Replies to LegCo questions
LCQ4: Obstetrics and gynaecology services of New Territories East Cluster
Following is a question by the Hon Li Kwok-ying and a reply by the Secretary for
Health, Welfare and Food, Dr York Chow, in the Legislative Council today (March
14):
Question:
Regarding the obstetrics and gynaecology services at the North District
Hospital, will the Government inform this Council whether it knows:
(a) given that it has been reported that the New Territories East Cluster of the
Hospital Authority (HA) has recently abolished the emergency gynaecology
services at the North District Hospital and redeployed the manpower there to the
Prince of Wales Hospital, resulting in patients seeking emergency gynaecology
services in that district having to go to the Prince of Wales Hospital, which is
about 30-minute drive from the North District, for such services, whether HA has
assessed the additional risks posed by such an arrangement to patients seeking
emergency gynaecology services (especially those experiencing extra-uterine
pregnancy or miscarriage, etc); if so, of the assessment results;
(b) whether HA has considered recruiting additional staff to solve the problem
and hence there is no need to abolish the above services; if so, of the details;
if not, the reasons for that; and
(c) given the increasing demand for obstetrics services from residents in the
North District, whether HA will consider providing obstetrics beds at the North
District Hospital; if so, of the timetable; if not, the reasons for that?
Reply:
Madam President,
(a) The seven public hospitals under the New Territories East (NTE) Cluster,
namely the Prince of Wales Hospital (PWH), the Shatin Hospital (SH), the
Bradbury Hospice (BH), the Cheshire Home of Shatin (CHS), the Alice Ho Miu Ling
Nethersole Hospital (AHMLNH), the Tai Po Hospital (TPH) and the North District
Hospital (NDH), provide medical services to residents in the New Territories
East. Within the NTE Cluster, PWH and NDH provide both inpatient and outpatient
gynaecology services, while only gynaecology outpatient services are available
at AHMLNH.
The NTE Cluster is planning to realign its emergency gynaecology services in
April this year. According to the Hospital Authority (HA), the main reason for
the service realignment is the departure of nine specialists and senior
professors of the Obstetrics and Gynaecology (O&G) Department of the Cluster and
the Chinese University of Hong Kong in the past two years. In order for
hospitals to properly handle emergency surgeries, one of the most important
factors is the the level of clinical experience of its healthcare staff. In view
of the loss of some senior doctors, the NTE Cluster has conducted a review on
its emergency gynaecology services in February this year. The findings of the
review showed that the utilisation of such services at NDH was relatively low.
In 2006, NDH handled a total of 664 emergency gynaecology cases, of which 93
cases required emergency surgeries, representing a weekly average of 12.8
emergency gynaecology patients and 1.8 emergency gynaecology surgeries. Among
the patients who required emergency surgeries, about two-thirds were residents
of the North District, with Tai Po residents making up most of the remaining
third.
Having regard to the overriding objective of ensuring the provision of quality
medical services, and after considering the matter very carefully and balancing
of all relevant factors, the NTE Cluster reached the conclusion that the most
appropriate arrangement in the circumstances is to converge all emergency
gynaecology services of the Cluster at PWH and cease providing such services at
NDH.
After the service realignment, non-emergency gynaecology services of NDH,
including specialist out-patient, ambulatory care and ward services, will remain
unchanged. The NTE Cluster will flexibly deploy the necessary manpower to cater
for the demand of emergency services at PWH.
The NTE cluster will strengthen its internal guidelines prior to the realignment
of its emergency gynaecology services, so as to ensure that patients would be
given timely and appropriate diagnoses, medical treatment and referrals. The HA
indicated that the proposed service arrangement will not pose any additional
clinical risks on patients in the North District who require emergency
gynaecology services.
(b) As regards manpower, the HA regularly reviews the human resources of various
specialist services and will make necessary readjustments from time to time in
order to support service development and meet service demand. In July 2006, the
NTE Cluster recruited four resident doctors for its O&G Department to fill the
vacancies left behind by doctors departed in 2005-06. For the coming year, the
NTE Cluster is actually planning to enhance its O&G services. In this
connection, the NTE Cluster will continue to recruit new doctors to fill
existing vacancies. On top of that, the Cluster will recruit an extra one or two
O&G resident doctors and promote four associate consultants. These newly
recruited/promoted doctors may need some time to fully familiarise themselves
with their new jobs. The NTE Cluster hopes that this will strengthen its O&G
team. It will also review its emergency gynaecology services in 2008 in light of
the latest situation at that time.
(c) As regards the obstetric services of the NTE Cluster, all such services are
currently converged at the PWH because of the availability of comprehensive
neonatal care and intensive care support there.
Pursuant to the benchmark laid down by HA's co-ordinating committee on O&G, the
HA should only consider the establishment of obstetric services at hospitals
with at least 3 000 childbirths per year, so as to ensure that their healthcare
personnel are sufficiently experienced to handle complications that may emerge
in the labour process. According to the statistics collated by the Census and
Statistics Department, the number of local new-born babies residing in Tai Po
and North District was around 2 600 per year, out of which 2 000 were delivered
in public hospitals. Considering that the number of new-born babies residing in
Tai Po and North District and delivered in public hospitals has yet to reach the
aforementioned benchmark, the HA does not have any plan at the present moment to
establish obstetric services at NDH.
Ends/Wednesday, March 14, 2007
Issued at HKT 12:59
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