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Tuesday, 22 November 2016
Page: 3986


Ms SHARKIE (Mayo) (18:17): I support the Australian Organ and Tissue Donation and Transplantation Authority Amendment (New Governance Arrangements) Bill 2016 because it gives effect to recommendations about governance and accountability in the report Review of the implementation of the national reform agenda on organ and tissue donation and transplantation. One of the observations in the review related to the advisory nature of the governance arrangements for the Organ and Tissue Authority, specifically the fact that they do not provide strategic oversight, performance monitoring, succession planning or mentoring of the CEO. So it is clear that a stronger leadership role would be beneficial at the national level if we are to achieve greater national consistency as well as an increase in donor rates. Stakeholders in the sector are broadly supportive of establishing a skills based board of governance for the Organ and Tissue Authority that will become the accountable authority and will set strategic direction.

We all recognise the complexities surrounding organ and tissue donation and transplantation. These are in part caused by the complexities of our health system and the fact that it is overburdened. But I am concerned that we have spent around $240 million over six years and have only achieved an increase of 3.9 in our deceased donors per million population rate. Over 1,000 Australians die each year because they have not been able to receive an organ transplant, and for many we know this is a preventable death. The waiting and hoping while your health deteriorates must be excruciating. Significantly, only one per cent of people die in circumstances which enable organ donation.

So, while improving governance and accountability is important, I believe we should be learning from the experience of other countries which have higher rates of donation than others. Which country has the highest deceased organ donation rate in the world? Spain. One of the major reasons is that they have an opt-out system. While the families still have a final say, the initial assumption under the law is that the default position of consent to donate organs has been given unless otherwise stated. We see an interesting trend when we compare the deceased organ donation rates in pairs of countries that are similar. For example, Austria and Germany are culturally similar and yet their organ donation rates differ drastically. Germany has only 10.45 deceased donors per million population, while Austria's rate is 150 per cent higher at 25 deceased donors per million population. Guess which country has an opt-out system. Yes, Austria.

Similarly, the Netherlands and Belgium have quite different rates. Belgium, which has an opt-out system, has a deceased donor rate of 27 per million whereas the Netherlands, which, like Australia, has an opt-in system, has a rate of only 17 per million. However, the Netherlands have recognised that his needs to be an area addressed. In September this year, the Dutch parliament considered a bill to introduce an opt-out system, meaning that everyone would be an automatic donor unless they request not to be. It has passed their House of Representatives and is now being considered by the Dutch Senate.

Australia is ranked a disappointing 22nd in the world for its rate of deceased organ donation at 16 per million—just 16 people per million Australians! A relatively small percentage of people do not register as donors because they object on religious or philosophical grounds. And, of course, that is their right; it is perfectly acceptable. But I think that one of the reasons our rate is so low is not because people do not want to donate but because many people are genuinely apathetic. If we are required to take action—for example, to opt into an organ donation scheme—people just do not quite get around to it.

I believe that if this bill passes—and I understand that, with the support of Labor, it will—the newly constituted board should have one of its key priorities the introduction of a nationwide opt-out system for organ donation. Of course, this would require extraordinary cooperation from the states and territories. Importantly, we must ensure that people are able to opt out easily if they have personal objections to organ donation for whatever reason. However, the introduction of an opt-out system is a worthwhile aim. The reversal of the burden will take action and save many lives.