Replies to LegCo questions

LCQ22: Colorectal Cancer Screening Pilot Programme

Following is a question by the Hon Paul Tse and a written reply by the Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council today (January 21):

Question:

At the end of this year the earliest, the Government will launch the Colorectal Cancer (CRC) Screening Pilot Programme (the Programme), which will cost $420 million, to subsidise people of specific age groups for CRC screening. It has been reported that the authorities intend to outsource colonoscopy services to private healthcare institutions and will conduct a survey on the relevant market fees in the first quarter of this year to determine the amount of subsidy. However, the media have found that, prior to the market survey conducted by the Government, three private hospitals have already raised their fees for colonoscopy services, with one of them raising its fees by almost 30%. Some patient groups are worried that such increases would have impact on the result of the market survey, push up public expenditure and unreasonably increase the gains of private hospitals. In this connection, will the Government inform this Council:

(1) whether it has approached the private hospitals to gain an understanding about the reasons to substantially raise the fees for colonoscopy services before taking up the outsourcing services;

(2) whether it has assessed the impacts of the fees for colonoscopy services having been raised substantially by private hospitals on the estimated expenditure, number of beneficiaries and the overall effectiveness of the Programme; and

(3) whether the authorities will introduce competition by allowing eligible private clinics or medical centres to take part in the Programme when they outsource the colonoscopy services; of the other measures to be put in place by the authorities so that the Programme may benefit more members of the public?

Reply:

President,

In 2012, colorectal cancer became the second most common cancer, after lung cancer, in Hong Kong. There were 4 563 newly diagnosed colorectal cancer cases in that year, accounting for 16.4% of all new cancer cases. In 2013, colorectal cancer was the second most common cause of cancer death, resulting in a total of 1 981 registered deaths and accounting for 14.6% of all cancer deaths. As the risk of colorectal cancer increases significantly from age 50, persons aged 50 to 75 should discuss with their doctor and consider screening for colorectal cancer.

In view of a growing and ageing population, the number of new colorectal cancer cases and related healthcare burden are expected to continue to increase in future. In the light of the above, the Government announced in the 2014 Policy Address and the 2014/15 Budget that it would allocate funding of around $420 million in the five years starting from 2014/15 for the study and implementation of a pilot programme to subsidise colorectal cancer screening for specific age groups.

Regarding the three parts of the question, my consolidated reply is as follows:

The Department of Health (DH), with support from the Hospital Authority (HA), established in January 2014 a multi-disciplinary taskforce (taskforce) with a number of representatives from the medical sector to embark upon the study and planning of the Colorectal Cancer Screening Pilot Programme (Pilot Programme). The taskforce comprises representatives from the HA, relevant Academy Colleges, medical associations, primary care doctors, academia and non-governmental organisation. The taskforce is responsible for tasks pertaining to the planning, implementation, publicity and evaluation of the Pilot Programme, including determination of inclusion criteria for participation in the Pilot Programme, method of screening, funding model, and operational logistics, etc.

The taskforce has identified faecal immunochemical test (FIT) as the screening method for use in the Pilot Programme. Primary care doctors will issue FIT tubes to participants. Where participants whose stool samples are found to contain minute amounts of blood, they will be referred by their primary care doctors for colonoscopy by specialists enrolled on a public-private partnership basis. Colonoscopists who are interested in participating in the Pilot Programme must meet requirements set out in terms of qualification, premises and facilities, as well as service quality and standard. The colonoscopy would not be confined to hospitals or medical centres. In the planning process, the DH has maintained close communication with various stakeholders in the medical field to enlist their active support and participation in the Pilot Programme.

To encourage eligible citizens to actively participate in the Pilot Programme and complete the screening process, apart from subsidising FIT, the Administration will provide subsidy to participants found to have positive FIT results for undertaking colonoscopy. The amount and details of subsidy will be determined by taking into consideration market practice, experience of existing subsidy schemes as well as issues that relate to fairness and equity, affordability and accessibility. To obtain a better understanding of the market situation and price information of colonoscopy services, the DH and the HA commissioned a market survey between July and August 2014. Moreover, the Hong Kong Medical Association conducted the Doctors' Fee Survey around the same time and these findings will serve as useful reference for the Administration when considering the details of the subsidy. The findings of the above studies reveal that there is adequate supply of service providers to cope with the demand generated from the Pilot Programme.

The Pilot Programme aims at gathering local experience of the colorectal cancer screening services and collecting relevant data to generate evidence and recommendations, thus facilitating the Administration to consider whether and how best colorectal cancer screening may be provided to the wider population in the future. We are working on a publicity strategy to promote the Pilot Programme with the aim of increasing participation among eligible individuals and healthcare professionals.

Ends/Wednesday, January 21, 2015
Issued at HKT 12:31

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