THE full extent of the report into the removal and retention of organs is as shocking and distressing as Health Secretary Alan Milburn warned it would be.

It must be absolutely awful for the families of children to learn that their loved ones' bodies were stripped in this way without their knowledge. Our heartfelt sympathies go out to those families.

However, at first sight, there appear to be three issues that it would be useful to separate from the welter of statistics and emotional out-pouring.

The first is the issue of rogue doctors. There are rogues in every walk of life, and the medical profession seems to be blessed with its fair share of them. To the list including Harold Shipman and Richard Neale will now be added the name of Professor Dick van Velzen.

While it is not possible to eliminate all risks in life, it is far from clear that the medical profession does its utmost to protect the public from some of its rogues. The cases of Shipman and Neale show that.

This leads on to the second issue, that of the old-fashioned belief that doctors are untouchable - the "consultant is king" ethos. This has given rise to an arrogance among a few doctors that they can do whatever they like and no one dare question them. Shipman's murder spree lasted so long, partly because he was a doctor and therefore above doubt. Similarly, to a layman it is incomprehensible that van Velzen should have accumulated so many organs for so little research over the course of seven years without any eyebrows being raised anywhere in Liverpool. Like every other walk of life, hospitals and doctors have to become more accountable for their performance.

And this leads on to the third issue, that of consent. It is quite shocking that so many doctors and hospitals across the country have been so arrogant as to believe that they haven't needed to consult parents and families about the fate of the bodies of their relatives.

In some cases, the report finds that they actually went out of their way to conceal what they were doing.

Yet most people accept that the removal of organs is, when appropriate, not only necessary but a good thing. Those of us who carry Donor Cards certainly think so, and anyone who read last year of Sally Slater's desperate wait for a heart transplant in North Yorkshire can certainly see why it is a good thing.

Most people will also accept the arguments put forward powerfully by Professor Alastair Burt of Newcastle Medical School in The Northern Echo yesterday. He quite rightly says that medical research must continue in order to save lives in the future. That research obviously requires organs.

Thankfully, following yesterday's horrific report, it is only a matter of time before doctors are legally required to remove those organs with the full and explicit consent of the relatives, and to treat them with dignity.

This step forward, though, will be of little consolation to the parents who have been so badly let down by a system that was supposed to care for them in their hour of need.