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Following is a question by the Dr Hon Pan Pey-chyou and a written reply by the Secretary for Food and Health, Dr York Chow, in the Legislative Council today (July 14):
Question:
A pharmaceutical dispenser association has earlier pointed out that in the past few months, seven drug incidents occurred one after another in the general out-patient clinics (GOPCs) of the New Territories East and New Territories West Clusters of the Hospital Authority (HA). The association has further pointed out that since pharmacists stationed in out-patient clinics need to handle administrative work, dispensers are required to undertake pharmacists' work in addition to their own work, which has increased their workload drastically, and the risk of dispensing errors has also increased correspondingly, hence posing threats to the lives of the public. Regarding the manpower and establishment of dispensing staff in public GOPCs, will the Government inform this Council whether it knows:
(a) the total number of drug-related medical incidents which occurred in public GOPCs in Hong Kong in each of the past five years, together with a breakdown by HA's hospital cluster;
(b) the existing staff (including pharmacists) establishment and the actual number of staff on duty in the dispensary of each of the day, evening and holiday GOPCs; the average number of days/nights/sessions per week during which the pharmacists therein act as the persons-in-charge of the dispensaries of the various clinics; the number of clinics stationed with only one dispenser; whether there are clinics in which dispensers act as the persons-in-charge of the dispensaries; and the number of clinics which manage to have four dispensers or pharmacists stationing there;
(c) the current number of dispensers qualified to act as "approved persons" or "authorised persons" among the dispensers in public GOPCs in Hong Kong, and the number of those who handle the duties of dispensing medicines in place of pharmacists at present;
(d) the number of new drugs available in public GOPCs in the past five years; the percentage of such number in the total number of drugs; and the number of patients referred in each of the past five years by specialist out-patient clinics to GOPCs for follow-up consultation and collection of drugs; and
(e) the increase in the past five years in the total number of doctors in public GOPCs in Hong Kong; whether the numbers of dispensers and pharmacists have increased correspondingly; if not, of the reasons for that; and the ratio of doctors to dispensers and pharmacists in the public healthcare system at present?
Reply:
President,
The Hospital Authority (HA) took over 59 General Outpatient Clinics (GOPCs) from the Department of Health (DH) in July 2003. Under the Dangerous Drugs Ordinance and the Pharmacy and Poisons Regulations, dispensaries of hospitals and outpatient clinics are required to have a registered pharmacist or a person approved by the Director of Health to be in possession of and to supply dangerous drugs and drugs classified as poisons. After taking over the above-mentioned GOPCs, HA has continued to adopt the system of "approved person" and recruited 45 additional pharmacists to work in the dispensaries of GOPCs. HA lodges applications with the Director of Health on a regular basis for appointment of its staff as approved persons.
The reply to various parts of the question is as follows:
(a) At present, the dispensaries of GOPCs under HA handle over four million prescriptions and over 14 million drug items each year. The number of drug incidents (in terms of drug items dispensed) reported by the GOPCs under HA in the past five years is set out in Annex 1. As compared with the number of drug items dispensed, the percentage of drug incidents reported each year was close to zero.
A breakdown of the above figures by clusters is set out at Annex 2.
(b) Among the 59 GOPCs taken over by HA, 49 provide regular day-time dispensing service. Some of the dispensaries of these GOPCs also provide dispensing service at night and/or on holidays. The number and percentage of service sessions with a pharmacist on duty are set out in Annex 3.
As for the other 10 GOPCs (comprising five on outlying islands, four providing non-whole-day consultation service and one mobile clinic), the operation of their dispensaries is relatively simple. These dispensaries are manned by dispensers deployed by the respective clusters to provide limited dispensing service in the capacity of "approved persons".
The staff establishment of the dispensaries of the 59 GOPCs under HA is determined having regard to operational needs and workload. Except the dispensaries of those GOPCs located on outlying islands or providing non-whole-day consultation service or being a mobile clinic, which are manned by one "approved person", the dispensaries of the remaining 49 GOPCs generally have a staff establishment of one pharmacist and one to nine senior dispensers/dispensers. At present, there are 36 dispensaries of GOPCs under HA being manned by four or more dispensary staff.
(c) At present, there are a total of 59 dispensers holding the status of "approved person" working in the dispensaries of GOPCs under HA. Of them, 10 provide dispensing service at the GOPCs located on outlying islands or providing non-whole-day consultation service or being a mobile clinic. The remaining 49 "approved persons" are assigned to provide dispensing service in different GOPCs within their respective clusters having regard to the operational needs of the dispensaries.
(d) Over the past five years, 10 to 60 additional drug items have been introduced to individual GOPCs to cater for the needs of patients in various clusters. These additional drug items account for 3 to 21% of all drug items in the respective dispensaries. The total number of drug items dispensed at the dispensaries of GOPCs remains more or less the same, with details are set out in Annex 4.
Currently, under the patient referral system in HA, the arrangements for patient referral between GOPCs and Specialist Outpatient Clinics (SOPCs) are two-way. HA has no statistical data on the number of patients referred by SOPCs to GOPCs for follow-up consultation and collection of drugs.
(e) Since March 2008, the number of doctors, pharmacists and dispensers working in GOPCs remains more or less the same. The actual number of staff is set out in Annex 5. As at the end of March 2010, there are 4,995 doctors, 355 pharmacists and 949 dispensers working in HA.
Ends/Wednesday, July 14, 2010
Issued at HKT 18:26
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