06/03/2013 CF99

Hello and welcome to CF99, live from the Senedd in Cardiff Bay.

Before we meet our guests, here's a taste of tonight's programme.

The concerns of the Archbishop of Wales regarding

one of the Government's iconic policies.

I think that this legislation is dangerous.

I am 100% in favour of organ donation,

but this should be voluntary.

And the rumours from the corridors over possible changes

to electing members.

The most important thing for the people in this place is the work.

They think that they are working too hard.

More shortly. Joining me this evening, Nick Bennett,

the chief executive of Community Homes Wales, columnist

and broadcaster Angharad Mair, and former Plaid Cymru AM Dr Dai Lloyd.

Thank you for your company.

Well, with a key vote approaching in the Assembly,

the Archbishop of Wales has attacked Government plans to introduce

a system of presumed consent for organ donation.

According to Dr Barry Morgan, there is confusion over how such

a system would work and the Labour chair of the Health Committee has

told CF99 that the Health Minister needs to explain the situation.

Aled ap Dafydd reports.

Behind the spring sunshine at the cathedral,

a black cloud is gathering. Dangerous and confusing,

a selection of the adjectives used by Wales' most prominent cleric,

in describing the Welsh Government's iconic legislation.

I think that this legislation is dangerous.

I am 100% in favour of organ donation,

but it should be voluntary.

And people should opt into it rather than opt out.

I don't think it's right that the Government tells people that

unless you decide to opt out, we have the right to take your organs.

That is a step too far, I believe.

On average, three people die every month in Wales whilst

waiting for a transplant.

Assembly Members will vote on the principle of opting out next

month, the first step before the final approval of the legislation.

But the matter has already caused splits within

the Assembly Health Committee.

Some oppose the general principle.

Others say there is a lack of clarity regarding

the role of the family. Will they have a veto?

What about a system that allows input,

depending on how close their relationship with the patient is?

The family will provide information rather than make a decision,

according to the Welsh Government.

What we think as a committee is that the most important

point for the Government is to be clear and consistent,

regarding the role of the family in the new system.

And also, to try and be sure that what is on the face

of the legislation reflects what is happening in reality.

In an uncertain world, one thing is certain - death.

The opinion here is that the Government has crossed

an ethical line and made a mess of things at the same time.

The sticking point is the final say.

Who has it - the deceased or the family?

The Health Minister has recently said that they need to

look at that once again

and maybe give some sort of a basis to evidence from family members.

Finding out their opinion rather than

the opinion of the deceased person.

I think that confuses the argument.

And so if they are going to do that, that is the process we have now.

I don't see any purpose in having this legislation.

So what do you think they are aiming for in introducing this legislation?

Well, I don't know. I don't know why.

I think the Labour Party, for example,

have put it in their manifesto and so they are determined,

as they have promised to do this, to go ahead.

And I don't think they have thought about the results.

And once you're in this situation,

you just go ahead despite the evidence against.

That is not the opinion at the Kidney Wales Foundation,

as they prepare for one of their main fundraising events of the year.

They say the archbishop is free to have an opinion, but...

It's not right because this law will save us

from the cruelty of waiting for organs.

And that is difficult for families right across Wales

and the rest of the world, of course.

And I see it as odd that he is against it.

The archbishop, the charity and the politicians agree on one thing -

the need for more donors.

But deciding on a way to achieve that is proving difficult.

And no-one has yet had the final say.

Aled ap Dafydd. Dai Lloyd, when you were here,

I think you were the first AM to try and bring forward such a measure.

What is the evidence that this would lead to more organ donations?

We have figures from 22 other countries who have this system.

There are more organs available,

that is why we have brought this forward.

That is why we need this legislation.

About one person in Wales dies every week

waiting for an organ transplant.

Everyone wants to hassle the Health Minister asking about resources.

This is one waiting-list we could all help out with.

One of the deficiencies is that the lack of organs

and we can all do something about that.

Some would say, if you increase the number of organs

available on the waiting list, do we have the specialist doctors

and surgeons to be able to carry out the operations?

Yes, because at the moment a third of the transplants

are being done on people who are still alive.

We do not have enough organs available from those who have died.

Voluntary transplants that take place in Cardiff this year

have organs which have come up from people who are still alive

The capacity is there because we use it with people who are alive.

There aren't enough organs being donated from the deceased.

We will follow the question about consent from the family's shortly.

But first, we will look at the moral issue.

The fact that the body is being somehow nationalised.

-Is this worrying for you?

-Not really.

After hearing Dr Barry Morgan, we would say that the soul

is the most important thing and the body is just the instrument of that.

When you think about 36 people dying waiting for a transplant every year,

it is like a bus accident or something like that.

Any moral dilemma for you, Angharad?

Of all the articles I wrote for Golwg, his is one I avoided.

Of course, I think that this bill should go on to become law.

I have a lot of respect for Dr Barry Morgan,

and there is something sinister

about the way the state owns the body.

But, I also believe this is a bill

has had a lot of attention in the press.

It's had a great deal of attention in the English press.

Wouldn't it be nice if the Assembly could pass a law

that would get attention and be admired by people

who are very supportive of this measure.

We need to have the backbone to pass important legislation like this.

Time for the difficult question about the role of the family.

How does it work at the moment? The family still has a role today.

There isn't a card anymore, everything is kept on a computer.

Talks are held with the family.

There is no sense that the state will have control.

Who is the state? We are the state.

We have a system at the moment where you register for organ donation.

But a minority of the population does so.

Most people agree with the idea of organ donation,

but a minority only registers for it.

If you really do not want to take part, then you can opt out.

You are not being forced to take part.

What if someone has not opted out but they had told their wife,

for example, they intend to opt out,

but perhaps they had a heart attack just after saying that.

Does the wife then have a voice?

We have been dealing with a situation like this

for a number of years.

The structure is in place to make sure mistakes do not take place.

The situation is very sensitive.

We have sensitive talks with individuals and families

and we reach a decision from this.

If anyone is unhappy, it won't happen.

That is what will happen in future.

If anyone is unhappy, it won't happen.

Dai says that but he's a doctor.

In Mid-Staffordshire, targets were set

and all kinds of mistakes were being made.

Can we trust doctors who may want to do the best,

but sometimes make mistakes?

This is a bill to save lives.

Dai Lloyd spoke of other countries

and we have seen the situation in Belgium improved.

I do not think it is causing any problems the civil society.

In the end, we are saving lives.

It is possible for individuals to opt in.

After we pass this bill, they can opt out, what's the problem?

How detailed should this become?

There is a feeling people may be willing to give some organs

but not others.

Some people wouldn't want to give their eyes, hands or skin.

Myself, I would be happy for anyone to take anything

if it saved someone's life.

One could think that should come from this

is that people should be able to discuss it.

It would make it much easier for doctors

and families then, when they lose someone close.

It is going to be a deep discussion

but it is important to have it in order to get it through.

If those demands are respected,

how reasonable is it that those wishes are respected?

How detailed should these demands be?

That is what we do at the moment.

You can tick different boxes when you register now for organ donation.

It is much easier for the doctor to have a sensitive discussion

with the family at their terrible time for the family's.

In countries like Spain and Belgium,

people realise this is the established will of the people.

Only around 15% of families turned down this when the situation arises.

In this country now, if you ask families about organ donation

at a terrible time for them, you can appear cold-hearted.

Under such circumstances, 40% of families refuse.

-This is why we have to change the law.

-Thank you.

Last week, the Presiding Officer, Rosemary Butler,

explained why she thought the number of Assembly Members

needed to be increased from 60 to 80.

It's possible that the British Government

will lift the ban on standing in both a constituency

and on the regional list in the Assembly elections.

We asked political commentator, Gareth Hughes,

who can often be found loitering in the corridors,

to assess how such changes could affect the Assembly's work

and the standard of its members.

I have been in this place since it opened.

I have seen people come in and go out.

Since it was first established, there was a lot of excitement.

Standards have gone up and down.

When it started, the standard was very high,

then it seemed to drop a little bit.

It seems things are starting to improve again.

In the first Assembly, candidates could stand in constituencies

and on regional lists.

That soon changed, why?

Labour was not happy with this, so they decided to scrap the system.

But the system is back on the agenda now,

because the Westminster Government wants to change this.

Last time, the Conservatives did very well in constituencies,

but they lost their leader, who was on a regional list.

They want to change the system,

so they can take things back to how they were.

But the most important thing for the people here is work.

But they believed they worked too hard.

Now they have the power to legislate.

The Presiding Officer has said they need 80 members.

They say they need to increase the number of Assembly Members.

There will be an increase but we won't know how much.

There are 60 members now, and they would like to see 80.

Everyone is quiet here. They followed the party line.

More people might shake things up a little bit.

Change is in the air, the Silk Commission is looking at this place

and perhaps it could bring more powers.

That would raise the question as to whether there are enough members.

On what about the standard of these members?

After five years, this place will be completely different.

I am sure he will be here to see it as well.

You were part of the convention that went around the country

and that led to the increase in powers here?

Are 60 members enough? Was 60 enough in the first place?

I would be in favour of having 80 members.

When you compare this with the Scottish Parliament

and in Northern Ireland, they have more than 100 members.

There's one member in Northern Ireland for every 16,000 people.

But it will be harder to sell that with the economy as it is.

There is also a drop in the number of MPs.

But, at the moment you also have the debate about local Government.

I was going to bring that up.

One of my favourite facts is that we have more councillors in Wales

than they have in Scotland.

That means we have too many people at one level and not enough at another.

I would agree with that.

I would like to reduce the number of MPs as well.

This is not just about the number of councillors.

We have to think about the efficiency.

There was a case in Caerphilly Council this week.

There is a case to save a lot of money

with local Government reorganisation.

We won't chase after that there now,

but we will look at the question of standards.

With only 60 members, shirkers cannot hide?

But there are enough that can go on screen

and it can appear to be painful at times.

I have to admit having watched coverage from the assembly,

two members embarrass me because they did not have enough knowledge

about the subjects they were talking about.

They were two female members from Labour,

and I could not believe they had been elected to represent people.

I won't name them because I don't remember their names.

Sometimes, that does happen.

Yes, but when you only have 60 people,

choosing weak people weakens the whole institution.

Labour quite spiteful in changing the rules

ensured this place became weaker.

I think that decision has now come back to haunt them.

You need trust between this place and the people of Wales,

and I do not think that is in place at the moment.

There is a sense among the people this place is too weak.

No-one from Labour is here.

The argument that was used to change the rule

was about Dyffryn Clwyd in North Wales.

Four candidates in one constituency. The Labour candidate won.

The three unsuccessful candidates came here on the regional list.

They had lost the election but they still got through.

That is quite an extreme example.

Usually, there are two elections on the same day.

You vote for constituencies and regional lists on the same day.

Many people vote in a different way.

Perhaps they vote for Labour locally,

but then vote for Plaid Cymru on the regional list.

It would suit Labour to put that argument across.

You have two different elections taking place with different results.

Labour has always been prejudiced against regional list members.

It is a waste to vote for Labour in South Wales on the regional list,

because they pick up all the constituency seats.

They insist on having people voting for them.

It doesn't make sense at all.

Do we need to look at the system and consider different voting methods?

Should we look at the national list rather than a regional one?

This place does not truly represent the voting percentages.

Labour has an advantage.

Perhaps a whole Wales regional list would be more representative.

It is also very difficult for the smaller parties in this election.

It's harder for them to have 60 members every time.

Nick Bourne, Glyn Davies, Helen Mary, Nerys Evans.

We have had a number of good candidates being lost

because of this change to the system.

We also need strong opposition parties as well as the government.

Thanks very much to all three of you. That's it for another week.

We shall be back at 9.30pm next Wednesday. Join us then.

But for now, good evening.