Replies to LegCo questions
LCQ16: Psychiatric inpatient services of Hospital Authority
Following is a question by the Hon James To and a written reply by the Secretary
for Food and Health, Dr Ko Wing-man, in the Legislative Council today (May 7):
Question:
Some members of the public have relayed to me that the Pamela Youde Nethersole
Eastern Hospital (PYNEH) under the Hospital Authority (HA) has implemented
certain rules for in-patients of its psychiatric wards (including no entering or
leaving the wards freely, a ban on the use of communications devices, and no
discharge from the hospitals without the consent of their attending doctors)
(in-patient rules). However, when PYNEH provides the "Application for reception
as a voluntary patient" (the application form) for completion by patients being
admitted, no leaflet stating such rules is attached to it. These rules are only
posted in an inconspicuous place inside the wards. Regarding the services of the
psychiatric wards in public hospitals (psychiatric wards), will the Government
inform this Council if it knows:
(1) the general admission procedures of the psychiatric wards;
(2) the number of admissions to the psychiatric wards in the past five years
and, among them, the respective numbers of cases in which the patients were
admitted under the following circumstances: (i) the application forms were
completed and lodged by the patients themselves, (ii) the application forms were
completed and lodged by the patients' guardians, and (iii) the patients were
detained for observation by the hospitals under the Mental Health Ordinance
(Cap. 136), together with a tabulated breakdown by name of public hospital;
(3) whether the psychiatric wards of other hospitals have implemented in-patient
rules and admission arrangements (including the arrangement for patients to sign
the application forms in the general wards and the relevant in-patient rules to
be posted inside the psychiatric wards only) similar to those of PYNEH; if they
have, of the details, with a tabulated breakdown of such information by name of
public hospital;
(4) whether HA has put in place measures to ensure that its hospitals will
clearly explain the in-patient rules to the patients who are voluntarily
admitted to the psychiatric wards, and to ensure that the patients understand
the contents; if it has, of the details and the procedures;
(5) the longest and the shortest periods for which patients stayed in the
psychiatric wards for observation in the past five years; among these patients,
the respective numbers of them who were subsequently (i) discharged directly,
(ii) referred to the Castle Peak Hospital or other psychiatric specialist
hospitals, and (iii) referred to the psychiatric wards of other hospitals for
continuous treatment, together with a tabulated breakdown by name of public
hospital;
(6) among the patients admitted to the psychiatric wards for treatment in the
past five years, the respective numbers of those who (i) had applied for
discharge by themselves and were approved for discharge, and (ii) had applied
for discharge by themselves but were considered by the hospitals concerned after
assessment that continuous observation in the hospital was required, together
with a tabulated breakdown by name of public hospital;
(7) whether HA received in the past five years any complaint about members of
the public being misled into consenting to be admitted to the psychiatric wards;
if it did, of the number of such complaints and how HA followed up such
complaints, with a tabulated breakdown by name of public hospital;
(8) whether HA currently has any mechanism for handling complaints lodged by
patients of the psychiatric wards about the treatments used, or the assessments
of their mental condition made, by the attending doctors; if HA does, of the
details; and
(9) whether HA has issued guidelines for its hospitals on the admission of
patients to the psychiatric wards; if HA has, of the date on which such
guidelines were last revised; whether HA has put in place measures to monitor
the implementation of such guidelines by its hospitals; if HA does not have such
guidelines, the reasons for that and whether HA will consider issuing such
guidelines, so as to enhance the management of the administrative work of
admitting patients to the psychiatric wards?
Reply:
President,
Generally speaking, patients in need of psychiatric inpatient services of the
Hospital Authority (HA) will be sent to designated mental hospitals under the
HA. The designated mental hospitals under the Mental Health Ordinance (Cap.
136B) are Castle Peak Hospital, Kwai Chung Psychiatric Observation Unit, Pamela
Youde Nethersole Eastern Psychiatric Observation Unit, New Territories East
Psychiatric Observation Unit and Kowloon Psychiatric Observation Unit.
For any patient who has been assessed by doctors of the HA to be in need of
psychiatric inpatient services and has indicated his consent for hospitalisation,
the HA will ask him or his parent/guardian (if the patient is under the age of
16) to sign the "Application for reception as a voluntary patient" (the
application form) in accordance with section 30 of the Mental Health Ordinance
(Cap. 136). Upon receipt of the application form, the medical superintendent of
the respective mental hospital may admit such patient as a voluntary patient.
According to section 31 of the Mental Health Ordinance (Cap. 136), an
application may be made by the HA to a District Judge or magistrate for
detention of a patient who is suffering from mental disorder of a nature or
degree which warrants his detention in a mental hospital for at least a limited
period for observation in the interests of the patient's own health or safety or
with a view to the protection of other persons. Patients detained in a mental
hospital under section 31 of the Mental Health Ordinance (Cap. 136) may make an
application to the Mental Health Review Tribunal for review of their cases
according to section 59B of the Mental Health Ordinance (Cap. 136).
The number of admissions to psychiatric wards of the HA through the aforesaid
means in the past five years is set out in Table 1 in the Annex.
The length of stay of patients admitted to psychiatric wards varies from a few
days to more than a year depending on their conditions. Doctors will assess the
patients' conditions from time to time and arrange services such as community
rehabilitation for patients who are suitable for discharge. In the past five
years, the number of patients discharged each year remained at around 16 000 to
17 000.
For patients who need to be admitted to psychiatric wards, the healthcare
personnel will explain to them and their family members the contents of the
application form and the operation of the psychiatric wards, including rules
that patients must comply with and the procedures and arrangements for
discharge, etc. The healthcare staff of respective psychiatric ward will also
explain the details to patients upon their admission and provide them with
information such as hospitalisation notes and Patients' Charter, so as to ensure
that the patients and their family members understand the relevant inpatient
arrangements.
Members of the public who are dissatisfied with the services of the HA,
including those who believe that they have been misled into signing the
application form or those who are not satisfied with the treatments or mental
assessments by the attending doctors during their stay in the hospital, may
lodge their complaints with the HA.
The HA has put in place a two-tier complaint mechanism for handling public
complaints against its hospitals. At the first tier, all complaints will first
be handled by the respective public hospitals. Upon receipt of a complaint case,
the Patients Relations Officer will pass it to the department concerned for
follow-up and investigation. The patient will be informed of the results after
investigation. If the complainant is not satisfied with the investigation
results or reply of the hospital, he may file an appeal to the HA's Public
Complaints Committee (PCC) (i.e. the second tier of the complaint mechanism).
The PCC, being a committee under the HA and comprising members from different
sectors of the community, is tasked to handle and consider all appeals for the
HA in an independent, fair and impartial manner.
The number of complaints from members of the public regarding being misled into
giving consent for admission to psychiatric wards received by different hospital
clusters of the HA in the past five years is set out in Table 2 in the Annex.
The HA issues guidelines on the operation and administration of wards (including
psychiatric wards) from time to time so as to improve the management of hospital
wards. The HA will continue to pay close attention to the operation and
arrangement of inpatient psychiatric services, and make appropriate improvement
as and when necessary.
Ends/Wednesday, May 7, 2014
Issued at HKT 15:54
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LCQ16 Annex