Replies to LegCo questions
LCQ5: Services of Hospital Authority
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 (December 18)
Question:
It is learnt that some patients were triaged as semi-urgent when
they sought treatments at the Accident and Emergency (A&E) Department of
the Prince of Wales Hospital (PWH) and treated only after waiting for 26
hours. Meanwhile, given the ageing facilities and inadequate space in
public hospitals, the Government is planning to apply to the Finance
Committee of this Council for an allocation of $13 billion for carrying
out minor works projects for public hospitals in the next five to 10
years with a view to improving their facilities. Regarding improvements
to the services and facilities of public hospitals, will the Government
inform this Council:
(a) as some members of the public living in areas without overnight
out-patient services can only seek treatments at the A&E departments of
public hospitals when they fall ill at night and if they are triaged as
semi-urgent and non-urgent patients, their illnesses might be aggravated
because of the exceedingly long waiting time for treatments, whether the
authorities will encourage private healthcare institutions to enhance
overnight out-patient services, and consider afresh introducing
overnight general out-patient services in public hospitals, so as to
alleviate the burden on A&E departments; if they will, of the details;
if not, the reasons for that;
(b) given the large population covered by the New Territories West
Cluster, and since Pok Oi Hospital (POH) in the cluster is not a general
hospital and Tin Shui Wai Hospital will be completed and commissioned
only after a few years, most patients seek treatments at Tuen Mun
Hospital (TMH) resulting in TMH's services being unable to meet the
demand, and coupled with a very tight supply of operating theatres in
the cluster as POH has only eight operating theatres and TMH, as a
general hospital, has only 11 operating theatres (compared with 16
operating theatres in PWH, which is also a general hospital), and that
the equipment of the cardiac catheterisation room of TMH is also
insufficient and its other facilities (such as drainage and electrical
wiring) are ageing, of the amount earmarked by the authorities for TMH's
improvement works in the $13 billion funding application, and the
details of the improvement works concerned; and
(c) given that in each year from 2015-2016 onwards, there will be more
local medical students graduating than now, whether it knows if the
Hospital Authority has any plan to make complementary arrangements in
respect of clinical equipment and facilities, so as to avoid the
situation of "having the software but without the hardware"; if HA has
such a plan, of the details; if not, the reasons for that?
Reply:
President,
We attach great importance to the public needs for healthcare
services and we strive to improve various kinds of healthcare services.
As regards Accident and Emergency (A&E) services, the Hospital
Authority (HA) has adopted a triage system which classifies patients
attending the A&E departments according to their clinical
conditions. In 2012-13, all patients triaged as critical and 97% of
patients triaged as emergency were treated immediately and within 15
minutes respectively, which is a performance meeting HA's performance
pledge. This shows that the majority of patients with pressing medical
needs are able to receive medical treatment in a timely manner. Under
such triage system, the waiting time for patients whose clinical
conditions are relatively less urgent is longer. To shorten the waiting
time and relieve the work pressure of front-line staff, HA has rolled
out in phases a pilot programme for support services in 12 acute
hospitals starting from this year to recruit additional manpower for the
A&E departments. As at the end of September, HA has recruited a total
of 792 healthcare staff, providing about 1 850 consultation sessions and
handling over 33 000 additional cases.
As for general out-patient (GOP) services, HA has been trying to
recruit additional staff, renovate and expand the clinics as well as
upgrade their facilities, so as to increase the service capacity of the
GOP clinics as far as possible. HA added 300 000 consultation quotas
for GOP clinics in 2012-13. It will provide about 85 000 additional
quotas in 2013-14.
In addition, HA manages about 300 buildings, with a total floor
area of over 2.6 million square metres. Over 56% of the buildings were
completed more than 30 years ago and some are even aged over 85. To
ensure that the conditions of such aging buildings will not affect our
services, we have submitted to the Finance Committee of the Legislative
Council (LegCo) the funding proposal of a one-off grant of $13 billion
to HA, so as to speed up the planned improvement works programmes over
the coming ten years.
My reply to the various parts of the question is as follows:
(a) HA offer various services with different scope and different target
groups. Patients receiving GOP services comprise two major categories:
chronic disease patients with stable medical conditions and episodic
disease patients. At present, HA operates 73 GOP clinics while 23 GOP
clinics provide evening out-patient services from 6pm to 10pm, and 12
GOP clinics provide out-patient services on Sundays and public
holidays.
Patients with severe and acute symptoms should go to A&E
departments of hospitals. HA will enhance measures and services in the
A&E departments subject to the availability of manpower.
As patients under the care of the GOP clinics mainly comprise
chronic disease patients with stable medical conditions and patients
with relatively mild symptoms, they do not require 24-hour service. In
fact, the GOP clinics are not set up to provide emergency
services. Although such arrangement would be at some patients'
convenience, it will further increase the pressure on healthcare
manpower.
As for private healthcare institutions , they may have different
services according to their operation modes. The Administration has
been encouraging private healthcare institutions to strengthen overnight
out-patient services. To facilitate the members of the public, the
Department of Health (DH) has set up the Primary Care Directory (the
Directory). Primary care providers and private healthcare institutions
can provide their consultation information and opening hours in the
Directory for the references of the members of the public.
(b) To enhance the existing facilities in the Tuen Mun Hospital (TMH),
HA launched about 25 minor works improvement projects in 2013-14. The
total expenditure is over $100 million.
If the grant of $13 billion is approved by the Finance Committee,
HA will, in the next few years, make use of the funding to continue the
various minor improvement works projects in TMH.
Regarding the need of a new operating theatre in TMH, as I have
explained earlier in the LegCo Health Services Panel meeting, we will
conduct a technical feasibility study given its larger scale. If the
technical feasibility has been established after the study, we will
apply for funding separately.
(c) To cope with the increasing demand for healthcare manpower, the
Government has introduced a number of measures to improve the manpower
supply. One of which is 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. It
is expected that 320 and 420 medical students will graduate in 2015-16
and 2018-19 respectively.
As regards hardware, a number of hospital redevelopment and
expansion projects are now underway. I have briefed the LegCo Health
Services Panel earlier about the blueprint for long-term development of
hardware in hospitals.
Ends/Wednesday, December 18, 2013
Issued at HKT 18:11
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