Ms ROSOL (Bass) – Honourable Speaker, I rise to make my first contribution to a bill in this place. I am pleased to say on behalf of the Greens that we will be supporting the Human Tissue Amendment Bill 2024. I want to thank the government for the briefing on this bill. It was a very short briefing, but it was quite comprehensive. For a relatively brief bill, it does quite a lot. The amendment to allow for the publication of identifying particulars of organ donors with the consent of families is obviously something we can support, and we welcome changes that allow the sharing of these people’s stories. We also commend the department for making the decision to not enforce the provisions as they currently stand.
Similarly, allowing a paramedic to fulfil the role of a secondary medical practitioner in remote rescue settings is welcome, as is modernising the consent provisions in the bill, which I understand is reflective of the recent reforms made to the Guardianship and Administration Act 1995.
The various other amendments, including the removal of breast milk from the application of the act, and ensuring that human tissue collected under provisions of another act do not attract offences under this act, are also supported by the Greens.
Organ donations save lives. There are around 1800 Australians on the organ transplant wait list, and 14,000 people on kidney dialysis, many of whom could benefit from a transplant. In 2023, of 191,000 Australians who passed away, only 84,000 died in hospital. Of those, only 1530 were potential organ donors, and of these, requests were made of 1435, consent was granted for 793, and 513 donations were actually made to 1396 people.
This is information provided in a helpful infographic by DonateLife, and it does a good job of illustrating just how much the potential donor pool narrows down throughout the various stages. It also illustrates how we need to do everything we can not only to respect and value the contributions made by organ donors and their families but to make it easier and to encourage the donation of organs. Hopefully, this bill can make a small but meaningful contribution towards saving lives.
The minister mentioned the ability to register online or through the Medicare app or myGov. Recent developments to make it easier to register to be an organ donor are very welcome. The Greens have argued for many years for an opt-out system for organ donations, but in saying that it is important to acknowledge the issue is more complex than it may appear on its face, and indeed there are a range of views in the medical community about this issue.
Contemporary studies on the issue are mixed. Few opt-out systems in the world only consider the opinions of the deceased and not their families. In practice, if a deceased person has not actively consented and family members object to a donation, medical practitioners are often not comfortable proceeding with the donation, even if they are legally entitled to do so.
Some studies have emphasised that because of this, the benefits of an opt-out system are largely limited to the circumstances in which the views of both the deceased and the family are not known, and have estimated the impact of this to be in the range of a potential 0-5 per cent increase in donations.
Some studies have additionally warned that swapping to an opt-out system without accompanying health system education and public awareness reforms can have a negative impact on donation rates. All of that being said, many of these studies tend to suggest that if done right, there may be benefits to donation rates of an opt-out system.
To my knowledge, the last time Tasmania examined this issue was during a Legislative Council inquiry in 2007, and the issue does not appear to have formed part of the 2018 national review. Perhaps it is time to consider this matter again.
The Human Tissue Act 1985 is quite an old piece of legislation now and has not been amended since 2010, and its age clearly shows. The linking of autonomy to marital status and the assumption that a medical practitioner must be a male are two relevant examples of this.
I am curious about the updating of gendered language in this bill. I notice that clauses that are being amended for other purposes are replacing gendered language with gender-neutral language, but on my read, gendered language remains in the definition of ‘senior available next of kin’, as well as clauses 7, 8, 18, 25(a), 27 and 29. I assume there is a policy for updating gendered language in dated bills, but only insofar as provisions are already being amended, and I wonder if there can be some flexibility in this policy.
Obviously, if there is a minor amendment to a behemoth piece of legislation like the Land Use Planning and Approvals Act 1993, it would be unreasonable to expect OPC to significantly increase the size of a bill just to update language, but if there are only half a dozen or so gendered references in a bill, it seems a shame to not update those as well. I would be interested on the minister’s thoughts on this.
Minister, I also have some questions about the proposed amendment to section 28, which sets out that the act does not apply to the removal of tissue from the body of a person permitted under another act. I am wondering if this has been identified as an issue and I am curious whether this is an active legal issue or whether it has been identified as a change that needs to be made for clarification purposes. Are there any particular acts that have been identified in respect of this clause?
