Replies to LegCo questions
LCQ10: Resource allocation mechanism of Hospital Authority
Following is a question by Professor Hon Joseph Lee and a written reply by the
Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council today
(May 21):
Question:
Regarding the resource allocation mechanism of the Hospital Authority (HA), will
the Government inform this Council if it knows:
(1) the criteria currently based on which HA determines the financial and
manpower resources to be allocated to various public hospitals;
(2) whether HA has based on some criteria in determining the financial and
manpower resources allocated to various public hospitals for the provision of
nursing services; if so, of the details; if not, the reasons for that;
(3) the estimates of expenditure made by various public hospitals in respect of
the provision of nursing services and the respective amounts of funding
allocated to them in the past five years, and whether there was any surplus
funding; if so, of the approach adopted for dealing with the surplus funding;
and
(4) whether HA has considered establishing an independent funding allocation
system for nursing services, so that the respective Cluster General Managers
(Nursing) of the various hospital clusters can deploy and use the funding
flexibly to assist the hospitals in need and the relevant departments in
enhancing their nursing services; if so, of the details; if not, the reasons for
that?
Reply:
President,
(1) The Hospital Authority (HA) is responsible for managing the public hospital
system and providing quality and affordable public health services to the
public. HA's services are organised through seven clusters according to
geographical locations so as to facilitate the integration of services and
enhance the continuity of various kinds of services with a view to achieving
economy of scale.
The mechanism of resource allocation to individual clusters in HA originates
from its annual planning work. The annual planning process is a participative
approach with bottom-up and top-down contributions from HA staff of various
ranks, including the collection of views from frontline clinical staff, cluster
management and Head Office executives. Every year, the resource requirements for
new services as well as that for specific pressure areas of individual
departments at hospital level are submitted for consideration of additional
funding through the annual planning exercises of respective clusters. All
proposed programmes submitted by clusters, and those from clinical/specialty
groups and Head Office, will be deliberated at the annual planning forums where
inputs from stakeholders across all clusters will also be considered.
Based on the above annual planning process, HA will formulate its Annual Plan,
incorporating all new programmes that are approved for implementation for the
year, including territory-wide and specialty-based programmes, as well as
cluster/hospital/department-specific initiatives. HA will also set targets for
its Annual Plan for necessary monitoring.
With the Government's notification of the total recurrent funding available to
HA for the year, HA will determine the resource allocation to clusters
(including manpower, equipment, facilities and other operating needs) having
regard to the following considerations -
(a) the resources needed to sustain the baseline operations of respective
clusters, including their core primary and secondary services as well as any
specialised or centralised services under their management;
(b) additional resources required to deliver the new services and priority
initiatives that have been supported during the annual planning process; and
(c) any other resources needed to address specific pressure areas/gaps.
Within the agreed parameters and targets set under the Annual Plan, cluster
management is responsible for ensuring operational efficiency. They will
likewise work out a service plan for its cluster taking into account the
baseline operations that need to be maintained, new services to be introduced
and pressure areas of its hospitals/departments that need to be enhanced, and
make necessary service reorganisation and rationalisation to deliver the agreed
Annual Plan targets while ensuring optimal deployment of resources.
(2) The mechanism and considerations in formulating resource allocation
(including nursing service and manpower distribution) to various clusters have
been provided in part (1) of the reply. As regards manpower for nursing
services, HA will evaluate manpower deployment having regard to service needs,
modes of nursing care and supply of healthcare personnel. It will also take into
account manpower wastage and estimate the nursing manpower requirements
according to the workload assessment model.
(3) and (4) Resources of each cluster are essentially allocated having regard to
the service programmes and targets defined in the process of formulating the
Annual Plan, and are allocated to the clusters in the form of a block vote.
Moreover, as most of HA's services are provided through multi-disciplinary
teams, hospitals will flexibly deploy manpower according to service needs. HA
has not set up an independent funding allocation system for nursing or other
grade of staff.
In the past five years (from 2009-10 to 2013-14), the number of nurses in
various clusters increased each year, with details set out in the Annex.
Ends/Wednesday, May 21, 2014
Issued at HKT 16:42
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LCQ10 Annex