POLITICS

'The medical profession sometimes loses sight of the fact that a heart means more to a parent than it does to a doctor, who just sees it as a bit of tissue, ' conceded a thoughtful friend of mine at the sharp end of medical research as the Alder Hey Hospital organ scandal raged over the weekend.

Alan Milburn has young children and will not have needed to think long or hard about the emotional impact upon parents who have lost their precious offspring to realise how damaging the controversy may prove to be. Hence the announcement of the Department of Health's external inquiry.

And yet. . . and yet. I suspect that many people associated with hospitals up and down the country (including the Milburns? ) will be surprised at the past week's furore. Didn't the press and public know that tissue - ah, what a neutral word - from the dead is routinely saved for the purposes of research as well as autopsy?

And won't the real damage be done to that vital supply of tissue, as always happens when there's a media uproar? Basically, that was the response of Dick van Velzen, the former professor of infant pathology at Alder Hey when the Sunday Times tracked him down at what it called his 'canal-side home' in the Netherlands.

What troubled him most were the procedures, pressure from colleagues for organs, minimal consent (or worse) for parents. 'I was deeply upset, ' he said. Dr van Velzen sounds a decent man, and offered to face his critics. He is not alone. In an era of public accountability and openness - after all, this problem emerged from the Bristol Royal Infirmary inquiry - it is inevitable.

When I telephoned two medical politicians on Sunday night, the response was instructive. Dr Jenny Tonge, Lib Dem MP for Richmond Park in Surrey, is a GP by trade, albeit married to a hospital consultant.

'It made me feel quite sick. I don't normally fuss about what happens to bodies, but to do that without the consent of the parents was nauseating. I know it's not entirely rational. I'm a doctor, but that's what I feel, ' she explained.

I then spoke to a politician (I'm not saying whether peer or MP), who has been a surgeon in his time. 'It goes on and it's been going on for years. . . a lot of things work because no one knows about them, but they are right and proper. I don't see what the scandal is, ' he told me. Like Dr Tonge, my surgeon friend is a sensitive chap with children of his own.

He admits his background makes him biased, and says that where organs are retained for research there must be specific consent as well as generic consent. That is a distinction with which I was not previously familiar. I consulted my friend who is a senior researcher in an important hospital, a parent too.

His hospital frets about these problems, knows (from an internal audit) that only in one case in five are the 20-page procedures completed in full, involving as they do the prior consent of the ethical approval committee and the parents. 'American hospitals have huge administrative suites to do this, our researchers don't have the time, ' he grumbles.

So when my friend wants 'a couple of mls of blood' from a patient for research as distinct from clinical assessment, he often just asks for it. What's the harm in that? He admits that if 'anything invasive or experimental' is involved, a very specific consent must be obtained. Tissue from dead people is an additional problem, especially where 'emotive' organs like the heart are at issue. 'For some people it's about the afterlife, ' admits my friend, himself a resolute atheist.

In conclusion he declares: 'Openness is a good thing, but it's got to be done in a way that makes people support it.' The politicians seem to agree, as will Mr Milburn's inquiry and internal reviews like the GMC's.

Education of what is (I suspect) a squeamish and increasingly sentimental public seems crucial.

We will, for example, have to be more specific about such terms as 'residual tissue'. Myself, I am already better educated. I had assumed that the dog-eared organ donor card I carry around would be sufficient for all purposes if I ever fall off my bike on to my head. Apparently not. The scrawled phrase 'PS: help yourself ' is not enough.