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Kidney donation law change should go further

Dominion Post

8 July 2015

Kidney donation law change should go further

 

Elsie Howarth donated her kidney to her father Robin Howarth and is struggling with the consequences financially and health wise while her dad's health is improving.
Ross Giblin/Fairfax NZ

Elsie Howarth donated her kidney to her father Robin Howarth and is struggling with the consequences financially and health wise while her dad's health is improving.

 

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OPINION: Organ donors fall into two general categories. Live donors include friends and family members who donate an organ (either a kidney or part of the liver) to a person needing a transplant t, together with so-called non directed donors who donate an organ with no specific recipient in mind.

Deceased organ donation refers to those situations where a person has been pronounced brain dead in a hospital, and their family has agreed – often in discussion with their family member prior to that person's death – that their organs should be donated. Kidneys from deceased donors are donated to patients on a national waiting list, based on waiting time and tissue match.

While recent increases in both live and deceased organ donation are encouraging, New Zealand continues to have one of the lowest rates of deceased organ donation in the developed world.

Elsie Howarth donated her kidney to her father Robin Howarth and is struggling with the consequences financially and health wise while her dad's health is improving.
ROSS GIBLIN/FAIRFAX NZ

Elsie Howarth donated her kidney to her father Robin Howarth and is struggling with the consequences financially and health wise while her dad's health is improving.

 

As a result, the gap between the number of people waiting for a transplant and the number of transplants able to be performed continues to grow. Despite a waiting list of around 700, fewer than 150 kidney transplants were performed last year.

Sadly, then, stories such as that of kidney transplant recipient Robin Howarth and his daughter Elsie are repeated throughout the country.

Some otherwise willing live donors delay or decline to donate due to potential loss of income during the six to eight weeks recovery post-surgery.

Recent New Zealand research indicates that patients the financial impact that being a donor would have on family finances is a key reason for patients' reluctance to ask a family member to donate a kidney.

Yet currently, the only financial support available to the likes of Elsie, in the weeks following her surgery - surgery that enabled her to give a new lease on life to her father - is the sickness benefit, plus some travel and accommodation support.

Such nominal financial support is demonstrably insufficient.

The reasons for increasing the financial assistance for live organ donors are many.

 

The World Health Organisation's Guiding Principles on Organ Transplantation endorse reimbursement for lost income and medical expenses for donors.

And given the latest Ministry of Health figures that put the cost to the New Zealand  health care system of dialysis for an individual as high as $60,000   a year the savings to the health system of a kidney transplant over continued dialysis are significant.

Of even greater significance is the weight of evidence that demonstrates that both the lifespan and quality of life of kidney transplant patients are both significantly improved compared with patients remaining on long-term dialysis.

For these reasons, Kidney Health NZ strongly supports Chris Bishop's Financial Assistance for Live Organ Donors Private Member's Bill, recently drawn from the ballot.

The Bill proposes that the level of reimbursement to live organ donors be increased from the level of the sickness benefit to 80 per cent of a live donor's lost income, in line with ACC payments. 

Given New Zealand's low rate of organ donation, and the life-changing difference that a donated organ makes for its recipient – quite apart from the millions of dollars that increased organ donation would save the heath budget – it is therefore not surprising that Bishop's bill has, as he notes, "broad informal support in the House."

But does it go far enough? Given that this was initially submitted some six years ago (in the name of Michael Woodhouse) , and the year-on-year burgeoning of the organ transplant waiting list that has occurred over those years, could the Government not have adopted this as a Bill in its own right – particularly given the broad cross-party support that is evident for such a change?

And is even 80 per cent reimbursement of lost income a sufficient contribution to the ongoing living expenses and additional medical expenses faced by a live organ donor over the six to eight weeks of their convalescence?

Has not a family member, friend or purely altruistic donor made sufficient a life-giving contribution in donating their organ – without being expected to "donate" a further 20 per cent of their income as well?

The drawing of  the bill, and its inevitable referral to a select committee, will at least allow some of these questions to be publicly aired.

Let's hope the public takes up that opportunity – so that stories such as those of Robin and Elsie Howarth do not continue to be repeated.

Max Reid is chief executive of Kidney Health NZ, a national not-for-profit organisation providing free education, support and advocacy for kidney patients and their families. For further information regarding the issues addressed in this article, please contact Kidney Health NZ on 0800 KIDNEY (543 639).

 - The Dominion Post



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