Wednesday, 2 April 2025

Legal and Social Issues Committee

Register and Talk about It: Inquiry into Increasing the Number of Registered Organ and Tissue Donors

Anthony CIANFLONE (Pascoe Vale) (10:34): I rise to speak on the Legal and Social Issues Committee’s inquiry into increasing the number of registered organ and tissue donors report that was tabled in March 2024. The health and wellbeing of our community of course is paramount, and regardless of age, background or circumstance everyone in our community deserves access to good quality health care in a good quality hospital being looked after by the hands of our highly trained and skilled health professionals. However, in some cases the best of quality health care, sadly, is not enough. Whether it be because of hereditary reasons, genetics, family history, lifestyle, an accident or unforeseen trauma, sometimes the healthcare system can only help to a point, and it is the generosity of another human being through their organs, tissue or blood that can save another’s life. As set out on page 1 of this report:

People who become organ and tissue donors perform a selfless and generous act that saves and improves lives.

In the words of Alfred Health, organ and tissue donation:

… is perhaps the most valuable, even sacred, gift it is possible to give. At a time of profound grief, the family of [a] donor have found the grace to recognise that they can help others.

As highlighted by this amazing inquiry, an individual’s registration on the Australian Organ Donor Register is important because it significantly increases the likelihood that a donation will proceed, honouring the donors wishes. The way a person can donate is as a deceased organ donor, a deceased tissue donor or even as a living donor. A deceased organ donation can include kidneys, heart, lungs, liver, stomach, intestines and pancreas and involves transplanting a viable organ from someone who has died, with family consent, to someone on the transplant waiting list. Deceased tissue donation is a separate process that includes heart valves and tissues, pancreas islets, bone and tendons, skin and eyes. This involves retrieving tissue from someone who dies, with family consent, that is then stored as a viable product and available when someone needs it. Deceased tissue donation can usually occur up to 24 hours after death, meaning the person does not need to die in hospital. Living donors can also volunteer to donate – usually a blood relative or close friend of a patient – kidneys or part of the liver, tissues, breast milk, faecal microbiota, blood, plasma, stem cells, bone marrow, eggs, sperm and embryos.

Currently Australia is an opt-in registration model, where a person over the age of 16 can register their decision to donate their organs and tissues when they die on the Australian Organ Donor Register via an online form, Medicare account, MyGov, post or phone. However, regardless of a person’s registrations status, consent from the family is currently and has always been sought when a person dies and their organs or tissues have been identified as suitable donors. The inquiry did show, however, that where a person is registered to be an organ and tissue donor there is a nine in 10 chance that their family will consent come the time of donation. That is compared to a four in 10 chance of a family consenting if a person is not registered.

Donation and transplantation of course provide tremendous benefits for the recipient’s survival chances. It is even cheaper for the health system and helps the patient recover quicker and lead a better life. Of course the donor’s family leaves a legacy behind. But as highlighted in this report, there still are a number of opportunities, challenges and barriers to increasing the rate of donation. In this respect the report highlights that Victoria’s organ donation rate remains consistently above the national average. Most people support donation; 81 per cent support it. However, only 23 per cent of Victorians are registered to be donors. That is compared to the national average of 36 per cent.

South Australia’s donation registration rate is at 72 per cent, namely because South Australia is the only state where it is still possible to record a donation decision on a drivers licence. While Victorians were previously able to record interest in becoming a donor on a drivers licence for a short period, that has not been possible since the early 2000s. With 99.9 per cent of Victoria’s eligible donation population holding a drivers licence, our state’s drivers licence system really does provide that major opportunity to drastically increase Victoria’s registration rates on a massive scale. Among young people, however, the statistics are even lower. Just 10 per cent of people aged 16 to 25 years have registered a donation decision, and rates among our culturally and ethnically diverse communities do remain particularly low as well.

However, in Australia about 1400 people died in hospital out of approximately 80,000 deaths where organ donation was possible. This measures to around 2 per cent of people who die in hospital each year who have the chance to become organ donors. The deceased organ donation rate has continued to fall during and since the COVID pandemic to a low of 16.5 per cent for Victoria and 16.4 per cent for Australia and is yet to fully rebound. At the same time, concerningly overall Australian’s organ waitlist continues to increase, including by 17 per cent in recent years, outstripping population growth by 11 per cent. That is why the work of this inquiry and its report, recommendations and findings are so important – 74 findings and 41 recommendations that I draw this house’s attention to.