Replies to LegCo questions
LCQ10: Public dental services
Following is a question by the Dr Hon Kwok Ka-ki and a written reply by the
Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council today
(May 31):
Question:
Regarding public dental services, will the Government inform this Council:
(1) given that under the Outreach Dental Care Programme for the Elderly, 22
outreach dental teams have been set up by 11 non-governmental organisations to
provide outreach dental services for eligible elderly people, of (i) the
establishment of each outreach team, (ii) the details of the dental services
(e.g. oral care training and oral health assessment), and (iii) the average
duration of and average number of elderly people receiving services in each
service session at present;
(2) given that the Pilot Project on Dental Service for Patients with
Intellectual Disability is due for completion in August 2017 and the authorities
are now studying the way forward to continue to provide dental service for
patients with intellectual disability, of the details and latest progress of the
study;
(3) as the Director of Audit pointed out in his Report No. 68 published in April
this year that there were a number of problems with public dental services (e.g.
outdated oral health goals, low overall participation rate of eligible elderly
people in the Elderly Dental Assistance Programme launched under the Community
Care Fund, a number of students who made appointments through the School Dental
Care Service not attending scheduled appointments, under-utilisation of the
emergency dental services in General Public Sessions), whether the authorities
will conduct a review of the public dental services in the light of those
problems and make improvements; if so, of the details; if not, the reasons for
that;
(4) as it was pointed out in a research report published in December last year
that there were only 2.13 dentists per 1 000 elderly people in Hong Kong, and
such ratio lagged behind those in advanced countries (e.g. the relevant figures
in Sweden, the United States, the United Kingdom and Japan were 8.84, 4.16, 3.60
and 3.15 per 1 000 elderly people respectively), whether the Government will set
a target on elderly population/dentist ratio and, based on such target, train up
a sufficient number of dentists; and
(5) whether the Government will, in the long run, formulate policies on the
provision of comprehensive public dental services; if so, of the details; if
not, the reasons for that?
Reply:
President,
My reply to the Dr Hon Kwok Ka-ki's question is as follows:
(1) The Outreach Dental Care Programme for the Elderly (ODCP), which was
launched in October 2014, aims to provide free outreach dental care services to
elders residing in residential care homes and using services of day care centres
and similar facilities; promote the oral care and oral health to the elders,
their family members and caregivers; and provide oral care training to
caregivers in residential care homes and day care centres for the elderly to
enhance their ability and knowledge in providing daily oral care services to the
elders.
Currently, a total of 22 outreach dental teams from 11 non-governmental
organisations (NGOs) have been set up under the ODCP. Each outreach dental team
comprises at least one dentist and one dental surgery assistant. The outreach
dental teams will co-ordinate with the residential care homes and day care
centres in arranging the dates and time of providing the services.
Between October 2014 and March 2017, about 68 300 elders (involving about 115
700 attendances) received annual oral check and dental treatments under the
ODCP. Dental treatments received include scaling and polishing, denture
cleaning, fluoride application, X-ray and other curative treatments such as
fillings, extractions, dentures, etc.
(2) The Government understands the oral health problems faced by patients with
intellectual disability (ID) and is concerned about their dental care needs. The
Pilot Project on Dental Service for Patients with Intellectual Disability (the
Pilot Project) launched by the Government aims to explore a cost-effective model
to provide appropriate dental services for adult patients with ID and with
financial difficulties. Since the launch in August 2013, the Pilot Project has
already provided dental services to over 1 800 eligible adult patients with ID.
The Government will continue to subsidise the organisations participated in the
Pilot Project to provide the relevant dental service in the coming year to meet
the service needs of patients with ID who are on the waiting list. The
Government fully recognises that the dental service concerned should be
continued and is now following up on how the provision of appropriate dental
care service for adult patients with ID after completion of the Pilot Project
should be continued.
(3) The Food and Health Bureau and the Department of Health (DH) accept the
Director of Audit's recommendations, and will, where feasible, actively
implement the recommendations made by the audit report which mainly include:
Oral health goals
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The Government's policy on dental care seeks to raise public awareness of oral
hygiene and encourage proper oral health habits through promotion and education.
Therefore, the DH will formulate appropriate oral health promotion measures
according to the results of the Oral Health Surveys conducted every 10 years
(including the surveys conducted in 2001 and 2011 respectively).
Based on the recommendations by the Director of Audit, the DH has also planned
to set up an expert group comprising academics and experts of dental public
health specialty, as well as representatives from other relevant fields as
appropriate. The expert group will, taking into account the report of Oral
Health Survey 2011 and the local situation, review and formulate appropriate
oral health goals for the population of Hong Kong. The DH will also consider
publishing the level of attainment against various oral health goals in the
report of the Oral Health Survey 2021.
Student Dental Care Service (SDCS)
----------------------------------------
Regarding the recommendation to encourage Primary six students' attendance at
scheduled dental appointments, the SDCS is now exploring with the participating
schools on the feasibility of providing round-trip transport for Primary six
students to attend school dental clinics for annual dental check-up. In
addition, SDCS has planned to actively encourage the participating students and
their parents to make use of the Student Internet Service which includes an
automatic appointment reminder service by email, so that students can be
reminded to attend their appointments as scheduled. We aim to implement the
measures in 2017/18 school year.
General Public Sessions (GP Sessions)
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In 2015/16, among the 11 government dental clinics which provide GP Sessions,
there were three dental clinics with relatively high rates of unutilised disc
quota, namely Tai O Dental Clinic (74.7%), Cheung Chau Dental Clinic (50.0%) and
Kennedy Town Community Complex Dental Clinic (25.2%).
To enhance utilised rate, the DH has stepped up effort to promote the service of
the GP Session at Kennedy Town Community Complex Dental Clinic, including
handing out clinic's information leaflet to encourage the public who are unable
to obtain disc quota from other government dental clinics to visit the clinic.
With the above promotional effort, and following the provision of MTR service in
Kennedy Town, the percentage of unutilised disc quota has greatly dropped to
13.94% in 2016/17. We anticipate that the percentage of unutilised disc quota
will continue to decrease.
As for the rates of unutilised disc quota for GP Sessions of Tai O Dental Clinic
and Cheung Chau Dental Clinic, it is quite difficult to attract cross-district
clients since these two clinics mainly serve the residents of Tai O and Cheung
Chau and their locations are quite remote. However, there remains a need to
maintain services of these two clinics to meet the service needs of the above
two districts. To utilise the existing resources in a more flexible manner, the
dentists deployed to Tai O GP Sessions and Cheung Chau GP Sessions will be on
duty at other government dental clinics during the period other than the above
GP Sessions.
The DH will closely monitor the utilisation rate of the GP Sessions and review
the service in a timely manner.
Community Care Fund Elderly Dental Assistance Programme (the Programme)
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The Programme provides free removable dentures and related dental services for
eligible elders. The Hong Kong Dental Association (HKDA) is the implementing
agent of the Programme. Currently, 180 district service units (comprising 160
elderly centres, five community centres and 15 NGO dental clinics that accept
direct applications) have participated in the Programme for processing
applications from elders who are Old Age Living Allowance recipients. The
Government will continue to work with the HKDA to further promote the Programme
on various fronts and encourage more elders to join the Programme. We will also
invite more district service units to participate in the Programme so as to
assist the eligible elders in making applications and scheduling dental
appointments.
(4) To ensure the sustainable development of our healthcare system, the
Government is conducting a strategic review on healthcare manpower planning and
professional development in Hong Kong (the Strategic Review), which aims to
formulate recommendations on ways to meet the projected demand for healthcare
manpower and foster professional development. The Strategic Review covers 13
healthcare disciplines which are subject to statutory regulation, including
dentists.
Based on the manpower projection conducted by the University of Hong Kong, there
is a shortage of dentists in the short to medium-term. To meet the anticipated
demand for dentist manpower, the Government has increased the number of
University Grants Committee-funded degree places in dentistry by 20 (amounting
to about 40%) from 53 to 73 in the 2016/17 school year - 2018/19 school year
triennium. It is expected that the increase will help alleviate the manpower
shortage of dentists.
(5) As mentioned above, the Government's policy on dental care mainly seeks to
raise public awareness of oral hygiene and encourage proper oral health habits
through promotion and education. To enhance the oral health of the public, the
Oral Health Education Unit of the DH has, over the years, implemented oral
health promotion programmes targeted at different age groups and disseminated
oral health information through different channels.
We wish to point out that only a few countries around the world can meet all the
dental care needs of their citizens solely with public resources. Citizens in
some countries may even have to bear higher medical insurance cost. As for Hong
Kong, providing comprehensive dental care services to the public will involve
substantial financial resources. In this regard, apart from promotion, education
(including SDCS) and publicity, the Government has focused resources to provide
emergency dental services for the public including GP Sessions, as well as
accorded priority to people with special needs, especially elderly with
financial difficulties. As such, in recent years, the Government has launched a
series of initiatives, including the Outreach Dental Care Programme and
Community Care Fund Elderly Dental Assistance Programme, to provide dental care
service support to low-income elders with special needs. Besides, eligible
elders may also use Elderly Health Care Vouchers for private dental services.
Ends/Wednesday, May 31, 2017
Issued at HKT 17:50
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