House debates

Monday, 25 October 2010

Private Members’ Business

Cord Blood Donations

Debate resumed, on motion by Mrs D’Ath:

That this House recognises:

that many lives have been saved through the research and the use of organ and blood donations throughout Australia;
that one form of donation is cord blood from the umbilical cord and placenta, and that:
research has shown that this blood is a rich source of blood forming stem cells known as haematopoietic stem cells;
the use of these cells for transplantation to a sufferer of leukaemia, lymphoma, and some tumours, provides the best chance for a cure; and
recent research has established that umbilical cord blood stem cells can demonstrate plasticity, suggesting a role for them in the treatment of diseases such as diabetes, cerebral vascular disease, and Parkinson’s disease;
that the collection of umbilical cord blood cells for research and for processing is a safe and non-invasive procedure, and that this procedure does not involve the destruction of an embryo given that the umbilical cord and placenta are usually discarded as waste;
that the collection of umbilical cord blood is not available in all States and Territories or hospitals throughout Australia, and that:
the collection, processing and storage of umbilical cord blood requires specialised techniques by appropriately trained and accredited professionals; and
based on limitations on the collection centres that currently exist, not all permissions for donations given by women at existing collection centres results in the actual collection of the cord blood;
that the Federal Government already funds the Australian National Cord Blood Collection Network; and
the great work being done by the Australian National Cord Blood Collection Network, AusCord, the Australian national network of umbilical cord blood banks and cord blood collection centres.

8:06 pm

Photo of Yvette D'AthYvette D'Ath (Petrie, Australian Labor Party) Share this | | Hansard source

I moved the motion before the House because it deals with an issue that I am extremely passionate about and believe needs broader community awareness. That issue is the use of umbilical cord blood. Why is this cord blood so important? Cord blood is very rich in stem cells, and these are the building blocks of all blood cells in our bodies. They carry oxygen, fight infection and stop bleeding. As the Australian Bone Marrow Donor Registry website explains:

The most common diseases currently treated using cord blood are related to blood disorders and some cancers such as:

  • Immune deficiency
  • Leukaemias
  • Blood diseases such as Aplastic and Fanconi Anaemia
  • Metabolic storage diseases
  • Thalassaemia

Leukaemias, lymphomas, myeloma and related blood disorders can develop in anyone of any age at any time. It is estimated that every two hours someone loses their life to leukaemia, lymphoma or myeloma. The Australian Bone Marrow Donor Registry notes:

In the future the range of diseases treated using cord blood might be expanded due to new technological and scientific advances.

Internationally, the use of human cord blood goes back to the 1970s, when the first report was released. In the 1980s, cord blood was shown to have similar attributes to bone marrow and recommended to be used as a bone marrow alternative in transplantation. In 1988, in Paris, the first successful cord blood transplant to regenerate blood and immune cells was completed on a six-year-old boy suffering from Fanconi anaemia, a blood disorder. Since that time, progress has steadily moved forward.

I became aware of blood cord donations when, in 2000, as an anxious and excited mum to be, I was handed a form from the Mater Mothers Hospital as part of the admission forms. The form asked me if I would give consent to donating the umbilical cord upon the birth of my child. As a first-time mother I was excited to think that I could make a difference in saving lives by donating what I understood to be a very valuable source for research into stem cells. After I delivered my daughter, Emma, I asked about my donation and was advised that the umbilical cord was not kept. The reason given was that the cord needed to be picked up by the blood bank that processed blood cords between the hours of 9 am and 5 pm Monday to Friday, excluding public holidays. Unfortunately, my daughter was not born between these times. In 2002 I found myself in the same situation. Having given consent to donate the cord, I gave birth to my second child, Cameron, who happened to arrive on the Queen’s Birthday long weekend. Once again, the cord could not be donated.

Umbilical cord blood is collected from the placentas of recently delivered newborns and is an accepted alternative to bone marrow and peripheral blood stem cells as a source of haematopoietic stem cells, or HSCs, for transplantation. For many paediatric transplant indications, umbilical cord blood is regarded as the preferred source of HSCs. The advantage of cord blood as a source of HSCs relates to its ease of procurement and its less stringent human leukocyte antigen, or HLA, compatibility requirements. Outcomes are influenced by cell dose, HLA matching and the length of the search process. Research is in progress to explore the means of optimising the effectiveness of cord blood transplants in adults.

What currently happens with the umbilical cord and placenta after a child’s birth is that they are disposed of as medical waste. This rich source of stem cells is simply thrown away in most cases. Considering the debates that have gone before us in this House on therapeutic cloning and embryonic stem cell research, the donation of cord blood does not carry such heavy moral burdens for our society. As such, many more women across Australia may be willing to be donors. Cord blood is obtained only from those mothers who are medically suitable and who have provided their written consent. While cord units are freely donated, there are substantial costs associated with the collection, processing, banking and matching of cord units. Only those hospitals accredited with the cord blood banks are able to collect cord blood. The collecting, processing and storage of cord blood are specialised techniques that need to be performed by trained and accredited staff. The cord blood collected also needs to be processed as soon as practicable, usually within 48 hours of collection.

To maximise Australia’s cord blood collection requires the collection and banking of cords which are most in demand by transplant patients or which better reflect the diversity of tissue types in the Australian population. For example, the National Cord Blood Collection Network commenced collection of Indigenous cord blood units in the 2006-07 financial year. At the end of December 2007, 52 Indigenous cord blood units had been banked. Compare this with the fact that in 2008 there were 15,000 births registered where at least one parent was an Indigenous Australian.

Simply ensuring more cord blood banking does not necessarily equal better clinical results. What is needed are strategies that focus on those cord units most in demand, which would increase the likelihood of providing a match unit. In the case of Indigenous Australians, it is about developing the strategies to increase the banking of suitable cord blood units. I do believe, however, that with the expansion of services for collection and the potential for more unused cord blood donations to be donated for research when they are unsuitable for transplantation we could provide greater opportunities for scientists to find new and improved ways of using HSCs.

Currently, cord blood banks operate in New South Wales, the Northern Territory, Victoria and Queensland. There are no participant hospitals in Western Australia, South Australia and Tasmania. With a total of 296,600 births registered in 2008 in Australia, according to the Australian Bureau of Statistics, it is worth investigating improved strategies for the future. At this point, I wish to acknowledge the efforts made over the past decade in the area of cord blood donation. The previous Howard government, in 2000, assisted in the establishment of the Australian National Cord Blood Collection Network. The Australian Bone Marrow Donor Registry, since 2001, has been funded by the Commonwealth and the state and territory governments for the operation of the National Cord Blood Collection Network. The ABMDR has contracts with each of the three public cord blood banks to collect, process, store, test and release Therapeutic Goods Administration compliant cord blood units.

I congratulate the federal Labor government, and particularly the Minister for Health and Ageing, for continuing to fund, and in fact increasing funding to, the National Cord Blood Collection Network in the budget for 2010-11. In Budget Paper No. 2 for 2010-11 it is noted that the government will provide $18.1 million over four years to continue and increase the level of funding for the National Cord Blood Collection Network, also known AusCord. It is noted in the budget papers that the increase in funding will improve the sustainability of the National Cord Blood Collection Network and bring funding in line with support for other blood products.

The government has also committed to continuing to work with the states and territories and the National Cord Blood Collection Network to ensure that the supply of cord blood units is adequate to meet the needs of the Australian population. I welcome the federal Labor government’s commitment to cord blood donation and hope that through public debates such as the debate on this motion more awareness can be generated in the broader community. With the knowledge that stem cells collected and processed through cord blood are potentially being used for transplantation to individuals with leukaemia, lymphoma and similar life-threatening diseases, I hope that all members would support this motion.

I end by thanking all of the scientists and medical professionals who every day are working on new ways to save lives, who persevere in their aim to find a cure for so many diseases that take the loved ones of so many people. These are diseases that take the lives of the young before they even get to create memories. To those scientists and medical professionals who are already today saving people from diseases that we once thought of as terminal—to all those hardworking medical professionals—we say thank you. I commend this motion to the House.

8:16 pm

Photo of Andrew LamingAndrew Laming (Bowman, Liberal Party, Shadow Parliamentary Secretary for Regional Health Services and Indigenous Health) Share this | | Hansard source

I congratulate the member for Petrie for bringing this issue to the attention of the House. The Australian Cord Blood Collection Network has been doing fine work over the past 10 years. I also thank the member for introducing the acronym HSC so that I do not have to wrangle with the almost impossible-to-pronounce word ‘haematopoietic’! All the diseases that have been shown since the early 1980s to respond to cord blood have seen significant improvements in survival ratios over the past two decades. I can recall that, during my training in 1988, cord blood was first used in a transplant. By 1990, things had moved very fast. There was already then a very good understanding of human lymphocyte antigen markers on the outsides of cell walls, which basically determine whether cells are recognised as foreign or not when they are transferred or transplanted between hosts. That applies to cord blood as it does to every other organ. I will make just a couple of comments on cord blood before moving to the more general issues of transplantation.

Cord blood banks were set up as early as 1992, I think. Eurocord was among the first of those, a few years later. By 1995 it was quite common in Europe to have access to those kinds of procedures. Australia leads the way outside Europe, in general, with about 168 procedures last year, making us probably the third or fourth outside Europe but still a long way behind nations like France and Spain that lead the world. It needs to be remembered that these stem cells are not quite the same as an embryonic stem cell, in that they have already been through one series of differentiation, so they are not quite as plastic as one would hope. But there is some positive news that there may be some use for them as stem cells in that truly plastic sense that they can actually differentiate into different tissues.

The main focus is on the treatment of aplastic anaemias and the family of anaemias and a whole range of blood-borne cancers for which the key treatment is systemic chemotherapy followed by a bone marrow transplant. That is what cord blood is all about. The key issue at the moment around cord blood is not so much HLA antigen compatibility—which is always really important—but, as we are now realising, the volume of blood and the amount of packed cell that is actually collected. There is very little point in collecting less than 60 millilitres. We are now finding that we are pushing higher and higher in Australia to 60-, 80- and ultimately 100-millilitre minimum collections as a useful sample for use in therapeutics. We are now discovering worldwide in the most recent research that it is not so much HLA compatibility as it is the amount of blood that can be collected from a placenta. As has already been pointed out by the previous speaker, we are avoiding a lot of the ethical and moral issues around the destruction of an embryo. By the same token, apart from some fairly unusual peri-Mediterranean traditions around the placenta, the placenta is normally discarded in Australia, which makes collection of the blood from a placental cord almost without concern—apart from the fact that you need skilled people to do it. If you are not able to collect 80, 90 or 100 millilitres of cord blood there is a real problem, because much of our collection consists of samples of less than 80 millilitres, which is very problematic in therapeutics.

We are also seeing, if you draw a bell curve of the volumes of blood that are being collected, a real depletion at the high end of the large collections. There is a real chunk coming out, because these collections are being deployed clinically and where there is a real gap in these large-volume collections. This is another very good reason for supporting the previous speaker, who talks about having specialised staff who are able to collect this blood in adequate volumes all around the country in as many hours of the day as is clinically and financially feasible.

There has been a tenfold increase in collection of cord blood over the past 10 years, and that matches what is happening overseas. We also know that there is increased storage and more rapid availability, and all of these elements are really important in our ability to treat people who need it. The benefit of cord blood cells is that they are a fairly immature cell—we call them immunogenically naive—and that makes them far more able to be used more broadly. They have a good gene transfection rate, longer telomeres and a higher expansion potential, which is always good if you are trying to maximise your clinical results.

Of course, for the banks themselves we need an ability to store these cells for years but to use them immediately, and that is why nothing else is going to work. That is why it was recognised as early as 2000 that we needed a well-funded cord blood collection network to support the work of the banks, which had been around but had not really grown to a point where there were enough samples to remove concerns around HLA matching. The problem is that, if you move to an Indigenous network or to Indigenous mums who have completely different HLAs, it is even harder to find a useful match. That is why it is a real challenge to move into some of the minority populations and expand the bank accordingly.

Moving more broadly to organ and tissue, work in encouraging people around the country to be donors is very important work of both governments as well. In Australia, even though we almost universally accept the importance of organ donation and the fact that it saves lives, we are still very, very low in the numbers. My general rule is 20-40-60, which means that only 20 per cent of Australians can actually recall an explicit conversation with family members about whether to become organ donors, around 40 per cent of people simply do not know and 58 to 60 per cent of people agree to it at the time when that very, very tough decision to allow a loved one to donate their precious organs has to be made.

What we do know is that if Australians do take that step then our rates are exceptionally good in regards to the number of organs that are harvested. At the moment, we have around 13 per million Australians in the population being organ donors. But once that decision is made, a large number of organs can be harvested and deployed in a clinically appropriate way within the time frame. That speaks to how well our system is operating. There are 1,700 people sitting on waiting lists for organs right now. Less than half of them receive a clinical operation in each year. Around 450 are required to provide 800 people with a life-changing organ transplant.

Right now, we know that there are up to 4,000 skin and tissue transplants per year and around 1,100 corneal implants, which can help around 1,600 people for the obvious reasons. I can tell you that talking to families about the very tough decision of whether or not to donate corneas is intensely personal and a very difficult conversation to have at that most difficult of times. But obtaining those corneas within a six- or 12-hour time period, being able to keep them cold, transport them and deliver them to where they are needed—to the entire surgical team that is ready to put those corneas in—is no mean feat. What we know is that that is working exceptionally well, particularly around the larger centres in Australia. We are now seeing around 1,600 people a year having their sight restored thanks to corneal transplants.

It is worth nothing that there is a bit of variation between states. A gold star goes to South Australia for having 38 donors per million. Bringing up the rear is Western Australia—and I am glad to see that there are no Western Australians in the chamber at the moment to take that message back to their state government—with eight donors per million. They really can do better. All of these figures improve slightly each year. That is very much due to the strong work that has been done by federal governments to encourage organ donations. The previous Prime Minister made that a particular focus during his tenure. That was much appreciated.

I will close where we began: with cord blood. There is one thing that we know: the collection of cord blood that occurs at every location where there is an obstetrics service. That should be the goal. We can train existing clinical staff to become specialised at collecting cord blood to maximise the odds that, if a mum decides to donate cord blood, she is able to. Finally, we need to make sure that that cord blood is available in a large enough sample to make it a clinically useful one. We face the challenge that there is a real deficiency of high-volume samples, because they are being heavily utilised. We have a library now that is skewing back towards having the smaller samples that are less and less clinical useful. I support the motion.

8:24 pm

Photo of Janelle SaffinJanelle Saffin (Page, Australian Labor Party) Share this | | Hansard source

I would like to begin my contribution in supporting this motion by thanking the honourable member for Petrie for bringing this matter of critical importance to the attention of the House. It was not something that I had turned my mind to in any forensic way. I was aware of it; it was there; it was happening; it is a good thing. But the fact that you put it on the Notice Paper and I said that I wanted to speak to it meant that I had to do some research. I would also like to thank the honourable member for Petrie for sending me some of the links to websites that made that research a bit easier. It is one of those issues where there is no browbeating or people saying that somebody else is responsible. It is just a question of this being a really important issue. It is a work in progress. It is an issue that we all have to do better on. The member for Petrie is raising awareness of this issue. That awareness raising is the important factor. When members hear about this and start to know things about it, they can take it up in other forums in their respective states

I would also like to thank the honourable member for Bowman for his contribution, which was technically informative. I am not going to try to match it, given his previous profession. It was good to hear that, as it provided a broad perspective on the whole issue of organ and tissue donation. It provided some facts and figures and also some of the challenges. Having served on hospital boards and having set up the first ethics committee at Lismore Base Hospital—and I understand that the honourable member was at Lismore Base Hospital—I know that hospitals face very real issues daily. We can debate a lot of those issues at a theoretical level and take philosophical positions on them—and we do—but the fact is that most people want us to address them in a way that is also practical so that we can help families and loved ones who struggle and have to face some very difficult challenges to do with illness, and particularly with their children.

I am coming to grips with this issue and what cord blood is. I have read that cord blood is the blood left behind in the placenta. I heard from the honourable member for Petrie that it is also left behind in the umbilical cord after the birth of the baby. It is a rich source of blood-forming stem cells. It can be used instead of bone marrow transplants in children. The cord blood research throughout the world continues to explore its potential. There are no guarantees that it can prevent or cure the range of disease that some claim it can. But it certainly is helping.

One of the things that the honourable member for Petrie said was that the umbilical cords and the placentas go into the medical waste of the hospital. Having served on hospital boards, I know that to be true. There were issues to do with getting rid of medical waste, what it is, where it goes and all of that that we had to deal with. So I was well aware of what constitutes medical waste in the system.

Something that I read about was what cord blood does, and not just in the technical sense. I had a look at the website of the Murdoch Children’s Research Institute. It says ‘cord blood gives a second chance’. That says a lot. That is clearly what is being expressed in this motion and by the honourable members speaking to it. That is what this is about: giving that second chance. Cord blood gives a second chance where there might have been no chance and no hope. To have this available as a medical resource is a great thing. For women who have given birth, it is a gift that they can give freely as they know how it is going to be used. As mothers, we are called on to give many gifts in our lives. This is another gift, but what a wonderful gift. It seems like we are always giving. This is one of those gifts that I will not get the opportunity to give, but if I was able to give it I am certain that I would.

The research, and statements by previous speakers, shows that cord blood cannot be given everywhere and it cannot be given out of hours. That is something that has to be worked on. I had a look at the hospitals where it is available, The member for Petrie spoke about the states where it is and is not available. When I look at New South Wales, the state that I live in, I see that public cord blood donation is available at just four hospitals—all in Sydney. I understand that cord blood donation may be difficult to do at some of the regional hospitals, but people do give birth at regional hospitals. I am sure that will change as things develop and more money is made available. It is very pleasing to know that in the 2010 budget the government made available $18 million over four years for the National Cord Blood Collection Network. When I looked at the hospitals, I saw that they are mainly in capital areas. I imagine that they are probably the teaching hospitals or the major referral hospitals in those areas.

My research informed me of the fact, which I did not know, that the Cord Blood Bank is a partnership between the Bone Marrow Donor Institute—the BMDI as it is also known—the Royal Children’s Hospital and the Murdoch Children’s Research Institute. It was nice to read about the work that they are doing together. The Murdoch Children’s Research Institute website talked about helping over 100 people, including a 5-year-old girl named Milli Kerr-Crowley, whom I mention because her name is publicly available. Milli was diagnosed with leukaemia when she was just six months old. After months of chemotherapy and an injection of cord blood from an anonymous donor Milli’s health quickly improved. I know that I cannot make any scientific comment, but the title reads ‘Cord blood gives second chance’. Clearly, that is what the institute is trying to show: that cord blood can be well utilised, including with other traditional forms of treatment. I imagine that in the future it will become a traditional treatment as well.

I thought about the risks involved, because we are talking about medical procedures, so I did some research on that. It would have been interesting to hear from the good doctor about whether there were any risks. Everything I read said, no, there were no risks. It is even easier, if you are a mother who has just given birth, to give that gift if you know that there are no risks associated with it. There can be risks for people who make organ and tissue donations. However, everything I have read about cord blood donation has said that there is no risk. That is very reassuring to know, because it makes cord blood donation much easier to promote.

In closing, the member for Bowman spoke about organ donation. It seems that the figures for organ donation in Australia are low. We talk about it a lot and we are conscious of it but we do not seem to sign on easily. I know that I hesitated, but I have now signed my licence to say that I will donate organs.

Photo of Andrew LamingAndrew Laming (Bowman, Liberal Party, Shadow Parliamentary Secretary for Regional Health Services and Indigenous Health) Share this | | Hansard source

You have to do it on a form as well.

Photo of Janelle SaffinJanelle Saffin (Page, Australian Labor Party) Share this | | Hansard source

Yes. But at least it is on my licence, and I have talked about it. I think donation is an issue we all have to turn our minds to. (Time expired)

8:34 pm

Photo of Rowan RamseyRowan Ramsey (Grey, Liberal Party) Share this | | Hansard source

I congratulate the member for Petrie for moving this motion. I also congratulate the government for its interest in this area, in particular the 2008 legislation which established the Australian Organ and Tissue Donation and Transplantation Authority. In my contribution to the debate on that legislation, I noted the difference organ donation made to people’s lives and how selfless were the people who had donated organs from loved ones to give the gift of life to others. I spoke about two friends. One, Peter, had died when he fell through a shearing shed roof. His widow donated every bit of Peter that she could give away—bones, eyes, kidneys—to give the opportunity for other people to have a good life. She has become a strident campaigner in our community, promoting the cause of organ and tissue donation. I also spoke of a woman that I know very well who has received a kidney. It has made such an enormous difference to her life, in fact, that she now works on dialysis helplines, helping people in that same position. These are very big events in people’s lives, even though they may seem to be remote from almost everybody who has not been faced with the issue of organ donation.

Australia has a proud history in medical science, with the bulk of our Nobel laureates, including William and Laurence Bragg, Howard Florey through to Barry Marshall and Robin Warren, coming as a result of medical breakthroughs. This motion recognises that stem cells are the new frontier in medicine and offer possible solutions to many of the diseases and ailments which bedevil our society, which has managed to extend our life expectancy. We all want to live longer—and, on average, we do. That means that along the way many more things are likely to go wrong with us and we will fall victim to ailments that, perhaps, in previous times we may not have lived long enough to have experienced. We all, particularly in this job, are confronted every day with people who are facing quality of life issues, and I suggest that we may be debating some things about quality of life in the very near future.

Stem cell research has the potential to make a great contribution to people’s quality of life. I remember well the campaign by the Juvenile Diabetes Research Foundation in the lead-up to the last election. They visited virtually every member of parliament lobbying for the establishment of a clinical trial base, and in the lead-up to the election the coalition committed $35 million for the establishment of those clinical trials for juvenile diabetes. I am disappointed to say up to this stage it has still not been matched by the government. Not only would those clinical trials address juvenile diabetes; they would also enable a network to be set up for trials on a broader base for many of the advances that are going to happen in stem cell research. Once this clinical base is set up it will be able to be used by many others in the industry—and, of course, in stem cell research this is exactly what they need. Researchers need a database to help with their understanding of the life and medical history of the individuals in the trial from start to finish. I hope that the government comes round to supporting that trial in the near future.

What is even more disappointing is that the government has also chosen not to renew support for the Australian Stem Cell Centre. Funding will cease in mid-2011. While Professor Richard Boyd, from the Monash Immunology and Stem Cell Laboratories, has welcomed the new funding committed in the area by the federal government, he notes that the overall reduction in funding will restrain researchers and tempt them to go offshore. In fact, the Australian Stem Cell Centre chairman, Professor Doug Macdonald, has said that the new funding is only about half the $8 million the centre will achieve in its spending program in its last two years leading up to 2011.

The Australian Stem Cell Centre was funded over nine years and so one must divide the total funding of $98.55 million by the nine years to get an approximate annual figure. Although this figure was not necessarily equalised in every year in this way, this would give average annualised funding of $10.95 million. The NHMRC has received additional five-year funding of $2½ million and that works out to about half a million dollars a year. So the new funding announced by Minister Carr is around about $3 million per year, thus making the total earmarked for stem cell research around about $3½ million a year. That is considerably less than the current commitment.

To come back to some of the diseases we may possibly be able to treat with advances in stem cell research, in the last parliament I was privileged to be part of the House of Representatives Standing Committee on Industry, Science and Innovation. In February this year we received a briefing from Professor Richard Boyd, from the Monash Immunology and Stem Cell Laboratories. He talked about some of the things it might be possible to address with stem cell treatment in the future, such as MS, Parkinson’s, Alzheimer’s, Huntingdon’s disease, motor neurone disease and acquired afflictions like stroke and spinal cord and brain injuries. The costs to individuals of these various diseases, ailments and injuries is absolutely enormous and, as you would know through your work in your electorate, Madam Deputy Speaker, you deal with people afflicted in this way on a regular basis. We all become involved, in a personal sense, in their lives in some way. I think of all those I know struggling every day with Parkinson’s and MS, and anything that we can possibly do in this place to achieve some kind of benefit in their life—and perhaps, for those in the future, complete cure—we should do.

I was pretty excited by the prospects that were outlined in this briefing we received, but I was taken aback to hear that there was a three per cent annual increase in the incidence of diseases like asthma and type 1 diabetes. I pricked up my ears at this and made a remark along the lines that I thought type 1 diabetes was a hereditary disease, or that at least it was inflicted normally at a young age. In comparison with type 2 diabetes, which is endemic. Professor Boyd replied that there were quite a few diseases in that category, asthma and peanut allergies being two that were increasing on an annualised rate. When asked why this was the case, he explained that they thought it may be because people are now living in an antiseptic environment where things are oversterilised—that we are taking too much care of the food we eat. So perhaps our kids do not eat enough dirt! I said, ‘So you mean the woman in the tuckshop who has got one glove on is actually killing us?’ In a roundabout way of speaking, that is what is happening. I know that is a bit of an aside to the subject we are debating today, but I found it to be a very interesting point that we are actually increasing our ailments. In fact, in our modern society we legislate as to how our food should be handled and contribute to the problem. The highest rates of type 2 diabetes in Australia are in remote Indigenous communities. The lowest rates of type 1diabetes type are also in remote Indigenous communities, where cleanliness is not set at such a high level. Their immune systems are challenged at a younger age and thus grow with the person. There are probably some lessons in that for all of us.

So I do recognise the government’s support for the National Cord Blood Collection Network and the intent of this motion. The possibilities are almost endless, and as the cord blood bank grows we will be able to match donors much better than we can at the moment. We need a national base to achieve these results. It is very encouraging not just for those with long-term incapacity but, probably more importantly, for those who are yet to face those challenges.

8:44 pm

Photo of Rob MitchellRob Mitchell (McEwen, Australian Labor Party) Share this | | Hansard source

I rise tonight to support the motion by the member for Petrie. I must say that when the member for Petrie first spoke to me about this I thought it was a great opportunity. She should really be commended for bringing it to this place for us to debate. The research and use of organ and blood donations across Australia has for decades been the difference between life and death. I have been registered as an organ donor for many years. In my inaugural speech I spoke about the death of my brother due to a genetic disorder. I think it is very important that we have the option for, in particular, organ and tissue transplants that can help save lives. As the previous speaker mentioned, the federal government, our government, should be congratulated on the work that we have done on a national organ transplant authority.

One form of donation that often goes unrecognised is cord blood, which over the years has increasingly been used as an alternative to bone marrow treatment, with over 90 per cent of patients able to find compatible cord blood for transplant. The most appropriate source of stem cells is from another person, whether that person be a family member or an anonymous stem cell donor. The chance of finding a match within your family is around 30 per cent, yet the chance of finding a more suitable unrelated donor is even higher at 80 per cent. Given its success in treating patients with dire illnesses, it is now more than ever the preferred option of treatment.

Cord blood is the blood from the umbilical cord and the placenta after the delivery of a baby, which research shows is a rich source of blood-forming stem cells. Cord blood may be collected by accredited staff using one of two methods. While the placenta is still in the womb, immediately after the delivery and the cutting of the umbilical cord, the midwife, doctor or collector will puncture the umbilical cord vein and drain the blood from the placenta into a bag. This will take several minutes. When the placenta is expelled, more blood may be collected from the veins in the placenta. The other option is after the placenta is out of the womb. The cord blood collection takes place after the placenta is expelled, away from the delivery room.

This blood is pivotal to birth, as it provides a baby with nutrients when it is in its mother’s womb, but research also shows that it can assist with the treatment of life-threatening illnesses, including acute and chronic leukaemia, lymphoma, immune deficiency, some haematological malignancy, blood diseases, metabolic storage diseases and other tumours. In 2005, stem cells similar to embryonic stem cells were isolated from cord blood. The stem cells, while not possessing the same potency as embryonic stem cells, have been shown to be convertible into non-blood cells, such as liver cells. Research is being undertaken into the therapeutic use of these cord blood derived stem cells for diseases such as cystic fibrosis. Other trials are being undertaken into the use of the cells in repairing organ tissue and in the treatment of diseases such as diabetes, Parkinson’s and cardiovascular diseases.

The Sydney Cord Blood Bank describes cord blood stem cells as the building blocks of the blood cells that are often found in bone marrow, which have the capacity to continually produce blood cells found in the circulating blood—white cells and red blood cells, for example. Cord blood can be obtained from the umbilical cord without harming the baby, the mother or normal delivery procedures. It ensures that these cells are immediately available if ever needed as the blood can be frozen and kept for around 20 years without affecting the potency of the stem cells. If you do not choose to store your baby’s cord blood it will normally be discarded as medical waste after the birth. That is frightening to think about. If we have opportunities to help people live, to have a better quality of life, we should clearly seize those opportunities to help keep people who are sick or have chronic illnesses to have a better quality of life and perhaps to prolong their lifespan.

In Australia there are two types of cord blood banks which cater for these options—government and community funded public banks which store donated cord blood for public access, and private and not-for-profit banks which store children’s cord blood for personal use. AusCord, which is the national cord blood collection and banking network, collects blood from participating hospitals in order to secure a sufficient supply for the entire Australian population. The three public cord blood banks in Australia licensed by the Therapeutic Goods Administration are the Sydney Children’s Hospital of New South Wales, the Royal Children’s Hospital in Victoria and the Mater Misericordiae Hospital in Queensland.

I am very pleased that in the 2010-11 budget the federal Labor government announced $18.1 million in funding over four years for AusCord. I am very proud to say that that is an increase on previous budgets and is aimed to bring the service in line with funding for other blood products. Hospitals around the country contribute to AusCord. However, due to the lack of specialist staff and appropriate facilities, donations from women in Tasmania, South Australia and Western Australia are more often than not inaccessible. I would like to congratulate AusCord on its fantastic efforts in research and its commitment to blood collection and donation.

The Australian Bone Marrow Donor Registry 2010 annual report states that the cord blood banks have collected more than 20,000 cord blood donations, which are searchable throughout its registry. In 2008, 2,218 cord blood donations were banked in the same year. Thirty-seven patients received cord blood donations from within Australia and a further 24 from overseas. To go back to what I was saying before, I think it is important that we do whatever we can, wherever we can, to help better the lives of Australians right across the country. In regional areas this is a problem. We need to be looking at where we can collect more of these samples to build up a greater bank and storage for use in the future. As I said earlier, the member for Petrie should be congratulated on bringing this forward. I have a very keen interest in research into genetic medical disorders through my family connection. The opportunity to help save lives is something that we should never underestimate. I think we should do all that we can within our power to help make lives better for Australians in the future. I commend this motion.

8:52 pm

Photo of Teresa GambaroTeresa Gambaro (Brisbane, Liberal Party, Shadow Parliamentary Secretary for Citizenship and Settlement) Share this | | Hansard source

I would also like to add my commendation to the member for Petrie for putting this valuable motion on the Notice Paper, and I acknowledge the contribution made by previous speakers. In the short time I have available to me I would like to speak on two aspects of the motion: organ donation and the Australian National Cord Blood Collection Network. Unfortunately, Australia has one of the lowest rates of organ donation in the world. In 2009 Australia had only 11.3 organ donors per million of population. This was a decrease from 12 organ donors per million of population in 2008. Spain has the highest rate of organ donation, with 34.4 out of every million of their population donating organs, the USA with 26.1 per million and the United Kingdom with 15.1 per million. In Australia so far 228 people have donated their organs, with 683 people having received donated organs. These are very sad figures for Australia’s health system and very sad figures for the thousands of Australians who are waiting years for a much-needed organ transplant.

During my time as an organ donor ambassador for the AMA there were many ways I saw in which we could improve our rates of organ donation under the current arrangements. We do not need radical reforms but we do need to see some changes in the system. There needs to be more awareness about the process of being an organ donor. In the past, many people mistakenly thought that by ticking a box on a drivers licence you were already registered as an organ donor. But you do have to fill in the necessary and appropriate forms with Medicare.

In Australia we do not really need to go down the rule in, rule out path that some countries have travelled. I do not think it is the most humane approach. I do think that there are many cases where individuals do not talk to their family. They agree to be organ donors, but they really need to speak to their family more, to just put it on the table and make their loved ones aware of their wishes, because it is always much more difficult at the time.

What we need is stronger awareness and we also need dedicated staff to talk to families during those very difficult times. Having the dedicated staff will ensure that those loved ones that have decided to be organ donors can assist and are able to donate to others. Improving the current system in this way will allow for more organ donations and optimal transplant times, resulting in greater success. There needs to be a greater understanding for families and patients involved.

As for the umbilical cord blood, we need to establish a national framework through COAG and there needs to be appropriate public and private holding and storage facilities in the majority of Australia’s major hospitals, not just, as previous speakers have mentioned, Sydney Children’s Hospital in New South Wales or the Royal Children’s Hospital in Victoria or the Mater Hospital in Brisbane. This is a front-line research area in medical science and stem cell research and it deserves to have the full government support that is afforded to other blood products. In Australia we have always been at the coalface of medical advances. Going back some time ago when I was a member here previously, in 2000, Dr Wooldridge was the first to announce a $9 million funding program over four years to establish a national cord blood bank. That was very innovative at the time and it also provided an opportunity for treatment for many Australians, including children, that had life-threatening diseases such as leukaemia. This is a very important area and we have come a long way since those days.

A considerable amount of funding has been put into the National Centre for Adult Stem Cell Research and it has benefited many Australians. Research is being done at the moment into diseases such as Parkinson’s, motor neurone and schizophrenia. An estimated 100,000 people suffer from Parkinson’s, a disease that I have personal experience of, having three family members afflicted with it. The other diseases are very long-lasting and debilitating.

The government in 2005 provided $20 million over four years to fund the operational cost of the National Centre for Adult Stem Cell Research, and then another $2 million was provided to support the infrastructure costs. It is very important that we keep funding these measures and that we ensure that the national collection framework is put in place. It is a very important initiative and we must ensure that the collection of cord blood and the network are there for all Australians and are there for all our medical researchers in the most efficient way. Cord blood needs to be collected. To brighten the light of science anywhere is to brighten the light of science everywhere. Let’s do what we can to ensure that the light of medical science stays bright always for all.

8:58 pm

Photo of John MurphyJohn Murphy (Reid, Australian Labor Party) Share this | | Hansard source

I would like to join with the other speakers in applauding the member for Petrie for putting this motion on the Notice Paper. It is certainly a very important motion that gives greater awareness of the opportunities that exist to promote medical science with regard to the extraction of blood from the umbilical cord and placenta. I well remember about a decade ago in this House the very divisive debate that we had in relation to embryonic stem cell research. Certainly a lot was said about the future of adult stem cell research and about the destruction of embryos in relation to extracting stem cells, which the scientists at that time were saying offered so much hope.

I was alarmed to hear the member for Petrie say that she had offered to have the blood from her umbilical cord and placenta extracted on the occasion of the births of each of her two children but that that did not take place. We would hope that with this motion being debated tonight there is greater awareness of the shortcomings in that area and that this type of blood will become available in all states and territories, because it obviously offers so much hope. Well done to the member for Petrie and congratulations to the previous speaker on her contribution to the debate. This is one of the best motions I have ever participated in debate on, albeit very briefly, in the time that I have been here.

Photo of Peter SlipperPeter Slipper (Fisher, Liberal Party) Share this | | Hansard source

Order! The time allotted for this debate has expired. The debate is adjourned and the resumption of the debate will be made an order of the day for the next sitting.