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Mr. Straw: The terms of reference are clear, and it is for the inquiry, within those terms of reference, to interpret how they should be followed.
Mr. Jon Owen Jones (Cardiff, Central) (Lab/Co-op): Will the inquiry be able to consider the doctrine of pre-emption, which depends upon there being reliable information and intelligence and rational and unprejudiced selection from it?
Mr. Straw: I had not anticipated that the inquiry would wish to spend its time looking at the doctrine of pre-emption, and nor was pre-emption the issue before the Security Council or the House last March. As far as I can recall, it was never suggested that we should enter into some kind of gratuitously pre-emptive strike. I point out to my hon. Friend that it is not a matter of intelligence that is open to doubt but a matter of historical fact that no other country but Saddam's Iraq has been in such horrendous and continuing breach of chapter VII obligations under the United Nations Security Council for a period of 12 years. He had invaded Iran, he had invaded Kuwait, he had unleashed missiles on three other neighbouring countries, he had gassed 5,000 people in Halabja in a couple of days alone, he had used chemical and biological weapons, he had covertly hidden a nuclear programme and other programmes—and even as late as 7 March last year, Dr. Blix published a 173-page document of unanswered disarmament questions, which I put before the House in Command Paper 5785. If Saddam at any stage, knowing the deadline given to him and the obligations imposed on him by resolution 1441, had wished to answer those 173 pages of questions, he could have done so, and war could have been avoided. He chose not to do so.
Gregory Barker (Bexhill and Battle) (Con): The Foreign Secretary has drawn certain fair comparisons with the Franks committee in 1982. There is one stark difference, however: before that committee even sat, following the failure of the intelligence services to warn adequately of the threat to British interests, the Foreign Secretary and his entire Foreign Office ministerial team resigned. At what point can we expect ministerial responsibility to apply, and on what basis would the present Foreign Secretary accept responsibility?
Mr. Straw: I have always made clear my responsibility to the House and to my Privy Council oath. Whatever people may disagree with me about, I have never sought to shirk those responsibilities. I regretted greatly, at the time and subsequently, that Lord Carrington chose to
resign. I also say, however, that the circumstances of the Falklands were different from those under consideration today.
Mr. Tam Dalyell (Linlithgow) (Lab): On Friday 22 October 1982, I was summoned by Lord Franks to appear in front of his committee for one and three quarter hours. Since then I have expressed a great deal of unease, which was endorsed on 16 July, as is recorded in column 302 of Hansard, by the Foreign Secretary, and again endorsed by him on 22 October, in column 682. Does he share a view that the Franks committee may not be a good precedent? Would it not be better for a few straight questions to be answered, such as when did the Prime Minister commit himself to President Bush, on what terms did he commit himself, and when did he tell his Cabinet colleagues that he had done so?
Mr. Straw: I—[Interruption.] I am advised by an Opposition Member from a sedentary position that my answer should be, "I shall write to my hon. Friend shortly." The decision and the lead-up to the decision to take military action was public—it was argued out in this House. There was no way in which the House could have been misinformed or, by implication, misled. If my hon. Friend and other Members who took a different view about going to war read the record, they will see that by the time of the lead-up to the decision to take military action in mid-March, the arguments were not about the dossier, and still less about the 45 minutes. The issue was the breach of resolution 1441 and what we should do about it. As for his point about the Franks committee, in the debate on 22 October I recalled that when Franks published his report in January 1983, some of my hon. Friends were sceptical about it, and used the customary adjective. It was the request and the proposal of the Opposition that we should have a Franks-style committee now, however, and it is important that, as far as is conceivably possible, it should be on a bipartisan basis. I believe that those who have accepted the invitation to serve on the committee will do so with great distinction and independence.
Mr. Andrew Mackay (Bracknell) (Con): Whereas the hon. Member for Cynon Valley (Ann Clwyd) and many Conservative Members would have supported the Government in going to war with Iraq even if there had not been evidence of weapons of mass destruction, it is clear that a large number of Labour Back Benchers voted with the Government only because they were told that weapons of mass destruction were there. Can I tempt the Foreign Secretary to speculate as to whether he would have won that vote with this evidence?
Mr. Straw: The right hon. Gentleman has greater insights into the state of mind of my hon. Friends on 18 March than I would ever claim. What I look at is the motion before the House, which was all about the breach of resolution 1441, and the arguments put before the House, which again were about the breach of resolution 1441. That was the basis on which people made their decision.
Mr. George Foulkes (Carrick, Cumnock and Doon Valley) (Lab/Co-op): May I ask the Foreign Secretary to draw the attention of members of the committee to the
whole of the debate on 18 March 2003, in which no one, including the leader of the Liberal party, questioned the existence of weapons of mass destruction? Indeed, arguments were put forward forcibly by the shadow Foreign Secretary:
- "does Saddam Hussein really pose a risk to international peace and security? Well, the UN certainly thinks so, and it has thought so for the past 12 years".
- "Hans Blix's 7 March report demonstrates the terrifying weapons of mass destruction that are missing, and that must still be assumed to be there."—[Official Report, 18 March 2003; Vol. 401, c. 892.]
Mr. Straw: I will indeed draw the Hansard of 18 March to the attention of the leader of the Liberal party. A fat lot of good that will do, however, because Members on both sides of the House are used to the Liberals jumping on to any passing bandwagon and seeking to rewrite their history. This is simply a further episode in the continuing story of why the Liberal Democrats are not taken seriously.
Organ Donation (Presumed Consent and Safeguards)
1.37 pm
Siobhain McDonagh (Mitcham and Morden) (Lab): I beg to move,
- That leave be given to bring in a Bill to provide for the removal of organs for transplantation purposes, after death has been confirmed in a person aged 16 or over, except where a potential donor previously registered an objection or where a close relative objects.
Medical advances in our modern NHS have enabled very sick people to live longer while they are waiting for transplants. They have also ensured that more people who might in the past have died in accidents or from strokes now survive. Their organs are therefore no longer available for transplant. Therefore, there is a widening gap between the number of people waiting for transplants and the number of organs that become available.
I want us to reflect seriously today on how we can begin to narrow that gap and save hundreds of lives every year. First, I thank the BMA, the National Kidney Federation and doctors and patients at my local hospital, St. Helier, which has one of the south-east's leading renal units. They have persuaded me to take up this issue now. I also praise the efforts of other Members on both sides of the House who have led previous campaigns to extend organ donation, especially my hon. Friends the Members for Linlithgow (Mr. Dalyell), for Broxtowe (Dr. Palmer) and for West Bromwich, East (Mr. Watson), the right hon. and learned Member for Rushcliffe (Mr. Clarke) and the hon. Member for Oxford, West and Abingdon (Dr. Harris). I also thank those listeners to the Radio 4 "Today" programme who voted for presumed consent as the measure that they most wanted us to pass.
Surveys repeatedly show that between 70 and 90 per cent. of the population want to help someone else to live by donating their organs for transplant after their death. However, fewer than 20 per cent. formally join the NHS organ donor register or carry an organ donor card, and most families do not discuss their wishes about donation.
Unfortunately, the upshot is that at a time of bereavement, half of all relatives opt for the default position, which is not to donate, although studies show that many families later regret that decision. I do not criticise the families of deceased, who are undergoing a terrible ordeal. I hope that changing to a system of presumed consent will make the decision a little easier for them.
The decisions made have terrible consequences for the very ill patients in hospitals such as St. Helier who are desperate for a transplant. Without a transplant, they may have to spend years getting treatment such as dialysis at great cost to the NHS, and are often unable to carry out normal everyday activities or have a good
quality of life. It is estimated that for the average patient, compared with dialysis, a kidney transplant saves £191,000 over nine years, which is the median graft survival time. A patient who has had a transplant is far more likely to be able to contribute fully to society: to have a full life, to work, and, indeed, to pay taxes.My constituency is in the London borough of Merton. Recently, Merton's head of special needs education, Trevor Cook, had to leave work because he was too ill to continue. The people of Merton have lost a highly experienced and respected man who has contributed enormously to local public services, simply because he cannot get a transplant. Obviously, there are many other Trevor Cooks throughout the country.
As long ago as 1994, the King's Fund carried out a major survey of potential solutions to the transplant shortfall. It concluded that
- "an initiative which increases the supply of organs will, ipso facto, have one very important ethical argument in its favour: the potential to avoid death and relieve suffering."
As things stand, we presume that the deceased have not given consent, even though the chances are that that is against their wishes. However, the Bill includes several safeguards. It will be easy for people to opt out. It would be fair to say that anyone who had not opted out had made an informed decision not to do so. The Bill applies only to transplants, not to organ retention, and the families of the deceased can opt out. The proposals will not apply to children.
Presumed consent is neither a new idea nor simply a theory. It already operates elsewhere in the world. In Belgium, some interesting research has compared Antwerp with Leuven, two areas that are otherwise similar. Antwerp did not introduce the new presumed consent system, and its donation rates remained the same. However, Leuven adopted the new law and in three years its rates rose from 15 to 40 donors a year.
Let us consider the slightly more complicated story of Spain, which currently has the highest rate of organ donation in the world. Although it has a presumed consent law, the Spanish transplant organisation always seeks the consent of those closest to the donor. I propose that practice. Spain has the mindset that consent is presumed but that the relatives can overrule. That is more likely to get a positive and accurate outcome than is currently obtained in the UK.
Some, like Dr. Rafael Matesanz, believe that Spain's law on presumed consent is not the cause of increasing donation rates. However, since the change in the law, the number of families who withdraw consent has fallen to about one in five, compared with approximately half in the United Kingdom. I believe that a soft form of presumed consent has helped to change the mindset in Spain and improved attitudes to organ donation. The best comparative evidence from abroad clearly shows that presumed consent works.
Gimble et al have conducted the most thorough analysis of organ donation. They considered all the factors that contribute to increased donation rates, including religion, culture, education and other social pressures. Their conclusions were that presumed consent laws
- "had a significant effect on the number of cadaveric donors per million population. As the gap between supply and demand for transplant organs continues to widen, professionals and policymakers should consider revisiting the implications of this legislation , or some hybrid of alternatives, as an effort to expand the 'gift of life' to those in need."
I hope that I will be allowed to take this brief opportunity to urge all hon. Members, and anyone following the debate—in the Galleries, in Hansard or in the media—to sign up to the NHS organ donor register. It is possible to do that by visiting website www.uktransplant.org.uk or by calling 0845 60 60 400. Until presumed consent is in place, that remains the best way in which to help someone else to live after one's death.
In the long term, I believe that the best means of increasing the number of lives saved by organ donation, respecting the wishes of the deceased and being kinder to grieving relatives is to presume consent unless someone has opted out. I hope that the Bill will persuade more people to consider organ transplants seriously and to discuss it with their families. For the sake of thousands of people who are awaiting transplants in my constituency of Mitcham and Morden and throughout the country, I commend the Bill to the House.
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