Replies to LegCo questions
LCQ9: Obstetric services in Sai Kung District
Following is a question by Hon James Tien Pei-chun and a written reply by
the Secretary for Food and Health, Dr Ko Wing-man, in the Legislative
Council today (February 6):
Question:
The Government sought funding from the Finance Committee of this Council
in 2008 for the expansion of Tseung Kwan O Hospital (TKOH), and planned to
provide obstetric services in TKOH in 2013-2014. However, the Hospital
Authority (HA) has recently decided not to provide obstetric services in
that hospital on the basis that the birth projection for Sai Kung District
(SKD) in the coming few years will be lower than the planning reference
set by HA’s Expert Committee on Obstetric and Gynaecology Services years
ago for the provision of such services in a public hospital (which is 3
000 delivery per annum), making it necessary for the pregnant women in the
district to continue to obtain delivery services from the United Christian
Hospital in Kwun Tong. In this connection, will the Government inform this
Council:
(a) given that HA has projected that the number of births in public
hospitals in SKD for the coming few years is only 2 300 to 2 500 per
annum, whether it knows the formula based on which the projection was
calculated;
(b) whether it knows how the Expert Committee on Obstetric and Gynaecology
Services formulated the aforesaid planning reference;
(c) given that the 2011 Population Census published by the Census and
Statistics Department revealed that women in the age group of 25 to 44,
who have a higher fertility rate, constitute around 35% of the women
population in SKD, whether the Government has taken this factor into
consideration in assessing the demand for obstetric services of SKD
residents; if it has, of the details; if not, the reasons for that;
(d) whether it has assessed the healthcare manpower needed for the
provision of obstetric services in TKOH as originally planned; if it has,
of the details; if not, the reasons for that;
(e) whether it has assessed the impact of the pregnant women in SKD having
to obtain delivery services from other districts on the demand for and
quality of obstetric services of hospitals in these districts, as well as
the impact on the safety of such pregnant women; if it has, of the
details; if not, the reasons for that;
(f) of the maximum capacity and utilisation of obstetric services of
public hospitals in the past five years (set out the annual figures by
each public hospital providing obstetric services); and
(g) given that the authorities indicated in the paper submitted to the
Panel on Health Services of this Council last month that HA would
constantly review the timeline for the provision of delivery services and
services of the neonatal intensive care units in TKOH, of the details of
the latest timeline?
Reply:
President,
At the meeting of the Legislative Council Panel on Health Services held on
January 21, 2013, we explained to Members the overall healthcare needs of
the Tseung Kwan O district as well as the considerations for the timeline
in providing obstetric services in the Tseung Kwan O Hospital (TKOH). In
considering the detailed arrangement (including the timing) for provision
of obstetric services in TKOH, we have to take into account a number of
factors such as the overall demand for services, the supply of healthcare
personnel and the overall allocation of healthcare resources. However,
these factors, in the current state, do not justify the provision of
obstetric services in TKOH in the next three years.
Nevertheless, we recognise that there may be a need for such services in
TKOH in the longer term. With due regard to manpower constraint and the
safety issue in connection with the provision of delivery and neonatal
intensive care units (NICU) services, the Hospital Authority (HA) will
continue to make plan for the provision of manpower to prepare for the
opening of obstetric services in TKOH at an opportune time as and when
sufficient manpower is available and safety standard can be assured.
My reply to the various parts of the questions is as follows:
(a) and (c) HA's projection of the number of deliveries in the Sai Kung
District (SKD) is based on the following information:
(i) the number of births in Hong Kong obtained from the latest population
projection (using 2011 as the benchmark) compiled by the Census and
Statistics Department;
(ii) the projection of population distribution by District Council
district/New Town and age (using 2009 as the benchmark) compiled by the
Planning Department; and
(iii) the fertility rates by district in 2011 (the estimation of which is
based on the known number of live births and the number of women aged
between 15 and 49 in each district).
HA has duly taken into account the future residential development projects
and the population growth in SKD based on the Planning Department's
projection of population distribution. The relatively higher proportion of
fertile couples in SKD has already been reflected in the fertility rate of
that district and taken into consideration in the projection.
(b) To ensure service safety and quality, HA's Co-ordinating Committee in
Obstetrics and Gynaecology Service has, based on expert advice, set a
planning reference, which advises that a public hospital in general will
only provide obstetric services when the number of births at that hospital
is projected to reach 3 000 per year. This planning reference aims to
ensure that the healthcare personnel can accumulate sufficient clinical
experience to handle the possible sudden changes of clinical conditions of
the pregnant patients.
(d) If obstetric services are to be provided, TKOH must also provide a
complete set of supporting facilities for the delivery services and for
the care of newborn babies in order to ensure the provision of safe
obstetric and neonatal care services. These facilities include NICU,
Special Care Baby Unit, delivery rooms, operating theatres and other
supporting services such as laboratory tests and allied health services
etc. The total manpower required for providing the aforesaid services
includes more than 30 doctors and 120 nurses.
(e) According to HA's records, for the local pregnant women in SKD who
chose to give birth in public hospitals in 2012, more than 70% gave birth
in the United Christian Hospital, which is also under the Kowloon East
Cluster as TKOH. The use of delivery services provided by hospitals in
other districts is not serious. It has not brought extra heavy pressure on
other hospitals either.
As for pre-natal and post-natal services, pregnant women and babies in SKD
may use the relevant services provided by TKOH.
(f) The numbers of delivery cases in public hospitals for the past five
years are set out in Annex.
(g) At present, the situation regarding the provision of obstetric
services in TKOH remains more or less the same as that when we briefed the
Legislative Council Panel on Health Services in January. HA will
constantly review the timeline for the provision of delivery and NICU
services in TKOH and continue to communicate with the stakeholders on the
progress.
Ends/Wednesday, February 6, 2013
Issued at HKT 14:38
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LCQ 9 Annex