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Following is a question by the Hon Lau Wong-fat and a reply by the Secretary for Health, Welfare and Food, Dr York Chow, in the Legislative Council today (June 13):
Question:
Will the Government inform this Council:
(a) of the current average queuing time for consultation in the Accident and Emergency ("A&E") departments of public hospitals for patients of categories 4 and 5 under the triage system, whose conditions are not considered urgent, broken down by hospital clusters of the Hospital Authority (HA);
(b) of the respective unit costs of treating patients in the A&E departments of public hospitals and clinics under HA; and
(c) whether it will consider setting up 24-hour clinics operated by private practitioners adjacent to the A&E departments of public hospitals, so as to reduce the number of patients seeking A&E services and save medical expenditure for HA?
Reply:
Madam President,
(a) According to the statistics collated by the Hospital Authority (HA) on Accident and Emergency (A&E) attendances of public hospitals in 2006-07, the average waiting time for cases in triage category 4 (semi-urgent) and category 5 (non-urgent) is 73 and 98 minutes respectively. A breakdown of average waiting time for the cases by hospital clusters is set out in the Table.
(b) The unit cost per attendance at HA's A&E departments is $720. It is almost two times higher than the unit cost per attendance at General Outpatient Clinics of $260.
(c) In 2006-07, the A&E departments of public hospitals handled a total of 1.34 million attendances in triage category 4 (semi-urgent) and category 5 (non-urgent), which accounted for 68% of the total number of A&E attendances.
The HA is very concerned about the improper use of A&E services by patients with non-emergency conditions. While it is understandable that some patients are not able to determine whether their acute conditions require emergency or non-emergency medical care, it is also true that others simply utilise A&E departments as a convenient alternative to out-patient clinics, in particular outside normal hours for consultation of clinics, resulting in a wasteful use of public hospital resources. In addition, the use the services of A&E departments by a large number of patients with non-emergency conditions would unduly add to the workload of frontline staff. This affects the efficiency of care for patients with genuine emergency conditions. Long waiting time for patients with non-emergency conditions would also result in patient complaint and conflict with frontline staff, which in turn will dampen staff morale.
In order to minimise improper use of A&E services by patients with non-emergency conditions, we will continue to encourage the public to make better use of the services of family doctors, who should be the first point of contact when accessing medical services. An assessment on the urgency on the patient's conditions should be made by the family doctors, and an attendance at A&E departments should only be made when there is a genuine need to do so.
The HA has stepped up family medicine specialist training over the past few years. It is hoped that more primary care doctors will put greater emphasis on developing long-term relations with their patients and provide them with the necessary medical care in times of need, for example, by providing patients with a means of contact after consultation hours so as to enable them to seek medical advice.
The HA has no plan to set up any 24-hour clinics to be operated by private practitioners adjacent to the A&E departments. At present, most private hospitals and some private clinics are providing round-the-clock services. We will encourage the private sector to make further development in this direction. For example, family doctors in solo practice within a district may collaborate to take turns to provide service beyond normal clinic opening hours.
To facilitate the choice of services required by patients with non-emergency conditions, information is made available in the A&E departments under the HA about the private practitioners and 24-hour clinics in the districts where the A&E departments are located. Such information includes, among others, the specialties registered, means of contact and operating hours. Public hospitals will also strengthen their liaison with private practitioners and 24-hour clinics operating in their district so as to ensure that patients with emergency conditions referred to the A&E departments by these practitioners and clinics will receive prompt attention and care.
Ends/Wednesday, June 13, 2007
Issued at HKT 12:50
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