Joe Ludwig (Queensland, Australian Labor Party, Manager of Government Business in the Senate) Share this | Link to this | Hansard source

I move:

That this bill be now read a second time.

I seek leave to have the second reading speech incorporated in Hansard.

Leave granted.

The speech read as follows—

AUSTRALIAN ORGAN AND TISSUE DONATION AND TRANSPLANTATION AUTHORITY BILL 2008

As we all know, organ and tissue transplantation is a highly effective treatment that saves or significantly improves the quality of life of Australians and their families. Australia is a world leader in clinical outcomes for transplant patients.

But we also know that, despite more than 90% of Australians supporting organ donation, we have a longstanding shortage of organs for transplantation.

The 198 deceased organ donors in 2007 resulted in 657 transplants, meeting just one third of demand.

We need to do better for the 1,800 Australians currently on organ transplant waiting lists, and the families who care for them.

People awaiting a transplant require debilitating, time-consuming and expensive treatment. It is hard, if not impossible, for them to carry on active work, and their capacity to engage with their families and the community is reduced.

The wait for a transplant can extend for many years and comes at a significant cost to the health system. For example, treatments such as dialysis cost our hospitals $83,000 per person per year, compared to the cost of a kidney transplant – $65,000 per recipient for the first year and $11,000 a year thereafter.

Against this background, on 2 July this year the Government announced a best practice national reform package to establish Australia as a world leader in access to life saving and transforming transplants.

The package was endorsed by the Council of Australian Governments the following day.

This integrated and comprehensive reform package will improve the number of life saving and transforming transplants for the 1,800 Australians languishing on waiting lists.

It provides $151.1 million – including new funding of $136.4 million – over four years for a range of national initiatives including a new funding stream for hospitals to cover the costs associated with organ donation, more hospital staff dedicated to organ donation, education and awareness campaigns, and funding to support the families of deceased donors.

We need a national body that will work with States and Territories, clinicians, consumers and the community sector to build this new system for Australia.

The experiences of the world’s top performing countries, including Spain, show us that a central, coordinating agency that is dedicated to leading and driving change is paramount to improving organ donation rates for transplantation.

Today I am delighted to introduce the Australian Organ and Tissue Donation and Transplantation Authority Bill 2008 which is at the core of our commitment to do better for Australians in need of a transplant – the establishment of an independent authority on 1 January 2009 to spearhead the implementation of the wide-ranging national initiatives.

The governance structure for the Authority is broadly modelled on that of the National Health and Medical Research Council, with the CEO exercising the powers of the Authority, advised by a Council of experts from a wide range of fields relevant to organ and tissue donation and transplantation, and from the community, business sector and governments.

In performing a number of functions, the CEO’s responsibilities will include:

• overseeing a new national network of clinical specialists and hospital staff who are dedicated to organ and tissue donation activity;
• facilitating and conducting training for professional staff involved in organ and tissue donation;
• ongoing national community awareness programs about organ and tissue donation and transplantation;
• introducing and managing a national data and reporting system;
• administering funds, including to non-government organisations to provide essential services such as those for national organ matching; and
• formulating and monitoring national policies and protocols, including working closely with peak clinical and professional organisations in the development of consistent clinical practice protocols and standards.

$24.4 million over four years is available to fund the Authority’s establishment, operations and infrastructure, including staffing and governance costs and a new, integrated national data and reporting system.

There are a few additional points that I would like to make about this important Bill and the context in which it has been developed.

First, I can assure members that the rationale for the establishment of the Authority, along with the various elements of the Government’s reform package, is firmly grounded in best international and national practice.

The experience of several comparable countries demonstrates clearly that a coordinated and integrated approach followed by sustained effort will over time see real improvements in organ donation and transplantation rates.

Countries that lead the world in organ donation and transplantation rates all have nationally consistent processes and systems extending into local hospitals, supported by ongoing community and professional education.

By contrast Australia has languished with a disjointed, insufficiently resourced system.

This bill, along with the related initiatives the Authority will implement, addresses these key issues.

The reform package and the creation of the Authority have the strong support of all Australian governments, the organ and tissue sectors, and community and consumer groups.

The second issue I wish to highlight is that the bill in no way impedes, restricts or replaces the existing State and Territory legislation that governs organ and tissue donation and transplantation in practice, nor the regulatory framework for ensuring the safety of organ or tissue transplants.

Over the years many representations have been made, including to my colleagues and I, about introducing an “opt-out” legal consent system as a means of increasing the number of organs available for transplantation from deceased donors. For many reasons the Government has not proposed a change to Australia’s current legal framework.

In developing the reform package the Government gave this issue the most serious and careful consideration and examined the best international evidence, local research and inquiries.

There is no clear evidence from anywhere overseas that “opt-out” legislation is the magic bullet solution. While proponents of “opt-out” point to the successful performance of Spain, that country changed its legal consent framework a decade before its donation rate began to improve. Improvement only began with the introduction of dedicated, hospital-level organ donation specialists.

In the top performing countries that have opt out legal frameworks, including Spain, Belgium and France, donation is still discussed with the family and any wishes of the family for donation not to proceed are respected.

We also know that an “opt-out” legal system will not change clinical practice. Australian doctors, quite rightly, will object strongly to the procurement of organs and tissue without family consent.

Instead of changing Australia’s legal consent framework, this new national approach, spearheaded by the Australian Organ and Tissue Donation and Transplantation Authority, will enable all families of potential donors to be asked about donation.

The Authority will work with the States and Territories, the professions and community organisations to educate people about donation, to support families and to make sure that all suitable patients will be considered as potential donors.

It will also coordinate ongoing community awareness efforts to encourage Australians to discuss their wishes with family, and give every family of a potential donor the information, knowledge and support to choose donation.

Australian families deserve the best organ donation and transplantation system in the world.

Through this package of reforms, including the bill I am introducing today, along with the extraordinary gift of individuals and families in tragic circumstances, Australia will become a leader in best practice organ donation for transplantation.

The establishment of a national Authority is the linchpin of this approach and I urge members to support the bill so that the Authority can be set up and get to work on the national reforms that will save Australian lives.

Ordered that the resumption of the debate be made an order of the day for a later hour.