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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