DIALYSIS TREATMENT

Dr Lee Chiaw Meng asked the Minister for Health (1) the number of patients undergoing dialysis treatment at Government hospitals; (2) the number of patients on the waiting list for such treatment at (a) Government hospitals, and (b) private hospitals; and (3) if his Ministry has any plan to expand the facilities for dialysis treatment at Government hospitals and the estimated capital and recurrent cost for each unit.

Mr Howe Yoon Chong: There are 2 Government centres for renal dialysis treatment, one at Singapore General Hospital (SGH) and the other at Alexandra Hospital (AH). In SGH, dialysis is done by a team of trained nurses. In AH, dialysis is carried out by the patients who are assisted by their relatives under the supervision of a trained nurse. The centre in AH is known as a Self-Dependency Dialysis Unit (SDDU). The SGH dialysis centre has 10 stations plus 4 training stations for SDDU, while the AH SDDU centre has 11 stations. The total number of patients presently undergoing dialysis treatment at the 2 Government centres is 89, 45 at SGH and 44 at AH.

(2) Every year, there are well over 100 new cases referred to the Department of Renal Medicine with end stage renal disease who require dialysis. Data over the last 7 years are shown below:- 1976 - 180 patients 1977 - 142 patients 1978 - 107 patients 1979 - 122 patients 1980 - 107 patients 1981 - 150 patients 1982 - 165 patients On a national basis, the actual number of new cases is higher as some patients are treated by the private sector.

At any one time, there are about 20 patients on the waiting list for dialysis treatment at Government centres. The Ministry does not have record of those treated or on the waiting list for dialysis treatment by private doctors.

(3) The estimated capital cost is about $500,000 for converting and renovating an existing building into a dialysis unit. The estimated recurrent cost is about $392,200 per 10-station SDDU per year for 40 patients, or over $9,800 per patient per year. Of the total recurrent cost of $392,200, approximately 90% or $352,000 are for expendables (dialysers, blood lines, chemicals).

The Ministry is developing a second SDDU in Tan Tock Seng Hospital (TTSH) at a cost of $559,100. This Unit is partly financed by donations. When completed next month (Sept 83), it will have 10 SDDU stations with space for expansion to 20 stations later on. There are also plans to expand the SDDU in AH to 20 stations in the near future.

(4) Treatment of chronic renal failure is a difficult area in medicine. It is a long lasting ailment, complicated by the fact that treatment is expensive while possible cure depends on the availability of donated kidneys. The Government is doing as much as possible within its limited resources for the unfortunate victims. However, members of the community and philanthropic foundations can play their part. The urgent need is for available kidneys for transplantation, failing which for more funds to meet the high establishment and operating costs of dialysis stations.

(5) It must be recognised that haemodialysis is no substitute for kidney transplant to achieve a better prospect for cure. A successful kidney transplantation will not only ensure a better lease of life to the recipient but will also create a vacancy for those anxiously waiting their turn for dialysis. Therefore the public can help positively by supporting kidney donations. Similarly, voluntary and community organisations can supplement the efforts of Government by providing funds and facilities for haemodialysis.