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Following is a question by the Hon Albert Chan and a written reply by the Secretary for Food and Health, Dr York Chow, in the Legislative Council today (April 1):
Question:
In reply to my question raised on December 17, 2008 regarding cases of non-urgent conditions for specialist out-patient (SOP) services at public hospitals, the Government only provided information on the waiting time for first appointment of new cases, and stated that such waiting time was not applicable to existing cases as the dates for follow-up consultation for these cases were arranged by doctors. Yet, I have received complaints from quite a number of members of the public that a remote date for follow-up SOP consultation was arranged for them. They are worried that their clinical conditions will worsen due to the lack of timely treatment over a prolonged period. In this connection, will the Government inform this Council whether it knows:
(a) in respect of existing cases of each SOP service, the average duration between the dates of follow-up consultations last year and the dates for the next consultations, as well as the number of existing cases as at the end of last year, broken down by the duration (i.e. less than one year, one year to less than two years, two years to less than three years, and three years or above) between the date of the last follow-up consultation and the date for the next;
(b) in respect of existing cases of each SOP service at present, the longest duration between the date of the last follow-up consultation and the date for the next; and
(c) whether the Hospital Authority will take any measure to improve the situation of existing SOP cases having to wait for a long time for follow-up consultation; if it will, of the details; if not, the reasons for that?
Reply:
President,
Currently, under the triage system for new specialist out-patient (SOP) cases of the Hospital Authority (HA), SOP clinics will fix the date of medical appointment for new patients on the basis of the urgency of their clinical conditions, taking into account the patients' clinical history, the presenting symptoms and the findings of physical examination and investigations. During consultation, doctors of SOP clinics will again conduct assessment for the patients and arrange for them to receive further examination and treatment or refer them to other specialties for follow-up based on patients' clinical needs. The date of follow-up consultation of each patient is determined according to the patient's clinical needs and so the appointment time for follow-up consultation varies from case to case. Information related to various parts of the question is provided as follows.
(a) & (b) The duration between the date of booking of appointment for follow-up consultation and the date of consultation for existing SOP cases of major SOP specialties in 2008-09 (up to December 2008) (with breakdown by less than one year, one year to less than two years, two years to less than three years and three years or above), as well as the median duration and the 99th percentile duration, are set out at the Annex.
Generally speaking, the date of follow-up consultation of patient will be arranged within three to four months from the date of booking of appointment. The data of 2008-09 (up to December 2008) shows that the follow-up consultation for 90% of the SOP patients was arranged within eight months of the date of booking and about 98% of the patients were arranged to have follow-up consultation within one year.
We understand that some patients in relatively stable condition would like to have a follow-up consultation within a short period of time. Doctors of SOP clinics will discuss with individual patients to arrange a suitable date for follow-up consultation in light of their clinical needs. In certain circumstances, patients will be arranged for follow-up consultation after a longer period of time. For example, for patients requiring regular clinical audiological assessment after cochlear implant, or for cataract patients and paediatric skin diseases patients whose condition have turned relatively stable, they will be arranged for a follow-up consultation after a longer period. Besides, patients suffering from renal stone assessed to be in relatively stable condition by the surgical SOP clinic will be referred to the family medicine SOP clinic for follow-up and arranged for follow-up consultation at the surgical SOP clinic after a longer period. Nevertheless, patients can approach the relevant SOP clinic to advance their follow-up consultation where necessary should their conditions deteriorate while waiting for the appointment. In case of emergency, they can also seek treatment from the Accident and Emergency Department direct.
(c) In line with the direction of healthcare reform to enhance primary care, promote public-private partnership and put emphasis on disease prevention, the Government has earmarked a total of about $509 million for the period 2009-10 to 2011-12 to implement a series of healthcare reform initiatives on a pilot basis to enhance primary healthcare services and the support for chronic disease patients, and to strengthen family medicine training. One of the pilot initiatives is to give stable chronic disease patients currently under the care of SOP clinics under HA the alternative choice to receive healthcare from private medical practitioners based on specified service models and protocols for effective care of their chronic diseases and with subsidies by the Government. As some of the chronic disease patients will change to be managed by private medical practitioners through the pilot project, the waiting time of SOP clinics could be shortened and other patients could therefore benefit.
Ends/Wednesday, April 1, 2009
Issued at HKT 14:41
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