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Following is a question by the Hon Andrew Cheng and a written reply by the Secretary for Food and Health, Dr York Chow, in the Legislative Council today (July 7):
Question:
Regarding the services provided by elderly health centres (EHCs), will the Government inform this Council:
(a) of the total amount of funds allocated to EHCs, the total number of members, the percentage of such number in the population eligible for enrolling as members, the number of elderly people waiting for enrolling as members and the median waiting time, in each of the past 10 years;
(b) of the respective numbers of male and female members of EHCs in the past three years, as well as the percentage of such numbers in the population eligible for enrolling as members; whether EHCs had provided examination services for their members which focused on male or female diseases; if they had, of the examination items included and the annual expenditure involved;
(c) whether the authorities had, in the past three years, assessed the effectiveness of the services of EHCs on improving the health of the elderly, if the services are welcomed by members of the public and are sufficient; if an assessment had been conducted, of the outcome; if not, whether they will consider conducting such an assessment; and
(d) whether the authorities will, when considering the strategy for developing primary care, allocate to EHCs part of the newly-increased resources for improving the primary care development in response to the increase in the elderly population, so as to increase the services provided by EHCs; if they will, of the details; if not, the reasons for that, and which items will have priority in receiving such resources as well as the justifications?
Reply:
President,
The Government has always attached importance to the health of elders. The Department of Health (DH) currently provides comprehensive primary health care services, including health assessment, physical check-up, health education, individual counselling and curative treatment, to elderly members aged 65 or above, through 18 Elderly Health Centres (EHCs) in the territory. The objectives of the EHCs are to enhance primary health care for the elders, improve their self care ability and encourage them to adopt a healthy lifestyle.
Our replies to various parts of the question are as follows:
(a) In each of the past ten years, the total amount of funds allocated to EHCs, total number of members, percentage of enrolled members in the population aged 65 or above, number of elders on the waiting list for enrolment as new members and the median waiting time of the EHCs are set out in Annex 1.
(b) The number of enrolled members of the EHCs by sex and the percentage of members of different sex in the population aged 65 and above in the past three years are set out in Annex 2.
A nurse will first conduct an in-depth interview by way of questionnaire and a preliminary assessment for each elder undergoing health assessment. Based on the nurse's assessment, physical examination will then be carried out on the elder by a doctor according to the needs of individual elders. This may include a digital rectal examination for prostate lesions among male elders, or a cervical smear for screening of cervical cancer among female elders. Such examinations designated for detection of male- or female-specific diseases are part and parcel of the overall health assessment and medical examination and there is no separate calculation for the expenses arising from them.
(c) The Government evaluates and assesses the service effectiveness and performance of EHCs from time to time, mainly by using the annual statistics on the number of enrolments, attendances of health education activities, and attendances of medical consultation and health assessment as criteria for the evaluation and assessment. The services provided by EHCs have been well received by the elders since their establishment, with about 80% of the old members renewing their membership each year.
(d) The Government mainly uses the past and anticipated numbers of membership enrolment and attendances for health assessment and medical consultation for formulating the estimated provision for the Elderly Health Service.
The Government allocates about $90 million to subsidise the services of EHCs in each year. In view of the ageing population, demand for primary health care services for elders will only increase in the long run. It is not possible to meet the health care needs of all elders through the EHCs alone. The provision of highly subsidised primary health care services by EHCs is not the most cost-effective and sustainable way to deliver services to elders.
Indeed, the EHCs are not the only providers of primary health care services for elders. Other service units under DH, the Hospital Authority, community service organisations and private health care providers also provide relevant services. Elders can also receive health care services offered by non-government organisations (NGOs) which are reasonably priced.
Enhancing primary care services is one of the major healthcare reform proposals of the Government. Building on the recommendations of the Working Group on Primary Care (chaired by the Secretary for Food and Health and comprises representatives from the healthcare professions and other relevant sectors), the Government's primary care development strategy mainly covers the following three areas -
(i) developing primary care conceptual models and clinical protocols to establish a comprehensive and effective model for provision of primary care services;
(ii) setting up a Primary Care Directory to promote the family doctor concept and comprehensive primary care services; and
(iii) devising feasible models which can effectively enhance primary care services in the community through the implementation of various pilot projects.
The Government will brief the Legislative Council Panel on Health Services on the primary care development strategy in Hong Kong on July 12, 2010. Pursuant to the strategy, the Task Forces formed under the Working Group on Primary Care will study the provision of primary care for the elderly and develop the relevant conceptual models and clinical protocols to determine the scope of services which need to be developed. Furthermore, the Government has implemented a series of pilot projects since 2009, including the Elderly Healthcare Voucher Pilot Scheme, the Elderly Vaccination Subsidy Scheme, programmes that enhance the care of chronic disease patients (who are mainly elders) in public hospitals and clinics, the Public-Private Chronic Disease Management Shared Care Programme, etc. Through these pilot projects, the Government seeks to devise effective models to enhance primary care to cater for the needs of different population groups (including the elderly).
On resources front, the Government has earmarked a total of about $2.93 billion for the period 2009-10 to 2012-13 for enhancing primary care services and implementing the primary care development strategy. Out of this sum, $1.818 billion will be used on the above projects currently under implementation for the benefit of the elderly while another $194 million is allocated to the Primary Care Office recently established under DH for the period 2010-11 to 2012-13 for implementing the primary care development strategy. The work includes implementing and evaluating various pilot projects to enhance primary care (including the pilot projects mentioned above to support chronic disease patients); conducting primary care-related research projects; undertaking work on training and capacity building related to primary care; supporting the overall promotion of primary care; developing and promoting primary care conceptual models and clinical protocols as well as the Primary Care Directory; setting up community health centres or networks; enhancing primary dental services and oral health promotion programmes in collaboration with the dental profession, etc.
Ends/Wednesday, July 7, 2010
Issued at HKT 17:15
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