Replies to LegCo questions
LCQ14: Chiropractic services
Following is a question by the Hon Paul Tse Wai-chun and a written reply by the
Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council today
(February 12):
Question:
In the Thematic Household Survey Report No. 53 published in November 2013, the
Census and Statistics Department estimated that about 33 700 persons aged 15 and
over in Hong Kong had received chiropractic treatment during the 12 months
before enumeration, and about 70% of the respondents claimed that chiropractic
treatment was effective. Also, relevant statistics in the United States
indicated that low back pain ranked second among the most common causes for
patients seeking medical services (with common cold ranking first). A
chiropractic organisation has pointed out that while the practising
qualifications and the conduct of chiropractors have been brought under
regulation since the Chiropractors Registration Ordinance (Cap. 428) came into
operation in 1993 and chiropractic services have been proven to be of
significant benefits in treating low back pain and other pains caused by
chiropractic problems, the chiropractor profession has still been excluded from
the public health system. The organisation is of the view that this situation
has not only wasted existing chiropractic talents, but also aggravated the staff
shortage problem among other medical professions in public hospitals and
lengthened the waiting time for consultation for the patients concerned. In this
connection, will the Government inform this Council:
(a) whether it knows the number of attendances seeking treatment from the public
health system due to low back pain and pains caused by chiropractic problems in
each of the past three years; the specialist clinics to which the patients
concerned were referred for follow-up, their average waiting time for treatment,
and the manpower figures of the specialties concerned;
(b) whether it knows the current number of registered chiropractors in Hong
Kong; how many of them are working in public hospitals; whether the Strategic
Review on Healthcare Manpower Planning and Professional Development conducted by
the authorities in 2012 has studied: (i) the feasibility as well as the pros and
cons of including chiropractic services in the public health system, and (ii)
whether recruiting chiropractors, increasing their number and setting up a
chiropractor specialty in a systematic manner can facilitate the treatment of
patients suffering from the aforesaid pains in a more effective and time-saving
way, thereby shortening unnecessary waiting and referral times as well as
reducing the workload of doctors; if such studies have been conducted, of the
outcome; if not, the reasons for that and whether such studies can be conducted
immediately; and
(c) as I have learned that a local university will start offering
chiropractic-related programmes from 2015 onwards, whether the Government knows
if the Hospital Authority (HA) has conducted studies on absorbing the graduates
of such programmes into the public health system; if HA has, of the
arrangements?
Reply:
President,
The Hospital Authority (HA) has been providing Hong Kong citizens with
comprehensive medical services and limited Chinese medicine services on the
basis of conventional medicine.
Chiropractic service is a form of alternative medicine. The diseases treated by
chiropractors are covered by the standard services of HA. At present, general
practitioners, Orthopaedics and Traumatology (O&T) specialists and other allied
health professionals (such as physiotherapists and occupational therapists) of
HA provide comprehensive services for patients suffering from musculoskeletal
diseases.
My reply to the various parts of the question is as follows:
(1) HA does not maintain figures on the referrals of patients to specialist
outpatient services due to preliminary diagnosis of low back pain and pains
caused by chiropractic problems.
As mentioned above, treatment for musculoskeletal diseases is mainly provided by
general practitioners, O&T specialists and other allied health professionals of
HA. The number of attendances of HA's general out-patient clinics (GOPC), O&T
specialist out-patient clinics as well as allied health out-patient clinics
(physiotherapy and occupational therapy) in the past three years are tabulated
in Annex.
HA does not maintain statistics on the waiting time of GOPC and allied health
out-patient clinics, nor manpower figures of specific specialist and allied
health clinics.
HA has implemented a triage system for all newly referred specialist out-patient
(SOP) cases to ensure that patients with urgent conditions requiring early
intervention are treated with priority. Under the current triage system, new
referral cases are usually first screened by a nurse and then by a specialist
doctor of the relevant specialty for classification into priority 1 (urgent),
priority 2 (semi-urgent) and routine categories.
The median waiting time of O&T specialist out-patient clinics new cases triaged
as priority 1 and priority 2 for 2010-11, 2011-12 and 2012-13 is less than one
week and five weeks respectively. For new cases triages as routine category, the
median waiting time is 32 weeks, 43 weeks and 52 weeks for 2010-11, 2011-12 and
2012-13 respectively.
(2) As at December 31, 2013, there were 180 registered chiropractors in Hong
Kong. HA currently does not employ registered chiropractors.
In the face of growing and ageing population and increasing demand for
healthcare services, the Government is conducting a strategic review on
healthcare manpower planning and professional development in Hong Kong. The
review covers healthcare professionals from 13 disciplines which are subject to
statutory regulation, including doctors, dentists, nurses and chiropractors,
etc.
The review will formulate recommendations on how to cope with anticipated demand
for healthcare manpower, strengthen professional training and facilitate
professional development, with a view to ensuring the healthy and sustainable
development of our healthcare system.
(3) The University Grants Committee (UGC) considers proposals of its funded
institutions for introducing new publicly-funded programmes in the context of
the triennial academic development planning exercise. In the academic
development planning exercise for the 2012/13 to 2014/15 triennium, no
institution ran training programmes on chiropractic.
The UGC-funded institutions are currently preparing for the academic development
planning exercise for the 2015/16 academic year and the 2016/17 to 2018/19
triennium, and are yet to submit proposals to the UGC. It is yet to know whether
they intend to provide any publicly-funded training programmes on chiropractic
in the future. Besides, institutions can provide such programmes on a
self-financing basis, but UGC does not have information of self-financing
programmes.
The Government keeps an open mind on training programmes offered by local
tertiary institutions for any healthcare disciplines. HA will consider and plan
new services and facilities with regard to the public demand for healthcare
services.
Ends/Wednesday, February 12, 2014
Issued at HKT 15:06
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LCQ14 Annex