Health-care reform is an urgent case
A dual live liver transplant from two daughters to their father at Queen Mary Hospital recently was not only the first of its kind anywhere but the circumstances also set Hong Kong apart.
The surgery, involving three simultaneous operations as a new liver was formed from donations by the two women and implanted in their father, was not performed at an exclusive medical institution, or only affordable to the wealthy or well insured. It was performed at a public hospital - one of 42 hospitals and clinics in the city used by more than 90 per cent of Hong Kong people - that is accessible to all at nominal cost.
Such examples enhance the enviable reputation of the city's health system and the renown of the liver transplant team, and shore up trust in public health care. But they also serve to underline issues that face each. The first is the financial stress on the system, which threatens to undermine general service quality. This adds urgency to the task of winning support for health-care reform to share more of the burden with the private sector. Meanwhile it is good that among emergency measures to reduce waiting times, the government will provide an extra HK$1.17 billion to help the Hospital Authority meet the challenges of an ageing population.
The second is the perennial problem of lack of deceased liver donors, without which doctors resort to live transplants where possible. Of nearly 1,200 liver transplants at Queen Mary since 1991, only 44 per cent were donated by those who had died. As a result about 90 per cent of patients with acute liver failure died before a liver suitable for transplant could be found.
The percentage of people willing to donate organs after death remains relatively low in Asia because of cultural belief. If the selfless sacrifice of the two young women inspires potential donors to help transplant candidates less fortunate than their father, it may lead to the saving of more lives. Meanwhile, the authorities must persist with a sensitive public education campaign to overcome cultural barriers.
