Replies to LegCo questions
LCQ17: Dispensaries of General Outpatient Clinics under Hospital Authority
Following is a question by the Dr Hon Pan Pey-chyou and a written reply by the
Secretary for Food and Health, Dr York Chow, in the Legislative Council today
(July 14):
Question:
A pharmaceutical dispenser association has earlier pointed out that in the past
few months, seven drug incidents occurred one after another in the general
out-patient clinics (GOPCs) of the New Territories East and New Territories West
Clusters of the Hospital Authority (HA). The association has further pointed out
that since pharmacists stationed in out-patient clinics need to handle
administrative work, dispensers are required to undertake pharmacists' work in
addition to their own work, which has increased their workload drastically, and
the risk of dispensing errors has also increased correspondingly, hence posing
threats to the lives of the public. Regarding the manpower and establishment of
dispensing staff in public GOPCs, will the Government inform this Council
whether it knows:
(a) the total number of drug-related medical incidents which occurred in public
GOPCs in Hong Kong in each of the past five years, together with a breakdown by
HA's hospital cluster;
(b) the existing staff (including pharmacists) establishment and the actual
number of staff on duty in the dispensary of each of the day, evening and
holiday GOPCs; the average number of days/nights/sessions per week during which
the pharmacists therein act as the persons-in-charge of the dispensaries of the
various clinics; the number of clinics stationed with only one dispenser;
whether there are clinics in which dispensers act as the persons-in-charge of
the dispensaries; and the number of clinics which manage to have four dispensers
or pharmacists stationing there;
(c) the current number of dispensers qualified to act as "approved persons" or "authorised
persons" among the dispensers in public GOPCs in Hong Kong, and the number of
those who handle the duties of dispensing medicines in place of pharmacists at
present;
(d) the number of new drugs available in public GOPCs in the past five years;
the percentage of such number in the total number of drugs; and the number of
patients referred in each of the past five years by specialist out-patient
clinics to GOPCs for follow-up consultation and collection of drugs; and
(e) the increase in the past five years in the total number of doctors in public
GOPCs in Hong Kong; whether the numbers of dispensers and pharmacists have
increased correspondingly; if not, of the reasons for that; and the ratio of
doctors to dispensers and pharmacists in the public healthcare system at
present?
Reply:
President,
The Hospital Authority (HA) took over 59 General Outpatient Clinics (GOPCs) from
the Department of Health (DH) in July 2003. Under the Dangerous Drugs Ordinance
and the Pharmacy and Poisons Regulations, dispensaries of hospitals and
outpatient clinics are required to have a registered pharmacist or a person
approved by the Director of Health to be in possession of and to supply
dangerous drugs and drugs classified as poisons. After taking over the
above-mentioned GOPCs, HA has continued to adopt the system of "approved person"
and recruited 45 additional pharmacists to work in the dispensaries of GOPCs. HA
lodges applications with the Director of Health on a regular basis for
appointment of its staff as approved persons.
The reply to various parts of the question is as follows:
(a) At present, the dispensaries of GOPCs under HA handle over four million
prescriptions and over 14 million drug items each year. The number of drug
incidents (in terms of drug items dispensed) reported by the GOPCs under HA in
the past five years is set out in Annex 1. As compared with the number of drug
items dispensed, the percentage of drug incidents reported each year was close
to zero.
A breakdown of the above figures by clusters is set out at Annex 2.
(b) Among the 59 GOPCs taken over by HA, 49 provide regular day-time dispensing
service. Some of the dispensaries of these GOPCs also provide dispensing service
at night and/or on holidays. The number and percentage of service sessions with
a pharmacist on duty are set out in Annex 3.
As for the other 10 GOPCs (comprising five on outlying islands, four providing
non-whole-day consultation service and one mobile clinic), the operation of
their dispensaries is relatively simple. These dispensaries are manned by
dispensers deployed by the respective clusters to provide limited dispensing
service in the capacity of "approved persons".
The staff establishment of the dispensaries of the 59 GOPCs under HA is
determined having regard to operational needs and workload. Except the
dispensaries of those GOPCs located on outlying islands or providing
non-whole-day consultation service or being a mobile clinic, which are manned by
one "approved person", the dispensaries of the remaining 49 GOPCs generally have
a staff establishment of one pharmacist and one to nine senior
dispensers/dispensers. At present, there are 36 dispensaries of GOPCs under HA
being manned by four or more dispensary staff.
(c) At present, there are a total of 59 dispensers holding the status of
"approved person" working in the dispensaries of GOPCs under HA. Of them, 10
provide dispensing service at the GOPCs located on outlying islands or providing
non-whole-day consultation service or being a mobile clinic. The remaining 49
"approved persons" are assigned to provide dispensing service in different GOPCs
within their respective clusters having regard to the operational needs of the
dispensaries.
(d) Over the past five years, 10 to 60 additional drug items have been
introduced to individual GOPCs to cater for the needs of patients in various
clusters. These additional drug items account for 3 to 21% of all drug items in
the respective dispensaries. The total number of drug items dispensed at the
dispensaries of GOPCs remains more or less the same, with details are set out in
Annex 4.
Currently, under the patient referral system in HA, the arrangements for patient
referral between GOPCs and Specialist Outpatient Clinics (SOPCs) are two-way. HA
has no statistical data on the number of patients referred by SOPCs to GOPCs for
follow-up consultation and collection of drugs.
(e) Since March 2008, the number of doctors, pharmacists and dispensers working
in GOPCs remains more or less the same. The actual number of staff is set out in
Annex 5. As at the end of March 2010, there are 4,995 doctors, 355 pharmacists
and 949 dispensers working in HA.
Ends/Wednesday, July 14, 2010
Issued at HKT 18:26
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Annex to LCQ17