Replies to LegCo questions
LCQ14: Appointment time for specialist out-patient cases follow-up consultation
Following is a question by the Hon Albert Chan and a written reply by the
Secretary for Food and Health, Dr York Chow, in the Legislative Council today
(April 1):
Question:
In reply to my question raised on December 17, 2008 regarding cases of
non-urgent conditions for specialist out-patient (SOP) services at public
hospitals, the Government only provided information on the waiting time for
first appointment of new cases, and stated that such waiting time was not
applicable to existing cases as the dates for follow-up consultation for these
cases were arranged by doctors. Yet, I have received complaints from quite a
number of members of the public that a remote date for follow-up SOP
consultation was arranged for them. They are worried that their clinical
conditions will worsen due to the lack of timely treatment over a prolonged
period. In this connection, will the Government inform this Council whether it
knows:
(a) in respect of existing cases of each SOP service, the average duration
between the dates of follow-up consultations last year and the dates for the
next consultations, as well as the number of existing cases as at the end of
last year, broken down by the duration (i.e. less than one year, one year to
less than two years, two years to less than three years, and three years or
above) between the date of the last follow-up consultation and the date for the
next;
(b) in respect of existing cases of each SOP service at present, the longest
duration between the date of the last follow-up consultation and the date for
the next; and
(c) whether the Hospital Authority will take any measure to improve the
situation of existing SOP cases having to wait for a long time for follow-up
consultation; if it will, of the details; if not, the reasons for that?
Reply:
President,
Currently, under the triage system for new specialist out-patient (SOP) cases of
the Hospital Authority (HA), SOP clinics will fix the date of medical
appointment for new patients on the basis of the urgency of their clinical
conditions, taking into account the patients' clinical history, the presenting
symptoms and the findings of physical examination and investigations. During
consultation, doctors of SOP clinics will again conduct assessment for the
patients and arrange for them to receive further examination and treatment or
refer them to other specialties for follow-up based on patients' clinical needs.
The date of follow-up consultation of each patient is determined according to
the patient's clinical needs and so the appointment time for follow-up
consultation varies from case to case. Information related to various parts of
the question is provided as follows.
(a) & (b) The duration between the date of booking of appointment for follow-up
consultation and the date of consultation for existing SOP cases of major SOP
specialties in 2008-09 (up to December 2008) (with breakdown by less than one
year, one year to less than two years, two years to less than three years and
three years or above), as well as the median duration and the 99th percentile
duration, are set out at the Annex.
Generally speaking, the date of follow-up consultation of patient will be
arranged within three to four months from the date of booking of appointment.
The data of 2008-09 (up to December 2008) shows that the follow-up consultation
for 90% of the SOP patients was arranged within eight months of the date of
booking and about 98% of the patients were arranged to have follow-up
consultation within one year.
We understand that some patients in relatively stable condition would like to
have a follow-up consultation within a short period of time. Doctors of SOP
clinics will discuss with individual patients to arrange a suitable date for
follow-up consultation in light of their clinical needs. In certain
circumstances, patients will be arranged for follow-up consultation after a
longer period of time. For example, for patients requiring regular clinical
audiological assessment after cochlear implant, or for cataract patients and
paediatric skin diseases patients whose condition have turned relatively stable,
they will be arranged for a follow-up consultation after a longer period.
Besides, patients suffering from renal stone assessed to be in relatively stable
condition by the surgical SOP clinic will be referred to the family medicine SOP
clinic for follow-up and arranged for follow-up consultation at the surgical SOP
clinic after a longer period. Nevertheless, patients can approach the relevant
SOP clinic to advance their follow-up consultation where necessary should their
conditions deteriorate while waiting for the appointment. In case of emergency,
they can also seek treatment from the Accident and Emergency Department direct.
(c) In line with the direction of healthcare reform to enhance primary care,
promote public-private partnership and put emphasis on disease prevention, the
Government has earmarked a total of about $509 million for the period 2009-10 to
2011-12 to implement a series of healthcare reform initiatives on a pilot basis
to enhance primary healthcare services and the support for chronic disease
patients, and to strengthen family medicine training. One of the pilot
initiatives is to give stable chronic disease patients currently under the care
of SOP clinics under HA the alternative choice to receive healthcare from
private medical practitioners based on specified service models and protocols
for effective care of their chronic diseases and with subsidies by the
Government. As some of the chronic disease patients will change to be managed by
private medical practitioners through the pilot project, the waiting time of SOP
clinics could be shortened and other patients could therefore benefit.
Ends/Wednesday, April 1, 2009
Issued at HKT 14:41
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