Replies to LegCo questions
LCQ6: Dispensers with status of "Approved Persons"
Following is a question by the Dr Hon Pan Pey-chyou and a reply by the Secretary
for Food and Health, Dr York Chow, in the Legislative Council today (June 27):
Question:
I have received a complaint from the Hong Kong Professional Pharmaceutical
Employees Association (HKPPEA) that the Hospital Authority (HA) has, since 2003,
made applications to the Department of Health on its own volition for some
dispensers to be appointed as "approved persons", without informing such
dispensers nor obtaining their consent or authorisation, and asked them to
undertake and perform the duties of pharmacists in-charge, which should be
performed by registered pharmacists. HKPPEA has pointed out that those
dispensers who hold the status of "approved persons" are not registered
pharmacists and HKPPEA is worried that drug safety may be affected. In this
connection, will the Government inform this Council if it knows:
(a) the numbers of additional pharmacists and dispensers employed by HA in each
of the past nine year to cope with the manpower needs of its dispensaries and
the average waiting time for patients of the general out-patient clinics and
specialist out-patient clinics of the various clusters of HA to collect
medicine; whether HA had ever withheld the recruitment of pharmacists because
there was a sufficient number of dispensers holding the status of "approved
persons" since HA has assigned such dispensers to perform the duties of
pharmacists in-charge in 2003; whether HA had consulted the dispensers and their
staff associations before implementing the "approved persons" system in 2003;
whether the system had been reviewed and enhanced in the past nine years; if
not, the reasons for that;
(b) whether HA had informed the dispensers concerned in advance before making
applications for them to be appointed as "approved persons"; whether it had
given copies of the appointment and other related letters to such dispensers for
their retention after application; how such appointments and recognition of
qualifications are of use to the experience and qualifications of the
dispensers; whether HA had, at the time of making applications for appointment
of these dispensers, provided them with additional training and opportunities
for further studies, and improved their remuneration packages to enable them to
cope with the additional workload and duties; and
(c) given that the employees in the trade and members of the public have strong
reservations about assigning dispensers who have been appointed as "approved
persons" to perform the duties of registered pharmacists, whether HA will
immediately put the system on hold (including immediately re-assigning
registered pharmacists who meet the qualification requirements to take up the
posts of pharmacist in-charge currently taken up by "approved persons") and
expeditiously employ additional staff for both grades so as to ease the pressure
of the workload in the dispensaries and to shorten the waiting time for patients
to collect medicine; whether HA will also review the duties, scope of work and
promotion ladder of the different grades of staff in the dispensaries so as to
enhance the procedures and efficiency in dispensing medicine in the dispensaries
under HA and reduce medicine incidents?
Reply:
President,
Under the Dangerous Drugs Ordinance (Cap.134) and the Pharmacy and Poisons
Regulations (Cap. 138A), pharmacies of hospitals and outpatient clinics are
required to have a registered pharmacist or a person approved by the Director of
Health to possess and supply dangerous drugs and to supervise the dispensing of
poisons. Before the Hospital Authority (HA) took over 59 General Outpatient
Clinics (GOPCs) from the Department of Health (DH) in July 2003, senior
dispensers and dispensers had all along been in charge of the GOPC pharmacies
and were responsible for possessing and supplying dangerous drugs and
supervising the dispensing of poisons. This is referred to as the "Approved
Person" arrangement. After taking over the GOPCs, HA has continued to adopt the
"Approved Person" arrangement and recruited 45 additional pharmacists to manage
the operation of GOPC pharmacies.
At present, HA applies to the Director of Health on a regular basis for
extending the "Approved Person" status of some senior dispensers and dispensers
working in the GOPCs, so that they can continue to perform dispensing-related
duties in accordance with the aforesaid Ordinance and Regulations. HA has
already, for each of the GOPCs, deployed pharmacists to be in charge of the
pharmacies and be responsible for the management of the daily operation of the
GOPC pharmacies. The "Approved Persons" are not required to be in charge of the
GOPC pharmacies but they have to perform the duties of "Approved Persons",
including possession and supply of dangerous drugs as well as supervising the
dispensing of poisons, in the absence of on-site pharmacists and when there is a
service need. The "Approved Person" arrangement is an established practice
adopted from the Department of Health and has been operating effectively. The
extension of the "Approved Person" status with the Director of Health's written
approval also complies with the law. In fact, the duties of "Approved Persons"
are part of the daily and professional duties of the dispenser grade staff. The
work arrangement is consistent with that when they worked in the GOPC pharmacies
under DH's management in the past. At present, all dispensers trained by the
Hong Kong Institute of Vocational Education have obtained the Higher Diploma in
Pharmaceutical Technology and received vocational training in uses of drugs and
drug dispensing practice. After they joined HA, dispensers will receive a
variety of continuous professional development training every year, covering the
pharmacy practice, drug knowledge as well as personal and career development
etc., to cope with the service needs. Therefore, dispenser grade staff of HA
have the professional qualification and knowledge and are competent to perform
dispensing-related duties in the GOPC pharmacies. HA will continue to uphold the
principle of appointment by merit and arrange both pharmacists and dispensers to
work together in the GOPC pharmacies so as to meet service needs.
My reply to the various parts of the question is as follows:
(a) The number of pharmacists and dispensers recruited by HA every year varies
according to service development and operational needs. In each of the past nine
years, HA took on additional pharmacists (maximum 53 in one year) and additional
dispensers (maximum 32 in one year). Detailed figures are at Table 1 of the
Annex. In recent years, the average waiting time for drug dispensing services
for patients attending HA's specialist out-patient clinics (SOPCs) has been
maintained at about 40 minutes. Detailed figures are at Table 2 of the Annex.
After taking over the GOPCs, HA has continued the "Approved Person" arrangement
in the GOPCs for operational reasons. As a matter of fact, the duties of
"Approved Persons" are within the scope of daily duties of the dispenser grade
staff, and the number of "Approved Persons" has been gradually decreasing from
93 in 2003 to 34 in July 2012. The 34 "Approved Persons" whose status have been
extended are all senior dispensers who are experienced and professionally
competent to perform dispensing-related duties. On the other hand, since
2011-12, HA has been recruiting and deploying over 20 pharmacists to work at the
GOPCs to strengthen the overall manpower support and enhance the overall
efficiency of GOPC pharmacy services. HA has been communicating closely with the
concerned staff and the dispenser staff associations on the need to extend the
"Approved Person" status of some of the dispenser grade staff.
(b) Since 2009, HA has issued written notice to the concerned staff on the
Director of Health's approval for extending their "Approved Person" status in
the GOPCs. The "Approved Persons" with their status extended in the past were
all senior dispensers and experienced dispensers. As mentioned above, HA
provides a variety of continuous professional development training, covering
pharmacy practice, drug knowledge as well as personal and career development
etc., for pharmacy staff every year (including dispenser grade staff working in
both hospitals and out-patient clinics) so as to meet service needs.
(c) HA understands the concerns of some dispensers about their roles as
"Approved Person". However, to ensure that the operation of the GOPC pharmacies
will not be affected, HA assesses that there is still a need to maintain the
"Approved Person" arrangement for senior dispensers in the near future.
In recent years, HA has been recruiting more pharmacist and dispenser grade
staff to shorten the waiting time and improve workflow in drug dispensing
services. HA will keep in view the service development and operational needs and
deploy its manpower flexibly and determine the appropriate staff mix in order to
deliver efficient and safe pharmaceutical services to meet patients' needs.
Ends/Wednesday, June 27, 2012
Issued at HKT 17:32
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Annex