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Following is a question by Dr Hon Joseph Lee and a written reply by the Secretary for Labour and Welfare, Mr Matthew Cheung Kin-chung, in the Legislative Council today (February 20):
Question:
The Government indicated in 2011 that there were not enough justifications for medical certificates (commonly known as "sick leave certificates") issued by chiropractors to be recognised under labour legislation, but it would conduct a more comprehensive survey to gauge the prevalence of chiropractic treatments in Hong Kong. The Government also indicated that the Hospital Authority (HA) had no plan to introduce chiropractor service. In this connection, will the Government inform the Legislative Council:
(a) of the details and current progress of the aforesaid survey, as well as the expected time for publishing the survey findings; whether the authorities will, upon completion of the survey, examine afresh the recognition of sick leave certificates issued by chiropractors under labour legislation; if they will, of the details; if not, the reasons for that;
(b) as the Government has indicated that "HA will consider new services and facilities in response to the demand of the public for different healthcare services", whether it knows if HA has clear criteria and indicators for determining what new public healthcare services are to be introduced; if so, of the details, and whether HA has assessed if public demand for chiropractor service is on the rise; if the assessment result is in the affirmative, whether HA will consider afresh the introduction of public chiropractor service; if they will, of the details; if not, the reasons for that; and
(c) whether the authorities have actively promoted the recognition of sick leave certificates issued by chiropractors under labour legislation (eg helping or encouraging the Chiropractors Council to expeditiously implement a system for maintaining medical records and to draw up guidelines for issuance of sick leave certificates, etc), so that patients in need of chiropractic treatments will not be deterred from seeking such treatments by the non-recognition of sick leave certificates issued by chiropractors, and so as to promote the development of chiropractor service; if they have, of the details; if not, the reasons for that?
Reply:
President,
The Administration had studied thoroughly the report on whether the medical certificates issued by chiropractors should be recognised under labour legislation in 2011. Having taken into account the local chiropractic practices, relevant surveys, experiences of other jurisdictions and views of stakeholders on the subject, the Administration considered that there were not enough justifications for recognising under labour legislation the medical certificates issued by chiropractors. However, in order to gain a more updated and thorough understanding of the community's knowledge and utilisation of chiropractic treatment, the Administration commissioned the Census and Statistics Department (C&SD) to conduct a comprehensive survey on the subject to gauge the prevalence of chiropractic treatment in Hong Kong.
My reply to the three parts of the question raised by Dr Hon Joseph Lee is set out below:
(a) With reference to the opinions from the chiropractic sector and stakeholders towards the above-mentioned survey, the Labour Department and C&SD formulated the questionnaire for the thematic household survey on chiropractor consultation. The fieldwork of the survey was conducted in the fourth quarter of 2012. C&SD is now verifying, consolidating and analysing the data collected. The survey results are expected to be released in the latter half of 2013.
Apart from the survey results, the Administration will also take into account the development of the chiropractic profession, its popularity, the community's knowledge and acceptance of chiropractic treatment, views and concerns of stakeholders, availability of sufficient ancillary facilities as well as experiences of other regions, etc. This will ensure that the many aspects of the subject will be considered and from different angles. The actual circumstances of Hong Kong will also be considered so as to assess the subject comprehensively.
(b) The Hospital Authority (HA) provides the community with comprehensive medical services and assists non-profit making organisations in providing limited Chinese medicine services. The multi-disciplinary teams, comprising general practitioners, orthopaedics and allied health professionals (including physiotherapists and occupational therapists), will provide patients suffering from musculoskeletal diseases with the necessary services. As the health conditions treated by chiropractors have been covered by the scope of the existing services provided by HA, at present HA has no plan to introduce chiropractic services which is a form of alternative medicine.
In general, HA will, based on the principle of effective utilisation of public resources, carefully take into account the demand, efficacy, medical evidence, international standards, manpower situation and cost-effectiveness of proposals of provision of new services. HA will also consider enhancing the existing services in order to cater for the demand more effectively. Subsequent to the consensus reached among relevant clinicians on the development of new services and the endorsement of the proposal at its Directors' Meeting of HA, HA will prioritise the implementation of various service programmes through its established mechanism under the Annual Plan.
(c) When considering the report on whether the medical certificates issued by chiropractors should be recognised under labour legislation, the Administration had already brought the attention of the chiropractic sector to the public concerns in respect of chiropractic treatment, including the importance of maintaining medical records and the need to draw up guidelines for issuing medical certificates, etc. The chiropractic sector valued and understood the concerns and recommendations raised in the report, and accordingly was actively improving their internal guidelines. On the other hand, the Chiropractors Council of Hong Kong (the Council) has set up committees to draw up guidelines for the issuance of sick leave certificates and to review the "Code of Practice for the Guidance of Registered Chiropractors", including consideration of inclusion of a section on handling medical records. Upon completion, the committees will submit their recommendations to the Council for consideration. In addition, the chiropractic sector will continue to organise various kinds of activities to promote and publicise chiropractic treatment so as to enhance the community's knowledge and to encourage continuing education for chiropractors with a view to promoting their professionalism.
The Administration has all along maintained communication with the chiropractic sector and stakeholders. Apart from seeking their opinions on the new round of survey on chiropractor consultation, the Administration will continue to liaise with the chiropractic sector and follow up relevant issues. The latest development of chiropractic in Hong Kong and other regions will also be closely monitored.
Ends/Wednesday, February 20, 2013
Issued at HKT 11:37
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