Replies to LegCo questions
LCQ10: Woman health services
Following is a question by the Dr Hon Elizabeth Quat and a written reply
by the Secretary for Food and Health, Dr Ko Wing-man, in the Legislative
Council today (December 12):
Question:
Breast cancer and cervical cancer ranked third and ninth respectively
among the cancers causing deaths of females in Hong Kong in 2010.
According to the statistics of the Hong Kong Breast Cancer Foundation and
the United Christian Hospital, education and screening are conducive to
early diagnosis of breast cancer. However, there are only three Woman
Health Centres (WHCs) providing woman health services in the entire
territory at present, while all the 10 Maternal and Child Health Centres (MCHCs)
with ancillary woman health services provide such services for only about
three to six hours each week. Some members of the public have relayed to
me that as there are few WHCs and MCHCs providing woman health services,
their service hours are short and publicity is inadequate, most women have
not used such services provided by the Government. In this connection,
will the Government inform this Council:
(a) of the details (including whether screening services for breast cancer
and cervical cancer and vaccinations against cervical cancer are
available) of the various woman health services provided by WHCs and MCHCs
at present as well as the service charges, broken down in tabulated form
by District Council (DC) district;
(b) of the average waiting time for each of the woman health services
provided by each WHC and MCHC, together with the number of women using
each service and the percentage of such number in the female population of
the district in which the WHC/MCHC is located, in each of the past three
years; whether it knows if these figures are comparable to the relevant
figures of neighbouring countries and areas, such as Japan, Taiwan,
Singapore, etc.; if they are not comparable, whether it has examined the
reasons for that;
(c) whether it will consider extending the scope of the coverage of woman
health services (e.g. free screening services for breast cancer and
cervical cancer) and providing free or subsidised vaccinations against
cervical cancer; if it will not, of the reasons for that;
(d) whether it will consider setting up at least one WHC or MCHC providing
whole-day woman health services in each DC district in Hong Kong so that
all women in Hong Kong can, on average, be provided with free and
comprehensive woman health services once every three years; and
(e) whether it will explore the introduction of a voluntary scheme which
subsidises all students of the relevant age cohort in Hong Kong to receive
vaccinations against cervical cancer for early prevention of the cancer;
if it will not, of the reasons for that?
Reply:
President,
The Government has always attached importance to woman health and put in
place a comprehensive woman health programme through the provision of
promotive, preventive, curative and rehabilitative services. To enhance
women's awareness and concerns about their health, a number of service
units under the Department of Health (DH) have provided women with
accurate information on woman health issues as well as relevant community
resources through different channels in an effort to empower women to make
choices that are conducive to their health and seek appropriate health
care or social services where necessary. On clinical services, there are
currently three Woman Health Centres (WHCs) (operated on a full-time
basis) and ten Maternal and Child Health Centres (MCHCs) (operated on a
sessional basis) under DH's Family Health Service, which serve to provide
woman health service for women aged 64 or below.
In formulating policies concerning disease screening programmes or
vaccination, the Government makes reference to the recommendations put
forward by experts, including consulting the Scientific Committees under
DH's Centre for Health Protection (CHP) and the Cancer Expert Working
Group on Cancer Prevention and Screening under the Cancer Coorindating
Committee. This can ensure that the Government's public health policies
are grounded in fact, scientific evidence and public interest, and that
the policy gives due consideration to the actual circumstances, such as
its cost-effectiveness and acceptability by the community etc.
My reply to the five parts of the question from Hon Quat is as follows:
(a) The Woman Health Service aims to promote the health of women and
provide women with health education, assessment and counselling services
according to their needs at various stages of life. If necessary, doctors
will arrange women to receive appropriate tests, including blood test,
cervical smear test and screening mammography (generally for women aged 50
or above, or individual women with high risk of breast cancer). A cervical
screening service is offered by all 31 MCHCs in the territory to women
aged 25 or above who have ever had sexual intercourse. WHCs and MCHCs have
not offered any cervical cancer vaccination. The health services provided
by DH to women are heavily subsidised by the Government. Hence, the fees
charged for such services can be maintained at a low level and are shown
in Annex 1.
(b) There is no area restriction for the woman health services provided by
the WHCs or MCHCs under DH. Women can choose to go to any one of the WHCs
or MCHCs for such services. The numbers of persons registered for woman
health services in the past three years are shown in Annex 2.
The waiting time for woman health service at each WHC and MCHC is shown in
Annex 3.
As mentioned above, WHCs and MCHCs provide an array of health services to
women members, and after assessment by healthcare personnel, each member
will receive appropriate medical examinations or tests. WHCs and MCHCs do
not maintain comprehensive statistics on the individual examinations and
tests that women members receive.
In addition, while DH is one of the woman health service providers, there
are also other service providers, such as the non-governmental
organisations (NGOs), private hospitals and doctors, providing a wide
array of health programmes for women. As such, DH does not have the number
of women having received body check by districts and their percentage in
the population of the respective districts.
Given the fact that the disease burden, healthcare system and social
institution are different between places and their service targets and
policy objectives also vary, it is difficult to draw a direct comparison
with other countries on the statistics of individual service items.
(c) and (e) On the prevention of breast cancer, the Cancer Expert Working
Group on Cancer Prevention and Screening takes the view that currently,
there is insufficient evidence to recommend for or against
population-based breast cancer screening in Hong Kong. In fact, in recent
years, a number of studies have cast doubts on the effectiveness of
conducting population-based breast cancer screening by mammography, as it
may generate more harm than good to women due to unnecessary check-ups and
treatment due to over-diagnosis. The Working Group suggests that women
with higher risk of developing breast cancer (such as women with
associated family history or personal history) should seek medical advice
on breast cancer screening. Generally speaking, doctors of the Woman
Health Service may arrange mammography for women aged 50 or above or those
at high risk.
On the prevention of cervical cancer, the Government has been actively
promoting the Cervical Screening Programme launched in 2004 to encourage
women to have cervical smears on a regular basis. The human papillomavirus
vaccine (commonly known as "HPV vaccine") is not infallible and thus
cannot eliminate the need of cervical screening. At present, the relevant
Scientific Committee has not recommended the introduction of a
population-based cervical cancer vaccination programme.
(d) The Government will make reference to the demand for services of WHCs
and MCHCs and the primary care development strategy in planning the long
term development of various healthcare services (including woman health
services). The Government currently has no plan to extend the woman health
services, but will continue to enhance its collaboration with other
service providers, including private doctors and NGOs, so as to enhance
the primary care services for local women.
Ends/Wednesday, December 12, 2012
Issued at HKT 15:10
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