Taskforce on Organ and Tissue Donation. The relevant bill, passed in 2008, provided new funding of $136 million over four years as part of a total package costing $151 million. As with a number of Labor government initiatives, the purpose here was to create a nationally consistent approach so that better health outcomes for individuals could be provided through more efficiently coordinated clinical service frameworks.

The Australian Organ and Tissue Donation Authority has made good progress in that time, and I would like to mention two aspects of their work. The first is the national protocol for donation after cardiac death, which was adopted in July 2010 and provides the first clear and consistent protocol for this aspect of clinical practice. As members would be aware, donation after brain death is at the more straightforward end of the clinical spectrum, as a person whose brain function has ceased can nevertheless continue to have circulatory and respiratory function, which means that the transplant of their tissue or organs can occur in a relatively calm and considered manner. Donation upon cardiac death presents a very different clinical challenge, and with that goes challenges in terms of patient and family communication, and in dealing with certain ethical concerns.

This new national protocol represents a clear advance as a document that consolidates the work and analysis already done in this area, and sets out a step-by-step procedural  framework for donation upon cardiac death. I congratulate Dr Gerry O’Callaghan, the chair of the Donation after Cardiac Death Working Party and the national medical director of the authority itself.

The second initiative of the authority that I would like to mention is one that I have a special regard for as it was pioneered by Dr Paolo Ferrari in his work at Fremantle Hospital. As part of its early work, the organ authority has now established a nationwide live kidney donor program, the Australian paired Kidney eXchange or AKX, which cross-matches compatible donors across family pairs so that a willing but incompatible family donor of one person needing a transplant can be matched with a similarly willing but incompatible donor-recipient pair to facilitate two compatible live kidney transplants. This innovation is the perfect example of how creative thinking and coordination can help solve a serious health problem. Approximately 30 per cent of potential donors cannot fulfil their wish to donate because they are incompatible with the family member they would like to assist. The AKX program will hopefully help to cross-match a large proportion of those people, thereby allowing them to assist their relative by a matched exchange of kidneys.

Finally, I would like to again emphasise how important it is that donation rates are lifted through programs which encourage and facilitate the registration of Australians as organ donors. On that point I welcome the move by the Western Australian government to commission a report on the creation of an opt-out—or possibly a single opt-in—approach to organ donation, rather than the double opt-in system that currently applies. It would surprise some people to know that currently a person who has chosen to be a donor can only have their organs or tissues donated if their family consents after their death. Full and informed consent is important but a double opt-in approach is, in my opinion, setting the bar too high and it is an approach that does not respect the individual’s decision, which is intended to be an act of generosity reflecting true altruism. This is an important motion and a critical health issue in Australia. Once again, I congratulate the member for Canberra and all the speakers to this motion.

See this speech in context