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1.47 pm
Mr. David Wilshire (Spelthorne) (Con): I oppose the Bill, not because I am against its objectives but because I disagree with its methods. Before I explain the reasons, I stress that I am not speaking as an official spokesman. We are considering an intensely personal, free-vote issue for all of us.
My views were formed following the death of my 12-year-old daughter 22 years ago. I explained the painful details in the debate on Second Reading of the Human Tissue Bill on 15 January, so I hope that hon. Members will forgive me if I do not repeat them today. However, I cannot avoid referring to them because the Bill would draw a distinction between a child and an adult. I do not believe that that distinction is valid. Surely a 17-year-old or a 25-year-old child is as precious to its parents as a 12-year-old. Many people of 30-something are just as precious to their spouses or children. I do not understand the distinction.
I have no objection in principle to the removal of parts of a dead body. I have carried an organ donor card all my adult life. However, I have serious anxieties about presumed consent. I readily accept that there are some powerful arguments for presumed consent, principally the shortage of donor organs and the many opportunities to help even more people who need a transplant. They are worthy objectives, which I hope that we all support.
However, I doubt whether presumed consent would solve the problems that its supporters claim it would. There are other, better ways in which to achieve the
Bill's objectives. In addition, there are understandable fears about abuse and the potentially distressing impact of presumed consent on bereaved relatives. In the circumstances I found myself in 22 years ago, had presumed consent been in operation, a doctor would have got on and done what he judged was needed, or would have had to check that I had no objections. Had I discovered later that although I was in the hospital, no one had taken the trouble to consult me, I would have been outraged. Had I been invited to object, rather than asked to agree, I would probably have been made to feel guilty for the rest of my life had I decided to refuse. When struggling to cope with the death of a loved one, of whatever age, the last thing a person needs is avoidable additional grief. In my mind, something that has the capacity to cause outrage and guilt, and add those to the hell that that person is going through, simply has to be wrong.That said, I well understand that doctors are busy people, and one might ask why I want to put obstacles in their way. Asking permission from a bereaved family will never be easy, so why make clinicians do something difficult and unpleasant? My answer is this: if ever there is a situation in which the needs and wishes of patients and their families must come first, this is it. On such occasions, clinical convenience is a very secondary issue. Even so, presumed consent would not spare doctors the dreadfully difficult task of raising the issue of organ donation with bereaved families. Asking, "Do you wish to object?" is no easier than asking, "Please may I do this?" but the latter is far kinder and gentler.
As I said at the outset, I believe that there are better ways of achieving the highly desirable outcome for which the hon. Member for Mitcham and Morden (Siobhain McDonagh) has spoken. My preferred way would be required request, and I shall give the House a few examples of what I have in mind. We could train, then require, general practitioners to raise the issue with
their patients, especially when registering new patients, and record all agreement on a central database. We could help, then require, hospital managers to add some sort of question to hospital admission forms. We could train, then require, hospital doctors, especially those who specialise in accident and emergency, to raise the subject gently with the bereaved.I am as keen on the objectives underpinning the Bill as its sponsors are. In opposing them, I mean no criticism of either the objectives or the sponsors. The last thing I want is to be divisive. Happily, all these issues, and more, are currently being fully considered by the Standing Committee handling the Human Tissue Bill. I understand that there will also be a very full debate during that Bill's Report stage. That is the time for all those who want to speak on and wrestle with these intensely personal issues to do so. That is the time to have a full and free vote on the best way of achieving the objectives. That is why I have no wish to divide the House this afternoon.
Bill ordered to be brought in by Siobhain McDonagh, David Cairns, Mr. Tom Watson, Laura Moffatt, Mr. Stephen Pound, Mr. Tam Dalyell, Mr. Alistair Carmichael, Mr. Kenneth Clarke, Dr. Evan Harris, John Austin, Mark Tami and Dr. Nick Palmer.
Organ Donation (Presumed Consent and Safeguards) Bill
Siobhain McDonagh accordingly presented 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: And the same was read the First time; and ordered to be read a Second time on Friday 30 April, and to be printed [Bill 47].
Orders of the DayChild Trust Funds Bill
Not amended in the Standing Committee, considered.
New Clause 1
Early Withdrawal, etc, for Disabled Children
'(1) If this section applies to a child, the responsible person may withdraw funds from the child's account in accordance with the provisions of this section.
(2) This section applies to a child if—
(a) a child trust fund is held by the child, and
(b) a person is, or persons are, entitled to Disability Living Allowance in respect of the child.
(3) A responsible person shall inform the relevant account provider if this section applies to a child trust fund.
(4) The account provider must inform the Inland Revenue of information provided in accordance with subsection (3).
(5) A responsible person may, after having informed the relevant account provider in accordance with subsection (3), apply to withdraw amounts from the fund, including the whole amount of the fund, for expenditure for one or more of the purposes specified in subsection (7).
(6) On receipt of an application, the account provider must—
(a) release the amount requested to be withdrawn, and
(b) inform the Inland Revenue in accordance with regulations.
(7) Those purposes are—
(a) the purchase or hire of equipment for use by the child in respect of their disability;
(b) payment for nursing, night or child care;
(c) payment for respite care or temporary residential care; and
(d) payment for any specialist medical or palliative service in respect of the child's disability.
(8) The responsible person shall, wherever practicable, consult the disabled child about the expenditure of amounts withdrawn in accordance with the provisions of this section.
(9) Regulations may prescribe—
(a) the means by which account providers and the Inland Revenue are informed about the application of this section to a child, and
(b) requirements for the provision of information to the Inland Revenue relating to expenditure of amounts withdrawn in accordance with the provisions of this section.'.—[Mr. Cameron.]
Brought up, and read the First time.
1.55 pm
Mr. David Cameron (Witney) (Con): I beg to move, That the clause be read a Second time.
Madam Deputy Speaker (Sylvia Heal): With this it will be convenient to discuss the following: New clause 2—Early withdrawal in case of terminal illness—
'(1) If this section applies to a child, the responsible person may withdraw funds from the child's account in accordance with the provisions of subsections (4) and (5).
(2) This section applies to a child if—
(a) a child trust fund is held by the child, and
(b) the child was first an eligible child by virtue of section 2(1)(a), and
(3) Regulations may prescribe the requirements for the issue of a certificate for the purposes of subsection (2)(c).
(4) A responsible person may, having given a certificate to the relevant account provider, apply to withdraw amounts from the fund, including the whole amount of the fund.
(5) On receipt of the certificate and application, the account provider must—
(a) release the amount requested to be withdrawn, and
(b) inform the Inland Revenue in accordance with regulations.
(6) The responsible person shall, wherever practicable, consult the child about the expenditure of amounts withdrawn in accordance with the provisions of this section.
(7) In this section—
"attending physician" means the physician who has primary responsibility for the care of the child and the treatment of the child's illness;
"consulting physician" means a consultant physician practising in the National Health Service who is qualified by speciality to make a professional diagnosis and prognosis regarding the child's illness and who is independent of the attending physician;
"physician" means a registered medical practitioner; and
"terminal illness" means an illness which, in the opinion of the consulting physician, is inevitably progressive, the effects of which cannot be reversed by treatment (although treatment may be successful in relieving symptoms temporarily) and which will be likely to result in the child's death before his eighteenth birthday.'.
Amendment No. 3, in page 2, line 44 [Clause 3], leave out 'as' and insert
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