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Following is a question by the Hon Alan Leong and a reply by the Secretary for Food and Health, Dr York Chow, in the Legislative Council today (December 5):
Question:
Among the seven hospital clusters under the Hospital Authority (HA), the Kowloon East Cluster (KE Cluster) ranks fourth in terms of population but last in terms of funding allocation for the current financial year. Comparing with KE Cluster, the populations of the Hong Kong West Cluster and Kowloon Central Cluster last year were respectively 43% and 47% less while their funding allocations for the current financial year are respectively 20% and 39% more. Consequently, the services of KE cluster are under great pressure. In this connection, will the Government inform this Council:
(a) as the Government has indicated that one of the main advantages of forming hospital clusters is the provision of comprehensive medical care in a single cluster, whether any hospital services currently provided by other clusters are unavailable in KE Cluster; if there are, whether it knows if HA has any plans to introduce such services in KE Cluster based on the demographic structure of KE and the medical needs of residents in the district;
(b) whether it knows if HA plans to revise the criteria for allocation of funds to various clusters to ensure that medical services for residents covered by KE Cluster are comparable to those for residents of other districts; if there are revision plans, of the details and implementation date; if not, the reasons for that; and
(c) whether the Government will take other measures to alleviate the pressure on the cluster (such as allocating land within the district for the construction of private hospitals); if it will, of the details of and implementation schedule for the measures; if not, the reasons for that?
Reply:
Madam President,
(a) & (b) At present, the Hospital Authority (HA) provides public health care services on a cluster basis. The objective of the cluster arrangement is to clearly delineate the roles of different hospitals within each cluster and enable collaboration and complementary support among hospitals, so that a full range of health care services can be provided to residents of different districts through the overall service network of the HA.
In planning their services, the clusters adopt the principle of taking into consideration the local services demand and the development of various specialist services. Specifically, health care services having a continual need such as basic, specialist, emergency and in-patient services are provided by all clusters. Specialist services having a relatively small demand and requiring other complex supporting facilities for delivery are mainly provided to the public on a cross-cluster basis under a service network formed by two or more clusters. Neurosurgery and oncology services are examples of such services. As for those specialist services that have a limited demand and require some state-of-the-art technologies, equipment and comprehensive supporting facilities for delivery, they are provided by tertiary services centres at designated hospitals. Organ transplant and burn centers are examples of these services. The above principle for service planning could achieve cost-effectiveness and help pool together the experience of health care professionals and ensure the quality of services.
As in the case of the other six hospital clusters, the Kowloon East Hospital Cluster (KE Cluster) does not solely consider the size of local population in planning its services. It also takes into account of other factors such as the role of each hospital within the cluster, the service utilisation pattern of residents and the demographic profile in order to provide appropriate services for residents in the region.
The KE Cluster now provides a range of comprehensive services including out-patient services, acute and emergency services, long term rehabilitation services and community-based specialist services, which are basically the same as those provided by the other six hospital clusters. These services cover 24 hour accident and emergency service, in-patient service (supported by the specialties of medicine; surgery, obstetrics and gynaecology, paediatrics and adolescent medicine, orthopaedics and traumatology, anaesthasia, intensive care unit, neonatal intensive care unit, infant high dependency unit, paediatric intensive care unit, high dependency unit, ophthalmology, ear, nose and throat, geriatrics, psychiatry, pulmonary and hospice), day services (such as day surgery, specialist out-patient service, general out-patient service and family medicine), clinical ancillary services (such as pathology, radiology, pharmacy and non-emergency ambulance service), rehabilitation services, and community outreach services (such as volunteer services and community nursing care). In addition, the KE Cluster also runs support service programmes for patients discharged from hospitals, pain clinic, medical imaging network and integrated rehabilitation services.
Furthermore, a cross-cluster referral mechanism is in place in the HA for referral of patients in need to hospitals in other cluster for appropriate follow-up treatment. For some specialist services, patients in KE Clusters are referred to other clusters to receive cross-cluster services. These services include major trauma, burn, neurosurgery, organ transplant, neonatal surgery, spinal rehabilitation, oncology, AIDS service, genetic medicine and infectious disease, etc.
When allocating its resources to the hospital clusters, the HA considers not only the population of the regions but also the demographic profiles as well as the resources required for the provision of basic and specialist health care services, for cross-cluster tertiary specialist services for residents in other clusters, and for manpower training and education. HA allocates its resources to clusters having regard to the above factors as well as the demand for manpower, drugs and equipments, etc of different clusters.
The HA reviews and improves from time to time its existing mode of resources allocation for the purpose of enhancing the overall effectiveness of resources utilisation. The HA and KE Cluster would continue to closely monitor the utilisation of health care services in the KE region, and adjust the resource allocation where appropriate in the light of the changes and development of service demand in order to ensure the provision of adequate health care services to residents in the region.
(c) To cope with the increase in service demand in the region, the HA has in 2007-08 provided the KE Cluster with an additional allocation of about $30 million on top of pre-existing provision to implement new service programmes and measures. The programmes and measures include, among others, day surgical and day care services of Tseung Kwan O Hospital; improvement scheme for the same-day admission service of the United Christian Hospital; a patient flow management scheme for medicine and geriatric departments within the KE Cluster; measures in response to the increase in service demand in obstetric departments and neonatal intensive care units; and a scheme to provide integrated discharge support services to elderly patients. These programmes and measures are being implemented progressively within this financial year.
Ends/Wednesday, December 5, 2007
Issued at HKT 14:29
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