Replies to LegCo questions

LCQ10: Planning for provision of public primary care services

Following is a question by the Dr Hon Elizabeth Quat and a written reply by the Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council today (February 3):

Question:

According to a forecast made in 2014, the population in Sha Tin District in mid-2015 was nearly 670 000, with more than 220 000 people living in Ma On Shan. Some residents of Sha Tin District have relayed to me that public healthcare services in the district (especially in Ma On Shan) are in short supply. In this connection, will the Government inform this Council:

(1) as the Government has stated in this year's Policy Address that the redevelopment/expansion of the Prince of Wales Hospital is included in its hospital development plan for the coming decade, of the details and works schedule for the redevelopment/expansion plan concerned;

(2) as it is mentioned in a paper submitted to this Council by the Food and Health Bureau in respect of this year's Policy Address that the pilot General Out-patient Clinic Public-Private Partnership Programme will be extended to all the 18 District Council districts of the territory in phases in the coming three years, of the date and details of the implementation of the programme in Sha Tin District, as well as the priority assigned to Sha Tin District among the 18 districts;

(3) as a number of public and private housing projects in Ma On Shan will be completed one after another in the coming few years and the population in that area will continue to rise, whether the Government has plans to set up public general out-patient clinics in Ma On Shan; if it does, of the details; if not, the reasons for that;

(4) given that among the 11 existing dental clinics with general public sessions (which provide pain relief and extraction services only) in the territory, not even one is situated in Sha Tin District, whether the Government will (i) consider setting up such clinics in that district, or (ii) make arrangements for the government dental clinics situated respectively on Sai Sha Road, Man On Shan and in Yuen Chau Kok, Sha Tin (which currently provide dental services only to civil servants and eligible persons) to provide dental services for the general public; if it will, of the details; if not, the reasons for that; and

(5) whether the Department of Health will consider setting up woman health centres in Sha Tin District to provide mammography screening and other health services for women in the District; if the Department will, of the details; if not, the reasons for that?

Reply:

President,

(1) To meet new demand and improve existing services, the Government has worked with the Hospital Authority (HA) to devise an overall hospital development plan, and $200 billion will be used to implement the plan in the next 10 years. The new arrangement can provide more certainty for resource planning. It can also facilitate HA's planning and taking forward of various major hospital capital works projects in the coming 10 years, including the phase 2 redevelopment plan of the Prince of Wales Hospital (PWH).

Based on the Clinical Services Plan for New Territories East Cluster formulated in 2015, HA is defining the project scope and arranging for a technical feasibility study for the phase 2 redevelopment of PWH. Upon completion of the above works, HA can formulate a more concrete timetable for the project and then seek funding approval in accordance with the established procedures so as to implement the PWH phase 2 redevelopment plan as early as possible.

(2) The General Outpatient Clinic Public-Private Partnership Programme (GOPC PPP) was launched by HA in mid-2014 on a pilot basis in three districts, namely Kwun Tong, Wong Tai Sin and Tuen Mun. HA is conducting an interim review for the GOPC PPP to look into the key implementation issues and operating experiences. In preparation of further extension of the GOPC PPP to other districts, the interim review focuses on areas which will have considerable impact on the operation and service provision of the GOPC PPP.

A roll-out plan for the GOPC PPP has been prepared having considered the initial positive feedback from the medical professional bodies, patients, private doctors and staff, the community call for extension of the GOPC PPP to other districts, as well as the related financial arrangements.

HA plans to start rolling out the GOPC PPP to all seven clusters in the third quarter of 2016 in phases, covering nine additional districts (including Sha Tin District). Remaining districts will be covered in 2017-18 and 2018-19. On the selection of districts, factors including median household income, service demand for general out patient clinics (GOPC) services, scope of existing public-private partnership projects for chronic disease management and readiness of stakeholders in the community have been taken into consideration. The proposed roll-out plan is outlined in the Annex.

(3) HA's general out-patient services are primarily targeted at serving the elderly, the low-income group and the chronically ill. At present, there are four GOPC managed by the New Territories East Cluster (NTEC) in Sha Tin District, namely Ma On Shan Family Medicine Centre, Yuen Chau Kok GOPC, Lek Yuen GOPC and Sha Tin (Tai Wai) GOPC.

HA has always endeavoured to improve the services of GOPCs, including active recruitment of additional staff, renovating clinic premises and modernising clinic facilitates to enhance the general out-patient services. For Sha Tin District, the renovation of Lek Yuen GOPC and Yuen Chau Kok GOPC was completed in 2011-12 and that of Ma On Shan Family Medicine Centre was completed in 2013-14. These renovation projects have streamlined the patient flow, improved the clinic environment and increased clinic space to keep pace with the service development of GOPCs. In fact, with the implementation of various measures, there has been an increase of around 110 000 general out-patient attendances in NTEC from 2010-11 to date. NTEC will also continue to increase the general out-patient quota in the future. Besides, as mentioned above, HA is planning to extend the GOPC PPP to 18 districts throughout the territory in phases in the coming few years.

In planning for the provision of public primary care services, we take into account a number of factors, including primary care service delivery model, demographic changes, distribution of the target groups, the provision of primary care services in the district, and demand for public primary care services, etc. Having considered the distribution of the target groups and the future population growth in the district, a site in Ma On Shan Area 90B has been reserved by the Government for the future development of primary care facilities. HA will continue to pay attention to the demand for public primary care services within the district and tie in with the policy development of Food and Health Bureau. Meanwhile, we will continue to closely monitor the operation and service utilisation of GOPCs, and flexibly deploy manpower and other resources to ensure that the primary care services could be properly provided to our target groups.

(4) As proper oral health habits can effectively prevent dental diseases, having regard to cost-effectiveness, the Government's policy on dental care seeks to raise public awareness of oral hygiene and facilitate the development of proper oral health habits through promotion and education, thereby improving public oral health. To enhance the oral health of the public, the Oral Health Education Unit of the Department of Health (DH) has, over the years, implemented oral health promotion programmes targeted at different age groups and disseminated oral health information through different channels.

At present, apart from providing dental service to eligible civil servants, pensioners and their eligible dependents (CSEPs) in the government dental clinics under the DH, the DH also provides free emergency dental services (generally referred to as "General Public Sessions") through its 11 government dental clinics, including Tai Po Wong Siu Ching Dental Clinic and Mona Fong Dental Clinic in New Territories East.

During the operating hours, the government dental clinics have to handle large volume of appointments made by as well as emergency dental care requests of CSEPs. In 2015, all the appointment slots of Tai Po Wong Siu Ching Dental Clinic and Mona Fong Dental Clinic, as well as the government dental clinics in Sai Sha Road of Man On Shan and Yuen Chau Kok of Sha Tin were fully booked. The average service utilisation rate of the appointments made by CSEPs was over 93 per cent. Taking into account the additional number of unscheduled emergency dental care requests from CSEPs, the service utilisation rate of these clinics had actually reached 100 per cent. Hence the above four clinics at New Territories East are at full capacity and there is no spare capacity for expansion of General Public Sessions.

The Government has put in place a series of measures in recent years to strengthen the dental service provided for the patients with special oral health care needs. Among others, the Government has provided dental care assistance to the low-income and needy elders, including the Elderly Health Care Voucher Scheme, Outreach Dental Care Programme for the Elderly and Community Care Fund Elderly Dental Assistance Programme.

(5) The Family Health Service of the DH provides the woman health service at its three Woman Health Centres (WHCs) and 10 Maternal and Child Health Centres (MCHCs) to all women at or below 64 years of age for health promotion and disease prevention, which includes health education, health assessment, counselling and appropriate screening test.

Currently, woman health service follows the recommendations of the Cancer Expert Working Group on Cancer Prevention and Screening (CEWG) and promotes healthy lifestyles as the main prevention strategy for breast cancer. CEWG advocates breast awareness among women, so that medical attention could be sought early if any breast abnormalities are identified. Regarding breast cancer screening, CEWG considers that there is insufficient evidence to recommend for or against population-based mammography screening in Hong Kong after reviewing the latest scientific information and local situation. Women with high risk of developing breast cancer may be arranged to receive mammography screening after medical assessment conducted by the WHCs or MCHCs of DH which provide woman health service. If abnormalities are found, they will be referred to specialists for follow-up.

Women living in Sha Tin District can attend Lek Yuen MCHC or Ma On Shan MCHC for woman health service. The waiting time varies among centres. Generally speaking, the waiting time in New Territories East region is approximately six weeks. DH will continue to monitor service demand on woman health and utilisation statistics of various services. Resources will be allocated for long-term service development as appropriate to support the development of primary care strategy. The Government currently has no plan to extend the woman health service.

Ends/Wednesday, February 3, 2016
Issued at HKT 16:47

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