Replies to LegCo questions
LCQ6: Healthcare manpower of Hospital Authority
Following is a question by the Hon Chung Kwok-pan and a reply by the
Secretary for Food and Health, Dr Ko Wing-man, in the Legislative
Council today (June 19):
Question:
In order to alleviate the shortage of doctors, the Hospital Authority
(HA) has in recent years employed non-local doctors who were granted
limited registration by the Medical Council of Hong Kong (MCHK) to work
in public hospitals. In this connection, will the Government inform this
Council:
(a) whether it knows the number of local medical graduates and the
number of newly recruited specialists in public hospitals in each of the
past three years; the current number of vacancies of specialists; the
specialties with the most acute shortage of manpower at present; and the
average waiting time for outpatient services in each specialty last
year;
(b) whether it knows the number of job applications received by HA from
non-local doctors in each of the past three years, the number of those
among them who were granted limited registration by MCHK, and the
specialties in which they mainly worked; the number of additional
non-local doctors needs to be employed in future as estimated by HA, and
if HA will increase the number of recruits particularly for those
specialties with the most acute shortage of manpower; given that at
present, the contract period for non-local doctors is one year only,
whether HA will consider extending the contract period in order to
attract more non-local doctors to apply for work in Hong Kong; and
(c) whether it will consider urging MCHK to relax the vetting and
approval criteria for limited registration of non-local doctors, extend
the validity period of limited registration, improve the licensing
examination system for non-local medical graduates and simplify the
registration procedures for specialists, with a view to alleviating the
shortage of doctors and enhancing the quality of medical services?
Reply:
President,
With factors like an ageing population, advances in medical technology,
and an increasing demand for healthcare services in the community, the
manpower requirement for healthcare personnel grows commensurately. In
the past few years, the Hospital Authority (HA) has implemented a series
of measures to address manpower issues. In 2013-2014, HA expects to
recruit about 300 additional doctors to meet the service demand. To
increase doctor manpower in the short-term, HA enhanced the remuneration
package and allowed greater flexibility for employment of part-time
doctors in early 2012. Without affecting the promotion of other young
doctors, HA has made proactive efforts to retain some of the doctors who
have retired or left HA. In 2011, there were 60 retired or departed
doctors continuing to serve in public hospitals on a part-time basis. As
at March 2013, there were approximately 290 part-time doctors working in
HA, in which 190 are retired or departed doctors, providing support
equivalent to about 110 full-time doctors. In addition, in recent years,
HA has created additional promotion posts, strengthened professional
training and relieved the workload of its frontline healthcare workers
by re-engineering the work processes and streamlining work procedures
with a view to boosting staff morale and improving staff retention. Such
measures have reaped positive results and the turnover rate of full-time
doctors dropped from about 5 per cent in 2010-11 to 4.4 per cent in
2012-13. Besides, the Government has taken steps to tackle the
healthcare manpower shortage problem at source by a number of measures,
including the allocation of an additional $200 million for the triennial
cycle starting from 2012 to increase the number of first-year
first-degree places in medicine by 100 to 420 per year. HA expects to
see an increase in the total number of doctors when 320 and 420 medical
graduates complete their internship in 2015-16 and 2018-19 respectively.
In tandem with the said measures, HA started the recruitment of
non-local doctors to practise with limited registration in 2012 as one
of the additional and immediate measures to address the manpower
problem.
My reply to the various parts of the question is as follows:
(a) The numbers of local medical graduates and Resident Trainees
recruited by HA in each of the past three years are set out in Annex 1.
The manpower shortfall of HA doctors in 2012-13 was around 250. The
specialties with the most acute shortage of manpower included
Anaesthesia, Accident and Emergency (A&E), Family Medicine, Intensive
Care Unit, Medicine, Paediatrics and Psychiatry. The 2013-14 central
recruitment exercise for Resident Trainees is underway. According to
HA's preliminary estimate, there will be a shortfall of around 290
doctors after this year's central recruitment exercise.
The waiting time for the first appointment of new cases in major
specialties of HA in the past three years is set out in Annex 2. HA will
regularly assess the manpower situation of each specialty and flexibly
deploy healthcare staff to meet the service demand and operational
needs.
(b) HA received 160 and 72 job applications from non-local doctors in
2011-12 and 2012-13 respectively. Applicants must have passed a
specialist training examination which is comparable to the Intermediate
Examinations of the constituent Colleges of the Hong Kong Academy of
Medicine, possess three years or above clinical working experience, and
be able to speak fluent Cantonese (except for the specialty of
Anaesthesia). After vetting by the Task Force on Limited Registration
Scheme and consideration by the selection panels, HA submitted 17
applications to the Medical Council of Hong Kong (MCHK), of which 16
applicants obtained the MCHK's approval for practice under limited
registration and were employed by HA to serve in the specialties of
Anaesthesia, A&E, Family Medicine, Medicine and Psychiatry. HA will
continue to work on the recruitment of non-local doctors for practice
under limited registration. As the MCHK's approval for practice under
limited registration is valid for a maximum of one year, this validity
period serves as a reference in devising the contract period for most
non-local doctors serving in HA under limited registration.
The recruitment of non-local doctors to practise with limited
registration is one of the additional and immediate measures of HA to
address the manpower problem and to provide immediate replenishment for
those specialties with the most acute shortage of manpower. Besides, HA
will continue to implement the above-mentioned measures to recruit and
retain local staff so as to ensure an adequate supply of healthcare
manpower to meet the service demand.
(c) The MCHK is established under the Medical Registration Ordinance
(Cap. 161) and empowered to handle regulatory matters relating to
medical practitioners in Hong Kong including registration and
disciplinary proceedings. Persons who wish to apply for limited
registration and specialist registration must satisfy the requirements
set out in section 14A and section 20K of the Ordinance respectively.
The MCHK will approve the applications in accordance with the
requirements in the Ordinance. The Licensing Examination of the MCHK
aims to ensure that those who wish to register as medical practitioners
in Hong Kong after receiving medical training outside Hong Kong have
attained a professional standard comparable to that of local medical
graduates. This is to safeguard the quality of our medical services and
hence public health. Papers of the Licensing Examination are set by the
two faculties of medicine with reference to the papers of local medical
examinations at a comparable level of difficulty.
Like other statutory regulatory bodies for healthcare professions, the
MCHK is operating on the principle of professional autonomy. The
Government respects its decisions on registration that are made
according to the Medical Registration Ordinance, the appropriate
arrangements for medical practitioners registration that are formulated
within the purview of its professional autonomy, as well as its
arrangements in respect of licensing examination.
In the face of challenges posed by an ageing population and increasing
demand for healthcare services, the Government has set up a high-level
steering committee to conduct a strategic review on healthcare manpower
planning and professional development in Hong Kong. The review covers
healthcare professionals from 13 professions which are subject to
statutory regulation. The steering committee will assess manpower needs
in the various healthcare professions and put forward recommendations on
how to cope with anticipated demand for healthcare manpower, strengthen
professional training and facilitate professional development having
regard to the findings of the strategic review, with a view to ensuring
the healthy and sustainable development of Hong Kong's healthcare
system.
Ends/Wednesday, June 19, 2013
Issued at HKT 15:34
LCQ6 Annex
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