NHS Organ Donation: England is Letting the UK Down

There were 6,331 people awaiting an organ transplant in the UK on June 15, 2017.

Some 4,959 needed kidneys, 479 needed a liver and 339 needed lungs. On that day there were 184 children in the queue. These aren’t just dry statistics about unfortunates whose fate was decided long ago. They are living, breathing and dying people who are in desperate need. Some of us could easily save their lives. Most of us choose not to.

The UK has an organ deficit that we could do a much better job of tackling but we don’t because of a lack of awareness, squeamishness or, to put it bluntly, plain old selfishness. We have to discuss why the entire UK does not have an “opt-out” system for organ donation and why you should immediately opt in.

Opt-in, Opt-out

Organ donation boils down to two options: everyone’s a donor unless they say they are not, or no one’s a donor until they sign up. England, Scotland and Northern Ireland operate as the latter.

Wales is noticeably missing from that list. Our neighbours made big news last year by becoming a “soft” opt-out country. That means that everyone over 18 has to register their preference to donate or not. Anyone who doesn’t will automatically become a donor. Now Scotland has announced it too will become a soft opt-out system.

The British Medical Association is campaigning to adopt the same system in England and Northern Ireland. Why? A February 2017 survey found that while two-thirds of British people supported a “soft opt-out” policy fewer than 40% of Brits have registered to be donors.

BMA ethics chair Dr John Chisholm says the figures show that “in the current system, a large number of people who wish to donate their organs are not signing up to the register. Vital opportunities to save people’s lives are being missed.”.

The Only Facts You Need

It’s not just the UK that’s split on organ donation. The same division reaches across all continents and it is not based on geography or politics. Austria is opt-out while neighbouring Germany is opt-in. France introduced an opt-out policy in January 2017 while the UK maintains its own unusual mix of policies.

The only thing we can agree on is the effectiveness of opt-out policy. Take Austria and Germany: two similar countries with different approaches to organ donation. In Germany the rate of consent for donation is just 12%. What’s Austria’s? A massive 99.98%. It’s a black and white contrast which condemns many Germans to death.

France and Wales offer tantalising glimpses of what the UK could achieve. Dr Chisholm says that “since soft opt-out was adopted in Wales, 160 organs have been transplanted, almost a quarter of which were down to the new system”. That is 40 lives saved or transformed.

There’s a similar improvement in France but on a much grander scale. Since the new policy came in 150,000 people have opted out. That sounds a lot until you realise that the French population is around 66 million. The number of potential life-saving donors has suddenly exploded, all due to the opt-out system.

The UK

Opt-out countries have an average donation rate of more than 90% but somehow that statistic is not enough to sway MPs. Following a 2008 debate, the Government decided to remain opt-in while increasing both awareness and the number of staff trained in the donation process. They’re positive steps but almost a decade later we still aren’t hitting targets and thousands of lives have been ruined or lost.

An overwhelming 90% of UK citizens support organ transplants but only 39% register to donate. Essentially, we’re for it when it’s our lives on the line. Otherwise we’d rather every last bit of us died together. It’s time we got over this outdated and self-centred view: we’re better than that.

Changing legislation on this isn’t easy as it’s a hugely controversial subject. If you think Brexit broke households, wait till you discuss who’d accept an organ while refusing to donate their own. It really livens up a family get-together.

Surprising Alternatives

Opt-out isn’t even the most drastic option. Some countries have taken organ donation to a whole new level.

Israel introduced opt-out with a twist – register as an organ donor and you’ll get preference over non-donors for transplants. Yes, that’s highly religious Israel in the conservative Middle East. Not even religion supports keeping your organs postmortem anymore.

Israel’s donor numbers had been low but when the so-called “don’t give, don’t get” policy arrived people were suddenly incredibly interested in altruism. Of course there’s extensive policing and research involved in prioritising people – it’s not an EasyJet flight – but that law change has motivated Israelis like never before.

Then we come to Iran, which believe it or not is the only country in the world to have no one on the kidney transplant waiting list. How did they manage to clear their backlog and keep it at zero? By paying people to donate bits they can live without. That, my friends, is controversial.

You Are Priceless

In 2015-16 a total of 1,347 people in the UK awaiting organs died. Some passed away while on the transplant list while others were taken off the list when they became too sick to survive the operation. Every donor can save up to five lives with their organs. If just a few hundred more people had donated, those patients and their families could have been saved.

What seems to be somebody else’s problem right now may one day be a lot closer to home. It could be you needing an organ or worse your loved one, and just one more person signing up to donate means the difference between life and death.

While a donor will never know their own sacrifice, a recipient and their family will never forget it. If you approve of organ donation, please opt in to be a donor. Spend just two minutes signing up here and you can spend the rest of your life knowing that you have done your bit to save up to five other people in the future.

 

by Jo Davey

 

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