Embargo: 00:01 Wednesday 2 July 2008
Contact: Owen Williams 020 7219 8659 or
Ashleigh Witcher on 020 7219 6640


The House of Lords European Union Committee has today welcomed EU proposals for a European directive on the quality and safety of organ donation and transplantation but has stressed that, in establishing minimum standards across Europe, the EU must not impose requirements beyond those which are clinically justifiable.

The Committee stress that any directive should include significant flexibility to allow scope for clinical judgement and patient choice. They point out that a for a patient who requires an urgent organ transplant to avoid imminent death, the clinical criteria for judging the acceptable quality of an organ will be different from those for a patient who can afford to wait longer for a transplant.

In conducting their inquiry, the Committee looked at the current state of organ transplant provision in the UK and other European countries. They found that Britain lags far behind some other countries in the level of organ donation. Britain only achieved an organ donor rate of 12.8 per million population compared to an EU average 18.8. The leaders in the field, Spain, achieved a rate of 35.1. They call on the Government to act urgently to address the shortage of available organs for transplantation in the UK.

In comparing the British and Spanish organ donation and transplantation systems, the Committee conclude that the reason for the vastly different performance has more to do with effective organisation of organ donation services, and the selection and training of staff, rather than legal differences. The Committee welcome moves by the Department of Health's Organ Donation Taskforce to draw on the Spanish model. This included the establishment of a centralised office for coordination, the appointment of regional organ donation coordinators and the appointment of organ donation coordinators in each hospital.

The Committee stress that organisational changes are the most effective way of improving the UK's organ donation rate. They argue that at this stage it would be premature to introduce an "opt-out" or presumed consent system for organ donation. They point out that a system of presumed consent would be ineffective without the numbers of skilled staff and coordinated system needed to deal with the greater volume of donor organs that this might generate.

The Committee state that before a decision is taken to introduce presumed consent, the Government must do more to raise public awareness of the importance of organ donation and to encourage more citizens to sign up to the existing organ donor register, which operates on an "opt-in" basis. They also argue that, if in the future a decision is taken to move to presumed consent, the system should not be implemented until considerable progress has been made in strengthening organ donation services.

The Committee heard evidence relating to the views of different ethnic minority, faith-based and other groups about organ donation issues. They recommend that the European Commission should support Member States in exchanging information about the views of such groups across the EU, especially those which are hard to reach, and in developing public awareness campaigns designed to engage them with the urgency of raising organ donation rates.

The Committee concluded that a standardised EU donor card would not command public support. Nevertheless, they suggest that the Commission should explore the options for a common format of donor card which is compatible with the donation consent process in force in the Member State of the holder's origin. Within the UK, they recommend that the Government should explore innovative means of expanding the extent of donor registration.

Commenting, Baroness Howarth of Breckland, who chairs the EU Sub-Committee on Social Policy and Consumer Affairs which conducted the inquiry, said:

"While we welcome the Commission's attempts to improve organ donation rates across the EU, we believe the measures which are introduced should not in any way undermine clinical judgement. Attempts to introduce common standards for organ quality and safety must not stop people in desperate need of a donated organ from getting a transplant."

"We looked in detail at the organ donation regime in the UK and concluded that we must do much more to emulate successful schemes such as that in Spain. We believe that all parts of the NHS must accept organ donation as a usual, not an unusual event, and that many more, and better trained, medical staff should have the role of providing organ donation services. This would go a long way to increasing the availability of organs for donation without needing to adopt a system of presumed consent."

Notes to Editors

  1. The report Increasing the supply of donor organs within the European Union, is available from The Stationery Office, House of Lords European Union Committee (Sub-Committee G), 17th Report of 2007/8, HL Paper 123.
  2. The report will be available online shortly after publication at:

For copies of the report, or to request an interview with Baroness Howarth, please contact Owen Williams, Head of Press and Media, House of Lords, on 020 7219 8659 or Ashleigh Witcher, Press Officer, on 020 7219 6640.