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Following is a question by the Hon Ip Wai-ming and a reply by the Secretary for Food and Health, Dr York Chow, in the Legislative Council today (January 19):
Question:
It has been reported that the turnover rate of the healthcare staff in obstetrics and gynaecology (O&G) departments of the Hospital Authority (HA) has been extremely high in recent years, directly affecting the O&G services provided in public hospitals. At present, only eight hospitals under the seven hospital clusters of HA provide O&G hospitalisation and delivery care services. In this connection, will the Government inform this Council whether it knows:
(a) the turnover rate of obstetricians and gynaecologists in public hospitals in each of the past 10 years; how the authorities will solve the problem of manpower shortages due to such turnover;
(b) the respective numbers of pregnant women from the North District, Tai Po District and Sha Tin District among those using the O&G hospitalisation and delivery care services of the Prince of Wales Hospital (PWH) in the past five years; the respective percentages of the numbers of pregnant women from these three districts in the total number of pregnant women using the O&G hospitalisation and delivery care services of PWH, with a breakdown by year; and
(c) the criteria based on which the authorities decide whether a hospital should provide O&G hospitalisation and delivery care services, and the details of such criteria; among the hospitals under HA, whether there are examples of those hospitals which have not fully met such criteria and yet they still or will offer O&G hospitalisation and delivery care services; if there are such examples, the details; given that the O&G department of the North District Hospital provides midwifery clinic service only, the utilisation rate of such service, and whether the authorities have any plan to provide O&G hospitalisation and delivery care services at the North District Hospital; if so, the details; if not, the reasons for that?
Reply:
President,
The Hospital Authority (HA) provides services (including obstetrics and gynaecology services) on a cluster basis. Each hospital cluster under HA takes account of the demographic profiles of the districts within the cluster and the service utilisation pattern of the local residents as well as the service scope of the hospitals within the cluster, in order to plan and provide appropriate services for the residents in the cluster. Each hospital has its own designated role within each cluster and hospitals within the same cluster will complement and provide support to each other.
As regards obstetrics and gynaecology (O&G) services, according to the planning reference drawn up based on the advice of HA's expert committee on obstetrics and gynaecology service, in general a public hospital in a cluster will only provide obstetric services when the number of births is projected to reach 3 000 per year. This reference aims to ensure that the healthcare personnel can accumulate sufficient clinical experience to handle the risk of sudden changes of clinical condition of the pregnant patient. In addition, all public hospitals providing O&G services must be equipped with appropriate supportive facilities both in terms of hardware and software so as to provide the public with safe and cost-effective O&G services. Regarding the hardware, these hospitals are provided with wards, delivery rooms, operating theatres, neonatal intensive care unit and special care unit, etc. As for the software, these hospitals are required to provide appropriate personnel as well as continuous training and comprehensive clinical guidelines for their O&G specialists, midwives and neonatal specialists. Currently, O&G services and relevant supportive facilities are provided in eight hospitals in the seven hospital clusters under HA to enable residents of various districts to access such services in the respective clusters. My reply to various parts of the question is as follows:
(a) Over the past 10 years, the turnover rates (which account for both outgoing and retiring staff) of obstetricians and gynaecologists in HA are set out in Annex 1. Although there was a rise in the turnover rate last year, there has been a net increase of about 10% in the total number of obstetricians and gynaecologists over the past five years, and a net increase of 20% in the total number of Consultants and Associate Consultants in the O&G specialty. The total numbers of obstetricians and gynaecologists in HA over the past five years are set out in Annex 2.
In view of the turnover of obstetricians and gynaecologists, HA has adopted measures to increase the manpower, retain existing talents and improve the working environment of obstetricians and gynaecologists. While a total of 17 obstetricians and gynaecologists left service in 2009-10, HA recruited 18 Residents to receive specialist training in July last year. On staff retention, apart from filling the existing vacancies of Consultant or Associate Consultant, HA also creates additional posts for internal promotion and reinstates the promotional mechanism for serving senior Consultants. HA has just extended this week the employment of part-time obstetricians and gynaecologists by inviting departed and retired obstetricians and gynaecologists to serve on a part-time basis to strengthen its manpower.
To improve the overall working environment, HA has taken various measures which include improving the working hours and roster arrangements of doctors, implementation of support measures to doctors so as to reduce the workload of frontline doctors as well as provision of more training opportunities, such as establishing scholarships to subsidise doctors to undertake overseas training.
(b) A breakdown by districts of the numbers of pregnant women using the inpatient and delivery service of the Prince of Wales Hospital (PWH) over the past five years is set out in Annex 3.
(c) The North District Hospital (NDH) is providing O&G outpatient service and the utilisation rates in the past five years are set out in Annex 4. As mentioned above, in order to enable healthcare personnel to accumulate sufficient clinical experience to handle the risk of sudden changes of clinical condition of the pregnant patient, in general a public hospital will only provide obstetric services when the number of births in that hospital is projected to reach 3 000 per year. As the number of new-born babies residing in North District who were delivered in public hospitals has yet to reach the relevant reference number, the New Territories East (NTE) Cluster has no plan at present to provide obstetric inpatient and delivery services at NDH. Obstetric services in the NTE Cluster are currently provided at PWH in order to pool together manpower and resources for effective provision of quality services and ensure patient safety. PWH has a comprehensive neonatal care and intensive care unit to ensure that immediate support can be provided to the new-born babies in need.
Ends/Wednesday, January 19, 2011
Issued at HKT 14:12
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