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Following is a question by the Dr Hon Elizabeth Quat and a written reply by the Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council today (December 12):
Question:
Breast cancer and cervical cancer ranked third and ninth respectively among the cancers causing deaths of females in Hong Kong in 2010. According to the statistics of the Hong Kong Breast Cancer Foundation and the United Christian Hospital, education and screening are conducive to early diagnosis of breast cancer. However, there are only three Woman Health Centres (WHCs) providing woman health services in the entire territory at present, while all the 10 Maternal and Child Health Centres (MCHCs) with ancillary woman health services provide such services for only about three to six hours each week. Some members of the public have relayed to me that as there are few WHCs and MCHCs providing woman health services, their service hours are short and publicity is inadequate, most women have not used such services provided by the Government. In this connection, will the Government inform this Council:
(a) of the details (including whether screening services for breast cancer and cervical cancer and vaccinations against cervical cancer are available) of the various woman health services provided by WHCs and MCHCs at present as well as the service charges, broken down in tabulated form by District Council (DC) district;
(b) of the average waiting time for each of the woman health services provided by each WHC and MCHC, together with the number of women using each service and the percentage of such number in the female population of the district in which the WHC/MCHC is located, in each of the past three years; whether it knows if these figures are comparable to the relevant figures of neighbouring countries and areas, such as Japan, Taiwan, Singapore, etc.; if they are not comparable, whether it has examined the reasons for that;
(c) whether it will consider extending the scope of the coverage of woman health services (e.g. free screening services for breast cancer and cervical cancer) and providing free or subsidised vaccinations against cervical cancer; if it will not, of the reasons for that;
(d) whether it will consider setting up at least one WHC or MCHC providing whole-day woman health services in each DC district in Hong Kong so that all women in Hong Kong can, on average, be provided with free and comprehensive woman health services once every three years; and
(e) whether it will explore the introduction of a voluntary scheme which subsidises all students of the relevant age cohort in Hong Kong to receive vaccinations against cervical cancer for early prevention of the cancer; if it will not, of the reasons for that?
Reply:
President,
The Government has always attached importance to woman health and put in place a comprehensive woman health programme through the provision of promotive, preventive, curative and rehabilitative services. To enhance women's awareness and concerns about their health, a number of service units under the Department of Health (DH) have provided women with accurate information on woman health issues as well as relevant community resources through different channels in an effort to empower women to make choices that are conducive to their health and seek appropriate health care or social services where necessary. On clinical services, there are currently three Woman Health Centres (WHCs) (operated on a full-time basis) and ten Maternal and Child Health Centres (MCHCs) (operated on a sessional basis) under DH's Family Health Service, which serve to provide woman health service for women aged 64 or below.
In formulating policies concerning disease screening programmes or vaccination, the Government makes reference to the recommendations put forward by experts, including consulting the Scientific Committees under DH's Centre for Health Protection (CHP) and the Cancer Expert Working Group on Cancer Prevention and Screening under the Cancer Coorindating Committee. This can ensure that the Government's public health policies are grounded in fact, scientific evidence and public interest, and that the policy gives due consideration to the actual circumstances, such as its cost-effectiveness and acceptability by the community etc.
My reply to the five parts of the question from Hon Quat is as follows:
(a) The Woman Health Service aims to promote the health of women and provide women with health education, assessment and counselling services according to their needs at various stages of life. If necessary, doctors will arrange women to receive appropriate tests, including blood test, cervical smear test and screening mammography (generally for women aged 50 or above, or individual women with high risk of breast cancer). A cervical screening service is offered by all 31 MCHCs in the territory to women aged 25 or above who have ever had sexual intercourse. WHCs and MCHCs have not offered any cervical cancer vaccination. The health services provided by DH to women are heavily subsidised by the Government. Hence, the fees charged for such services can be maintained at a low level and are shown in Annex 1.
(b) There is no area restriction for the woman health services provided by the WHCs or MCHCs under DH. Women can choose to go to any one of the WHCs or MCHCs for such services. The numbers of persons registered for woman health services in the past three years are shown in Annex 2.
The waiting time for woman health service at each WHC and MCHC is shown in Annex 3.
As mentioned above, WHCs and MCHCs provide an array of health services to women members, and after assessment by healthcare personnel, each member will receive appropriate medical examinations or tests. WHCs and MCHCs do not maintain comprehensive statistics on the individual examinations and tests that women members receive.
In addition, while DH is one of the woman health service providers, there are also other service providers, such as the non-governmental organisations (NGOs), private hospitals and doctors, providing a wide array of health programmes for women. As such, DH does not have the number of women having received body check by districts and their percentage in the population of the respective districts.
Given the fact that the disease burden, healthcare system and social institution are different between places and their service targets and policy objectives also vary, it is difficult to draw a direct comparison with other countries on the statistics of individual service items.
(c) and (e) On the prevention of breast cancer, the Cancer Expert Working Group on Cancer Prevention and Screening takes the view that currently, there is insufficient evidence to recommend for or against population-based breast cancer screening in Hong Kong. In fact, in recent years, a number of studies have cast doubts on the effectiveness of conducting population-based breast cancer screening by mammography, as it may generate more harm than good to women due to unnecessary check-ups and treatment due to over-diagnosis. The Working Group suggests that women with higher risk of developing breast cancer (such as women with associated family history or personal history) should seek medical advice on breast cancer screening. Generally speaking, doctors of the Woman Health Service may arrange mammography for women aged 50 or above or those at high risk.
On the prevention of cervical cancer, the Government has been actively promoting the Cervical Screening Programme launched in 2004 to encourage women to have cervical smears on a regular basis. The human papillomavirus vaccine (commonly known as "HPV vaccine") is not infallible and thus cannot eliminate the need of cervical screening. At present, the relevant Scientific Committee has not recommended the introduction of a population-based cervical cancer vaccination programme.
(d) The Government will make reference to the demand for services of WHCs and MCHCs and the primary care development strategy in planning the long term development of various healthcare services (including woman health services). The Government currently has no plan to extend the woman health services, but will continue to enhance its collaboration with other service providers, including private doctors and NGOs, so as to enhance the primary care services for local women.
Ends/Wednesday, December 12, 2012
Issued at HKT 15:10
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