Replies to LegCo questions

LCQ15: Psychiatric services

Following is a question by the Hon Cheung Kwok-che and a written reply by the Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council today (July 11):

Question:

It has been reported that the Hospital Authority (HA) anticipates that the North Lantau Hospital (NLH) will launch its services (including eight-hour accident and emergency services and out-patient services for four specialties, namely, medicine, surgery, orthopaedics and psychiatry in the first stage) in the third quarter of 2013. It is anticipated that the hospital will not be fully commissioned until 2016-2017. During its study on medical services in Tung Chung, the Government anticipated in 2007 that the population of Tung Chung New Town would be 89 000 in 2015. However, there are already 130 000 residents living in Tung Chung New Town at present, and the Government has anticipated that the population will increase to over 200 000. In this connection, will the Government inform this Council:

(a) whether it knows the respective numbers of people with mental illness and people recovering from mental illness in Tung Chung New Town and the rural areas in Tung Chung at present, as well as the respective percentages of such numbers in the total population of North Lantau; the respective numbers of people with mental illness and people recovering from mental illness who are aged 60 or above in various districts in Hong Kong;

(b) given that some social workers have reflected that people with mental illness and people recovering from mental illness in Tung Chung are unable to receive psychiatric services in Tung Chung district, whether it knows if the general out-patient clinic (GOPC) of Tung Chung Health Centre at present provides psychiatric out-patient services for people with mental illness and people recovering from mental illness; if it does, the details; if not, the reasons for that; given that some social workers have pointed out that the launch of the Integrated Mental Health Programme (IMHP) at GOPC will facilitate the mental rehabilitation of people with mental illness and people recovering from mental illness, whether it knows if HA will consider launching IMHP at GOPC of Tung Chung Health Centre; if it will, the details; if not, the reasons for that;

(c) whether it knows if the people with mental illness and people recovering from mental illness on Lantau Island at present will be referred to NLH to receive its services in the future; if they will, the details; if not, the reasons for that;

(d) given that some people with mental illness and people recovering from mental illness who live in Tung Chung have pointed out that as they have to go to Queen Mary Hospital for follow-up consultations, the long distance and high transport costs add to their psychological, mental and economic pressure, lower their desire for follow-up consultations and increase their chances of relapse, whether the authorities know if HA will arrange for these people to go to Kwai Chung Hospital for follow-up consultations; if it will, the details; if not, the reasons for that; whether HA is unable to refer patients to hospitals in suitable districts in response to their change in home address; HA's principles for determining the location of follow-up consultations arranged for people with mental illness and people recovering from mental illness, and whether the location of the patients' present residence will be given prime consideration; and

(e) given that the Integrated Community Centre for Mental Wellness (ICCMW) serving the Islands District still does not have any service point or permanent site on Lantau Island, to tie in with the provision of support for people recovering from mental illness and help them integrate into the community as early as possible, whether the authorities will request The Link Management Limited to change the use of the vacant car park no. 3 at Yat Tung Estate in Tung Chung and expeditiously launch ICCMW's services there; if they will, of the details; if not, the reasons for that?

Reply:

President,

To cope with the long-term development and population growth of the North Lantau New Town and the Lantau area, and considering that the Hong Kong International Airport and some major tourist facilities are situated in North Lantau, and given the distance and travelling time from the North Lantau New Town to other acute hospitals, we have decided to develop a new hospital in North Lantau before the population in the district reaches the relevant level under the general planning standard. Under the existing cluster arrangement of the Hospital Authority (HA), the North Lantau Hospital (NLH) will be managed by the Kowloon West Cluster of HA. Hospitals under the Kowloon West Cluster, leading by the Princess Margaret Hospital, will provide support to the services of NLH.

The reply to various parts of the question is as follows:

(a) Currently, there are about 1 500 people with mental illness living in the new town area at North Lantau who have received various psychiatric services provided by HA. In 2011-12, the number of elderly persons aged 60 or above who have received psychiatric services in various hospital clusters under HA is set out below:

HA cluster                         Number of elderly persons
                                          aged 60 or above who have
                                          received psychiatric services
                                          in 2011-12 (in round number)
Hong Kong East                  6 380
Hong Kong West                 4 240
Kowloon Central                 5 860
Kowloon East                      6 710
Kowloon West                  16 440 (Note 1)
New Territories East            8 340
New Territories West           7 500
HA Overall                       54 520(Note 2)

Note 1: The number of Kowloon West Cluster is higher mainly because the population coverage of Kowloon West Cluster is around 27% of the Hong Kong population, which is higher than that of other clusters.
Note 2: Since some elderly persons have received services in more than one cluster, the numbers of patients of the clusters do not add up to the HA overall figure.

(b) At present, the general out-patient clinic (GOPC) of the Tung Chung Health Centre provides general out-patient services for local residents, including people with mild mental problem. Doctors at the GOPC will arrange these patients to receive appropriate treatment and support according to their clinical conditions and, where necessary, refer them to psychiatric specialist out-patient clinics or GOPCs covered by the Integrated Mental Health Programme (IMHP) for further follow-up.

IMHP was launched by HA at selected GOPCs of five HA clusters (Hong Kong East, Hong Kong West, Kowloon East, Kowloon West and New Territories East) in October 2010 to provide better support to patients in the primary care settings. In 2011-12, the programme has been expanded to cover all clusters. Under the programme, patients with stabilised conditions will be provided with maintenance treatment by psychiatrists, family medicine specialists and general practitioners working in multi-disciplinary teams at the Common Mental Disorder Clinics. HA will continue to monitor the demand for primary care services in each district and make flexible deployment of manpower and other resources having regard to the relevant factors, so as to provide the local community with appropriate mental health services.

(c) At present, HA provides psychiatric specialist services (including in-patient services, specialist out-patient services, day training and community psychiatric services) to people with mental illness living in the new town area at North Lantau through the Kwai Chung Hospital under the Kowloon West Cluster. To further strengthen the services, HA will consider launching psychiatric specialist services such as community psychiatric services, psychiatric consultation-liaison services in Accident and Emergency Department as well as psychiatric specialist out-patient services in the planned NLH as necessary so as to provide more comprehensive support to residents in North Lantau.

(d) HA always gives foremost consideration to the location of the patients' residence when arranging patients to receive specialist follow-up in suitable HA clusters. At present, most of the people with mental illness living in the new town area at North Lantau have been arranged to receive psychiatric specialist follow-up at the Kwai Chung Hospital under the Kowloon West Cluster.

(e) The Social Welfare Department (SWD) has set up the Integrated Community Centres for Mental Wellness (ICCMWs) at 24 service points across the territory to provide one-stop, district-based and accessible community support and social rehabilitation services ranging from early prevention to risk management for discharged mental patients, persons with suspected mental health problems, their families/carers and residents living in the serving districts.

The ICCMW services in the Islands District are operated by the New Life Psychiatric Rehabilitation Association (NLPRA). While the ICCMW in the Islands District has not yet secured a permanent accommodation, NLPRA will continue to make use of existing service facilities and networks in the district to provide services for users. Following consultation with the Housing Department, we have secured a vacant site at the ground floor of Luk Yat House, Yat Tung Estate in Tung Chung for use as a temporary office of NLPRA. Local consultation has been completed and fitting-out works for the office will soon commence. As regards the vacant car park no.3 at Yat Tung Estate, the Link Management Limited has indicated that there will be no change to its land use for the time being.

SWD and NLPRA will continue to identify suitable premises in the district for use as the permanent accommodation of this ICCMW.


Ends/Wednesday, July 11, 2012
Issued at HKT 16:03

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