Human Tissue (Scotland) Bill
The next item of business is a debate on motion S2M-3785, in the name of Andy Kerr, that the Human Tissue (Scotland) Bill be passed.
This morning's consideration of amendments has been good and has reflected a broad consensus not on every issue but on the basic principle of the Human Tissue (Scotland) Bill that, wherever possible, we should respect and follow the positive wishes that the living express about what should happen to their bodies after death.
The Executive's stage 3 amendments have put some final touches to the bill and round off changes that were made at stage 2. I believe that the bill has been very much strengthened and improved by the range of amendments that have been agreed to, many of which were brought forward by the Executive as a response to comments made and issues raised at stage 1. The thoughtful and serious way in which issues were raised and debated at every stage is a credit to the Parliament, the Health Committee and all those involved in the process.
The process by which ministers sought to respond to members' views has been in keeping with our approach to the development of the bill. We started by responding to concerns about past practice in post-mortem examinations and we worked closely with patients representatives and with a range of clinicians to ensure that the bill supports and strengthens best practice in each of the areas with which it deals.
It is worth reflecting briefly on the main changes that have been agreed to the bill since our stage 1 debate on 30 November. First, we have incorporated an approach to donation by adults with incapacity that is in harmony with the principles in the Adults with Incapacity (Scotland) Act 2000. The bill, as amended at stage 2, now makes it clear that the only forms of donation that are open to a living adult with incapacity under part 1 of the bill are organ donation as part of a domino transplant operation or the donation of regenerative tissue. In practice, "regenerative tissue" will mean bone marrow and skin. Our consultation last autumn showed that there is general support for our approach. The approach will also apply to donation by living children.
We have also responded to concerns about the original definitions of the terms "organ" and "tissue" by clarifying the areas of uncertainty that members had raised, specifically to do with corneas and skin. We have made adjustments to the provisions in parts 1 to 3 of the bill relating to authorisation. In particular, we have made sure that the needs of those who are blind or unable to write can be taken into account for each type of authorisation and for the withdrawal of authorisation.
The key feature of the bill is that the concept of authorisation has replaced the concept of consent. By "authorisation", we mean the way in which people express their wishes about what they want to happen to their body after death. We use the word in the sense of, "I give my authorisation for the use of any part of my body after my death for the purpose of transplantation." That is a very direct and forceful statement for a person to make, as it allows the individual to take the initiative in making their views known.
Does the minister accept that, despite the vote this morning, many of us have every sympathy with the amendments lodged by John Farquhar Munro on presumed consent? I echo the words of my colleague Janis Hughes, who said that, although we could not move to a system of presumed consent, that is not the end of the matter. If we can regain trust in the system, presumed consent may one day be a possibility.
It is certainly worth saying that one of the purposes of the bill is exactly what Ken Macintosh says: to regain trust in the system of organ donation and post-mortem examination. I believe that we will be able to move forward. However, it is important to acknowledge that passing the bill today will be the biggest contribution that we can make to increasing the number of organs that are available for donation. The wishes of the quarter of the Scottish population—more than a million people—who have already indicated that they would like their organs to be used for transplantation after death will now have legal force. As Mike Rumbles said, that is new and significant. The bill will significantly increase the number of organs that are available for donation. On that basis and on the basis of the trust that would thereby be regained, more and more people will register as donors.
The bill will also update the Anatomy Act 1984. In response to evidence that was given at stage 1, we introduced amendments at stage 2 that provide more stringent controls on authorisation by children aged 12 to 15. The amendments will exclude bona fide museums from the need to be licensed for the public display of anatomical human remains. They will allow, subject to conditions, the public display of a wide range of anatomical human remains in the interests of education, training or research, including the health education of the general public.
We have had a thorough debate on the principles of the bill from stage 1 on and we have just had a full debate about how those principles are best applied in today's circumstances. The Parliament's support for those principles is to be welcomed. The bill is about respecting people's wishes by giving effect to them after a person's death; that respect is enshrined in the principle of authorisation. The bill modernises and replaces the unsatisfactory approach that exists in the current legislation and it gives us a system in relation to transplant matters that is fit for purpose in the 21st century.
I move,
That the Parliament agrees that the Human Tissue (Scotland) Bill be passed.
The Scottish National Party is pleased to support the Human Tissue (Scotland) Bill at stage 3. I would like to thank all those who gave evidence to the Health Committee. It is crucial that the focus of the bill has been on determining the wishes of the deceased and on ensuring that those wishes are respected. The concept of authorisation should ensure that a person's wishes are respected if those wishes are registered in some way and that, when no wishes have been registered, there is a clear process for ascertaining any wish that the deceased might have made and for seeking authorisation through the nearest relative hierarchy.
The hope is that, by strengthening the opt-in system, there will be an increase in the number of organ donations in Scotland. There are members in all parties who favour a system of presumed consent, as expressed by John Farquhar Munro and others. However, the Parliament made the right decision in rejecting the amendments that called for the introduction of presumed consent. It is important that we build public confidence in the system, which proposals for a system of presumed consent would not do.
The new system of informed consent should make it easier to ascertain a person's wishes. As we know, most people would want to donate their organs, so, alongside the new legislation, a public awareness campaign will be crucial in encouraging more people to register their wishes and to discuss them with family members. The rules for living donation in the bill are sensible.
It is essential that the bill should provide the required reassurance to parents and others who find themselves in the traumatic situation of having to deal with a hospital post mortem. Procedures have already changed in the wake of what happened at Alder Hey children's hospital, but it is crucial that we frame such changes in legislation. The concept of authorisation also applies to hospital post mortems, although it is complicated by the fact that different standards of authorisation are required in different cases. Concerns about that were expressed during the progress of the bill. The minister has gone some way to reassure us that the guidance on authorisation will be very clear. It is right that the penalties for a breach of procedure will be severe—they must be so that public confidence is restored and the public is reassured that scandals like Alder Hey do not happen in future.
With regard to the reform of the Anatomy Act 1984, there is a need to ensure that human body parts are not displayed for purely entertainment purposes and that they are treated with respect. The amendments to the bill provide reassurance that that need will be respected. I compliment the minister on going out of his way to provide reassurance and to lodge amendments in answer to concerns that were raised.
The bill's overarching aim is to increase organ donation and therefore the number of lives saved. I hope that we will have a system for carefully monitoring the impact of the legislation in achieving that aim. I hope that the minister, in his summing up, will tell us how he will ensure that such a monitoring system is introduced and that there will be regular feedback to the Parliament on the success of the legislation.
I, too, thank all those who gave evidence to the Health Committee. I also thank the committee clerks and lawyers who guided me through the plethora of amendments—which arose from one policy intention—in my name at stage 3. The Conservatives welcome this complex and important bill, with its separate provision for, first, organ and tissue donation and, secondly, the retention of organs and tissues at post mortem.
The new framework for organ donation and transplantation at post-mortem examinations and the associated removal, retention and use of body parts should go a long way to ensuring that the wishes of the deceased and their families are respected. It should in future spare bereaved families the distress that was caused to relatives in the past by the discovery that their loved ones' organs had been removed at post mortem and retained without their knowledge or permission.
The updating of the provisions in the Anatomy Act 1984 on anatomical examination and the public display of bodies and body parts is welcome, too. We had concerns about the lack of clarity of the bill as introduced on biomedical research and its proposal of an overly restrictive licensing system to control public display. However, the Executive dealt with those worries at stage 2 and we are happy with its amendments. We are satisfied that the Executive has gone a considerable way to acknowledging the need for clear definitions of "tissue", "organs" and "body parts", so that people who sign authorisation forms are sure about exactly what they are authorising. That is an important part of fostering trust between the medical profession and the public and we welcome the minister's response to the concerns that were raised.
With regard to organ donation and transplantation, we are pleased that authorisation by a potential donor cannot be overruled by relatives after the person's death because we feel that it is important that the informed consent of a donor is respected. The strengthening of the opt-in system, coupled with the intention to promote, support and develop programmes of transplantation that is clearly expressed in the bill, should help to increase the level of organ donation, without progressing us to the point—at this time—of having the opt-out policy that exists in Spain, which was promoted in some of the amendments that we considered earlier. As I have said on previous occasions, even in Spain it is acknowledged that the most important factor for the identification of donors is not the opt-out system but the availability of staff in hospitals who are responsible for identifying possible donors.
Valid concerns have been expressed to me that the bill does not provide a fail-safe mechanism for ensuring that the wishes of those people who object to donation are respected. In cases in which the deceased person has not made known their wishes prior to death, the bill allows for a soft form of presumed consent; in other words, it provides for an opt-out system that is similar to the one that is used in Spain. The fact that it does not make provision for people who object to donation in general or to the donation of specific organs is of serious concern to some people who do not know their nearest relatives or who do not trust them to respect their wishes.
As I said during our consideration of amendments, the Scottish Council on Human Bioethics has stated that it is aware of a number of single people who are considering taking their names off the national health service organ donor register—
I was a little puzzled by the member's assertion that the bill offers a form of presumed consent, because the bill is based on authorisation. It is fine if someone has authorised organ donation in the past, but those people whose names will appear on the list will be asked to give authorisation. There is no presumed consent.
I was referring to cases in which the deceased has not stated their wishes and they have no close relatives who might know their wishes. The Scottish Council on Human Bioethics certainly interprets what the bill proposes as a soft opt-out system. Some people are considering removing their names from the organ donor register and it would be a tragedy if they were to do so because they were afraid that their wishes would not be implemented.
I welcome the minister's offer of guidance on the matter, but I am disappointed that Parliament rejected my stage 3 amendments because, like the minister, I want as many potential organ donors as possible to come forward to help the many people in Scotland who are suffering end-organ failure. My son would not be alive today but for the generosity of a donor family and I would not want to lose even one donor because of their fear that their wishes would not be respected.
However, all in all, I welcome the bill's provisions. The Executive's amendments go a long way to alleviating the concerns that the Health Committee and others expressed at stage 1. As a result, the bill has been improved significantly. It represents a great advance on the Human Tissue Act 1961, which it replaces, and we will be happy to give it our support at decision time.
The Liberal Democrats welcomed the bill's introduction in June last year and, in common with all members, we are gratified to have watched its subsequent progress. I pass on my party's thanks and appreciation to everyone who has made the bill's passage to this stage possible. The Health Committee, its witnesses and ministers have all made major contributions to what is another important success for the Scottish Parliament. The bill is an example of progressive reform of outdated legislation and a clear response to some of the public concerns that were raised in cases to which other members have referred.
The bill modernises, clarifies and improves the law in the areas of organ and tissue donation, transplantation and hospital post-mortem examination. It deals with deficiencies in the law in the difficult area of the use of bodies and body parts. The first of its five key objectives is to repeal the Human Tissue Act 1961 and to replace it with separate provision for, first, organ and tissue donation and transplantation and, secondly, hospital post mortems. Its second and third objectives are to make clear the purposes of a post-mortem examination and to introduce the concept of authorisation for obtaining permission for organ donation, post-mortem examinations and the removal and retention of body parts at post mortem. Fourthly, it provides for authorisation for the retention and use of organs and tissue that have been removed during post-mortem examination and, fifthly, it seeks to amend the Anatomy Act 1984 on the use and display of bodies and body parts.
The key debate has been about the difference between informed consent and presumed consent. To move to a system of presumed consent would be a highly significant—indeed, a radical—change. As was said during consideration of the first group of amendments earlier this morning, the NHS is founded on the principle of informed consent. In my view, a change from a system of informed consent to one of presumed consent would require a sea change in public opinion and, frankly, I do not detect such a shift.
Many members have said that an increase in levels of organ donation is essential for the 400 or so people who are waiting for transplants, and everyone can agree with that. Given that we need to encourage more people to register, a public awareness campaign is necessary, but the key is the bill's purpose of restoring trust in the system. If people trust the system, they are more likely to engage with it.
In summary, the bill moves us from a position of passive consent to one in which active authorisation is required, but it does not provide for a system of presumed consent, in which individuals would have to register to dissent from the use of their organs. As Ken Macintosh has said, public opinion may move further on the issue in time and, in all probability, much will depend on the success of the public awareness campaign and the number of people who register for organ donation.
I was pleased that during this morning's stage 3 consideration of amendments the minister gave an assurance that guidance would be issued for the benefit of people who object to the use of certain, but not all, of their body parts. Guidance is important in such an interesting and difficult area. Like other members, I would regret it if people chose to withdraw their consent because they felt uncertain. Although the Executive rejected the amendments on that subject that were considered this morning, it acknowledged that a genuine issue was being raised. It is therefore incumbent on the Executive to provide the maximum possible reassurance to those people who find themselves in that position. I hope that very few people will consider withdrawing from organ donation as a consequence of what is in the relevant part of the bill.
The minister sent a letter on foetal tissue to the convener of the Health Committee and I welcome the assurance that it gave that guidance will be issued on that particularly difficult area. I hope and believe that both that letter and the guidance that will be issued will help.
Today we have considered some valuable amendments that responded to issues that were raised during the committee stages. The genealogy profession may not be expanded as a result of the amendment on bodies that are more than 100 years old, but it was nonetheless an important amendment.
Overall, the bill is extremely valuable. The Liberal Democrats have supported it from the outset and have supported the changes that it has been necessary to make to it. We commend it to the Parliament and will be pleased to vote for it this evening.
I will be brief. I simply want to put on record my and my party's support for the bill, which addresses issues of public concern. It will provide clarity on the law on hospital post mortems and on the difference between authorisation for post mortem and authorisation for organ retention. I hope that the bill results in increased confidence and trust among the public that their bodies and those of their relatives will be treated after death in the way in which they wish. I also hope that it will encourage people to make their wishes clear prior to their death.
Of course, I am disappointed that the amendments in my name, which would have allowed consent to a child's organs being donated to be given by the nearest relative in the event of the death of both parents, were not agreed to. I will not revisit that debate, but I thank all those who helped with the drafting of the amendments. I supported the amendments in the name of John Farquhar Munro on the introduction of a system of presumed consent. I would like to think that, through a process of awareness raising and perhaps by training and changing practice in hospitals, we can greatly increase the number of organ donations. I share Ken Macintosh's view that the issue may have to be revisited.
I welcome the bill and I thank all those who have worked on it.
As other members have done, I thank the Health Committee clerks who, over the past few years, have had to deal with a steady stream of proposed legislation and inquiries. I record my sincere appreciation for the support that they offer members, which was crucial as we dealt with the sensitive issues that surround organ donation and retention. I pay tribute to those who gave evidence to the committee during our stage 1 deliberations. For many of them, the experience was emotional, so I thank them for their valuable assistance and contribution. I am sure that the bill is all the better for that.
As with last week's debate on prescription charges, there is consensus that we need a new approach to organ donation. As I have mentioned before, I worked in a renal unit for 11 years, where I saw at first hand the difficulties that are faced by patients who suffer from renal failure. All too often, they have to wait an inordinate amount of time for a suitable donor to be found. I support the bill because it will make a real difference to the lives of many people in Scotland. However, the Executive must take the lead on the matter, because the bill will not in itself result in a huge increase in the availability of organs. The Executive must do as much as possible to raise awareness of the importance of organ donation. As Shona Robison said, a high-profile public information campaign is vital. I urge the minister to ensure that that takes place should the bill be passed.
Much has been done to raise awareness of organ donation, but there is still a huge disparity between the level of support for donation and the number of organs that become available. It has been argued, forcefully in some quarters, that a system of presumed consent would remedy the problem. As I said earlier, I have sympathy with John Farquhar Munro's arguments in relation to presumed consent, but I do not believe that the timing is right for the introduction of such a system. As the issue is extremely sensitive, we would need to be sure that there was significant public understanding of and support for such a move, but I am not convinced that we can say that at this stage. I do not believe that the bill is the correct vehicle with which to achieve John Farquhar Munro's aim. Nonetheless, like Ken Macintosh, I hope that the matter will be considered further. As has been said, we should first increase public confidence in the system; that is what the bill, if it is passed today, will achieve. If we assume that a system of presumed consent would not be right at this time, it is surely even more incumbent on the Executive to do as much as possible to transfer the support for organ donation into positive action.
Nanette Milne's amendments raised important issues but, ultimately, I was not persuaded that they were necessary. I note that Nanette Milne did not move most of her amendments. The bill starts from the fundamental principle that the individual's wishes should be paramount. We will move from a system of consent to one of authorisation. That is far more than just semantics, because the term "authorisation" implies a positive decision. As the minister said, if people do not give authorisation, that should be enough to indicate their wishes. As someone who has long argued for greater use of modern technology in our health service, I look forward to the introduction of the electronic patient record. We heard from the Executive that it will allow general practitioners to register patients' wishes. For those reasons, Nanette Milne's amendments were not necessary, although they allowed us to broaden the debate.
The bill ranks as one of the most important pieces of proposed legislation that the Parliament has considered. For people who are waiting for suitable donors, it will be a huge step forward. I hope that the Parliament will vote in favour of the bill—I will certainly give it my full support.
We heard earlier that, last year, 52 Scots died while they were waiting for an organ transplant and that almost 700 Scots are waiting on the transplant list. Those figures are a stark reminder to members that, for every one of those people and their families, a real tragedy might be averted if we increase the number of transplants. The central aim of the bill is to increase the availability of transplants and to save lives. Therefore, the focus has always been on how best to achieve that objective and how best to save lives.
The Scottish Executive ministers' move away from a system of consent for transplants towards a far more appropriate system of authorisation is entirely the right approach to an emotive subject. It must be right that the wishes of the individual should be respected and that the opportunity should be given to ensure that their wishes are carried out. I understand the motives behind John Farquhar Munro's amendments on presumed consent, but I am pleased that they were defeated because they would have undermined the whole purpose of the bill. That was accepted by Health Committee members—John Farquhar Munro's proposals did not receive support from any committee member at stage 2. However, as Lewis Macdonald said, the bill will improve the current organ donation system.
I mentioned donor cards earlier. Part of the problem with the present donor card system is that, until the bill is passed, the cards will carry no legal authority. It comes as a surprise to many people that the cards and the organ donor register have no legal status. That means that relatives, who may be entirely unaware of the deceased's wishes, are asked to give consent to organ donation in obviously difficult circumstances. That is not a good situation, to say the least. However, the bill will give the organ donor card scheme legal status. The system of authorisation that the bill outlines is the right way in which to proceed, as it is based soundly on the clear wishes of the individual. If authorisation has been given, no other hurdle will need to be overcome. If the individual has not made clear a wish to donate—although 25 per cent of Scots have already done so—the nearest relative will be asked for authorisation to proceed. That huge improvement on the current system should lead to a dramatic improvement in transplant rates. As Janis Hughes said, to achieve the successful outcome that all members want, the bill must be combined with a comprehensive advertising campaign by the Scottish Executive.
The bill is a good one; it is perhaps one of the best bills that the Scottish Parliament will ever pass. It is good news for the families who are waiting for a transplant for their loved ones. I hope that, at decision time, the bill will be passed unanimously.
The issue is sensitive, so I congratulate the Health Committee and the minister on the way in which the bill has been handled. Committee members have welcomed the evidence that was given on the bill. Since the Parliament began in 1999, all members have received regular communications from people expressing anxiety about permission and organ retention. There has been utter confusion on those issues, which, combined with the bad practice that has occurred in hospitals throughout the country, has led to bad press, which in turn has resulted in a complete lack of confidence and a lot of mistrust. I hope that the bill will set that right. If we do not have public trust and confidence, we have no chance of achieving a decent system of authorisation.
I can see where John Farquhar Munro's amendments on presumed consent came from, but the measures that he proposed would be a move too soon. The public are not ready for them and there is no appetite for his principles to be accepted at this time.
Others spoke about problems such as rising refusal rates, people withdrawing from the donor card scheme and the bad experiences at some hospitals before the bill was published. Shona Robison, along with Mike Rumbles and others, said that the system must be based on informed consent. I welcome the minister's definitions, which give clarity to and confirm the authorisation system. The guidance that will be issued to general practitioners is also welcome. GPs will be a vital link in maintaining patient records, but many of them do not know what is contained in their patient records. That process must be made easier. More people move around and do not necessarily live in the same area where their records are kept. The instant transfer of records and electronic access to them will make the scheme work. Access to authorised consent forms must be made easier.
Donor cards will have legal status, which is important, but I have sympathy for the argument that was made by the amendments in the name of Eleanor Scott and Nanette Milne. We could all highlight scenarios that are not covered by the bill's provisions; lawyers in particular could do that. The Executive must maintain an open mind in that respect should a particular case arise. In time, changes may have to be introduced by regulation to include particular cases, not to remove them from the provisions of the bill. The need to review the legislation was pointed out by Ken Macintosh and others.
Janis Hughes referred to the campaign to increase the number of organ donors. We must ensure that people are encouraged to sign up to donor schemes and give them confidence in the system. Some concerns in the biomedical field remain. However, the bill is a vast improvement on what was in place.
There is an issue concerning changes that relatives may wish to make to a deceased individual's donation request. A close eye must be kept on that. It will not be easy to increase trust in the various sectors involved. People still write to MSPs with their concerns about organ retention. Not just ministers, but health professionals can convince people about organ donations. When I ran several pharmacies, they all carried donor card application leaflets, mainly from the British Medical Association. Health Scotland has a role to play in promoting organ donor cards. Approximately 700 people are waiting for organ transplants and the number is increasing every year. After the bill is passed, I hope that some inroads will be made in reducing that figure to give hope to many people and their families.
The bill concerns organ donation, transplantation, post-mortem examination and research. For obvious reasons, the debate centred mainly on donation and transplantation provisions. This morning's debate has shown broad consent and support from all parties for the bill's proposals. The legislation is necessary because of advances in technology and medical science and widespread concern following the revelations about past practices at Alder Hey children's hospital, Bristol royal infirmary and other hospitals. We cannot gloss over those concerns or the serious nature of what occurred in those cases. At the Health Committee, such cases were forcibly presented in evidence as examples of presumed consent that had gone badly wrong and as a warning of what can happen if one presumes too much. That is why the committee took the view that it did.
The main debate has centred on presumed consent—on opting in or opting out. In evidence that the committee heard on post-mortem donations, it was clear that—despite the organ donor register, opt-outs and authorisations—the process would stall if relatives were in serious and evident distress. The professionals told us that, notwithstanding the existence of an organ donor card, they would not be happy to proceed if relatives were in serious distress. We learned that, even in Spain, which purports to operate an opt-out system, the same thing happens.
The Parliament was right to reject John Farquhar Munro's amendments. No matter what one thinks of the arguments, it would be quite wrong procedurally to introduce such a radical change to our system by means of amendments at stage 3.
I note Ken Macintosh's comments about presumed consent. Given the concerns about introducing such a provision at stage 3, I wonder whether presumed consent would be a suitable subject for a standalone debate in the chamber, at some point, simply to allow the arguments to be rehearsed in more detail. It would be interesting to see the outcome of such a debate.
One or two issues were raised to do with live donation and anomalies such as domino transplants. Members have noted that such concerns have been addressed. It is a testament to the Parliament's legislative process that anomalies were picked up and addressed at the committee stage and did not find their way into legislation—which might very well have happened in the past in another place.
Concerns were raised about complicated authorisation forms, which have now been considerably simplified. The legislative process has been extremely useful. However, Shona Robison, Janis Hughes and Mike Rumbles are absolutely right when they talk about the urgent need for publicity and education. That, of course, will require resources.
On the issue of presumed consent, I think that it was John Farquhar Munro who talked about the likelihood that the majority of people who are not currently on the organ donor register would not actually object to their organs being used. That may be true, but the answer lies not in moving towards presumed consent, but in encouraging more authorisation. With the greatest of respect to members, that will entail more than just advertising. We will have to go out to where people are and take the campaign to places such as the supermarkets and the high streets. I hope that the minister will come back to Parliament with some outreach proposals along those lines.
If the proponents of presumed consent stood outside supermarkets and actually asked people to sign up and give their authorisation there and then, we could test the assumptions about how many of the silent majority are relaxed about giving their agreement, and how many of them are just saying that they are relaxed while hiding their concerns. We have to be very careful about making assumptions. If the proponents of presumed consent are right, people will be happy to sign up there and then when they are offered the cards. There is a challenge for the minister. Let us proceed with such a campaign.
Although I am closing the debate for the SNP, I have had a long and close involvement in the passage of this bill as convener of the Health Committee. I thank once again all those who helped the committee during its discussions on the bill. In particular, I thank the clerks—especially for making written sense of our various verbal discussions—and all those who came to give evidence. Of course, I also thank the committee members themselves. It has been a bill of moral, medical and legal complexity.
I give a particular mention to the people whose concerns over some of the issues have been driven by deep personal and emotional connections. Chief among those people were the parents groups that were set up after the scandal over the retention of children's organs. For those people, the continuing debate must sometimes be very difficult indeed.
With those thanks to all involved, I commend the bill to Parliament.
I thank members across the Parliament for their support for the Human Tissue (Scotland) Bill, which they have demonstrated here at stage 1, in committee at stage 2, and here again this morning. The bill's passage through the Parliament has been assisted by a great many people, whose contributions I acknowledge. I thank the many individuals and organisations who took the time to work with ministers and with our officials, as well as with the Health Committee, on identifying the aspects of the bill that could be clarified and improved. I acknowledge those who responded to the various consultations and those who gave evidence to the Health Committee.
Members of the Health Committee deserve particular recognition for the careful way in which they considered the bill and for the measured way in which a potentially difficult debate was conducted. I put on record the Scottish Executive's thanks to the Health Committee clerks, who ensured the effective management of the committee stages of scrutiny, and I record my own particular appreciation for the hard work and commitment of the Executive's bill team throughout the process.
The bill gives us a modern system of authorisation for organ donation, post mortems and other purposes that is fit for the 21st century. I believe that the bill has been further strengthened by all the attention that it has received. It gives us an excellent basis from which to move forward. I have no doubt that, as Ken Macintosh suggested, the bill will restore and improve public confidence in the system of post-mortem examinations. I am equally convinced that it will give all the health professionals who are involved with post-mortem examinations renewed confidence about approaching family members in circumstances that are obviously very distressing. The expected increase in the number of examinations that I believe will result from the bill will yield enormous benefits, both for families and for society as a whole.
There is widespread support in the chamber for action to increase the number of organs that are available for transplantation and for ensuring that a person's wish to be a donor is not overturned after their death. Currently, families refuse to agree to donation going ahead in 40 to 50 per cent of cases. Our new system of authorisation, which is founded on honouring people's wishes, will mean that the person's own wishes are paramount. That will, I believe, lead to a considerable increase in the number of organs that become available.
We want to go further, however—as members have suggested in today's debate that we should do—and take advantage of the new legislation to develop further the transplantation infrastructure in Scotland. One of the key messages that we have gleaned from the evidence that was gathered during scrutiny of the bill is that we need to ensure that the right arrangements are in place and that we devote the necessary resources to the organisation of organ donation and transplantation. I am asking the Scottish transplant group to develop that, taking into account the views of NHS board chief executives and regional planning groups.
We have been asked about monitoring. We will monitor the impact of the eventual act on transplantation in every respect. The Scottish transplant group and UK Transplant will undertake that monitoring on our behalf, especially in relation to the organ donation rate in Scotland, which is clearly a matter of concern. On post mortems, the Executive will track the number of hospital post-mortem examinations and we will work with NHS Quality Improvement Scotland on monitoring the standards that apply to hospital post mortems. As regards aspects relating to the Anatomy Act 1984, the inspectorate arrangements that are in place will ensure on-going monitoring of the provisions.
Throughout the process, we have kept an eye on what has been happening with human tissue legislation in the rest of the United Kingdom. The bill will be a distinct piece of Scottish legislation, but we want to ensure consistency for people throughout the United Kingdom as far as possible, particularly when it comes to the timing of the introduction of the new arrangements. The Human Tissue Authority will scrutinise applications from Scotland for living donation, and it will do the same for the rest of the United Kingdom. The authority will be in a position to begin that work in the autumn. For that reason, the UK Human Tissue Act 2004 will not commence in England and Wales in general until 1 September this year.
Given the cross-border role of the Human Tissue Authority, that appears to offer us here in Scotland a very suitable commencement date. Commencement on 1 September will allow us time to put in place the training that health professionals and others will need to help them to implement the new legislation as effectively as possible. It will also allow us proper time to develop the regulations and guidance that will add detail to the bill's provisions, on which I have given further undertakings today. Above all, it will give us more time to raise public awareness and to inform people about the effects of the bill and its significance for each of us. That is the central message about the bill.
I advise Roseanna Cunningham that we will come back to the Parliament and say more about how we will carry forward the policy. A campaign is under way to encourage donation, and we will seek to put in place a registration campaign over the next few months. We will issue a Health Department letter to NHS boards, with guidance of the kind that I described earlier in the debate and at previous stages. Above all, the bill is about ensuring that everyone has the opportunity to make their wishes known.
One of the key changes under the bill is that the organ donor card will change from being a gesture of willingness to being a legal statement. Once the act comes into force, it will be even more important for people either to carry a donor card or to put their name on the organ donor register. Under the bill, those steps remain the two most convenient vehicles by which people may make their views known about what they wish to happen to their bodies after their death. The result is that carrying a donor card or putting our name on the register will count under the bill as a form of authorisation. The provisions of the bill will work to ensure that all such authorisations are respected. On that basis, we expect there to be a significant increase in the number of organs that are made available for donation.
A number of the points that have been made in the debate have emphasised how important it is that, as well as registering or carrying a card, people discuss their wishes with family members and those who are close to them so that, in the event of their death, those who might be asked about the person's wishes are aware of them. That is clearly a wise action to take, although it does not take the place of authorisation, which, as has been said during the debate, removes the requirement for a relative to be asked.
We will work with UK Transplant to change the wording on the existing forms that are available from general practices, from the Driver and Vehicle Licensing Agency, through passport applications and elsewhere, so that they reflect the new legislation. That will enable us to ensure that not only will we have changed the law but, at the point at which we implement it, a sustained effort will have been made to ensure that people can take advantage of the law and authorise donation if that is what they wish to do. Those who make a declaration to that effect will know that it has the backing of the law.
It is incumbent on each of us to take advantage of the power that the bill creates, whether that gives someone else the gift of life after our own death or enables medical research, which could save or enhance the life of future generations. We want to encourage every citizen to think about that. The decision on self-authorisation is one for each and every citizen to make, and we want to ensure that each and every citizen is aware of how the law is changing. We want to encourage people to give the matter serious thought.
Will the Deputy Minister for Health and Community Care encourage the Minister for Education and Young People to consider ways in which schoolchildren can be taught about the background to the subject and what their rights will be in the future? In that way, authorising donation will become a part of growing up and a natural response.
That is a valid point. When we address the issue of how to raise awareness and ensure that that is the case, we will have regard to the fact that the law will make specific provision for children of secondary school age or over the age of 12. David Davidson's point is pertinent to that.
On that basis, and on the basis of the very broad support that we have heard this morning, I look forward to the vote later today confirming that the bill is the appropriate vehicle for the changes that we propose and that it has support across the Parliament.
As we have reached the end of the debate before the time that is set out in the Business Bulletin for the next item of business, I suspend the meeting, under rule 7.4.1(d), until 11.40.
Meeting suspended until 11:40.
On resuming—