Ban on Ex-offenders from Donating Blood within One Year of Release from Prison

2 Mr Louis Ng Kok Kwang asked the Minister for Health what is the rationale for banning ex-offenders from donating blood within one year of their prison release.

The Senior Minister of State for Health (Dr Lam Pin Min) (for the Minister for Health): Mr Speaker, to ensure a safe and high-quality blood supply for our patients in Singapore, pre-donation interviews are conducted to screen blood donors for risk factors and blood donations are also tested for blood-borne infections.

However, infections can only be detected some time after the blood donors have been infected. This is known as the window period. Therefore, donors who have been exposed to infection risks will be asked to defer their donation until after the window period.

For this reason, the World Health Organization recommends an appropriate deferral period after ex-offenders have been released from prison before blood donation. HSA has adopted a one-year deferral period, aligned with the practices of other countries such as Australia, Canada and the United States of America. It ensures that the window period after these donors become infected has passed, enabling the screening tests to detect blood-borne infections if any, as patient safety is utmost important and cannot be compromised.

Mr Louis Ng Kok Kwang (Nee Soon): I do understand we are following WHO guidelines. But WHO says prisons are extremely high-risk environments for transmission of HIV due to over-crowding, poor nutrition, limited access to healthcare, continued drug use, unsafe injecting practices, unprotected sex and tattooing.

This might be representative of other prisons, but can I ask the Senior Minister of State whether this is representative of the Singapore prisons? And having myself visited the prisons, I am quite sure that this is not. If it is not, then why do we follow the WHO guidelines when our prisons are not the same as other prisons?

The second clarification is, if we really do believe that the Singapore Prison is an area where there is high infections, then, surely, MOH should be doing something to protect our inmates against HIV, Hepatitis B which we can vaccinate against, and Hepatitis C, rather than the stigma of the ex-offender coming out and then, going to try and donate blood, and the doctor says, "No, you can't because you are an ex-offender." And that is a real-life example because it was an ex-offender who emailed me after coming to my blood donation drive in Nee Soon East and being turned away.

Dr Lam Pin Min: I would like to thank the Member for those clarifications. As I have mentioned, HSA has very high standards on donor criteria to ensure the safety of blood supply. I think that this is something that all of us do support. We also know that studies have shown that inmates of prisons and corrective institutions have a higher incidence of infections from blood-borne diseases such as Hepatitis B and Hepatitis C. This is a fact.

Although there are no reported instances of inmates contracting blood-borne or infectious diseases while in Singapore's prison – and this is something that we are very proud of as compared to many of the other prisons that Mr Louis Ng has alluded to – we still need to err on the side of caution as inmates may have contracted the infectious diseases before their admission to prison. We also acknowledge that they are considered a higher risk group compared to the population. If I can just quote some statistics: for HIV, for the general population between the age 15 and 45 in Singapore, the HIV prevalence is 0.2% but it is 1.1% amongst inmates or ex-inmates. This is a fact that they are of a higher risk profile.

Like I have mentioned in my reply, they may be in the window period, so therefore, we have adopted what WHO has recommended, taking into consideration all these factors.

I also thank the ex-inmate who came forward to donate. I think for genuine donors, they can still continue to come forward to donate their blood after that 12-month deferral period.

Mr Speaker: Ms Anthea Ong.

Ms Anthea Ong (Nominated Member): Thank you, Speaker. I thank the Senior Minister of State. On this topic of blood donation, I mentioned it yesterday in my cut, too, that there are persons with mental health conditions who declared and were also turned away at the blood banks here in Singapore. It just concerns me that between ex-offenders and persons with mental health conditions, our blood donation policy seems to be entrenched deeply in stigma that we are trying so hard to get rid of. Could the Senior Minister of State explain why persons with mental conditions are turned away at blood donation drives?

Dr Lam Pin Min: I thank the Member for that clarification. As far as I know, not all mental conditions will be excluded from blood donation. In fact, we have checked with HSA. There is a wide spectrum of mental illnesses – from very mild mental conditions to very severe conditions. So, as long as the patient with mental illness is able to prove from maybe some form of certification from their psychiatrist or doctor that they able to make decisions on their own, then, we will be able to accept them as blood donors.

Mr Louis Ng Kok Kwang: Sir, the follow-up question to my second point – what is MOH doing to help the inmates who have been released? We are saying that a year from their release date, they have very high potential of being infected with Hepatitis B, Hepatitis C and HIV, surely, MOH should have a programme to help these inmates following their release.

Dr Lam Pin Min: I think we must be cognisant that the reason why they are inmates is because of certain things that have happened, prior to that. That actually pre-disposes them to some high-risk behaviours. While we do not want to say that every single person who has been admitted to prison is considered high risk, we do need to take an approach whereby we have to err on the side of caution. Like I have mentioned, for genuine donors, they are still welcomed to donate after the 12-month deferral period.