Replies to LegCo questions

LCQ7: Specialist out-patient services of public hospitals

Following is a question by the Hon Cyd Ho and a written reply by the Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council today (April 27):

It has been reported that the appointment dates available for booking by new cases at the medical specialist out-patient (SOP) clinics of one public hospital are in general at the end of 2017 the earliest, and those for certain specialties are even as late as May 2018. This situation reflects a serious shortage of manpower for various medical SOP clinics. In this connection, will the Government inform this Council whether it knows:

(1) (i) the current number of specialists in various medical specialties of public hospitals, and among such types of personnel, (ii) the number of those who left the service and (iii) the number of new recruits, in each of the past three years; among the new patients for the SOP clinics, the respective numbers of those who, before receiving the first treatment, (iv) sought treatments at the accident and emergency departments for the diseases concerned and (v) died of the diseases concerned, in each of the past three years (set out in Annex 1); and

(2) the new measures put in place by the Hospital Authority to shorten the waiting time for bookings by new cases at various medical SOP clinics, so that the patients concerned may receive treatments as early as possible?

Reply:

President,

My reply to the question raised by the Hon Cyd Ho on the waiting time for first appointment at medicine specialist outpatient clinics (SOPCs) of public hospitals is as follows:

(1) The Hospital Authority (HA) assesses its manpower requirements from time to time having regard to the service and operational needs. As at December 31, 2015, there were a total of 1 251 specialists in Medicine in the HA. Annex 2 sets out the number of intake and attrition of specialists in Medicine in the past three years. As a specialist in Medicine may serve more than one sub-specialty in Medicine, the HA does not maintain the relevant statistical record broken down by sub-specialty.

The HA does not have the statistics on the number of patients who have sought treatments at the accident and emergency departments before the first appointment at SOPCs or who passed away while waiting for specialist consultation.

(2) The HA has implemented a series of measures to alleviate the waiting time problem of SOPCs, including Medicine SOPCs. The measures include:

(i) Triage and prioritisation

The HA has implemented the triage system for new SOPC referrals to ensure patients with urgent conditions requiring early intervention are treated with priority. Under the current triage system, referrals of new patients are usually first screened by a nurse and then by a specialist doctor of the relevant specialty for classification into Priority 1 (urgent), Priority 2 (semi-urgent) and routine categories. HA's targets are to maintain the median waiting time for cases in Priority 1 and 2 categories within 2 weeks and 8 weeks respectively. The HA has all along been able to keep the median waiting time of Priority 1 and Priority 2 cases within this pledge.

(ii) Enhancing primary care services

The HA is committed to enhancing public primary care services. Patients with stable and less complex conditions can be managed at Family Medicine Specialist Clinics (FMSCs) and general out-patient clinics (GOPCs), thereby reducing the service demand at SOPC level. The HA will continue to promote primary care services to alleviate the pressure on SOPC waiting time.

(iii) Public-Private Partnership

With the setting up of the HA Public-Private Partnership (PPP) Fund, the HA plans to extend the GOPC PPP Programme to the remaining 15 districts in three years starting from 2016-17. The capacity so vacated can be utilised to serve other patients in need, thus helping the HA to cope with the demand for relevant clinical services.

(iv) Enhancing manpower

In 2014-15, the HA engaged about 350 part-time doctors and non-local doctors under "limited registration" to improve the manpower strength. The HA will continue to provide the Special Honorarium Scheme for the existing workforce, engage part-time doctors, rehire retiring doctors and adopt other measures as well in 2016-17 to strengthen its medical manpower in SOPC service.

(v) Annual plan programmes implemented to manage SOPC waiting time

In 2016-17, the HA will address the issue of SOPC waiting time through service development programmes that have incorporated SOPC elements. For example, Kowloon East Cluster and Kowloon West Cluster will enhance their FMSC services to alleviate the pressure on SOPC waiting time. Kowloon West Cluster will also expand the SOPC capacity for services including the specialty of Medicine.

(vi) Reducing the disparity in waiting time at SOPCs in different clusters

The HA has implemented measures to address the disparity in waiting time at SOPCs in different clusters.

Firstly, in order to enhance transparency, the HA has, since April 2013, uploaded the SOPC waiting time on HA's website by phases. Effective from January 30, 2015, the SOPC waiting time information for eight major specialties, including the specialty of Medicine, is available on the HA's website. This information facilitates patients' understanding of the waiting time situation in the HA and assists them to make informed decisions when considering whether they should pursue cross-cluster treatment.

To let more patients benefit from cross-cluster referral arrangement according to their preferences, the HA has reminded frontline staff to accept new case bookings from patients residing in other clusters. In February 2015, the HA produced a poster on the procedures and practice on the booking of first appointment at SOPC for the information of both the public and its staff.

(vii) Optimising appointment scheduling practices of SOPCs

The HA has completed the comprehensive review of the appointment scheduling practices of SOPCs and identified good practices on scheduling appointments for patients in order to optimise the use of the earliest available slots. Such good practices have been incorporated into the SOPC Operation Manual which was issued to all SOPCs on January 1, 2016.

Ends/Wednesday, April 27, 2016
Issued at HKT 14:05

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