Question Time, when a panel of experts in renal medicine were quizzed by delegates, was followed by a general debate on the floor. This proved to be a stimulating and lively part of the Conference.
On the panel were Ross Taylor, retired transplant surgeon from Newcastle, Andy Stein, at the time senior registrar at the Mayday Hospital, Croydon, and now consultant at Walsgrave Hospital, Coventry, Juliet Auer, kidney patients support manager at the Oxford renal unit, and Richard Moore, clinical director at the Cardiff renal unit.
Ian McGeehan from Addenbrookes KPA: Are there any circumstances in which conditions on organ donation should be accepted? Ross Taylor gave an absolute No, and said the only argument against might be that a few organs might be lost. "I hope they would be very few."
"If you have absolute rules, you will waste organs," said Andy Stein, who was concerned that the Government might be pushed into rushing through laws because of media comment.
Garfield Dullam from Exeter KPA: Is it possible for kidney patients to be prescribed Viagra? Dr Evan Harris MP, from the floor, said that it was now recognised that kidney failure was one cause of impotence. Each patient was rationed to one tablet per week. GPs could prescribe it after talking to consultants.
Simon Lloyd from Tyneside KPA: How could we encourage doctors to be positive about asking patients about their wishes, since it is a legal right to refuse treatment which could be done in advance by making a living will.
Richard Moore said the BMA had guidelines, and the Americans had a scheme where patients were asked when they were admitted to hospital.
Juliet Auer said her unit introduced the idea of not having dialysis at pre-dialysis clinics. "I talk to people who say life on haemodialysis is insupportable please make it better for me. Other people say life is unbearable I want it to stop."
Andy Stein raised the problem of a patient having a cardiac arrest in the small hours, when doctors have to decide whether it is right to resuscitate and there was no time to look up notes.
Gordon Nicholas, North East KPA: Why are some patients prescribed Tacrolimus and others not?
Richard Moore said that there was no evidence that Tacrolimus was more effective than Cyclosporin, though the side effects were less.
Tom Burns, South Cumbria and West Lancashire: Do league tables improve services?
Richard Moore said that league tables needed to be corrected against differences. The data was available from the UK Renal Registry (see the Links page on this site). "It's up to you as patients to ask for information," he said. "We doctors wouldn't mind you doing this. It would help to improve care."
After Ross Taylor pointed out that the data was anonymised, so that patients could not identify their units, Dr Evan Harris said that this was one of the things that the NKF could take up.