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LCQ12: Dental care services
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     Following is a question by the Hon Albert Chan Wai-yip and a written reply by the Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council today (October 30):

Question:

     I have learnt that many members of the public are currently suffering from persistent dental problems, and quite a number of them are low-income persons who are, nonetheless, ineligible for various subsidies, such as the grant to cover dental treatment costs under the Comprehensive Social Security Assistance Scheme, the subsidy for dental services for the elderly under the Community Care Fund nor the Elderly Health Care Voucher. Due to the inadequacy in public dental services, they can seek treatment only in private dental clinics, which is a heavy financial burden on them. In this connection, will the Government inform this Council:

(a) whether it has assessed the number of adults in need of dental treatment services; if it has, of the details; if not, the reasons for that;

(b) whether it has assessed the number of members of the public who cannot afford private dental treatment services; if it has, of the details; if not, the reasons for that;

(c) whether it has assessed if the existing public dental services are sufficient to meet public demand; if it has, of the details; if not, the reasons for that; and

(d) whether it will consider enhancing public dental services, including the introduction of ex-gratia allowances for elderly dental services and increasing the number of public dental clinics, so that more members of the public can receive inexpensive quality dental services; if it will, of the details; if not, the reasons for that?
 
Reply:

President,

     The Government's policy on dental care seeks to raise public awareness of oral hygiene and facilitate the development of proper oral health habits through promotion and education, thereby improving public oral health and preventing dental diseases.  The Government has been allocating resources primarily to promotion and preventive efforts. To enhance the oral health of the public, the Oral Health Education Unit (OHEU) of the Department of Health (DH) has, over the years, implemented oral health promotion programmes targeted at different age groups and disseminated oral health information through different channels.

     My reply to the various parts of the question is as follows:

(a) and (b) To help the Government formulate effective goals and programmes on oral health, the DH is committed to conducting a territory-wide oral health survey every ten years in accordance with the criteria recommended by the World Health Organisation. According to the territory-wide oral health survey in 2001, the oral health status and gum condition of the adult population in Hong Kong had the same ranking as, if not better than, its counterparts from most developed countries in the world. The DH conducted another territory-wide oral health survey between May 2011 and February 2012 to continuously monitor the oral health status of specific groups and assess their oral health behaviours and habits. The preliminary findings of the survey showed that the oral health of Hong Kong population, in terms of tooth loss, was satisfactory as compared with most developed countries. The oral health survey report is expected to be completed in six months and the findings will be useful for planning and assessing various oral health programmes.  

(c) and (d) Apart from working on promotion and prevention, the Government also provides emergency dental treatment for the public and special oral care services for in-patients and persons with special oral health care needs. Basic and preventive dental treatment is provided for primary school students through the School Dental Care Service to help them build up a good foundation in oral health and develop proper dental care and cleaning habits.

     At present, the DH provides free emergency dental services (generally referred to as General Public Sessions) through its 11 government dental clinics.  Dental services provided in General Public Sessions include treatment of acute dental diseases, prescription for pain relief, treatment of oral abscess and teeth extraction. The dentists will also give professional advice to patients with regard to their individual needs. In addition, specialist oral maxillofacial surgery and dental treatment are provided by the Oral Maxillofacial Surgery and Dental Units (OMS&DUs) of the DH in seven public hospitals for the referred in-patients as well as patients with special oral health care needs and dental emergency. The specialist dental care services in OMS&DUs are provided through referral. Members of the public in need of these services may seek referrals by hospitals/out-patient clinics under the Hospital Authority or any registered dentists or medical practitioners. OMS&DUs will arrange appointments for them according to the urgency of their conditions. Patients with emergency needs, such as cases of dental trauma, will be provided with immediate consultation and treatment. Currently, the Government does not have any plan to expand the public dental services. Curative dental services are mainly provided by the private sector and non-government organisations (NGOs). As at September 2013, there were about 2 100 registered dentists in Hong Kong serving members of the public.

     As for elderly people with financial difficulties, dental grants are available under the Comprehensive Social Security Assistance (CSSA) Scheme for recipients who are aged 60 or above, disabled or medically certified to be in ill-health to pay for dental treatment services (including tooth extraction, dentures, crowns, bridges, scaling and polishing, fillings and root canal treatment). Eligible recipients can approach the 57 dental clinics (including 2 mobile clinics) designated by the Social Welfare Department (SWD), for dental examination and cost estimation. They may choose to receive the relevant dental treatment from either the designated dental clinics or any registered dentists at non-designated dental clinics. The amount of grant payable will be based on the exact fee charged by the non-designated clinic, the cost estimated by the designated clinic or the ceiling set by the SWD, whichever is the less.

     As far as the elderly people are concerned, the Government has put in place a series of measures in recent years to strengthen the dental services provided for them. In 2009, the Administration launched the Elderly Health Care Voucher Scheme to provide financial subsidies for elders aged 70 or above to use private primary healthcare services, including dental services, within their neighbourhood. As at mid-September 2013, a total of 392 dentists enrolled in the Scheme. The annual voucher amount has been increased to $1,000 since January 1, 2013 and the Scheme will be converted from a pilot project into a recurrent support programme for the elderly in 2014.

     As elders residing in residential care homes (RCHEs) or receiving services in day care centres (DEs) are generally physically weak with frail conditions, the Government launched the three-year Pilot Project on Outreach Primary Dental Care Services for the Elderly in RCHEs and DEs (Pilot Project) in collaboration with NGOs in April 2011 to provide these elders with free outreach primary dental care and oral health care services. The Pilot Project is expected to provide services for about 100 000 attendances. We are actively considering its long-term implementation.

     The Community Care Fund (CCF) has also set aside $100 million for the Elderly Dental Assistance Programme (programme) to subsidise low-income and needy elders for dentures and related dental services. The programme has been implemented since September 2012. The CCF Task Force under the Commission on Poverty has been monitoring the implementation of the programme. A working group has been set up to enhance the arrangements of the programme and consider expanding the number of beneficiaries progressively, taking into account the progress of implementation and the experience gained, as well as the supply of local dentist manpower, so that more elders who are facing financial difficulties and are not recipients of CSSA will benefit.

     We will continue our publicity and education efforts to improve the oral health of the public.

Ends/Wednesday, October 30, 2013
Issued at HKT 16:36

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