Last month a government advisory committee said the system was the only way to relieve 'the chronic shortfall' of donors in Britain. The number of organs available for transplant is falling; in 1991, the last year for which figures are available, it fell by 8 per cent. Hundreds of people on waiting lists die before an organ is found.
But speaking at the launch of the first television advertising campaign on organ donation, Mrs Bottomley said an opt-out scheme would be counter productive and cause medical and legal problems.
Instead, she argued that the new campaign would get families talking about organ donation. If a person has signed a donor card then technically his or her organs may be used but in practice, the next of kin must also agree. About one-third of those approached by a doctor do not give their consent, according to Mrs Bottomley.
'The real issue is to make it (organ donation) commonplace and normal,' she said. 'I hope that by bringing it into the home during peak evening viewing we will trigger a discussion . . . Then should tragedy strike, relatives will be prepared to carry out their loved one's wishes.'
A voluntary donor consent box is to be incorporated on all new driving licences. Such a scheme was introduced in Northern Ireland in 1991. Kenneth Carlisle, minister for roads and traffic, said yesterday that he believed it had been successful although no data was available. In a report last month to the Cabinet Office, the Advisory Council on Science and Technology (Acost) said that past measures - such as donor cards and advertising - had failed and radical actions were needed.
Only 30 per cent of the population carries cards and of the transplants carried out in 1990, none came from a person carrying a donor card. Successful opt-out schemes have been introduced in Belgium, France and Austria.
Dr Peter Doyle, chairman of Acost, yesterday welcomed the new campaigns but said that opt- out was the only permanent solution to the problem. 'There are legal and ethical problems but other countries have not allowed them to be a barrier; they have been faced and overcome.' The year after an opt-out system was introduced in Belgium, the number of available organs doubled; France now does more transplants per head of population than any other country.
About 5,000 transplants are carried out here each year; in 1991 there were 2,730 solid organ transplants - kidney, heart, liver, lung or pancreas - of which 1,765 were kidneys. There are more than 5,000 people who need a solid organ at any one time and are unable to get one and the demand is growing. Another 500 people need corneas and others need tissues such as heart valves. Less than a fifth of possible recipients had a kidney transplant last year.