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Following is a question by the Dr Hon Leung Ka-lau and a reply by the Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council today (January 7):
Question:
I have recently received complaints that the management personnel of a public hospital reduced the number of medical beds in that hospital on their own volition without seeking their supervisors’ prior approval, thereby affecting the services provided to patients. In this connection, will the Government inform this Council:
(1) whether it knows the actual numbers of medical beds providing inpatient care in various public hospitals at present, as well as whether there is any difference between such numbers and the planned numbers of such beds; of the relevant numbers in each of the past five years;
(2) whether it knows if the Hospital Authority (HA) will conduct an investigation into the aforesaid incident of reduction in the number of medical beds and assess the impact of the incident on the services provided to patients, including whether patients in the Accident and Emergency Department waited for a longer time before admission to the medical wards as a result; if HA will conduct such an investigation, of the details; if HA will not, the reasons for that; and
(3) how the Government monitors if the actual numbers of various types of inpatient beds in public hospitals differ from the respective planned numbers, for instance, whether a Hospital Chief Executive is required to report to the Chief Executive of HA and the Secretary for Food and Health prior to reducing the number of inpatient beds of a particular specialty; if there is such a requirement, of the details; if not, the reasons for that?
Reply:
President,
The Hospital Authority (HA) manages all public hospitals in Hong Kong. It is projected that HA will be providing a total of 27 645 hospital beds as at March 31, 2015. Beds may be classified, in terms of types, into general beds, infirmary beds, beds for the mentally ill and beds for the mentally handicapped. General beds are further classified into beds for major specialties (e.g. medicine, surgery, gynaecology, obstetrics, paediatrics, orthopaedics and otorhinolaryngology) and beds for other sub-specialties like oncology, neurosurgery and emergency medicine.
HA will assess the demand for different types of beds as well as the demand for beds among different specialties having regard to the number of patients, types of diseases and severity of patients' conditions. HA will then allocate hospital beds taking into account the actual circumstances and the healthcare model to cater for the needs of patients.
Given the varying seasonal demand, HA will temporarily provide additional beds as appropriate. For example, HA is planning to provide 282 additional beds during winter surge this year to meet extra demand.
Concomitant with the growth and ageing of population, we understand that the demand for healthcare services in the community, especially the demand for hospital beds, will continue to increase. Over the years, HA has rolled out various measures to reduce public demand for inpatient services. For example, outreach services are provided for elderly patients residing in residential care homes and the community; transitional integrated support services are provided for high-risk elderly patients who have been discharged from hospital but may need emergency hospital readmission any time. The Community Health Call Centre of HA also provides support services for discharged high-risk elderly patients living in the community through communications by telephone.
Moreover, we are planning to embark on a number of projects, including the construction of Tin Shui Wai Hospital and Hong Kong Children's Hospital; the redevelopment of United Christian Hospital, Kwong Wah Hospital, Queen Mary Hospital and Kwai Chung Hospital; and the planning for a general acute hospital in the Kai Tak Development Area, so as to enhance service capacity and provide more hospital beds to cater for public needs.
I note that Dr Hon Leung Ka-lau points out, in the preamble of the question, that he has received a complaint involving a certain public hospital reducing the medical beds on its own volition without seeking proper prior approval. I have verified the issue with HA, which has confirmed that it has not received the relevant complaint. As the question has neither mentioned the hospital involved nor provided any specific information regarding the complaint, I can, in such circumstances, only give an overall and general reply to various parts of the question. If Dr Hon Leung has more specific information, I am happy to follow up separately later.
(1) The number of medical beds provided by various clusters of HA in the past five years is set out at Table 1 in the written reply distributed to Members.
Overall speaking, the total number of medical beds provided by HA in the past five years has increased on a year-on-year basis from 8 261 in 2010 to 8 660 in 2014, representing an increase of 5 per cent. Over these five years, the number of medical beds in six clusters has all recorded increase. The only cluster which has recorded a slight drop in the number of medical beds is Kowloon Central. The reason for such a slight drop includes the need to transfer some beds in medicine to orthopaedics in the Hong Kong Buddhist Hospital to facilitate the establishment of the Joint Replacement Centre; and the classification of 24 beds in the Special Observation Wards in the Queen Elizabeth Hospital from medicine to mixed specialties to more accurately reflect the mixed operation model of the beds concerned (it should be noted that such change in classification had no effect on the actual service provision). Individual clusters might add or reduce the number of medical beds during certain periods having regard to the actual operational needs and changes in healthcare models. However, any adjustment on the number of beds and any re-allocation of beds among specialties are undertaken with formal approval in accordance with procedures. And if the number of medical beds is reduced, the number of beds for other specialties will be increased correspondingly through re-allocation. As such, the total number of beds provided by HA has remained unchanged and the overall services provided for patients has not been reduced.
(2) and (3) Hospital beds are crucial medical resources. HA has put in place a mechanism to monitor the operation of hospital beds in the clusters. The use and allocation of hospital beds must be approved by the Cluster Chief Executives concerned and reported to HA Head Office. HA is required to regularly report the overall number of hospital beds to the Food and Health Bureau (FHB) via the Controlling Officer's Report. FHB will also set out the number of hospital beds provided by HA in its Controlling Officer's Report under the relevant Head in the annual Estimates for inspection by the Legislative Council and the public.
All in all, HA attaches great importance to the use of such crucial medical resources as hospital beds, and has put in place a mechanism to ensure that these resources are used properly to meet actual needs. I would reiterate that should Dr Hon Leung have any specific information regarding any incident of the reduction in medical beds without proper prior approval, he could convey the information to us and I will ask HA to follow up and conduct a thorough investigation.
Ends/Wednesday, January 7, 2015
Issued at HKT 15:55
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