Replies to LegCo questions
LCQ11: Palliative care services for terminally-ill patients
Following is a question by the Professor Hon Joseph Lee and a written reply by
the Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council
today (March 16):
Question:
The Hospital Authority (HA) launched, in collaboration with some organisations,
in 2009 the Home End-of-Life Care Programme (the Programme) to enable elderly
patients suffering from designated chronic or long-term diseases (e.g. organ
failures and cancers) to choose, after being assessed by a doctor, to stay in a
suitable home living environment or residential care homes for the elderly
(RCHEs) and enjoy a peaceful time in the last days of their lives. When those
patients are in the very last moments of their life, their family members or the
RCHEs concerned may, according to the documents signed and issued by doctors in
advance, arrange to send them to the designated accident and emergency
departments, but the hospitals will not administer first aid to or perform
operations on them and will let them pass away naturally. The doctors will then
go through the death certification procedures and issue death certificates. In
this connection, will the Government inform this Council if it knows:
(1) the number of participants of the Programme since its launch in 2009, with a
breakdown by the diseases from which they suffered;
(2) the public hospitals in which the Programme is currently implemented, and
the manpower and resources involved; and
(3) whether HA has considered extending the Programme to all public hospitals
and has assessed the additional manpower and resources so required as well as
the number of additional persons who may benefit from the Programme; if HA has,
of the details; if not, the reasons for that?
Reply:
President,
The Hospital Authority (HA) has all along offered appropriate palliative care
services to terminally-ill patients and their families according to the
principle of "providing holistic care for patients". Such services are delivered
in an integrated mode through palliative care teams comprising doctors, nurses,
medical social workers, clinical psychologists, physiotherapists and
occupational therapists. In respect of the question raised by Professor Hon
Joseph Lee on services provided for terminally-ill patients, my reply is as
follows:
(1) and (2) The Palliative Virtual Ward Programme is a palliative care project
offered by the United Christian Hospital (UCH) of the Kowloon East Cluster
(KEC). It aims at providing multi-disciplinary support for terminally-ill
patients who wish to spend the last days of their life at home. At present, all
seven clusters of HA provide comprehensive palliative care services including
in-patient service, out-patient service, day care service, home care service and
bereavement counselling for terminally-ill patients. While the names of these
services may not have the same name as the one used by UCH of KEC, namely the
Palliative Virtual Ward Programme, they all provide palliative care services for
patients.
HA does not maintain the statistics of palliative care services under individual
programmes by clusters. The annex sets out the overall statistics on palliative
care services of HA.
Palliative care services of HA are mainly provided by healthcare personnel of
the Palliative Care Units (PCUs) and oncology centres. The oncology centres are
subsumed under the overall establishment of the oncology departments, and HA
does not maintain the statistics on the manpower specifically providing
palliative care services. As at December 31, 2015, there were around 200
full-time equivalent nurses serving in the PCUs. And as at December 31, 2015,
there were around 400 full-time equivalent nurses serving in the oncology
centres.
(3) HA has all along been committed to enhancing palliative care services. Over
the years, HA has continued to improve its mode of service and strengthen the
provision of multi-disciplinary service so as to alleviate the physical and
emotional distress of patients, and improve their quality of life at the
end-of-life stage. Since 2010-11, HA has extended the main targets of its
palliative care services from mainly cancer patients to patients with end-stage
organ failure. The additional resources involved are about $34 million per year.
In 2012-13, HA has enhanced the services by clinical psychologists and medical
social workers to provide psychosocial service for terminally-ill patients and
their family members, and to identify high-risk patients and their family
members for early intervention. The additional resources involved are about $12
million per year.
In 2015-16, HA also strengthened the service of the Community Geriatric
Assessment Teams to, through the collaboration between multi-disciplinary
service teams of the hospitals and the residential care homes for the elderly
(RCHEs), better support terminally-ill patients in RCHEs in phases and provide
training for staff of RCHEs to improve the quality of care. The additional
resources involved are about $7 million per year.
HA will continue to monitor the demand for various healthcare services, and plan
and enhance palliative care services having regard to factors like the
demographic growth and changes, advances in medical technology and healthcare
manpower.
Ends/Wednesday, March 16, 2016
Issued at HKT 15:56
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