Replies to LegCo questions
LCQ7: Governance of Hospital Authority
Following is a question by the Dr Hon Leung Ka-lau and a written reply by the
Secretary for Food and Health, Dr York Chow, in the Legislative Council today
(May 30):
Question:
Will the Government inform this Council whether the Food and Health Bureau had
appointed any consultant in the past two years to conduct an assessment of the
governance (e.g. issues such as resource deployment, manpower planning, mode of
service delivery or waiting time, etc.) of the Hospital Authority; if it had, of
the assessment results; if not, whether such an assessment will be conducted in
the future, and of the details?
Reply:
President,
The Hospital Authority (HA) is an independent statutory body established under
the Hospital Authority Ordinance (Cap 113). The Ordinance includes provisions
specifying that HA should use the resources efficiently to provide hospital
services of high quality.
To ensure accountability to the public for the management and control of the
public medical services system, three Government officials (including the
Permanent Secretary for Health, the Director of Health, and the Deputy Secretary
for Financial Services and the Treasury) are ex-officio members of the HA Board
and participate in the governance of HA. The Secretary for Food and Health holds
monthly meeting with the management of HA for the purpose of monitoring its
work. Moreover, the Government will set out the performance targets of HA in the
Controlling Officer's Report under Head 140 in the Government's Estimates for
each year. These performance targets cover various aspects, including access to
services (such as waiting time), delivery of services, quality of services, cost
of services and manpower, etc. Through regular reports submitted by HA, the HA
Board and the Government assess and examine the performance of HA in accordance
with these targets.
In addition, being an independent statutory body and under the governance of its
Board, HA has a comprehensive mechanism for conducting internal and external
reviews from time to time to examine its operation and services in an effort to
achieve efficient use of its resources and provide quality healthcare services
to the public in a more effective manner.
For the purpose of maintaining and improving quality of healthcare services, HA
will closely monitor the performance of its hospitals based on the principles of
independence and professionalism. These include self assessment based on
established international standards and peer evaluation by external institutions
on the service performance of hospitals. HA will also formulate and adopt
measures to improve quality of hospital services continuously with reference to
code of good practices, standards and principles commonly used internationally,
in order to enhance the service quality of hospitals.
In addition, HA launched the pilot scheme on hospital accreditation in 2009 in
cooperation with the Australian Council on Healthcare Standards. Five HA
hospitals participated the pilot scheme and all have been awarded four-year full
accreditation status. HA will further extend the hospital accreditation scheme
to another 15 hospitals in the next five to seven years.
In order to have an objective and comprehensive examination of its development
in various aspects, HA has engaged independent consultants for conducting
assessments in the past years.
For example, HA commissioned a consultant last year to conduct a review on the
structural reorganisation of the HA Head Office implemented since November 2006.
The review was completed at the end of last year and the consultant's
recommendations were accepted by HA with measures being put in place step by
step to strengthen the HA Head Office's functions in cluster co-ordination,
corporate communications, staff communications and grade management. In
addition, after review, HA has proceeded to set up a consolidated corporate risk
management framework to identify and handle the potential risks faced by HA in
its various business areas.
HA has also conducted other reviews related to its management structure to
examine how the HA Management manages the operation of HA. As affirmed by the
findings of the review, the current governance framework of HA can afford
reasonable assurance that it can facilitate the effective deployment of the
resources of HA to achieve its corporate targets. HA is now implementing in a
gradual manner the various recommendations put forward by the consultant
including rationalising the terms of reference of some administrative
committees, modernising its corporate communications strategy as well as
strengthening the training of management personnel.
In order to further improve the standard of clinical services and the mechanism
for patients safety to meet effectively the increasing demand for services and
the rising expectation from the community, HA appointed a consultant in early
2012 to review the professional governance of clinical practice. The review is
expected to complete in June this year.
Apart from engaging independent external consultants for assessment in different
areas, HA also conducts internal reviews from time to time. On resource
allocation, HA has been adopting an approach that integrates its service
planning and resource allocation through a structured framework and defined
process to ensure the best use of resources for the delivery of quality service
to the public. As for service planning, the drawing up of the annual plans at
hospital and cluster levels is guided by the overall direction and priority
service planning at the corporate level. Both the HA budget and the resource
allocation among hospital clusters are put to the Finance Committee and the
Administrative and Operational Meeting of the HA Board for consideration and
endorsement. The allocation of resources within each cluster is essentially
based on the service programmes and targets as defined in the process of drawing
up the annual plan.
HA has also put in place a resource management framework, under which resource
inputs are linked up with service outputs, targets and quality standard. The use
of resources at cluster level is then monitored and evaluated by the HA Head
Office in an objective manner through a financial and performance reporting
system. The clusters are requested to submit regular reports to the HA Head
Office to show its performance indicators in regard to its service activities,
manpower and financial situation, clinical outcome and progress of its annual
plan. HA will examine closely any variations from the pre-determined targets and
where appropriate, take remedial actions with corresponding adjustment in
resource allocation.
On manpower planning, HA will regularly assess and make projections on the
growth of demand for its various healthcare services and staff turnover so as to
determine the number of healthcare staff required to be recruited each year in
the coming years for implementing various services included in its annual plan
to meet the healthcare needs of the public.
On service delivery models, when formulating its five-year strategic plans and
annual work plans, HA conducts extensive consultation with its frontline
healthcare staff, patients' groups and other stakeholders. Regular reviews are
also conducted on the service delivery model of public hospitals from time to
time, including the introduction of public-private partnership (PPP) model for
provision of quality healthcare services to the public. Since 2008, the
Government has, in collaboration with HA, implemented a number of PPP pilot
projects to provide patients with subsidies to use outsourced services and
promote PPP in healthcare. These pilot projects include the Tin Shui Wai Primary
Care Partnership Project, Haemodialysis Public-Private Partnership Programme,
Cataract Surgeries Programme, and magnetic resonance imaging and computerised
tomography scanning services project.
Regarding waiting time, HA has always been concerned about the waiting time
required for the public to use various public hospital services and has set up
an ad hoc working group to review the waiting time problem. In the case of
specialist out-patient (SOP) services, for instance, HA has taken various
measures to shorten the waiting time at SOP clinics, such as implementing a
triage system to ensure that the public can be given timely and appropriate
treatment. HA will review the operation of its various services from time to
time, closely monitor the waiting time for its services and conduct internal
audits of its various major service areas with a view to formulating and
implementing improvement measures.
On organisational structure, in the past two years, HA followed up on the
cluster structure review commenced in 2007. After thorough consultation, HA made
further improvements on the cluster management structure in January 2011 to
define more clearly the powers and responsibilities of all hospitals and
departments under each cluster and facilitate efficient delivery of appropriate
and holistic services to the public. Such improvements included streamlining and
standardising the existing roles of the management positions in all clusters,
service re-engineering, as well as appointment of Deputy Hospital Chief
Executives and designated Specialist Clinical Co-ordinators and Cluster Service
Directors.
The Government will continue to closely monitor the services of HA and conduct
assessment when necessary with a view to ensuring that HA's operation and the
services it provide suit the needs of the community.
Ends/Wednesday, May 30, 2012
Issued at HKT 15:56
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