***********************************************************
Following is a question by the Hon Albert Chan and a reply by the Secretary for Health, Welfare and Food, Dr York Chow, in the Legislative Council today (June 13):
Question:
Recently, quite a number of members of the public have complained to me about the long waiting time for the specialist out-patient (SOP) services at public hospitals. For example, a resident of Tung Chung has to wait for three years for a consultation appointment. Many people have told me that their clinical conditions have worsened due to the lack of timely treatment over a prolonged period. In this connection, will the Government inform this Council:
(a) of the average waiting time for each SOP service last year, together with a breakdown of the cases by the waiting time (i.e. less than one year, one to less than two years, two to less than three years and three years or above) as at the end of last year;
(b) of the longest waiting time among the present cases for each SOP service; and
(c) whether it will take measures to alleviate the problem of excessively long waiting time for SOP services; if so, of the details; if not, the reasons for that?
Reply:
Madam President,
The Hospital Authority (HA) has put in place a triage system at its specialist out-patient (SOP) clinics. Health care personnel will arrange the date of medical appointment for new patients on the basis of the urgency of their clinical conditions at the time of referral, taking into account various factors including the patients' clinical history, the presenting symptoms and the findings from physical examination and investigations.
Under the triage system, new SOP cases are classified into priority 1 (urgent), priority 2 (semi-urgent) and routine categories. To ensure that patients with urgent conditions are given appropriate medical attention in a timely manner, the HA will arrange doctors to attend to priority 1 and priority 2 cases as soon as possible. The current median waiting time for these two categories of cases are 1 week and 5 weeks respectively. The triage system benefits patients with urgent conditions by shortening their waiting time. Nevertheless, the waiting time for patients with non-urgent conditions would be longer.
Referrals of new patients to SOP clinics under the HA are usually screened first by a nurse and then by a doctor in the relevant specialty. To ensure that no urgent medical conditions are overlooked at the initial triage, all referrals that have been classified as routine cases would be double-checked by a senior doctor in the relevant specialty within seven working days of the initial triage. If a patient's condition deteriorate before the date of appointment, he may contact the SOP clinic concerned and request for an earlier appointment. However, if the condition is acute, the patient should seek immediate attention from accident and emergency departments. Depending on the patient's needs, the medical staff there may arrange for an earlier SOP appointment for the patient.
(a)&(b) A breakdown by major specialties of the median waiting time and the waiting time at the 99th percentile for new cases booked in 2006 is set out in Table 1.
The overall median waiting time for new SOP cases booked under the HA is about 7 weeks. In terms of median waiting time, the three specialties with the longest waiting time in descending order are Surgery, Orthopaedics and Medicine.
A breakdown of the number of new SOP cases booked by the waiting time (i.e. less than a year, one to two years, two to three years and over three years) is set out in Table 2.
Of the 670 000 some new cases in 2006, the waiting time was less than one year in nearly 590 000 cases (or 88% of the total number of new cases). Of these new cases in which the waiting time was less than one year, the waiting time for more than 240 000 cases (or 36% of the total number of new cases) was less than two weeks, and for about 130 000 other cases (or 20% of the total number of new cases), the waiting time was between two to eight weeks. In other words, for about 55% of all the new cases, the first appointment could be arranged within eight weeks. This shows that the triage system is effective in facilitating the provision of appropriate medical services for patients with urgent medical conditions in a timely manner.
(c) On the other hand, we are also concerned about the waiting time for patients with non-urgent conditions. To improve the situation, the HA has taken the following measures:
* Increasing the appointment quota of the SOP clinics, family clinics and general out-patient clinics (GOPCs);
* Deploying specialists on a sessional basis at GOPCs to support the management of chronically ill patients;
* Setting up 18 family medicine specialist clinics to take up the patients categorised as routine cases and act as a gatekeeper for SOP clinics;
* Training more specialists;
* Reducing unnecessary referrals by the distribution of referral and triage guidelines to relevant doctors in the private sector; and
* Establishing protocols for the discharge of medically stable patients to be followed up at the primary care level.
On top of the above measures, the HA has decided to set up a working group to conduct a thorough examination of the operation of the existing SOP service and put forward feasible options for shortening the waiting time.
Ends/Wednesday, June 13, 2007
Issued at HKT 12:10
NNNN
