Mike Symon (Deakin, Australian Labor Party) Share this | Hansard source

I also rise to speak in support of the Australian Organ and Tissue Donation and Transplantation Authority Bill 2008, which establishes the national authority of that name. This bill is vital and will introduce a long-awaited reform and improvements in organ and tissue donation in Australia. It is vital because it creates the framework through which the Rudd government’s $151 million reform package in organ and tissue donation can be delivered. And it is vital because, for the first time in Australia, the federal government will play an instrumental role in our efforts to reduce Australia’s transplant waiting lists—waiting lists for organ transplants that we know at any one time average around 1,800 people. That is 1,800 Australians, just like you and me, who are getting by as best as they can in complete uncertainty about their own futures.

Many of these people may be after life-improving procedures such as a cornea, bone or skin tissue transplants. But for many it is a matter of life or death as they wait, often in a dire state of health, for a major organ transplant—for a heart, lung, kidney, liver or pancreas. They are waiting every day for that phone call from the hospital to say that the hospital has located a suitable donor. This is the day-to-day reality facing those on kidney dialysis, for example. They wait an average of four years for a suitable donor organ to become available. I mention those on kidney dialysis because more than 75 per cent of those on the waiting list for all organ transplants are waiting for a kidney. Sixty per cent of all transplants carried out relate to the kidney. For many of them, a suitable donor simply comes too late.

For a country like ours, where donor survival rates are very high, and we are amongst the very best at transplantation surgery, it feels like some critical part of the process has not been working. In 2006, Australia had only 9.8 donors for every one million people population. This places us well behind the world leaders: Spain with 33.8 donors per million population, and the United States with 26.9 donors per million population. That is really quite surprising, considering the difference between their health systems and ours. According to Transplant Australia, Australia currently stands 17th out of 19 countries listed on the International Registry of Organ Donation and Transplantation. The result of our low donor rate meant there were only 198 deceased organ donors in Australia last year, resulting in 657 transplants and meeting only one-third of the demand that exists.

To put this into perspective, if we had the same rate as the USA we would have 500 donors a year, and if we had the same rate as Spain we would have 680 donors a year. In fact, Australia’s organ donation rate has hovered around 200 donors per annum for many years. If we were able, for instance, to achieve a 10 per cent increase in organ donors in Australia annually, that would change the lives of about 70 more people a year, plus many others through tissue donation.

The need for a national response was made loudly and clearly at the Australia 2020 Summit this year by the health experts that gathered in Canberra. At the 2020 Summit, one of the key ideas discussed was the possible establishment a national organ donation scheme. This bill provides for a national authority that will deliver the government’s broader reform package in organ and tissue donation as announced earlier this year. This is a scheme that Australia needs to urgently boost our woefully deficient organ and tissue donor rate.

There is no doubt that the Rudd government’s reform package announced in July has been roundly welcomed by health experts and the people that are working tirelessly in the field. Dr Tim Mathew, Medical Director of Kidney Health Australia recently stated:

The changes are strongly supported by the kidney transplant sector where more than 1,350 patients are waiting today for the chance of a new life with a transplant.

Chris Thomas, CEO of Transplant Australia, has also thrown his support behind the government’s reform efforts. He said:

Across Australia there are 1,866 Australian families praying and hoping that their loved one will receive a telephone call that will save their life, with the news that an organ has become available … That phone call will be far more likely with this reform package.

This bill recognises the simple fact that we cannot boost organ and tissue donation and transplantation rates in Australia, saving more lives every year, without a national system in place. It moves on the government’s commitment to establish Australia as a world leader for organ donation and transplantation. When we look at what the leading nations in organ donation and transplantation rates are doing, they all have one thing in common: they have national leadership in that field. It is the one thing that has been crucial to their ability to achieve world’s best practice in this area while other countries, like Australia, have sadly lagged behind. World leaders such as the USA and Spain have national organ donation systems in place that take on the job of coordinating and driving the activity on the ground—in their local hospitals, through their clinical networks. They have national systems that spearhead the vision, monitor the results and bring the whole effort together while being supported by constant community and professional education efforts. In light of the successes with organ donations in some countries, Australia should learn and apply the successful principles of these schemes where we can.

This bill provides for an independent national authority, with funding of $24.4 million over four years, to lead our new national approach. It will be managed by a CEO with direct accountability to the federal Minister for Health and Ageing. That CEO, working with the authority and other peak organisations, will have responsibility for a multipronged approach to boosting organ donation. That will include such areas as: formulating and supporting national policies and protocols for donations; overseeing a national network of clinical specialists, hospital staff and agencies dedicated to organ and tissue donation activity; monitoring and supporting in-hospital practice improvements; and education to upskill those involved in organ and tissue donation. It will also include managing ongoing national community awareness campaigns and education programs, which are vital if we are going to get a scheme such as this to work properly and in a continuing manner. And it will also involve constantly monitoring and analysing data that relates to organ and tissue donation, making financial grants to organisations that provide essential services such as clinical data collection and organ matching, and implementing a national eye and tissue banking network. In addition, expert advice will constantly be made available to the CEO through a new 15-member advisory council, whose members will be experts in a vast range of areas affecting organ and tissue donation.

Collectively, the measures in this bill will help establish Australia as a world leader in organ donation and transplantation. And, as I have stated, the authority will have the task of implementing the government’s broader, $151 million reform package in this area which includes $136.4 million of new funding over four years. The key features of this include: $67 million to fund dedicated organ donation specialist doctors in hospitals; $17 million in new funding for hospitals to meet additional staffing, bed and infrastructure costs that come with an increasing rate of organ donation; $13.4 million to maintain and increase public awareness in the community about organ donation schemes; and $1.9 million to support the bereaved families of organ donors.

What we are talking about here is an extremely comprehensive and historic set of reforms tackling all points of the process. One critical point, of course, is the point at which bereaved relatives are asked to give consent. This bill ensures that there are dedicated staff on the ground who are trained in the delicate matter of dealing with families who may be asked to give their consent. The inadequacies at this point largely explain why, with six million registrations on the Organ Donor Register, there has been no real increase in the number of lives being saved. And we must not discount the cost benefits that transplants can bring, versus ongoing treatment. If I may go back to the example of a patient on kidney dialysis, the figures show that dialysis costs $83,000 per year per individual who is waiting for a transplant, but the cost of a transplant is $65,000 in the first year and then $11,000 per annum thereafter. So there is an immediate benefit, taking a drain on costs off our health system, and there are long-term cost savings to be made by getting this right. More importantly, however, transplants improve the lives of so many individuals who could have a better life but who are just waiting for that phone call.

All of these initiatives have strong support from all Australian governments at COAG, the organ and tissue donation sector and very influential community groups including Kidney Health Australia, Transplant Australia and ShareLife. We know Australia is a world leader in clinical outcomes. Our surgeons, the people who are doing the transplanting, are among the best in the world. As the member for Longman noted in his speech, more than 90 per cent of Australians support organ donation. However, we know that this has not translated into actual organ donations to date. Under the provisions of this bill, with everybody working under the one umbrella, and with great community support and goodwill on both sides of this House, we can truly become a world leader in organ donation and transplantation. I commend this bill to the House.

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