WHEN Belgium switched to an opt-out system of organ donation in 1986, there was an 86% rise in the number of kidneys retrieved for life-saving transplants.
Today, only a tiny minority – 1.7% – of the 11million population have said they do not wish to donate organs after death.
It is not time-consuming or complicated to 'opt out' of the system. All it takes is a simple visit to the local town hall.
Luc Colenbie, head of the country's transplant strategy, says the switch to a presumed consent generated a positive change in the public's perception of organ donation.
It is considered the norm to help save lives after another person dies.
"In Belgium we have a positive culture on organ donation in part because policymakers made organ donation a priority," he said.
"It is necessary to give positive, active information to people so they can register their will."
As of 2010, 24 European countries have some form of presumed consent system in place, with the most prominent systems in Spain, Austria, and Belgium yielding high donor rates.
In 2015, Wales will become the first country in the UK to adopt an opt-out system. The Evening Times is campaigning for a similar change in the law in Scotland and thousands of readers have shown their support by signing our petition.
Research shows opt-out legislative systems dramatically increase rates of consent for donation. However, experts agree this must be backed up with investment in the infrastructure.
In Belgium there are 88 dedicated donor hospitals and eight transplant centres.
When the country introduced the opt-out system in 1986, the number of transplant co-ordinators was also increased.
Luc has been working for years as a transplant co-ordinator at the university hospital of Ghent and also works at the federal ministry of health, where he is in charge of the country's Beldonor.be campaign.
He said: "The success is not just down to the laws, but also the enormous effort and financial support of the government.
"We have a lot of TV spots, a donor action plan in all Belgium hospitals and each hospital receives a donor co-ordinator.
"There is also a lot of great deal of work done by patient organisations such as donor and family organisation and transplant organisations.
"They help create a positive effect on public opinion.
"Transplant co-ordinators give lectures in schools, universities and businesses.
"The media in Belgium often report on organ donation and transplantation, which results in good public awareness and a high organ donation rate.
"The government realises there is an economic advantage.
"Dialysis costs a lot of money. When we can transplant a patient, the cost is much lower."
Belgium has one of the highest rates of organ donation at 29.7 deceased donors per million inhabitants. Spain is slightly higher at 34 but the figure also includes tissue donors.
Members of the public may 'opt out' of the system or register a wish to donate, which means family do not have a legal write to veto your choice.
Everyone else is considered a donor by law. However, it is customary for the question of donor- ship to be discussed with relatives, even if it is not required by law.
In Belgium, only 15% of families object when asked.
In some hospitals in Spain the figure is as low as 3%. This compares to the British rate of around 40%.
Luc believes the prominence given to organ donation means it is commonplace for families to discuss the issue.
Doctors and transplant co-ordinators are also specially trained to broach the subject of organ donation with families.
There is evidence that some doctors in the UK avoid even having the discussion with families because they are uncomfortable broaching the subject.
Luc said: "It is a very emotional time. In Belgium, doctors are trained to bring bad news.
"Each year there are organised EDHEP (the European Donor Hospital Education Programme) sessions with a course for improving communication skills with bereaved relatives.
"If people are convinced during their life and express their will to family, it is easy to talk about organ donation with the family."
BELGIUM was the first European country to switch to an opt-out system of organ
donation. The head
of the country's
transplant strategy tells reporter
CAROLINE WILSON why he believes
Scotland should follow its lead.