Wales could today be the first country in the UK to back organ donation without a person’s consent.

A radical, and controversial, shake-up of the law on organ donation has been voted on by Welsh assembly politicians, and if passed would pave the way for an ‘opt-out’ system. This would mean that, in the event of death, unless a person has registered to opt-out, they are presumed to have given consent for organs to be removed and donated.

The current opt-in system, which operates across the UK, relies on people signing up to a voluntary scheme and carrying a donor card.

Ministers in Cardiff say there is a desperate need to drive up transplantation rates, with 226 people in Wales waiting for a transplant, and they hope the new system will improve rates by around a quarter.

There has been strong opposition to the changes from religious groups, who believe that dead patients’ families should have a greater say than is being proposed. But health minister Mark Drakeford insisted the new system would be safe, as well as fair.

In Yorkshire, the number of people donating organs after death has increased by 32 per cent in the past five years. In the past year, more than 1,200 people in the UK donated organs, leading to around 3,100 transplants.

Yet across the country people continue to die while waiting for a transplant. Earlier this month, the Telegraph & Argus revealed that 18 Bradford patients have died in the past four years while on the waiting list.

Bradford has 121,000 people on the UK Organ Donor Register out of an estimated population of 522,452. Last year in the district six donors saved 11 lives with six kidneys, two livers, two lungs and one pancreas transplanted.

More donors are needed, in particular from black and ethnic minorities, of which 73 cases are active and 38 have been temporarily removed from the list as they are too ill to undergo the operation. Donors from the same background make for a more successful operation.

Angelo Clarke has had two stem cell transplants, the first using his own bone marrow, and the second from his sister, Anna.

While he agrees “in principle” with the possible change in the law, he foresees problems. “They are going to have to be very careful as to how they promote this. It is such a personal thing, it could be seen as though they own us.

“It’s a scary thought.”

The packaging designer, from Pudsey, believes that problems will arise through the involvement of family members. “If a loved one is involved in a car crash and killed, and family members suddenly find that parts are being removed, that could come as a huge shock and cause a lot of upset.

“If an ‘opt-out’ system is adopted it should have to include the signatures of family members. They should be made aware. If not, there could be all sorts of difficulties, it would be like opening a can of worms.”

He adds: “It is not going to be a ‘donation’ as such, it could be seen to be more like harvesting – it is hard to distinguish.”

Angelo, 46, believes that a better option would be to beef-up awareness campaigns to encourage more people to volunteer.

“Public information about donation is poor at best. More information, on TV, in doctors’ surgeries, or in newspapers, would be better rather than telling people ‘we are going to take your kidneys or lungs.’”

Ministers have stressed that the legislation makes it clear that if people are uncomfortable with being an organ donor, they have a right ‘in the simplest way possible’ to opt out by putting their name on a register. “The legislation is nothing to be scared of,” said Mr Drakeford.

If passed, the presumed consent system – which would apply to adults aged over 18 who die in Wales and have lived there for more than a year – could come into force by 2015. The Welsh government would have to spend at least £8 million publicising the changes.

Organs made available under the system would be the same as the ‘opt-in’ method and could go to patients anywhere in the UK.

Some critics say that evidence from other countries where the opt-out system is already in place have not produced any real changes.

A spokesman for NHS Blood and Transplant welcomed the Bill, adding: “Any change that encourages people to discuss and support organ donation is welcome. We will work within whatever legislative framework is introduced in any of the four health administrations in the UK.”