HUMAN ORGAN TRANSPLANT ACT

HUMAN ORGAN TRANSPLANT ACT:

(Update on number of transplants and reimbursement applications): The following Question stood in the name of Dr Ahmad Mohd Magad

–: 2. To ask the Minister for Health since the implementation of the Human Organ Transplant Act (HOTA) (a) what is the number of successful organ transplants; (b) how many Singaporeans have opted out of HOTA and, of those who have opted out, how many of them are Muslims; (c) how many applications for reimbursement of expenses incurred by live organ donors have the hospital transplant ethics committees received;

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and (d) how many applications were approved and how much was each applicant reimbursed on the average.

Mdm Halimah Yacob (Jurong): Question No. 2, Sir.

The Minister for Health (Mr Khaw Boon Wan): The Human Organ Transplant Act (HOTA) was enacted in 1987. As at the end of last year, 52 hearts, 144 livers, 1,080 kidneys and 1,181 corneas from deceased donors have been successfully transplanted. Many lives have been saved by HOTA. All Members of this House can claim some credit for this outcome by supporting this Bill.

The vast majority of Singaporeans support organ donation. Less than 3% of the potential HOTA population, or about 77,000 people, have opted out. As we do not ask objectors to indicate their religion, I do not know how many are Muslims.

As for the question on applications by living donors for reimbursements of expenses, I do not have the data in the format as requested. But last year, there were 156 applications for living donor organ transplant. Of these, 142 were approved by the Transplant Ethics Committee (TEC).

The majority of living donations are between family members and close relatives. In such cases, there is no reimbursement per se but the family will pool its resources to pay for all the medical expenses.

For the others, most recipients would pay for their donors’ hospitalisation directly to the hospitals. The size of the medical bills would depend on the type of transplant, the class of ward and the extent of subsidy enjoyed by the patients.

In addition to the direct payment for hospitalisation expenses, there would be regular follow-up expenses for the donors.

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These follow-ups usually cost about $100 to $300 per consultation. They would be picked up by the recipients in most cases.

There were a few cases where the recipients had also reimbursed their donors for loss of income. The average quantum of such reimbursement ranged from $500 to $750.

To support needy Singaporean patients, the National Kidney Foundation has set up the Live Donor Support Fund. So far, it has received 11 applications and approved 10 of them. This is about one a month. The eleventh application is still under review.

Mdm Halimah Yacob: A couple of questions, Sir. I would like to ask the Minister: those who have opted out of the HOTA, what efforts have been made to persuade them or dissuade them from opting out? Secondly, on the 14 that were not successful in the applications for living donors: what were the reasons? Thirdly, on the NKF Live Donors Support Fund. The numbers that have applied seems to be rather small. Are there any efforts to make it known to those who are needy and who would benefit from this scheme about the availability of this scheme?

Mr Khaw Boon Wan: For those who have opted out, we leave it as it is because organ donation really ought to be purely voluntary. All over the world, the preferred approach is for an "opt in" scheme. But it is not effective to get the required numbers and that is why nations, like us, go for the "opt-out" scheme. For those who have expressed a decision to opt out, we respect their wishes. We do not make any effort to try to dissuade them or persuade them to re-opt back in. But the general public education on the value of organ donations and how it can save lives continues and that goes across to the whole population.

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As for the dozen or so live donor applications which were rejected, there were a number of reasons. These are decisions made by the Ethics Committee. The applicants have to satisfy the Ethics Committee that the donors are fully informed of what they are going into and there is no coercion of any kind. If the Committee is suspicious about the motive behind the applications, it will reject the applicants. So, I suppose, some of the reasons could be that.

As for the NKF scheme, I would not describe it as achieving little. I thought they have achieved a lot for a very new scheme which has yet to reach one year. Having benefited almost a dozen lives – about one a month – I consider the outcome as quite successful. In reaching out to the possible applicants, a natural platform is there as these are patients who are undergoing dialysis. Hence, NKF has a way of reaching out to them and can explain to them that it would be better if they can get family members or whoever to come forward to donate. And where they may have been concerned about financial expenses, the NKF scheme comes in extremely handy.