Replies to LegCo questions
LCQ20: Medical social workers
Following is a question by the Hon Tang Siu-tong and a written reply by the Secretary for Health, Welfare and Food, Dr Yeoh Eng-kiong, in the Legislative Council today (December 18):
Question:
At present, patients who cannot afford the charges for public hospitals medical services may apply to medical social workers ("MSWs") in hospitals for fee remission. In this connection, will the Government inform this Council:
(a) of the vetting and approval process for such applications, the average time required for each case, and the party responsible for making the final decisions;
(b) in the past three financial years, of
(i) the number of applications each year;
(ii) the number of MSWs responsible for processing these applications each year;
(iii) the average administrative cost for processing each case; and
(iv) the total number of approved cases, together with a breakdown by the grounds of approval and their respective percentages in the total number of cases; and
(c) whether it has estimated the number of fee remission applications by patients of the accident and emergency ("A&E") departments in the first 12 months following the introduction of A&E service charge; and how the workload of MSWs in that period will compare to that of the preceding 12 months; if it has, of the details?
Reply:
(a) At present, there is an established mechanism for patients who have difficulties to pay for even the highly subsidised public health care services to seek financial assistance from the Medical Social Workers (MSWs) stationed in the public hospitals. The MSWs will, based on their professional judgment and on a case-by-case basis, consider the following factors and decide whether full or partial fee waiver should be granted to a patient:-
(i) the financial situation of the patient's household, taking into account its income and assets;
(ii) relationship problems between the patient and his/her relatives, which may render it difficult to obtain appropriate support from family members;
(iii) the nature of the patient's illness, frequency of consultation, treatment and duration of hospitalisation; and
(iv) other financial and non-financial factors.
At present, we do not maintain statistics on the average time required to process each fee waiver application.
(b)(i) The number of applications approved for fee remission in the past three years are as follows-
Financial Year | Number of approved applications |
1999/2000 | 221,302 |
2000/2001 | 203,788 |
2001/2002 | 244,418 |
The Hospital Authority (HA) has not maintained statistics on the number of unapproved fee waiver applications.
(ii) The number of MSWs responsible for processing the applications mentioned in (b)(i) in the past three years are as follows:-
Financial Year | Total number of MSWs |
1999/2000 | 508 |
2000/2001 | 504 |
2001/2002 | 503 |
(iii) Given that in practice, the processing of fee waiver application is part and parcel of the psycho-social and counselling service provided to patients and their relatives, it is difficult to provide an estimate on the average administrative cost for processing each fee waiver application.
(iv) Please refer to part (b)(i) for the number of fee waiver applications approved in the past three years. Given the unique combination of financial and non-financial factors in each application, it is difficult to provide a breakdown of the approved applications by the grounds of approval.
(d) Given the A&E service charge has only been introduced since recently (November 29, 2002), there is no 12-months period for calculating the number of fee waiver applications by A&E patients, or for comparing the future workload of MSWs to the preceding 12 months. In fact, most recipients of Comprehensive Social Security Assistance and chronically ill patients who may also be frequent users of A&E services, but have difficulties to pay for their medical expenses, are already covered by the existing fee waiver mechanism and their applications for fee waiver of A&E service charge can be processed without additional assessment. Hence HA's assessment is that the existing mechanism should be able to cover any additional workload for fee waiver applications as a result of the introduction of A&E service charge.
End/Wednesday, December 18, 2002
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