England’s opt-out scheme for organ donation does not seem to be working.

Rolled out in 2020, the system was supposed to provide an 100 extra donors and 230 more transplants every year. Fewer people, officials predicted, would die on waiting lists. Everyone was presumed to consent to organ donation unless they had objected. Under the old system, only people who had registered their consent could become organ donors. 

But four years on, fewer people are donating their organs, not more. The number of deceased donors actually fell by 10% from 2022 to 2023. The waiting list for an organ is nearly 30% higher than the previous year. 

Labour peer Lord (Philip) Hunt, told The Mail on Sunday: “I had great hopes we would see a real upturn in the number of donations, but the reality is we haven’t seen any strong evidence of significant change. It’s very frustrating. … If we could get the donation rate up, we could do so much good to save the lives of people who are desperately unwell.”

The stumbling block seems to be families. When they are consulted, they often object. As in many other countries, England respects the wishes of the family of a potential deceased organ donor. And fewer families are agreeing. In England, only 61% permitted their relative’s organs to be used last year – compared to 65% per cent in 2017. This is far below the 80% predicted when the law changed.

UK families who are poor or who are from ethnic minority groups are more likely to object. Government figures show that only 39% of Asian and black families agreed to donate a loved one’s organs last year in England.

“The failure of education is the most important issue here,” Professor Hugh Perry, oft the University of Southampton, told the Daily Mail. “Many families can’t deal with the conversation at the bedside, and others object to the idea that the Government now ‘owns’ their family member’s body. People also say their religion doesn’t allow them. If you take away the family’s input, you’d get many more donations. But Brazil tried this and it led to outrage and the policy being reversed.”