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Following is a question by the Hon Paul Tse Wai-chun and a written reply by the Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council today (February 12):
Question:
In the Thematic Household Survey Report No. 53 published in November 2013, the Census and Statistics Department estimated that about 33 700 persons aged 15 and over in Hong Kong had received chiropractic treatment during the 12 months before enumeration, and about 70% of the respondents claimed that chiropractic treatment was effective. Also, relevant statistics in the United States indicated that low back pain ranked second among the most common causes for patients seeking medical services (with common cold ranking first). A chiropractic organisation has pointed out that while the practising qualifications and the conduct of chiropractors have been brought under regulation since the Chiropractors Registration Ordinance (Cap. 428) came into operation in 1993 and chiropractic services have been proven to be of significant benefits in treating low back pain and other pains caused by chiropractic problems, the chiropractor profession has still been excluded from the public health system. The organisation is of the view that this situation has not only wasted existing chiropractic talents, but also aggravated the staff shortage problem among other medical professions in public hospitals and lengthened the waiting time for consultation for the patients concerned. In this connection, will the Government inform this Council:
(a) whether it knows the number of attendances seeking treatment from the public health system due to low back pain and pains caused by chiropractic problems in each of the past three years; the specialist clinics to which the patients concerned were referred for follow-up, their average waiting time for treatment, and the manpower figures of the specialties concerned;
(b) whether it knows the current number of registered chiropractors in Hong Kong; how many of them are working in public hospitals; whether the Strategic Review on Healthcare Manpower Planning and Professional Development conducted by the authorities in 2012 has studied: (i) the feasibility as well as the pros and cons of including chiropractic services in the public health system, and (ii) whether recruiting chiropractors, increasing their number and setting up a chiropractor specialty in a systematic manner can facilitate the treatment of patients suffering from the aforesaid pains in a more effective and time-saving way, thereby shortening unnecessary waiting and referral times as well as reducing the workload of doctors; if such studies have been conducted, of the outcome; if not, the reasons for that and whether such studies can be conducted immediately; and
(c) as I have learned that a local university will start offering chiropractic-related programmes from 2015 onwards, whether the Government knows if the Hospital Authority (HA) has conducted studies on absorbing the graduates of such programmes into the public health system; if HA has, of the arrangements?
Reply:
President,
The Hospital Authority (HA) has been providing Hong Kong citizens with comprehensive medical services and limited Chinese medicine services on the basis of conventional medicine.
Chiropractic service is a form of alternative medicine. The diseases treated by chiropractors are covered by the standard services of HA. At present, general practitioners, Orthopaedics and Traumatology (O&T) specialists and other allied health professionals (such as physiotherapists and occupational therapists) of HA provide comprehensive services for patients suffering from musculoskeletal diseases.
My reply to the various parts of the question is as follows:
(1) HA does not maintain figures on the referrals of patients to specialist outpatient services due to preliminary diagnosis of low back pain and pains caused by chiropractic problems.
As mentioned above, treatment for musculoskeletal diseases is mainly provided by general practitioners, O&T specialists and other allied health professionals of HA. The number of attendances of HA's general out-patient clinics (GOPC), O&T specialist out-patient clinics as well as allied health out-patient clinics (physiotherapy and occupational therapy) in the past three years are tabulated in Annex.
HA does not maintain statistics on the waiting time of GOPC and allied health out-patient clinics, nor manpower figures of specific specialist and allied health clinics.
HA has implemented a triage system for all newly referred specialist out-patient (SOP) cases to ensure that patients with urgent conditions requiring early intervention are treated with priority. Under the current triage system, new referral cases are usually first screened by a nurse and then by a specialist doctor of the relevant specialty for classification into priority 1 (urgent), priority 2 (semi-urgent) and routine categories.
The median waiting time of O&T specialist out-patient clinics new cases triaged as priority 1 and priority 2 for 2010-11, 2011-12 and 2012-13 is less than one week and five weeks respectively. For new cases triages as routine category, the median waiting time is 32 weeks, 43 weeks and 52 weeks for 2010-11, 2011-12 and 2012-13 respectively.
(2) As at December 31, 2013, there were 180 registered chiropractors in Hong Kong. HA currently does not employ registered chiropractors.
In the face of growing and ageing population and increasing demand for healthcare services, the Government is conducting a strategic review on healthcare manpower planning and professional development in Hong Kong. The review covers healthcare professionals from 13 disciplines which are subject to statutory regulation, including doctors, dentists, nurses and chiropractors, etc.
The review will formulate recommendations on how to cope with anticipated demand for healthcare manpower, strengthen professional training and facilitate professional development, with a view to ensuring the healthy and sustainable development of our healthcare system.
(3) The University Grants Committee (UGC) considers proposals of its funded institutions for introducing new publicly-funded programmes in the context of the triennial academic development planning exercise. In the academic development planning exercise for the 2012/13 to 2014/15 triennium, no institution ran training programmes on chiropractic.
The UGC-funded institutions are currently preparing for the academic development planning exercise for the 2015/16 academic year and the 2016/17 to 2018/19 triennium, and are yet to submit proposals to the UGC. It is yet to know whether they intend to provide any publicly-funded training programmes on chiropractic in the future. Besides, institutions can provide such programmes on a self-financing basis, but UGC does not have information of self-financing programmes.
The Government keeps an open mind on training programmes offered by local tertiary institutions for any healthcare disciplines. HA will consider and plan new services and facilities with regard to the public demand for healthcare services.
Ends/Wednesday, February 12, 2014
Issued at HKT 15:06
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