South Australia is urging other jurisdictions to adopt organ and tissue donation registration through drivers’ licences, pointing to its own results as evidence that the approach lifts participation.
The proposal will be taken to a meeting of health ministers by Blair Boyer, who is calling for a consistent system across the country. South Australia already allows residents to record their donation decision when applying for or renewing a licence, and the state reports a participation rate of 74 per cent. Nationally, the figure sits closer to 35 per cent.
Officials argue that linking registration to a routine process makes the decision easier and more immediate. The contrast is particularly sharp among younger people. In South Australia, around 41 per cent of those aged 16 to 24 are registered, compared with about 7 per cent nationwide. Most of those registrations in the state are made through the licensing system.
The push comes amid ongoing pressure on transplant waiting lists. Around 2,000 Australians are waiting for an organ transplant, while a further 14,000 people are on dialysis for kidney failure, many of whom could benefit from a transplant. Donation opportunities remain limited, with only a small proportion of hospital deaths meeting the criteria for organ donation.
Recent figures show that in 2025, 557 donors contributed to 1,438 transplant procedures across the country. While public support for donation remains high, with surveys suggesting about four in five Australians are in favour, registration rates have not kept pace.
South Australia’s model has drawn backing from some quarters, including the Police Commissioners Forum, which last year supported allowing residents in all jurisdictions to register their intent through their driver’s licence.
Boyer said the state’s experience shows that a simple prompt at a familiar touchpoint can shift behaviour. He described the current gap between support and registration as an avoidable barrier, and argued that a national approach could help normalise the decision and ensure people’s wishes are clearly recorded.
The case for reform, however, is not without debate. Some experts note that registration alone does not guarantee donation, as family consent still plays a role at the time of death. Others point to the need for ongoing public awareness campaigns and investment in hospital systems to ensure potential donations can proceed.
There are also practical considerations in aligning systems across states and territories, particularly where licensing processes differ. Any national rollout would require coordination between health and transport agencies, alongside updates to existing registers such as the Australian Organ Donor Register.
Even with these challenges, South Australia’s figures have added weight to calls for change. Advocates say the approach offers a low-cost way to prompt decisions and improve visibility, especially among younger cohorts who are already engaging with licensing systems.
For now, the proposal will be considered by health ministers, with South Australia continuing to press for broader adoption. Whether other states follow may depend on how they balance administrative changes against the potential to lift donor numbers and reduce waiting times for patients.
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