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House of Assembly - Fifty-Fourth Parliament, First Session (54-1)
2019-09-11 Daily Xml
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DonateLife Week

Mr BELL (Mount Gambier) (11:49): On behalf of Ms Cook, I move:

That this house—

(a) recognises DonateLife Week from 28 July to 4 August;

(b) recognises the importance of organ donation;

(c) encourages families to discuss the importance of organ donation and to register their decision on the Australian Organ Donor Register; and

(d) encourages the Marshall government to support comprehensive publicity and education programs focusing on both the public and healthcare professionals.

I support the motion by the member for Hurtle Vale recognising the importance of organ donation. Some issues surpass politics and state borders, and I believe that organ donation is one of them.

A bit of interesting history about the Australian Organ Donor Register, established in 2000, is that it is a national register for people aged 16 years or older to record their decision about becoming an organ and tissue donor. Prior to this, questions on state driver's licences was the main way a person's intentions could be noted.

A study was conducted in 2002 on the number of people prepared to donate their organs and those numbers were 45 per cent in New South Wales and Tasmania, 47 per cent in South Australia and 52 per cent in Queensland. Information was incomplete for the remaining states. Over the years, many states have scrapped driver's licence donor registration. South Australia is now the only remaining state in Australia where residents can record a donation decision via their driver's licence.

When we tick the box to become an organ donor at the motor registry or online, that information goes directly to the Australian Organ Donor Register. It is a decision that we are reminded of every time we renew our licence. At 68 per cent, South Australia has the highest registration rate of any state in Australia, while the national average is just 33 per cent. This is a fact we can and should be proud of. Statistics from 2018 show that 93 per cent of families agreed to organ donation if their loved one was registered on the Australian Organ Donor Register. It is the ultimate way to let your wishes be known.

At 73 per cent, South Australia also has one of the highest consent rates in Australia, versus the national average of 64 per cent. Consent for donation was given in seven out of 10 cases when the family had prior knowledge of their loved one's wishes. This dropped to five out of 10 families agreeing to donation when the family was unsure of their loved one's wishes.

While it is vitally important to have that conversation with your family about your wishes, it is equally important to register the decision with the national registry. If registration increases, consent rates will also increase, and more people will be given a second chance at life. As we are all aware, successful organ donation can be a bit of a lottery of odds and circumstance. Less than 2 per cent of people who die in hospital are eligible to donate their organs through circumstances often beyond their control.

Their organs may not be in the best condition for transplant or not compatible with those on a waiting list, so it is critical that registration is as high as it can possibly be to increase those odds. The more people who are registered, the more likely that organ donation will occur. Last year, a record 95 South Australians received organ transplants from 36 donors. One of these was Mount Gambier's Kimberley Telford, who had the state's first kidney/pancreas transplant and who I know personally and have spoken to many times and also relayed her story in this house.

Currently, one in three Australians is registered on the national Organ Donor Register, which is a positive figure, but it could be higher. Just like dying without a will, I imagine sometimes that people die without making their intentions clear about organ donation. The intent is there, but they just have not got around to formally completing the task. Something needs to prompt people into action. If other states were to adopt our licence scheme, that call to action would occur every time someone renews their licence.

Often I look at what colleagues are doing in other states for ideas that could also assist our state, and I hope that by raising this issue today it will prompt discussion in other states on reinstating state-based licence schemes. As a nation, we could be leading the way on organ donation. As we often get up here and draw attention to things that are not working, I also feel it is important to talk about when something is going right and give credit where credit is due. I feel proud to live in a state that is leading the way on organ donation rates. It shows that education campaigns by DonateLife SA are working and attitudes are changing. I commend this motion to the house.

Ms COOK (Hurtle Vale) (11:55): I would like to thank the member for Mount Gambier for moving this motion on my behalf today:

That this house—

(a) recognises DonateLife Week from 28 July to 4 August;

(b) recognises the importance of organ donation;

(c) encourages families to discuss the importance of organ donation and to register their decision on the Australian Organ Donor Register; and

(d) encourages the Marshall government to support the comprehensive publicity and education programs focusing on both the public and healthcare professionals.

It is certainly a subject that we, across all parties and Independents in this place and the other place, agree on, that organ donation is something that is vital and is a subject that we must keep front of mind and on the political and public agenda.

While we talk about organ donation today like it is a routine part of the surgical process for many conditions, it actually started way back in 1869—a century before many of us were born—when the transplantation of skin was performed. We then saw vision being restored through corneal transplants at the turn of the century. It was not until the mid-1950s when the first kidney transplant was undertaken. Of course, now kidney transplants are reasonably frequent and common in most cities of the world.

The operations now almost seem routine to healthcare workers and, thankfully, recovery is at most times rapid and complete. In fact, recovery for an organ transplant recipient is often easier than for a live donor of a kidney, for example, for whom it is more uncomfortable and difficult from a surgical recovery process. We see hearts, lungs, livers, or a combination of all three being transplanted. Extraordinarily, we now see facial transplants and entire limb transplants, not even just bones—it is quite incredible.

The community awareness campaigns being run by DonateLife are extraordinary and raise the profile of organ and tissue donation in Australia. High-profile cases of organ donation and organ recipients also do a great job of lifting awareness in the public sphere. This year, DonateLife used a different type of event, the Amazing Race, to help launch DonateLife Week. As parliamentarians, we were given an opportunity by DonateLife attending here in this place to have a chat. Many members of parliament—in fact, most of those to whom I am speaking in this house today—visited the DonateLife team and took the opportunity to learn more and make commitments to promote organ donation within their electorate.

I would like to thank DonateLife director, Dr Stewart Moodie, who is an extraordinary physician working with some of the sickest people in our state, for helping to progress organ donation in the public sphere through DonateLife and through conversations and changes in procedures within our hospitals.

To be placed in the situation to make the decision about donating the organs or tissue of your loved one can be, could be and is the most difficult time of your life. It is very difficult for a family to make that decision, particularly if you are unaware of the wishes of your family member. The member for Mount Gambier pointed out some statistics. Only a couple of per cent of people in hospitals are eligible to donate their organs. The circumstances have to be right from a medical and emotional position. DonateLife have a priority of ensuring that all patients who die in critical care areas within hospitals are screened for donation when medical consensus about their end of life is achieved.

There has been a rollout at the Royal Adelaide Hospital of the end-of-life follow-up service, and it is hoped that this will be implemented at all SA Health intensive care and emergency departments. They report an increase in annual donors within South Australia, particularly at the Royal Adelaide. In the year to date, 40 South Australians have donated organs for transplant. Nationally, it is 375, so we are batting above the average, so to speak. If the numbers continue at that rate, we should achieve our highest annual total from 2008, which was 43. Nationally, there are some telling stats as well, which I will not repeat, but we do very well in Australia, and there have been conversations about how we can lift that rate.

Often, people will talk about making it an opt-out rather than an opt-in process, so people would automatically be an organ donor unless they say, 'I don't want to be.' There is no evidence to say that that lifts transplant or donor rates. I have looked at this, and asked many of the experts, and it has been investigated by parliamentary committees. The evidence is that the conversations that we have with our families and our friends, the very positive conversations and the very positive campaigns, are the weightiest in terms of influence and where we see the results of organ donation and organs being received. If the family knows, if the intention has been made, if it is very clear, then it is easier for a family to decide.

I do speak on a couple of levels. I am an intensive care and retrieval nurse, and I have been involved in many cases where families have been supported through the process. I have been privileged to look after people who have been worked up for organ donation in the intensive care unit. It is a highly emotional time, but the most beautiful time as a nurse to be connected to that patient, knowing that they are going off to provide a gift to many people, in some cases. I have often come back and looked after people after that who have been a recipient of the organ from the person who has given it. It is an extraordinary privilege to be able to be involved in that.

Yesterday would have been my son's 29th birthday, but in 2008—the year when they did have the most organ donors in South Australia—he was an organ donor. He gave life to four people. Sadly, it could not be more because his body was not able to hold out for long enough. I was involved in that process as a mother. When he got his driver's licence he proudly showed me that he had highlighted that he was going to be a donor, because we had spoken about it. We had talked about how important it was, as sometimes mum would come home from work most upset about what had happened at work; I would explain why and we would have conversations. I think those types of things are very powerful.

I would encourage everybody to follow the request of DonateLife and people associated with organ donation in our state, and that is to register on your driver's licence, because that indicator itself is linked with a higher level of organ donation, and then follow through by going to donatelife.gov.au to make your intentions very clear by completing the forms online and registering as a donor.

I would like to take this opportunity to thank DonateLife for all the wonderful work they do and to thank all families and all individuals who have made the choice to be part of this very special process of becoming an organ donor. Whether it is by wish for the future or, if it has already happened, thank you very much for the lives that you have given and the support and the hope that you offer to people who suffer from the most debilitating and crippling lifelong illnesses. I thank in advance the people in this place who will speak on this motion, and I commend the motion to the house.

Mr DULUK (Waite) (12:05): I also thank the member for Hurtle Vale for moving this motion. I know she is very passionate and real about this issue and the importance of organ donation. I thank the member for Mount Gambier as well. In the time the members for Mount Gambier and Hurtle Vale and I have been here, similar years, we have constantly been raising this matter.

I do support the motion, as organ donation does save lives. Of course, the motion acknowledges DonateLife Week, which runs from Sunday 28 July until 4 August. Obviously, that was celebrated about a month or so ago. The week is about raising awareness of organ and tissue donation. It is about encouraging all Australians to register their donation decision on the Australian Organ Donor Register and discuss their donation decisions with their loved ones, their families and those who are close to them.

As the member for Hurtle Vale said, every time someone registers to become an organ donor and every time that that donation is accepted and used at some point, a life is saved or a quality of life is improved. I thank everyone who is an organ donor from the bottom of my heart. I also want to thank the families of everyone who has donated an organ. It is one of the most important things you can do to transform a life. I would like to, once again, as I do every year, put on the record my thanks to that family that donated an organ to my mum, which ensured that she can have a fuller life, which is so important. In my family, we are very grateful to those who choose to make organ donation available, so thank you very much.

A lot of people, as has been discussed, do not actually know what their obligations are in terms of the process to go about donating their organs. I think it is so important that we as parliamentarians, as a government and as a community raise that awareness so people know how they can easily make a difference to someone's life by merely putting their name on the register and the simple process of doing that. The more we talk about this issue and the more we raise it, if we get just one extra person every day putting their name on the register that is a fantastic thing.

Australia has one of the best transplant success rates in the world, and research shows that the majority of Australians support organ and tissue donation. In many fields of transplant, whether it is kidneys, livers or harvesting of other parts, we have been doing this for many, many years, and many of the people who practise in this field are world leaders, which is a fantastic testament to our Australian medical profession.

At times, it can be a hard decision for families to accept the consent of a loved one who has said they would like to be an organ donor. By and large, that donation is made at a time when loss of one's life gives the ability for organs to be donated, and that is quite often a hard conversation to be had at the time by the families. But I do urge everyone here to go home and discuss organ donation with their families and friends to make it clear that you would like to be an organ donor. While the majority of Australians, about 71 per cent, think it is important to talk about the situation with their family, only about half of those Australians have discussed whether they actually want to be a donor.

How does one become a donor? The Australian Organ Donor Register is the official national register for people 16 years of age or older to give them the intention to be a donor. Recording your decision on the register ensures that authorised healthcare professionals anywhere in Australia can check your donation decision at any time. In the event of your death, information about your decision will be provided to your family.

There are currently about 1,400 Australians on a short list waiting for life-saving organ transplants. A further 11,000 Australians are on kidney dialysis, many of whom would benefit from a kidney transplant. In 2018, 554 deceased and 238 living organ donors and their families gave 1,782 Australians a new chance at life. More than 10,500 Australians have benefited from eye and tissue donation.

The majority of Australians—69 per cent—have indicated they would be willing to become an organ or tissue donor but, as I said before, only about one in three are on the register, so it is really important for us to translate the desire of the Australian community into a practical outcome. Nine in 10 families say yes to donation when their loved one is a registered donor, and that is so important. Our national consent rate currently sits at about 64 per cent but, if our consent rate and take-up rate get to hit about 70 per cent then Australia would be in the top 10 performing countries in terms of organ donation.

Another interesting statistic is that, of the 36 per cent of Australians who feel confident they know if their loved ones are willing to be a donor, 93 per cent say they would uphold their wishes. As the member for Hurtle Vale commented, having those conversations is so important so that your loved ones actually know your wishes and to make sure that wish is carried through at the important time.

People who need organ transplants are usually very sick or dying because one or more of their organs is failing. They are all of us in the community: they are our children, they are our parents, they are our families, they are our grandparents. Organ donation has progressed over the years and, of course, the success of transplants and the technologies have greatly improved to make the process a much more seamless transition.

We never know when illness could affect a family member, friend or colleague who may need a transplant, and how many of us would be enormously grateful to receive a donor organ if we required one. The gift of life is the most amazing gift anyone can give. After I am gone, I will not have use for my organs, and maybe not all of them will be any good to anyone, but that opportunity will be there. Hopefully, we can all make a difference in this important issue.

Mr PICTON (Kaurna) (12:11): I thank both the member for Hurtle Vale and the member for Mount Gambier for moving this motion today. It is such an important motion, that we continue to do anything we possibly can—as a government, as a parliament, as a state—to increase organ donation rates, to increase the awareness and acceptance of organ donation in South Australia. We know what an important difference it makes to families, those people who are waiting on donations, and we also know what a great gift it can be out of tragic circumstances for those who are lost.

We have had a great record, in South Australia, of organ donation. We have the highest sign-up rate of any state, and that is largely due to the fact that we have an excellent system of signing up through driver's licences. This is something other states, which had previously had such a sign-up system, discarded, opting instead for the national register. Here in South Australia we have kept that through driver's licences, and it has been an enormous success. It has led to greater sign-up and greater acceptance, and I think other states are now looking to reinstate the driver's licence method of signing up.

I would like to give credit to the hardworking clinicians, who do excellent work in this space, led here by Stewart Moodie at the RAH, who does an excellent job as the head of DonateLife in South Australia. Right the way through, our clinicians at every level do an excellent job in terms of undertaking transplants where appropriate and also caring for people who are at the end stage of their life, having those conversations—that can be difficult at times—with loved ones about how they can make sure their loved one who is passing away can contribute to bettering the lives of other people.

We know from international evidence that having that conversation, having trained people, loving people, doing that work and having those conversations plays a large part in increasing the donor rate, something we have done well in South Australia. I hope that continues to be resourced; I hope we see continued resourcing of that work here in South Australia.

Probably over the last decade there has been a significant amount of increased attention, focus and funding in this area since DonateLife was established under the Rudd government. There was also significant work done here under the Rann and Weatherill governments at our state level. I hope that we see that work continue and I hope that we do not see any reduction of that effort or funding in the future.

I congratulate all the hardworking staff who undertake that work. It is because of them and their hardworking efforts that other people's lives are able to be saved. I particularly thank those families, those loved ones, who have given their permission to make sure that organ donation can occur, because that is a gift that continues. Obviously, the member for Hurtle Vale has spoken many times about her personal experience, but there are so many other families in South Australia as well. Thank you to all of them for the gifts that they have provided to other people. It means that they can go on to live a fulfilling and healthy life in this state or in other states thanks to those gifts and sacrifices.

This is an area where there is always some policy debate about whether you change to an opt-out system. I think the evidence is that it is not necessarily successful or that it would lead to an increased rate; in fact, it would lead to a number of people opting out, people who may well consider it in the future under the current system in South Australia, particularly when we have a state with such a high sign-up rate already. I do not think the evidence has been shown on that. Obviously, we will continue to look at any possible effort to increase our donor rate and the number of successful organ donations.

I am happy to look at any possible advice, but we need to make sure that we do not sacrifice the excellent strides and efforts that we have made in the state already. I therefore wholeheartedly endorse this motion.

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