Organ transplantation is a remarkable success story. An end-stage renal-failure patient lucky enough to receive a transplant can now anticipate many years of good-quality life.

The 40,000th transplant was performed in 1996, the same year the 70,000th patient was added to the waiting list. Sadly, the gap between supply and demand is widening, and Britain's performance now contrasts poorly with achievements elsewhere.

So few people carry donor cards that a rummage through a patient's belongings is rarely considered worthwhile. Surveys consistently reveal that four out of five people have no objection to their organs being used for transplants, yet less than 10 per cent have recorded that willingness on the computerised NHS organ donor register.

It has been suggested that the supply of organs might have been exhausted. The fact that 56 per cent more transplants are performed in Spain, and that 43 per cent more Welsh organs are retrieved than Scottish ones, would belie this.

That five out of six organs emanate from just half the hospitals suggests that staff in the other half are less inclined to broach the possibility.

Alternative approaches to retrieval exist. A recent medical ethics group report concluded that the sale of organs shouldn't be ruled out just because we find the idea repellent. Required request is now mandatory in some US states. And a recent article in The Lancet pressed for the computer's role to be reversed so that consent is presumed unless someone has opted out. It concluded with a plea for a national debate - but how best to generate it? Early day motions in the Commons produce magnificent, well- informed debates but no action. Yet another government taskforce is needed.

A succinct report from a group charged with evaluating the available evidence, followed by an NHS Executive letter and associated media publicity, would save the service tens of millions of pounds. The impact on the quality of life of thousands of our fellow citizens would be huge. No change in the law would be required, and we might not have to resort to breeding pigs to plug the gap.