Replies to LegCo questions
LCQ4: Evening out-patient services
Following is a question by the Hon Chan Han-pan and a reply by the Secretary for
Food and Health, Dr Ko Wing-man, in the Legislative Council today (November 7):
Question:
Given that the general out-patient clinics under the Hospital Authority (HA)
provide evening out-patient services until 10pm only, members of the public
seeking medical consultation in late nights may seek consultation only at
private clinics offering overnight out-patient services or the accident and
emergency (A&E) departments of public hospitals. However, since only 16 public
hospitals across the territory have A&E departments, members of the public
seeking medical consultation often have to wait for hours to receive treatment.
In this connection, will the Government inform this Council:
(a) whether it will request HA to enhance the existing evening out-patient
services, including extending the service hours to midnight and increasing the
number of consultation quotas; if it will, of the details; if not, the reasons
for that;
(b) whether it will request HA to implement overnight out-patient services in
individual districts on a trial basis, with a view to alleviating the existing
pressure on A&E departments; if it will, of the details of the plan; if not, the
reasons for that; and
(c) given that some members of the public have relayed to me that as the demand
for evening out-patient services is greater in some densely populated districts
or districts with relatively more elderly residents (e.g. Tin Shui Wai), and
there is no A&E department of public hospitals in such districts, great
inconvenience has been caused to members of the public, whether the authorities
will require HA to extend the service hours of the evening out-patient services
provided in such districts or set up overnight out-patient services there, so as
to enable patients to receive timely treatment?
Reply:
President,
My consolidated reply to the three parts of the question raised by the Hon Chan
Han-pan is given below. Primary care services in Hong Kong are mainly provided
by the private sector. Public primary care services including general
out-patient services provided by HA are primarily targeted at low-income groups,
elders and chronically ill patients. At present, HA operates a total of 74
general out-patient clinics (GOPCs) in Hong Kong, of which 23 provide evening
out-patient services.
Patients under the care of GOPCs comprise two major categories: chronic disease
patients with stable medical conditions, such as patients with diabetes mellitus
or hypertension, and episodic disease patients with relatively mild symptoms,
such as those suffering from influenza, cold, gastroenteritis, etc. For those
with episodic diseases, consultation timeslots at GOPCs in the next 24 hours are
available for booking through HA's telephone appointment system. As for chronic
disease patients requiring follow-up consultations, they will be assigned a
visiting timeslot after each consultation and do not need to make separate
appointments by phone.
In 2011-12, the 74 GOPCs under HA have recorded around five million attendances
involving more than 1.3 million patients. Over 90% of the target users of
general out-patient services, including elders and recipients of Comprehensive
Social Security Assistance and medical fee waiver, were able to secure a
consultation timeslot successfully through the telephone appointment system
within two working days.
To improve public primary care services, enhance support for chronic disease
patients and raise the public's awareness of health issues, the Government has
in recent years rolled out a series of primary care services through HA to
strengthen the management of chronic diseases. These include the provision of
health risk assessments and follow-up care for patients with diabetes mellitus
or hypertension etc. by multi-disciplinary teams at GOPCs, and targeted
treatment services for high-risk chronic patients by nurses and allied health
professionals such as physiotherapists, occupational therapists and pharmacists.
Through these measures, it is hoped that the risk of complications and the need
for consultations can be reduced for chronic patients, thereby releasing
consultation timeslots for patients with episodic diseases. At the same time, HA
has been taking steps to renovate the premises and upgrading facilities of GOPCs
to streamline patient flow and improve the clinics' environment. It is also
trying to recruit additional staff as far as possible to increase the service
capacity of GOPCs.
Regarding Tin Shui Wai, the Government and HA have over the years introduced
various measures to enhance public healthcare services in the area. In February
this year, the first community health centre (CHC) in the territory, which is
located at Tin Yip Road, Tin Shui Wai and designed according to our primary care
development strategy and service delivery model, came into operation to provide
one-stop primary care services including general out-patient as well as nurse
and allied health services for the public. HA envisages that the new CHC,
together with the existing Tin Shui Wai Health Centre at Tin Shui Road, will be
able to provide over 200 000 attendances of general out-patient services for the
district on a yearly basis. HA has also launched the Tin Shui Wai Primary Care
Partnership Project since 2008, under which patients suffering from specific
chronic diseases with stable medical conditions in need of follow-up treatment
at the Tin Shui Wai GOPCs can opt to receive out-patient services from private
medical practitioners in the district with subsidies from the Government. This
Project has now been extended to the entire Tin Shui Wai area, benefitting some
1 600 patients. At present, 24-hour accident and emergency (A&E) services are
available at Pok Oi Hospital in Yuen Long. The planned Tin Shui Wai Hospital,
which is scheduled to come into operation in 2016, will also provide A&E and
other services including specialist out-patient services and ambulatory services
to address the healthcare needs of the district.
As GOPCs are not intended for provision of emergency services, patients with
severe and acute symptoms should go to A&E departments of hospitals where the
necessary staffing, equipment and ancillary facilities are in place for
appropriate treatment and comprehensive care. To ensure efficient use of GOPC
resources, extending general out-patient services into the small hours or
providing overnight services is not cost-effective and would create greater
pressure on healthcare staffing. At this point, the Administration has no plan
to operate general out-patient services at late nights or round-the-clock.
HA will continue to implement measures to enhance general out-patient services,
including strengthening its staffing, renovating and expanding existing GOPCs,
upgrading clinic facilities, etc. It will also closely monitor the operation and
service utilisation of GOPCs, and deploy manpower and other resources flexibly
to enhance the efficiency and quality of general out-patient services for
meeting patients' needs for public primary care services.
Thank you, President.
Ends/Wednesday, November 7, 2012
Issued at HKT 13:11
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