Transplant waiting lists (February 2001)

Renal transplant - 4,907 Heart - 125 Heart and lung - 97 Lung - 207

Although figures suggest that Alder Hey has not had a major impact on the number of donor organs becoming available, donation rates have fallen for some time - while demand for transplants has increased sharply.

In 1990, surgeons carried out 2,893 transplant operations - in 1999, this had fallen to 1,820.

Last year just 19% of the more than 8,000 kidney patients waiting for a transplant underwent surgery.

A quarter of the 1,048 heart and lung patients had a transplant, while two-thirds of the 996 liver patients received a new organ.

Mr Milburn wants to increase the number of people on the organ donation register from 8 million to 16 million by 2010.

New ways to attract donors will include schemes to distribute donor cards with credit card bills and voter registration forms.

Council scheme

One such scheme has been masterminded by a councillor from south-west England, producing an extra 110,000 donors in just two years.

Too few organs are available

John Meikle's plea for donors went out with letters to residents from Taunton Deane Borough Council in Somerset, and gathered 11,500 new recruits - 15% of the electorate.

It has been successfully extended through his efforts to nine other councils, and he wants to see even more take it up.

He told BBC News Online: "I can almost guarantee a million new organ donors coming forward this year if between 50 and 100 councils take part.

"It's a simple formula which has worked really well."

Although official figures suggest otherwise, transplant surgeon Professor Sir Peter Morris, of the John Radcliffe Hospital in Oxford, said he felt there was some evidence that people had lost faith in the donor scheme in the wake of the Alder Hey scandal.

Genuine confusion

He told BBC News Online he believed there was genuine confusion in some people's minds between the retention of organs following death, and their use in transplant operations.

Sally Slater's life was saved by a transplant

He said: "If Mr Milburn goes away from this summit simply realising there is a major problem, then some good will have come of it.

"Although it could be a statistical blip, we had six donors in January, prior to Alder Hey, and just one in the first two weeks of February.

"And one of our helplines has had a number of callers asking how they could be taken off the donor register."

Professor Morris chaired an inquiry two years ago into transplantation by the Royal College of Surgeons, which called for more training places for transplant surgeons.

So far, the government has not made money available for this, and has also not responded to the recommendation that vital transplant co-ordinators should be organised in a national network rather than on an ad hoc basis region by region.

Shadow Health Secretary Dr Liam Fox accused the government of failing to act swiftly enough to boost organ donor numbers.

He said: "Now faced with a crisis, exacerbated by the Secretary of State's response to Alder Hey, the Government produce yet another stunt.

"It is typical of a Government which lives by photo opportunities and headlines rather than being concerned with the substance of any arguments."

Urgent need

Some transplant experts are keen for the UK to adopt a more pro-active role in recruiting donors.

Spain operates a system in which everyone is presumed to have given consent unless they register their objections - although relatives are also allowed the right to veto organ donation.

In Spain, 33% of suitable organs are used, as opposed to 13% in the UK.

An Australian state which introduced this method doubled its donation rates.

However, there are concerns that any moves towards a system of "presumed consent" will be publicly unacceptable in the present climate.

Dr Michael Wilks, of the British Medical Association, said: "We have got to have an improvement in the way in which transplants are done by having more transplant surgeons, more beds, more intensive care beds and more transplant co-ordinators."