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Following is a question by the Hon Paul Tse and a written reply by the Acting Secretary for Food and Health, Professor Sophia Chan, in the Legislative Council today (February 25):
Question:
It has been reported that the number of patients suffering from macular degeneration (MD) has increased continuously in recent years. Not only the number of elderly patients, but also that of young patients has been on the rise. Some ophthalmologists have pointed out that the cause of the illness is related to the use of tablet computers and smart phones for a prolonged period and in a dark environment. The fees for examination (such as Fluorescein Fundus Angiography) and treatment (such as Photodynamic Therapy) of MD are high and the chances of relapse are quite high, with serious MD cases even resulting in eye cancer. In this connection, will the Government inform this Council whether it knows:
(1) if the Hospital Authority (HA) has compiled statistics on MD patients such as their number and ages, the proportion of them seeking treatment from public/private healthcare institutions, and their per capita medical expenses; if HA has, of the relevant statistics in the past three years; if HA has not, whether HA will compile such statistics as soon as possible;
(2) the details of the MD examination and treatment services currently provided by public hospitals; the average waiting time for patients to be diagnosed and treated respectively; whether HA will make reference to the upcoming plan of outsourcing colorectal cancer screening services and outsource MD examination services to private healthcare institutions, so as to reduce the waiting time and streamline the procedures of patient care; and
(3) the respective current waiting time at the Eye Specialist Out-patient Clinics of various hospital clusters (in particular the Kowloon East Cluster), and the clusters with the longest and the shortest waiting time; whether patients are given the choice of seeking treatment in a cross-cluster manner in the light of the length of the waiting time at different clusters?
Reply:
President,
There are various types and causes of macular degeneration (MD). Treatment of the disease varies according to the cause and clinical conditions. My reply to the various parts of the question is as follows:
(1) As the Hospital Authority (HA) does not assign codes to patients of specialist out-patient clinics (SOPCs) by disease type, the requested statistics on MD patients are not available. There is no plan for compilation of such statistics at the moment.
(2) Currently, HA hospitals treat MD patients with medication, laser and surgery. MD patients are referred to ophthalmology SOPCs for treatment. The HA does not maintain statistics on waiting time by disease type.
The HA has adopted a triage system for new referrals to major SOPCs to ensure that urgent cases requiring early intervention are given priority treatment. Under the current triage system, new referrals 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. Ophthalmology SOPC services also adopt this triage system. The HA has set a target of maintaining the median waiting time for cases in priority 1 and 2 categories within two weeks and eight weeks respectively, and has so far been able to meet this pledge.
Before launching any public-private partnership (PPP) programme for a clinical service, the HA has to discuss with the relevant specialty department, consult patients and consider a series of factors, including the magnitude of the service demand, service capacity of the market and patients' acceptance. Regarding MD examination, the HA has no plan to launch any PPP programme for the time being. When necessary, the HA will discuss with the specialty concerned and examine whether any pilot PPP programme for this clinical service should be considered.
(3) The table in Annex sets out the median (50th percentile) and the longest (90th percentile) waiting time for new case booking for ophthalmology SOPC services by priority 1 (urgent), priority 2 (semi-urgent) and routine categories under each HA cluster in 2013-14.
To manage the waiting time in a more effective manner, the HA has established a centrally co-ordinated mechanism to enhance cross-cluster collaboration and pair up clusters. Where appropriate, SOPC patients in clusters with longer waiting time can be referred to clusters in which they can take shorter waiting time for treatment. Under this mechanism, the HA started to refer suitable ophthalmic patients in New Territories East Cluster to Hong Kong West Cluster for treatment in October 2013.
In April 2013, the HA began to publish in phases the waiting time for SOPC services. The waiting time for eight major specialties (namely Ear/Nose/Throat, Gynaecology, Ophthalmology, Orthopaedics, Paediatrics, Medicine, Psychiatry and Surgery) has been uploaded to its website since January 2015. Comprehensive, standardised and updated waiting time information will also be displayed in the clinics from the first half of 2015. This will help patients make informed decisions about treatment plans and choice of venues to receive treatment.
While patients may book medical appointments at a SOPC of their own choice, the HA will take due account of individual patients' clinical conditions and nature of services required in arranging appointments for SOPC services. For example, for patients who require community support and frequent follow-up treatments, staff of the HA may recommend them to receive medical care at SOPCs close to their residence and make corresponding arrangements so as to provide greater convenience for the patients and encourage compliance with treatment plans.
Ends/Wednesday, February 25, 2015
Issued at HKT 15:22
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