Organ donation legal provisions are ‘no substitute for investment’ in services 

New legislative provisions for organ donation are not a “substitute for investment” in services, heard a meeting involving senior clinical leaders.

At a meeting in April, the HSE’s national organ donation and transplant advisory group (NODTAG) also noted that “significant work” was required to ensure the system was prepared for commencement of the Human Tissue (Transplantation, Post Mortem, Anatomical Examination and Public Display) Act 2024.

NODTAG members discussed how the Act represented a “statement of national values and will not substitute for investment to enable [the] system”, according to meeting minutes obtained under Freedom of Information law.

Under the Act, which was enacted in February, an adult’s consent for organ donation will be presumed unless they have registered to opt-out of donation. Family consent will still be required in cases where their family member had not registered to opt-out. Separately, the Act also introduces a legislative basis for altruistic living donation to the transplant system (living donations to persons known to the donor already occur).

Clinical experts have emphasised that the key to enhancing organ donation rates, based on international experience, is adequate numbers of specialist staff.

In 2015, six nurse managers and five clinical leads in organ donation were appointed to the Hospital Groups. This provision has remained largely unchanged with six nurse managers and six clinical leads currently in post.

In 2017, the nurse managers and clinical leads expressed their concern over low specialist staffing levels in a submission to the Department of Health. They also stated that an opt-out system was not an important component of increasing donation rates.

Earlier this year, Minister for Health Stephen Donnelly announced €1.6 million in new development funding to support the “early phases” of the 2024-2026 strategic plan of HSE Organ Donation and Transplant Ireland.

A HSE spokesperson said this is a “three-year input plan to develop the services required over the next 10 years”. The plan has progressed through HSE governance structures and will be launched “when finalised”.

According to the Department, the Minister has indicated his intention to commence the organ donation/transplant provisions of the Act this year, “subject to the necessary prerequisites being in place.”