10511 (2004). Dr Paul Hutchison to the Minister of Health (4 August 2004): Does the government propose changing organ donor legislation and if so what are those changes?

Hon Annette King (Minister of Health) replied: The Ministry of Health is undertaking a Review of the Regulation of Human Tissue and Tissue-based Therapies. This review includes consideration of the legislative arrangements for organ and tissue donation including consent issues and the role of families. Five options for consent are outlined in the Review of the Regulation of Human Tissue and Tissue-based Therapies Discussion Document: presumed consent; requirements for wishes to be followed; requirement to state wishes; requirement to request; and status quo. A copy of the discussion document is available on the Ministry’s website (http://www.moh.govt.nz).

10512 (2004). Dr Paul Hutchison to the Minister of Health (4 August 2004): When, if at all, does she expect the government to table legislation that changes the organ donor laws?

Hon Annette King (Minister of Health) replied: The Ministry of Health is analysing the written submissions and feedback from consultation meetings and will be preparing advice for Cabinet and me on the new legislative framework in the coming months. Once Cabinet has agreed on a policy direction, drafting instructions will be issued to the Parliamentary Counsel Office.

10513 (2004). Dr Paul Hutchison to the Minister of Health (4 August 2004): Will the governmentl change organ donor legislation so the onus falls on the concept of the donors wishes prevailing over the wishes of the relatives; if not why not?

Hon Annette King (Minister of Health) replied: The Government will consider policy options around the consent framework for organ donation as part of the Review of the Regulation of Human Tissue and Tissue-based Therapies in the coming months. The Government’s preferred policy on consent for organ donation and the role of the family will be determined by Cabinet.

10514 (2004). Dr Paul Hutchison to the Minister of Health (4 August 2004): Is the government planning to increase the number of intensive care beds in New Zealand hospitals?

Hon Annette King (Minister of Health) replied: District health boards are responsible for ensuring that their hospitals have an appropriate number of intensive care beds. Where financial assistance is required from the Crown for this purpose it is subject to the normal capital approval processes.

10515 (2004). Dr Paul Hutchison to the Minister of Health (4 August 2004): Is the government planning to initiate a national awareness campaign to help increase the number of organ donors in New Zealand; if so when, and if not ,why not?

Hon Annette King (Minister of Health) replied: The Ministry of Health is in the process of setting up a national organ donation agency. Before a national awareness campaign can commence, the national organ donor agency needs to be established as part of its responsibility will be to educate health professionals and provide information on organ donation to the public and the media. Any public awareness campaign about organ donation needs to be based on sound evidence and cost effectiveness. The Ministry is aiming for the national organ donation agency to be established by early 2005.

10664 (2004). Dr Paul Hutchison to the Minister of Health (5 August 2004): Are any recommendations planned that government pay reasonable expenses for people who are prepared to be live donors; if not why not?

Hon Annette King (Minister of Health) replied: The Ministries of Health and Social Development are considering welfare assistance for lost earnings and/or medical expenses for live kidney donors. Consideration of this issue will include examining the impact compensation would be expected to make on the donor rate. The review will also consider whether putting funding into compensation for live donors will achieve more than putting funding into some other aspect of organ donation and transplantation.

10665 (2004). Dr Paul Hutchison to the Minister of Health (5 August 2004): Have there been any health situations where the family of a potential donor have said no, against the wishes of the donor, which have resulted in the government paying substantial amounts of money to maintain the health of intended recipients; if so how many?

Hon Annette King (Minister of Health) replied: We do not have data for the number of times that New Zealand families have overridden a known wish to donate from a medically suitable donor. However, health professionals involved in organ and tissue donation report that where families are aware of their relative’s wishes, the majority agree to those wishes being carried out. A recent American study found that almost 90 percent of families who knew (as a result of family conversations and other means) that their relative wished to donate allowed donation to occur (see reference below). During the year beginning 1 April 1999 a study carried out by a group of intensivists on organ donation in New Zealand (Streat et al 2002) found that of the nearly 28,000 deaths during that year, only 102 were potential donors. Sixty-nine families were asked and of these 37 consented and 32 refused consent. The reasons for refusing consent are not known but are likely to include cultural or religious considerations, or knowledge of the deceased's opposition to becoming an organ donor.

Siminoff LA, Lawrence RH (2002). Knowing patients’ preferences about organ donation: does it make a difference? Journal of Trauma Injury, Infection, and Critical Care 53: 754-760.

10666 (2004). Dr Paul Hutchison to the Minister of Health (5 August 2004): Does she agree with Professor Stephen Munn that achieving a 20% increase in donors in New Zealand would save in the order of several million dollars per year in other treatments?

Hon Annette King (Minister of Health) replied: The cost/benefit equation for organ donation is complex and depending on how costs-benefits are accrued the outcome differs (that is, donor quality life years, the savings to the heath sector). The cost/benefit of transplanted organs also differs depending on the type of organ transplanted. The key focus is around kidneys where demand is greatest. On an individual basis, kidney transplants are shown to be a cost effective treatment. However, subtracting the cost of a transplant operation and ongoing cost of immuno-suppressant drugs from the cost of dialysis is overly simplistic and not an accurate reflection of the savings to the health system as increasing demand means that dialysis machines will be filled by other patients who would benefit from dialysis as quickly as transplant recipients vacate them.