Replies to LegCo questions

LCQ17: Organ donation

    Following is a question by the Hon Albert Ho and a written reply by the Secretary for Food and Health, Dr York Chow, in the Legislative Council today (June 11):

Question:

    It has been reported that a Hong Kong resident suffering from acute liver failure and in urgent need of a liver transplant operation was recently admitted to hospital, but as there were insufficient cadaveric livers and his family members in Hong Kong were unsuitable for donating live liver, arrangement was made for a close relative on the Mainland, who was suitable for donating liver, to come to Hong Kong to do so to cure him.  However, his close relative, being a non-eligible person (NEP), had to pay the public hospital concerned a big deposit as well as very expensive fee for staying at the intensive care unit for the liver transplant operation.  In this connection, will the Government inform this Council of:

(a) the authorities' justifications for requiring that non-Hong Kong residents who donate human organs in Hong Kong to cure Hong Kong residents have to pay the medical fees concerned at the levels NEPs are charged, and whether the Hospital Authority has any mechanism for assessing and waiving the fees payable by NEPs for using public medical services;

(b) the respective numbers of patients in Hong Kong who died last year because they were unable to obtain donated livers and kidneys for transplant operations; the current numbers of patients in Hong Kong who are waiting to receive a transplant of liver and kidney respectively; and whether the authorities know if the number of local cases of organ donation from deceased persons is lower than that in other places; and

(c) the up-to-date total number of members of the public who have indicated consent to donate their organs, and among them, the number of those who indicated their consent last year, and whether the Centralised Organ Donation Register, which the Department of Health has planned to launch in the second quarter of 2008, has come into operation?

Reply:

Madam President,

(a) Under the current fee-charging system of the Hospital Authority (HA), all users of public hospital services are required to pay a prescribed amount of fee for the services they have used.  While Hong Kong residents should pay the fee applicable to eligible persons, people other than Hong Kong residents are required to pay the fee applicable to non-eligible persons (NEPs).  HA has put in place a medical fee waiver mechanism to provide assistance for patients in financial difficulties.  As for NEPs, HA will provide discretionary assistance for them under exceptional circumstances.  According to the records maintained by HA on past cases of organ donation, there were cases in which non-Hong Kong residents who donated human organs in Hong Kong were granted a waiver of the medical fee arising from the organ donation.  HA will consider putting in place appropriate arrangements in future for living organ donors (whether they are Hong Kong residents or non-Hong Kong residents) to be granted a waiver of the medical fee arising from the organ donation.

(b) In 2007, there were 31 liver disease patients in Hong Kong who died while waiting for liver transplantation.  As for kidney disease patients, as their health conditions could be improved by peritoneal dialysis or haemodialysis,  HA does not maintain statistical data on the number of patients who have died as a result of failing to obtain kidneys for transplantation.  As at  December 31, 2007, 126 and 1,489 patients in Hong Kong were on the waiting lists of liver and kidney transplantation respectively.

    In the past three years, the numbers of livers and kidneys donated by deceased persons in HA are as follows (cases of organ donation by living persons are not included):

      Number of livers  Number of kidneys
2005          24              50
2006          23              53
2007          26              58

    According to the statistics of the International Registry of Organ Donation and Transplantation, the rates of organ donation (excluding the donation of non-organ tissue) by deceased persons (per one million population) of Hong Kong and some other places in 2007 are as follows:

Hong Kong          4.7 persons
Japan              0.1 person
Malaysia          0.9 person (2006)
Republic of Korea  2.97 persons
Singapore          5.9 persons (2005)
Australia          9 persons
United Kingdom    13.2 persons
United States      26.6 persons

(c) At present, the Government does not have up-to-date statistics on the number of people who have indicated consent to donate their organs.  There are currently about 44,000 registered donors in the organ donation register of the Hong Kong Medical Association.

    The Department of Health (DH) is now setting up and implementing the Centralised Organ Donation Register (CODR) to make it more convenient for prospective donors to voluntarily register their wish to donate organs after death, and for such wish to be systematically kept and expediently retrieved by authorised persons such as the Organ Transplant Coordinators of HA to facilitate arrangement of possible organ donation.  The system development of CODR was completed in January 2008 and DH is carrying out an assessment on the privacy implications.  Upon completion of this assessment, CODR will be in operation in the second half of 2008 for members of the public to register online and through other channels.  DH will also run publicity programmes to promote organ donation in tandem with the launch of CODR.
 

Ends/Wednesday, June 11, 2008
Issued at HKT 12:08

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