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Following is a question by the Hon Chung Kwok-pan and a reply by the Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council today (June 19):
Question:
In order to alleviate the shortage of doctors, the Hospital Authority (HA) has in recent years employed non-local doctors who were granted limited registration by the Medical Council of Hong Kong (MCHK) to work in public hospitals. In this connection, will the Government inform this Council:
(a) whether it knows the number of local medical graduates and the number of newly recruited specialists in public hospitals in each of the past three years; the current number of vacancies of specialists; the specialties with the most acute shortage of manpower at present; and the average waiting time for outpatient services in each specialty last year;
(b) whether it knows the number of job applications received by HA from non-local doctors in each of the past three years, the number of those among them who were granted limited registration by MCHK, and the specialties in which they mainly worked; the number of additional non-local doctors needs to be employed in future as estimated by HA, and if HA will increase the number of recruits particularly for those specialties with the most acute shortage of manpower; given that at present, the contract period for non-local doctors is one year only, whether HA will consider extending the contract period in order to attract more non-local doctors to apply for work in Hong Kong; and
(c) whether it will consider urging MCHK to relax the vetting and approval criteria for limited registration of non-local doctors, extend the validity period of limited registration, improve the licensing examination system for non-local medical graduates and simplify the registration procedures for specialists, with a view to alleviating the shortage of doctors and enhancing the quality of medical services?
Reply:
President,
With factors like an ageing population, advances in medical technology, and an increasing demand for healthcare services in the community, the manpower requirement for healthcare personnel grows commensurately. In the past few years, the Hospital Authority (HA) has implemented a series of measures to address manpower issues. In 2013-2014, HA expects to recruit about 300 additional doctors to meet the service demand. To increase doctor manpower in the short-term, HA enhanced the remuneration package and allowed greater flexibility for employment of part-time doctors in early 2012. Without affecting the promotion of other young doctors, HA has made proactive efforts to retain some of the doctors who have retired or left HA. In 2011, there were 60 retired or departed doctors continuing to serve in public hospitals on a part-time basis. As at March 2013, there were approximately 290 part-time doctors working in HA, in which 190 are retired or departed doctors, providing support equivalent to about 110 full-time doctors. In addition, in recent years, HA has created additional promotion posts, strengthened professional training and relieved the workload of its frontline healthcare workers by re-engineering the work processes and streamlining work procedures with a view to boosting staff morale and improving staff retention. Such measures have reaped positive results and the turnover rate of full-time doctors dropped from about 5 per cent in 2010-11 to 4.4 per cent in 2012-13. Besides, the Government has taken steps to tackle the healthcare manpower shortage problem at source by a number of measures, including the allocation of an additional $200 million for the triennial cycle starting from 2012 to increase the number of first-year first-degree places in medicine by 100 to 420 per year. HA expects to see an increase in the total number of doctors when 320 and 420 medical graduates complete their internship in 2015-16 and 2018-19 respectively.
In tandem with the said measures, HA started the recruitment of non-local doctors to practise with limited registration in 2012 as one of the additional and immediate measures to address the manpower problem.
My reply to the various parts of the question is as follows:
(a) The numbers of local medical graduates and Resident Trainees recruited by HA in each of the past three years are set out in Annex 1. The manpower shortfall of HA doctors in 2012-13 was around 250. The specialties with the most acute shortage of manpower included Anaesthesia, Accident and Emergency (A&E), Family Medicine, Intensive Care Unit, Medicine, Paediatrics and Psychiatry. The 2013-14 central recruitment exercise for Resident Trainees is underway. According to HA's preliminary estimate, there will be a shortfall of around 290 doctors after this year's central recruitment exercise.
The waiting time for the first appointment of new cases in major specialties of HA in the past three years is set out in Annex 2. HA will regularly assess the manpower situation of each specialty and flexibly deploy healthcare staff to meet the service demand and operational needs.
(b) HA received 160 and 72 job applications from non-local doctors in 2011-12 and 2012-13 respectively. Applicants must have passed a specialist training examination which is comparable to the Intermediate Examinations of the constituent Colleges of the Hong Kong Academy of Medicine, possess three years or above clinical working experience, and be able to speak fluent Cantonese (except for the specialty of Anaesthesia). After vetting by the Task Force on Limited Registration Scheme and consideration by the selection panels, HA submitted 17 applications to the Medical Council of Hong Kong (MCHK), of which 16 applicants obtained the MCHK's approval for practice under limited registration and were employed by HA to serve in the specialties of Anaesthesia, A&E, Family Medicine, Medicine and Psychiatry. HA will continue to work on the recruitment of non-local doctors for practice under limited registration. As the MCHK's approval for practice under limited registration is valid for a maximum of one year, this validity period serves as a reference in devising the contract period for most non-local doctors serving in HA under limited registration.
The recruitment of non-local doctors to practise with limited registration is one of the additional and immediate measures of HA to address the manpower problem and to provide immediate replenishment for those specialties with the most acute shortage of manpower. Besides, HA will continue to implement the above-mentioned measures to recruit and retain local staff so as to ensure an adequate supply of healthcare manpower to meet the service demand.
(c) The MCHK is established under the Medical Registration Ordinance (Cap. 161) and empowered to handle regulatory matters relating to medical practitioners in Hong Kong including registration and disciplinary proceedings. Persons who wish to apply for limited registration and specialist registration must satisfy the requirements set out in section 14A and section 20K of the Ordinance respectively. The MCHK will approve the applications in accordance with the requirements in the Ordinance. The Licensing Examination of the MCHK aims to ensure that those who wish to register as medical practitioners in Hong Kong after receiving medical training outside Hong Kong have attained a professional standard comparable to that of local medical graduates. This is to safeguard the quality of our medical services and hence public health. Papers of the Licensing Examination are set by the two faculties of medicine with reference to the papers of local medical examinations at a comparable level of difficulty.
Like other statutory regulatory bodies for healthcare professions, the MCHK is operating on the principle of professional autonomy. The Government respects its decisions on registration that are made according to the Medical Registration Ordinance, the appropriate arrangements for medical practitioners registration that are formulated within the purview of its professional autonomy, as well as its arrangements in respect of licensing examination.
In the face of challenges posed by an ageing population and increasing demand for healthcare services, the Government has set up a high-level steering committee to conduct a strategic review on healthcare manpower planning and professional development in Hong Kong. The review covers healthcare professionals from 13 professions which are subject to statutory regulation. The steering committee will assess manpower needs in the various healthcare professions and put forward recommendations on how to cope with anticipated demand for healthcare manpower, strengthen professional training and facilitate professional development having regard to the findings of the strategic review, with a view to ensuring the healthy and sustainable development of Hong Kong's healthcare system.
Ends/Wednesday, June 19, 2013
Issued at HKT 15:34
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