LIVER TRANSPLANT SURGEONS (Shortage)

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LIVER TRANSPLANT SURGEONS:

(Shortage):

. Dr Lily Neo asked the Acting Minister for Health (a) why is there a shortage of liver transplant surgeons in our hospitals; and (b) whether this will jeopardise the 24 cases of patients presently waiting for liver transplants.

The Acting Minister for Health (Mr Khaw Boon Wan): Actually, there is no shortage of liver transplant surgeons in Singapore . But there is a shortage of donated liver. As a result, the number of liver transplantation done on Singaporean patients is small, about 15 a year.

Recently, this House amended the Human Organ Transplant Act. With the amendments, we can expect some increase in organ transplantation, including liver. Currently, there are 24 Singaporean patients on the liver transplant waiting list. Hopefully, some or all of them will soon benefit from the amended Transplant Act.

Liver transplant is a highly specialised procedure and, given the small number of surgeries, we have so far concentrated

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our public sector resources in the National University Hospital (NUH). The NUH liver transplant team, with four liver transplant surgeons, has been doing liver transplantation for 14 years now. It specialises in cadaveric and living donor adult-to-child liver transplantation. These operations make up the bulk of liver transplant operations.

However, they have yet to develop the capabilities to do adult-to-adult liver transplants, as these require more demanding expertise. The NUH team expects to be able to do adult-to-adult liver transplants by next year. Fortunately, we do have such capabilities in Singapore 's private sector. Arising out of the recent case of a liver failure patient, my Ministry has made an arrangement with the private hospital's transplant team, whereby such a surgery, if and when needed by a subsidised patient, can be outsourced to them, with the subsidised patients paying the same rate as if the surgery is carried out in NUH.

This is an excellent example of public-private sector cooperation, with patients' benefits in mind.

Dr Lily Neo: May I ask the Minister whether there has been a reduction in medical postgraduate training, such as HMDP? Has there been a recent review on postgraduate training? Should there be more emphasis and creation of opportunities for disciplines in shortage?

Mr Khaw Boon Wan: Does the Member mean whether there has been a reduction in postgraduate training in liver transplantation?

Dr Lily Neo: Where necessary?

Mr Khaw Boon Wan: Of course, the HMDP programme is reviewed regularly. I do not have the data off the top of my head but, as far as we could, we always

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try to match supply with demand. As far as liver transplantation is concerned, as I said earlier, we do not have a shortage. But capability shortage there is, and we will try to fill the gap, as we do in this particular case.