Replies to LegCo questions
LCQ7: Visiting Medical Officer/Community Geriatric Assessment Team Collaborative Scheme
Following is a question by the Hon Fernando Cheung and a written reply by the
Secretary for Health, Welfare and Food, Dr York Chow, in the Legislative Council
today (May 2):
Question:
Under the Visiting Medical Officer/Community Geriatric Assessment Team
Collaborative Scheme launched by the Hospital Authority (HA) in October 2003,
medical staff are dispatched to residential care homes for the elderly (RCHEs)
to provide them with regular multi-disciplinary outreach medical consultation
and after-care services (outreach services). It has been reported that the
Health, Welfare and Food Bureau has imposed a cap on such services in order to
control expenditure and the RCHEs being denied such services are all
privately-run institutions. In this connection, will the Government inform this
Council:
(a) among the residents presently staying in private RCHEs and subsidized RCHEs,
of the respective numbers and percentages of elderly persons whose levels of
impairment have been assessed as "mild", "moderate" and "severe" under the
Standardized Care Need Assessment Mechanism for Elderly Services;
(b) of the respective numbers of visits to private RCHEs and subsidized RCHEs by
the medical staff, the respective numbers of attendances by elderly persons for
outreach services, as well as the annual expenditure and unit cost of such
services, in each of the past five years; and
(c) of the respective numbers of applications by private RCHEs and subsidized
RCHEs for outreach services rejected in each of the past five years, the reasons
for rejection and their percentages among all such applications?
Reply:
Madam President,
The Administration's subvention to the Hospital Authority (HA) for 2007-08 is
estimated to be $28.63 billion, representing an increase of roughly 2.4% when
compared to the revised estimate of $27.96 billion for 2006-07. The subvention
is in the form of a block grant for HA's deployment.
HA's Community Geriatric Assessment Teams (CGATs) have been providing outreach
medical consultation and after-care services to the elders in residential care
homes for the elderly (RCHEs) since 1994. In October 2003, HA implemented the
Visiting Medical Officer/CGAT Collaborative Scheme (the Collaborative Scheme) to
recruit private medical practitioners on a part-time basis to render support to
the CGATs by helping out with the outreach work in RCHEs. Given the difficulty
in recruiting private medical practitioners to participate in the Collaborative
Scheme, at present HA mainly recruits qualified medical graduates on a contract
and full-time basis to help out with the outreach work in RCHEs to render
support to the CGATs.
My replies to the specific questions are as follows:
(a) The requirement for applicants of the subsidised long-term care services to
undergo the Standardised Care Need Assessment (the Assessment) to ascertain
their impairment levels for service matching (including community care services
and/or subsidised residential care places) was introduced in November 2000.
Elders who were admitted to subsidised residential care places prior to that
date were not required to go through the Assessment. With the Assessment in
place, all the applicants for the government-subsidised residential care places
and the self-financing places in contract homes have to be assessed, but not for
those applying for self-financing places not in contract homes. Against this
background, the Social Welfare Department (SWD) can only provide information on
the impairment levels of elders who have gone through the Assessment and are
currently staying in the government-subsidised residential care places and the
self-financing places in contract homes, as shown in Annex 1.
(b) HA does not have records on the number of visits to RCHEs by the CGATs and
the Visiting Medical Officers (VMOs) of the Collaborative Scheme in each year.
The statistics on the number of attendances are however available.
The number of attendances served by the CGATs at the private and subsidised
RCHEs respectively in the past five financial years is shown in Annex 2.
Since October 2003, the VMOs of the Collaborative Scheme have taken on the
number of attendances shown in Annex 3. HA does not have a breakdown on the
attendances in terms of the types of RCHEs. However, we believe that the
majority of them was taken up by elders in private RCHEs.
The CGATs also provide in-patient services in hospital wards apart from the
outreach support to RCHEs. HA does not have a breakdown on the cost of CGAT's
outreach services to the RCHEs alone. Only the overall cost of the CGATs'
services is available. The total costs for the CGATs and the Collaborative
Scheme in each of the past five financial years (counted since October 2003 for
the Collaborative Scheme) are shown in Annex 4.
The above statistics show that, in the past five financial years, HA has
allocated additional resources each year to strengthen the outreach services.
Also, there has been an increase in the total number of attendances.
(c) At present, most of the RCHEs have made their own arrangements to appoint
private medical practitioners to provide medical care to their residents in
accordance with the advice laid down in the Code of Practice for Residential
Care Homes for the Elderly issued by SWD. The CGATs and the Collaborative Scheme
are currently providing outreach services to some 660 RCHEs (i.e. 89% of all the
RCHEs). In view of the growing number of RCHEs, the CGATs and the Collaborative
Scheme were unable to provide services to about 50 RCHEs which had asked for the
services in the past few years.
Ends/Wednesday, May 2, 2007
Issued at HKT 12:29
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Attachment:
Annexes to LCQ7