A leading transplant surgeon became the first to call for the sale of human organs to be legalised yesterday so that controls can be imposed on the growing international trade.
Professor Nadey Hakim of St Mary's Hospital, London, who is president of the Royal Society of Medicine's transplant committee, is the latest member of the medical establishment to argue that the black market in organs can no longer be ignored and measures must be taken to deal with it.
But he went further than colleagues by arguing that the risks of the unregulated trade in organs outweighed the dangers of legalising it.
"As this trade is going on anyway, why not have a controlled trade where if someone wants to donate a kidney for a particular price, that would be acceptable? If it's done safely the donor will not suffer," he said on BBC Radio 4's File on Four programme.
His remarks echo those of Sir Peter Bell, vice-president of the Royal College of Surgeons and professor of surgery at the University of Leicester, who suggested "compensatory payments" should be made to relatives who donate a kidney to a family member, as a way of staving off the growing trade in organs from the developing world.
Sir Graeme Catto, president of the General Medical Council and a kidney specialist, has also called for a debate on the issue. He said the desperation of dying patients whose only hope was to obtain an organ, legally or illegally, was driving the trade and demanded attention.
"It is illegal in this country and the vast majority of people find it distasteful but nevertheless it is one way of obtaining more organs and it needs to be discussed. People prefer not to think about it because that is more comfortable. People prefer to hide from the grim reality," he said.
Last year, the GMC's professional conduct committee found two British GPs guilty of serious professional misconduct for encouraging the trade in human organs. They were exposed by undercover reporters from a Sunday newspaper posing as patients seeking a kidney for the father of one of them. Kidney patients from Britain who have despaired of the long NHS waiting lists for a replacement organ have sought treatment abroad with organs bought from living donors in the developing world.
About 7,000 patients are waiting for kidney transplants in the UK but only 3,000 operations are conducted each year. Some kidney patients spend years on dialysis before a replacement organ becomes available. A survey of UK transplant units last year found 29 NHS patients had travelled abroad to buy kidneys illegally. In more than half the cases the kidney failed and more than a third of the patients died.
Andrew Ready, head of the renal unit at Queen Elizabeth Hospital, Birmingham, who conducted the survey, said the black market in organs should not be allowed to flourish. "Increasingly we have to look at newer concepts and some may argue that there may be a role here for financial incentives," he said.
The Department of Health is due to publish a white paper on organ donation following a consultation paper last year.