Praise for NKF's organ donor fund
MPs, kidney specialists and patients say it will improve lives and curb organ trading -  BY YEN FENG

Experts say the new $10 million fund for reimbursing kidney donors' costs is unlikely to create a surge in donations, but should succeed in discouraging organ trading.

Lawmakers, kidney specialist and administrators interviewed yesterday expressed this view of the Kidney Life Donor Support Fund, an initiative announced on Saturday by the National Kidney Foundation (NKF).

It pays for donors' health-care costs and loss of income after they have donated their kidneys.

Those interviewed generally agreed that the fund, which applies a strict set of criteria when approving applicants, was well thought out, given the sensitivity of the issue. The bulk of the payout goes directly to hospitals and insurance companies, while donors receive cash only to offset lost income, capped at $5,000

The NKF maintains and administers the fund, while hospital doctors are the gate-keepers who will assess an applicant's eligibility.

The fund's aim is to throw open the door to more kidney donors by compensating them for lost income and taking care of their related expenses, while keeping it shut to potential organ traders.

Kidney patients here can wait up to nine years for a new kidney. Last year, 26 people died while waiting for one. About 80 transplants were done.

But experts say it is not immediately clear if the fund will give would-be donors the assurance they need to proceed.

"If the response is not good, then we will have to sit down and tweak it," said NKF chief executive Gerard Ee, adding that the funds is "not about giving donors a financial incentive, but to reduce fears of the cost of post-operation care".

"Donors usually would have already made up their minds. We want to make it easier for them to go through with it," he said.

Including surgery, hospitalisation and laboratory tests, kidney donors might pay up to $80,000 for a transplant operation.

Mr Ameerali Abdeali, chairman of the Muslim Kidney Action Association, said the fund has a "sound and noble objective", although it will take time to discern its impact on patients and donors.

"Donating a kidney is a complicated process, not like donating shoes," he said.

The Donor Support Fund is the country's first initiative to reimburse organ donors following a law passed in March making it legal. The Bill faced objections from some lawmakers, who felt it would open the door to organ trading, as issue that divided the country when it was reported that retail tycoon Tang Wee Sung tried to buy a kidney off a poor Indonesian man last year.

In Singapore, organ trading, or the sale of organs, is illegal.

Madam Halimah Yacob, MP for Jurong GRC and former head of the Government Parliamentary Committee for Health, said she was glad to see the fund being restricted to citizens and permanent residents. She argued in Parliament last year that if it was open to other foreigners, foreign workers would be targeted.

Holland-Bukit Timah GRC MP Christoper de Souza, who objected to the Bill, said it should include a standard formula that determined the compensation amoung. Such a formula, he said, would account for the donor's health and income level, so that the process would be transparent.

But he commended the NKF for taking on the role of a third party between donor and patient: "It creates some distance, and keeps the donation altruistic in nature. Overall, this is a cautious and modest tart."

Like Mr Ee and Mr Ameerali, kidney patients and medical specialists said that while it was unlikely the fund would result in vastly more donors, it was an improvement over previous arrangements in which donors had to pay their own medical bills.

Mrs Agatha Lau, 40, who is still waiting for donor after her kidneys failed four years ago following a viral infection, said money is "not something that would motivate a lot of people".

"But it would help poorer kidney donors who may want to donate to a relative, but cannot afford it," she said.

Dr Akira Wu, a renal physician of 30 years, said that if the fund led to more donors, it would be a win-win situation for patients who received transplants and those who still need dialysis.

"More patients can gain access to dialysis. This is a good thing. Patients who receive transplants will also have a better quality of life," said Dr Wu.

"But it remains to be seen whether the new guidelines will have a significant impact on the donor pool."

HOW THE FUND WORKS

· What can the Kidney Live Donor Support Fund be used for?
Post-operation costs: These include the cost of health checks, laboratory tests, surgery, hospitalisation and follow-up visit.

Loss of income: Applicants can also claim for loss of income as a result of the donation, capped at $5,000.

Insurance premiums: The fund will pay for the premiums of a new $100,000 insurance policy put up by NKF and Income for a donor's post-operation costs. It covers death, total and permanent disability and 30 critical illnesses, including stroke.

· Am I eligible?
You have to be a citizen or permanent resident of Singapore. After applying, you will be assessed to see if you meet the financial criteria to qualify for the fund. Doctors are trained to weed out donors in it for financial gain; details of this "means-testing" are not public.

· How do I apply?
Ask your doctor for a referral. Applicants must be referred through a restructured hospital; namely: Singapore General Hospital, Changi General Hospital, National University Hospital, Tan Tock Seng Hospital and Alexandra Hospital.