Under ministers' plans, almost the whole of the adult population could be placed on the national computer run by the UK Transplant Support Services Authority (TSSA) in Bristol, a statutory body under the NHS with a current annual budget of pounds 4.5m.
The new database could give a lifeline to thousands of people waiting for transplants. At present there are 5,700 people waiting: 4,976 for kidneys, 282 for hearts, 173 for hearts and lungs, 164 for lungs and 112 for livers. The numbers have been rising steadily for 20 years but there are only about 1,000 donors a year.
The number is small because organs are usually taken only from patients who have died in intensive care units. About 30 per cent of all families asked by doctors to approve donation refuse to give their consent.
A feasibility study for the Department of Health has convinced ministers that a national register would work. They believe that the organ donor card is not working effectively, with too many people forgetting to carry it and families being reluctant to agree to their relatives' organs being used after fatal accidents.
The Department of Health said last night that no final decision had been reached, but ministers have privately made it clear they back a national register, expected to be announced in the autumn. It will recruit donors by using the vehicle driving licence form. GPs will be asked to recruit donors, and 10 million donor forms are to be issued through public offices.
New driving-licence forms currently carry a box to be ticked if the holder wishes to be a donor, but the information is not carried on a computer. Under the new system, the information will be passed by the driving licence centre at Swansea to the computer at Bristol.
GPs will be asked to invite new patients to sign forms volunteering to be donors, which will be logged on the Bristol computer. The rest of the adult population will be urged to volunteer for the national donor register on forms available at most public offices.
Although a pounds 1m television campaign to encourage more people to carry donor cards was launched in April, the present system has not provided enough donors to meet the demand. The success of the seat belt campaign has also cut the numbers of organs for donation, with donors from fatal road traffic accidents falling from 29 per cent in 1989 to 19 per cent in 1993.
The TSSA has 5,700 patients on its register waiting for transplant organs. Local and regional registers of donors exist, but there is no national register.
Ministers have decided to keep the donor system entirely voluntary, and have rejected an 'opt out' system under which people would have been assumed to be donors unless they left instructions saying they did not wish to be. Tom Sackville, Under-Secretary of State for Health, said after a survey by the King's Fund in April that most medical professionals opposed such a scheme, and it was 'entirely at odds with the spirit of organ donation as a voluntary act . . . '
A national register has the support of the UK transplant support centre. A spokeswoman said: 'A national register would make it easier for the family. If someone can say their relative is on the register, they will be reassured. If people really do wish to donate their organs they can register. That will end the confusion for families.'
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