Interview: ABC Hobart, Statewide Mornings with Leon Compton - Tuesday 27 September 2011
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27 September 2011
Subject: Organ and Tissue Donation in Tasmania
Leon Compton: On other matters this morning, Tasmanian families are donating organs over the last 10 years at better rates than we were in the previous 10, but there are some difficulties in making it perfect transfer because of, well, a range of reasons - and some that you mightn't have thought of before. Do you know what your plans are with your organs? Have you ticked a box? Have you told somebody else what you want to happen to your organs when you go? Do you know what those closest to you want done with their organs? Because that is perhaps an even more important question.
Catherine King is in the studio this morning, and indeed in the state. She's the Parliamentary Secretary for Health and Ageing. Catherine King, good morning.
Catherine King: Good morning.
Leon Compton: : What do you want done with your organs when you pass?
Catherine King: Well, I’ve made the decision to go, and I did quite some time ago before I took over responsibility for the Organ and Tissue Donation Authority to tick the box and get on the Organ Donor Register. And I've had that conversation with my husband as well. And I knew that he wanted to be an organ donor because one day I was, you know, going through his wallet for some reason or other, and pulled out his organ donor card and said, ‘Oh, I didn't realise you're on the register’. And we've had a conversation about that. So we both know each other's wishes. I've also got a three-year-old and we have had a conversation about what, you know, in the awful circumstances, what would we do then - and that's a really tough conversation to have.
So we've taken the decision that we would donate his organs as well if something terrible happened. And it's not - no, it's not something that you immediately think that you should have a conversation about around the dinner table, but what I - what we do know is that it makes an enormous difference if you are ever in the circumstances where you are being asked to consent to your loved ones wishes around organ donation, it is a much easier decision to make if that conversation's already been had and I've talked to a large number of families of organ donors and they will say that absolutely, it's a traumatic circumstance; often unexpected. If they've had that conversation beforehand they just said it was an easy decision to make.
I knew what they wanted. And that really does make a difference in terms of our consent rates. And obviously then that translating through into people being able to get lifesaving transplant surgery.
Leon Compton: You talk about consent rates. What about to actual organ donation from Tasmania? How are we going at the moment re organ donation?
Catherine King: The national reform program which the federal government's put $151 million into, and you've now got a Tasmanian DonateLife team, you've got staff - I'm going to see Royal Hobart Hospital today to have a chat to the staff there who've been working really hard to lift the rate. 2010 was an amazing year I'd have to say in terms of the rate of organ donation for Tasmania and [indistinct]…
Leon Compton: And I'll just stop you there for a moment.
Catherine King: Yeah.
Leon Compton: So, listeners, Catherine King's about to give you a figure - an amazing year for organ donation. How many people do you think she's going to say donated their organs from the state? What do you think's an amazing year from her perspective? Okay?
Catherine King: [Laughs] That's fine.
Leon Compton: Catherine King, what is the figure?
Catherine King: So last year there were 10 organ donors, so that actually means there's multiple organs obviously donated from those people, and compared to your previous year's figures that was well over something like a 50 per cent increase on your previous year's. So, in fact, over double what you've done previously so that's meant that lifesaving surgery across [inaudible]… those organs are obviously offered to people on the transplant waiting list across the country.
But certainly has meant lifesaving surgery for a large number of people compared to previously, but the real issue which is, this is sort of where the real crux of this work is done, is in your intensive care units - with your transplant surgeons interstate, making those decisions with families in really difficult circumstances, and it's worked there actually making sure we're looking after families - we know people's wishes, we're actually following through with all of those procedures properly is really what makes the difference. And I'd have to say, you know, Tasmania has really improved markedly on previously… years to date.
We're struggling a little bit this year. The organ donation rate is not quite where we'd like it to be in Tas this year. But - and there's a few reasons for that and I'm going to have a chat to the DonateLife team about that.
Leon Compton: But it takes a quite specific range of circumstances for somebody to be in a position where well, they can donate - or somebody, you know, they can, their wishes can be observed - and their organs can be donated.
Catherine King: Yes, absolutely.
Leon Compton: Could it be that it's not that people are saying no, rather that simply we just haven't had the type of death that lends organ donation.
Catherine King: It can be those reasons as well as, you know, obviously people making the decision not to consent to their families wishes or people not knowing what their family members wishes are. So it can be a range of reasons. Yeah. There are very sp… not everybody who dies can become an organ donor, there are some very specific circumstances in which that obviously has to happen to make it viable. So that certainly can be part of the reason as well. And to some extent we've - there is some correlation between our success in getting the road toll down and a drop in organ donation at different points in time as well. And you know that can only obviously be a good thing.
But we want to make sure that every available person who does wish to become an organ donor, that those wishes are acceded to, because there are 1500 people currently waiting on the transplant waiting list and you only get on that waiting list if it is the last possible thing that can save your life. And I'm going to be meeting with Sophie who's a three year old, today, who received a liver transplant, and I'm looking forward to meeting her. As I said I've got a son the same age. I cannot imagine being those parents and waiting for that sort of surgery for a young three old and there are many children on the waiting list.
Leon Compton: Sure. So Sophie could die on the w… I mean this is…
Catherine King: She's had a transplant so she's…
Leon Compton: … okay, she's had a transplant. I - children like Sophie on the waiting list who have been in her position can die on the waiting list.
Catherine King: Absolutely. Yes. That's correct.
Leon Compton: We imagine that the problem is a lack of suitable organs for donation. But what about the idea that as budgets are being slashed at the moment in health in Tasmania and other places that the problem in the future might be the availability of doctors and nurses and governments not able or willing to spend the money to actually get these procedures done.
Catherine King: Yes.
Leon Compton: Is that a risk at the moment?
Catherine King: Look, it can be. And that's part of every state and territory and the Commonwealth have signed on to this national reform program.
There was work being done in previous years as well which is a commitment of funding that's come from the Commonwealth but also states and territories have also contributed funding to make sure we lift the organ donation rate but also all state and territory ministers have made the commitment that they will meet the increasing costs, and there are increasing costs from the number of transplant surgeries that are being done.
There is a bit of a stoush on in Victoria at the moment. The Alfred Hospital is in a funding impasse in essence with the Victorian State Government over this very issue. Transplant surgeons there are clearly saying that they have capacity to do more surgery, but the Alfred, for a range of reasons, you know, they're saying publicly that it's around workforce capacity, but there's obviously - we understand there's some other issues around funding, literally putting their lung transplant for adults on a lighter caseload, which means they're not going to be doing as many surgeries…
Leon Compton: So they've got…
Catherine King: …over the course of the next two weeks. So [indistinct] decision.
Leon Compton: The organs might be there, but they don't - there's effectively a [indistinct]. And that's where Tasmanians go…
Catherine King: That's exactly where…
Leon Compton: …to have…
Catherine King: …Tasmanians go - yep, that's exactly right. So lung transplants - so anyone who's on Tasmania who's on the lung transplant waiting list would go to the Alfred Hospital. It's not to say that organs that are being donated will go to waste, they will be offered to other hospitals. There are two other major hospitals in Sydney and Brisbane that do lung transplants, and obviously there's a possibility of patients then having unfortunately to have to go to those hospitals for those transplants.
But it's - it is a circumstance that we are as a Commonwealth concerned about and keeping an eye on. State ministers have made a commitment, and to Victoria's credit, they have put substantial money on the table already to increase - for the increasing transplant cost. But we obviously - it's something that we're concerned about and continued in a - to keep a pretty close eye on.
Leon Compton: Look, I'm sorry to jump in again, but I understand we've only got you for a short amount of time. So my understanding… are Tasmanians getting caught up in this funding issue at the moment with the Tasmanian Government needing to fund some part of the treatment for Tasmanians who got to Victoria for treatment?
Catherine King: Well, Tasmanians are completely meeting all of their costs and their obligations, so the Tasmanian Health Department is. But potentially, if someone was to go - was waiting to go to surgery at the Alfred, they may get caught up on that - it's a bit hard to speculate to that.
But certainly the Alfred has given assurances that they will continue to meet clinical need and continue to meet the safety of their patients. But my concern is that having a major transplant hospital saying that it's going to lighten its clinical load for the next two-and-a-half weeks is not really something that we want to have happening.
To some extent it's a good problem to have because we're seeing more people donate their organs and tissue. And again, that's sort of one of the myths that are around organ donation, is that there are lots of other things that you can donate other than your organs. Tissues are very important for - obviously, and eyes are very important for people for restoring sight; tissue for burns victims as well as a whole range of other matters.
But certainly, our concern with the Alfred at the moment is if their lightening their clinical load, we certainly don't want to see any other hospitals doing that, and we certainly want to make sure all states and territories are meeting their funding commitments to increasing transplant surgery.
Leon Compton: And I would imagine the way that medicine is heading, because of our capacities and because of our ageing population, there will be a significantly increasing need for this sort of surgery into the future. Will the federal government have to pick up the increasing cost of transplants in Australia?
Catherine King: Yeah, well, look, certainly in terms of a national reform program, there are components that we do fund in terms of activities to support organ and tissues donation. Obviously through the Health and Hospitals Reform Program that the Health Minister, Nicola Roxon has negotiated through with all states and territories, there is substantial amounts of Commonwealth funding going into new money - going into hospitals.
But obviously on a national reform program that we're all committed to, which is raising the rate of organ and tissue donation, and therefore, transplant in this country, I think it's something that we're all responsible for and need to continue to vigilantly work towards because it is the only way that we can save those people's lives on the waiting list.
Leon Compton: I think we've got a team of people waiting for you at the moment at our Southern Hospital. We better let you go. Appreciate you coming in.
Catherine King: Lovely to talk to you. And I want to thank everyone in Tasmania for the efforts that they've made to raise awareness around organ and tissue donation. It's certainly one of the states where this is talked about a lot. So it's a good job, and certainly keep up the efforts here in Tasmania.
Leon Compton: Donna suggests that we get - or get acceptable noted tattoos - TMO - have you heard of this before?
Catherine King: No.
Leon Compton: Take my organs…
Catherine King: [Laughs]
Leon Compton: …tattooed somewhere on your body so that people can just look for in and go; okay, I understand their wishes?
Catherine King: Yeah, you can certainly still do that, but people are still going to ask your family members with - whether they'll consent or not. It's sort of one of those ethic - pretty tough ethical issues within a hospital setting. But it's good to - good if you do that. But I reckon it's better if you have that conversation with your family.
Leon Compton: : Appreciate you coming in.
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