Replies to LegCo questions
LCQ14: Paediatric in-patient service
Following is a question by the Hon Chan Hak-kan and a written reply by the
Secretary for Labour and Welfare, Mr Matthew Cheung Kin-chung (in the absence of
the Secretary for Food and Health), in the Legislative Council today (May 23):
Question:
Recently, quite a number of residents in Tai Po and the North District have
relayed to me that at present the North District Hospital does not provide
paediatric in-patient service, causing the sick children in the North District
having to be admitted to Alice Ho Miu Ling Nethersole Hospital (Nethersole
Hospital) in Tai Po, but the population in the district is increasing, and quite
a number of children from the Mainland cross the border to seek medical
treatment in Hong Kong, resulting in the hospital beds in Nethersole Hospital
being fully occupied from time to time. They have pointed out that as such, some
sick children living in Tai Po District have to go to Prince of Wales Hospital
in Shatin to seek medical treatment, causing inconvenience to the sick children
and their parents. In this connection, will the Government inform this Council:
(a) whether it knows the respective numbers and average occupancy rates of the
paediatric beds in Prince of Wales Hospital and Nethersole Hospital in the past
five years, and the numbers of in-patient children who were not Hong Kong
residents;
(b) of the anticipated numbers of people aged 18 or below in Shatin, Tai Po and
the North District respectively in the next five years;
(c) if it knows the factors and criteria based on which the Hospital Authority
(HA) at present considers whether to provide paediatric in-patient service in a
hospital; when such factors and criteria were formulated and whether they are
reviewed on a regular basis;
(d) whether it knows if HA has assessed the impact of children crossing the
border to seek medical treatment in Hong Kong on the paediatric in-patient
service in the New Territories East Cluster (NTEC); and
(e) whether it knows if HA will conduct a comprehensive review of the paediatric
in-patient service in NTEC to facilitate the formulation of improvement plans;
if it will, the details; if not, the reasons for that?
Reply:
President,
To reduce duplication for more effective utilisation of resources, the Hospital
Authority (HA) provides its services on a cluster basis. As the bed occupancy
rate of the paediatric wards of the North District Hospital and the Alice Ho Miu
Ling Nethersole Hospital (Nethersole Hospital) remained below 60% continuously
in 2002 and 2003, the New Territories East (NTE) Cluster decided to re-organise
its services in 2004 by combining the paediatric in-patient services of the two
hospitals into one unit and centralising the provision of paediatric services at
the Nethersole Hospital with a view to fully utilising the relevant facilities
and healthcare manpower.
At present, paediatric specialist out-patient services are provided at the
Prince of Wales Hospital, Nethersole Hospital and North District Hospital under
the NTE Cluster to serve residents of Shatin, Tai Po and the North District. And
paediatric and neonatal in-patient beds are also provided at the Prince of Wales
Hospital and Nethersole Hospital to take care of the local patients in
accordance with the complexity and severity of their medical conditions.
On the other hand, the Government has taken various measures to tackle the
problem of non-eligible persons delivering in Hong Kong in order to ensure that
Hong Kong residents are accorded priority for quality obstetric services. As for
the measures taken by HA, these include ceasing the acceptance of bookings from
non-local women for delivery in 2013 and raising the charge from $48,000 to
$90,000 for delivery by emergency admission through Accident and Emergency
Departments without prior booking. We believe that these measures would help
alleviate pressure on the obstetric and gynaecological services as well as
neonatal services in various HA clusters.
My reply to various parts of the question regarding the paediatric services in
NTE is as follows:
(a) The number and average occupancy rate of the paediatric and neonatal beds in
the Nethersole Hospital and Prince of Wales Hospital in the past five years are
at Table 1.
The overall paediatric admissions and the admissions of "non-eligible"
paediatric patients in the NTE Cluster in the past five years are at Table 2.
(b) Projections of geographical distribution of population by districts over a
ten-year period are prepared on a need basis by the interdepartmental Working
Group on Population Distribution Projections under the co-ordination of the
Planning Department. According to the latest set of population distribution
projections released in 2010, the projected mid-year population figures for the
age group of 18 or below for 2012-2016 in Shatin, Tai Po and the North District
are at Table 3.
(c) HA conducts assessment on the demand for its various services on a regular
basis and undertakes reviews on the healthcare service delivery models so as to
meet the needs of the community. As in other countries with a more
well-developed healthcare system, HA has, in designing the provision of its
paediatric services, adopted the guiding principle that where necessary, medical
cases are centralised for management to achieve greater effectiveness and where
feasible, services are provided in respective districts to facilitate the public
to access the services.
HA has adopted an internationally-accepted demand projection model to forecast
the future service needs in order to determine the demand for hospital beds.
These forecast figures are updated regularly based on the projected Hong Kong
resident population provided by the Census and Statistics Department and the
projections of population distribution provided by the Planning Department. In
making such a forecast, factors like the service delivery models adopted, the
growth of population and changes in demographic profiles, as well as the trend
of service outputs by age groups and specialties have been taken into account.
These figures are calculated on a cluster basis.
HA will continue to strengthen its paediatric services where necessary in order
to provide patients with appropriate care at different stages of treatment.
(d) and (e) As at early May 2012, there were a total of 64 and 170 hospital beds
in the Paediatric and Neonatal Care Units of the Nethersole Hospital and the
Prince of Wales Hospital respectively to serve the residents in the NTE.
To meet the additional service demand, the Prince of Wales Hospital will enhance
the high dependency care for its paediatric service and open an additional
neonatal intensive care bed in 2012-13, making the total number of neonatal
intensive care beds in NTE to 22. As for the Nethersole Hospital, an additional
Advanced Practice Nurse will be recruited in 2012-13 to support the operation of
its paediatric ward. The NTE Cluster will closely monitor the rate and trend of
utilisation of its paediatric services and, considering the overall supply of
healthcare manpower, make appropriate resources planning.
Ends/Wednesday, May 23, 2012
Issued at HKT 12:42
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Table 1
Table 2
Table 3