An organ donation campaigner says the latest data on the use of driver licences as an indicator of wishes confirms the system is broken and needs to be replaced.
New Zealand has a low rate of deceased organ donors at around 10 for every 1 million people, in contrast with world leader Spain on 36 per million. New Zealand had 53 deceased organ donors last year, the second year of increase after a downward trend since 2009. A low of 25 was recorded in 2006.
Data supplied to campaigner Andy Tookey by the NZ Transport Agency shows 46 per cent of the more than 3.4 million licensees at March 15 said they would want to donate organs in the event of their death, down from 53 per cent in February last year.
The data also show young drivers are the least likely to have said yes, at 39 per cent. Most age groups are at around 44-46 per cent. Those aged 70 to 74 are at 49 per cent and those over 75 are the most likely to want to donate organs, at 55 per cent.
"It shocked me a bit," Mr Tookey said of the reduction since last year. "I thought it would be going up with all the publicity in the last couple of years."
Mr Tookey, who has made submissions to the Ministry of Health's review of deceased organ donation and transplantation, was also surprised by young people's comparative reluctance, because the issue was discussed at school.
It was time to stop using the licence for organ donation wishes and create a proper system, he said. "I think there should be a register as they do in virtually every Western country."
He said the experience of countries with registers indicated families were far more likely to consent to organs being removed from a deceased relative if a person had signed up as willing to donate.
The donation consent rate in Australia was 93 per cent for people known to be registered as a donor, compared with 70 per cent for those not known to be. In New Zealand, 39 per cent of families approached about donation consented.
Mr Tookey said problems with New Zealand's driver licence database included that it left out non-drivers; willing donors thought saying yes on the licence was all they needed to do, so might omit the more important step of telling family; and in situations where a person's body might be suitable for donation, hospital staff "refuse to check" the licence.
Organ Donation NZ, based at the Auckland District Health Board, has said staff consult the licence database only if a family asks, because many families already knew their relative's wishes.
The agency attributed last year's increase in deceased donors to a quality improvement programme in intensive care units, supported by extra annual funding of $500,000 for four years from mid-2012.
Janice Langlands, a donor coordinator at the agency, said yesterday: "We believe a register is hard to populate. Organ donation should be discussed with all families irrespective of registers or driver licence information and they should be given appropriate information at that time then supported to make a decision that they can agree on.
"We continue to work with health professionals to ensure that all opportunities for organ donation are recognised and that all families have organ donation discussed with them.
"The family's decision is always respected and the donor cared for with dignity."