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Following is a question by the Hon Li Kwok-ying and a reply by the Secretary for Health, Welfare and Food, Dr York Chow, in the Legislative Council today (March 14):
Question:
Regarding the obstetrics and gynaecology services at the North District Hospital, will the Government inform this Council whether it knows:
(a) given that it has been reported that the New Territories East Cluster of the Hospital Authority (HA) has recently abolished the emergency gynaecology services at the North District Hospital and redeployed the manpower there to the Prince of Wales Hospital, resulting in patients seeking emergency gynaecology services in that district having to go to the Prince of Wales Hospital, which is about 30-minute drive from the North District, for such services, whether HA has assessed the additional risks posed by such an arrangement to patients seeking emergency gynaecology services (especially those experiencing extra-uterine pregnancy or miscarriage, etc); if so, of the assessment results;
(b) whether HA has considered recruiting additional staff to solve the problem and hence there is no need to abolish the above services; if so, of the details; if not, the reasons for that; and
(c) given the increasing demand for obstetrics services from residents in the North District, whether HA will consider providing obstetrics beds at the North District Hospital; if so, of the timetable; if not, the reasons for that?
Reply:
Madam President,
(a) The seven public hospitals under the New Territories East (NTE) Cluster, namely the Prince of Wales Hospital (PWH), the Shatin Hospital (SH), the Bradbury Hospice (BH), the Cheshire Home of Shatin (CHS), the Alice Ho Miu Ling Nethersole Hospital (AHMLNH), the Tai Po Hospital (TPH) and the North District Hospital (NDH), provide medical services to residents in the New Territories East. Within the NTE Cluster, PWH and NDH provide both inpatient and outpatient gynaecology services, while only gynaecology outpatient services are available at AHMLNH.
The NTE Cluster is planning to realign its emergency gynaecology services in April this year. According to the Hospital Authority (HA), the main reason for the service realignment is the departure of nine specialists and senior professors of the Obstetrics and Gynaecology (O&G) Department of the Cluster and the Chinese University of Hong Kong in the past two years. In order for hospitals to properly handle emergency surgeries, one of the most important factors is the the level of clinical experience of its healthcare staff. In view of the loss of some senior doctors, the NTE Cluster has conducted a review on its emergency gynaecology services in February this year. The findings of the review showed that the utilisation of such services at NDH was relatively low. In 2006, NDH handled a total of 664 emergency gynaecology cases, of which 93 cases required emergency surgeries, representing a weekly average of 12.8 emergency gynaecology patients and 1.8 emergency gynaecology surgeries. Among the patients who required emergency surgeries, about two-thirds were residents of the North District, with Tai Po residents making up most of the remaining third.
Having regard to the overriding objective of ensuring the provision of quality medical services, and after considering the matter very carefully and balancing of all relevant factors, the NTE Cluster reached the conclusion that the most appropriate arrangement in the circumstances is to converge all emergency gynaecology services of the Cluster at PWH and cease providing such services at NDH.
After the service realignment, non-emergency gynaecology services of NDH, including specialist out-patient, ambulatory care and ward services, will remain unchanged. The NTE Cluster will flexibly deploy the necessary manpower to cater for the demand of emergency services at PWH.
The NTE cluster will strengthen its internal guidelines prior to the realignment of its emergency gynaecology services, so as to ensure that patients would be given timely and appropriate diagnoses, medical treatment and referrals. The HA indicated that the proposed service arrangement will not pose any additional clinical risks on patients in the North District who require emergency gynaecology services.
(b) As regards manpower, the HA regularly reviews the human resources of various specialist services and will make necessary readjustments from time to time in order to support service development and meet service demand. In July 2006, the NTE Cluster recruited four resident doctors for its O&G Department to fill the vacancies left behind by doctors departed in 2005-06. For the coming year, the NTE Cluster is actually planning to enhance its O&G services. In this connection, the NTE Cluster will continue to recruit new doctors to fill existing vacancies. On top of that, the Cluster will recruit an extra one or two O&G resident doctors and promote four associate consultants. These newly recruited/promoted doctors may need some time to fully familiarise themselves with their new jobs. The NTE Cluster hopes that this will strengthen its O&G team. It will also review its emergency gynaecology services in 2008 in light of the latest situation at that time.
(c) As regards the obstetric services of the NTE Cluster, all such services are currently converged at the PWH because of the availability of comprehensive neonatal care and intensive care support there.
Pursuant to the benchmark laid down by HA's co-ordinating committee on O&G, the HA should only consider the establishment of obstetric services at hospitals with at least 3 000 childbirths per year, so as to ensure that their healthcare personnel are sufficiently experienced to handle complications that may emerge in the labour process. According to the statistics collated by the Census and Statistics Department, the number of local new-born babies residing in Tai Po and North District was around 2 600 per year, out of which 2 000 were delivered in public hospitals. Considering that the number of new-born babies residing in Tai Po and North District and delivered in public hospitals has yet to reach the aforementioned benchmark, the HA does not have any plan at the present moment to establish obstetric services at NDH.
Ends/Wednesday, March 14, 2007
Issued at HKT 12:59
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