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The Steering Committee on Review of Hospital Authority (HA) today (July 14) released a report proposing a number of recommendations to help the HA use resources effectively to get prepared to meet the challenges arising from an ageing population, increased prevalence of chronic diseases and increasing healthcare costs due to advances in medical technology.
Speaking at a press conference, the Secretary for Food and Health, Dr Ko Wing-man, said, "The Steering Committee has made a total of 10 major recommendations, focusing on issues which are of concern to patients, community members and HA staff and on areas in which the Steering Committee considers that the HA should work to improve. These issues include, for example, long waiting time, co-ordination problems of clusters, resource allocation, and staffing and training arrangements.
"To ensure that the HA could actively implement these recommendations, the Government will provide the HA with additional funding totalling $1.17 billion for three years.
"To ensure timely implementation of the recommendations made by the Steering Committee, the HA will prepare an action plan within three months with a view to implementing the recommendations in three years. The HA will also report progress on the implementation of recommendations to the Food and Health Bureau on a regular basis."
The Steering Committee hopes that, through this review, ways could be identified to further improve the service and operation of the HA. As far as patients are concerned, the Steering Committee hopes that they could enjoy better services with shorter waiting time and they could see more consistent service provision among clusters and an enhanced level of safety and quality of services. As for HA staff, the Steering Committee hopes to enhance fairness and transparency in resource allocation and staff management practices and strengthen their training and development.
The relatively more important recommendations proposed by the Steering Committee are as follows:
(1) Management and Organisation Structure
* The HA Board should play a more active role in leading and managing the HA.
* While the Steering Committee recognises the merits of having a cluster structure for the HA and considers the present arrangement of having seven clusters appropriate, it recommends refining the delineation of cluster boundaries so as to ensure a closer match between the supply of and demand for healthcare services in each cluster. For example, the HA can consider re-delineating Wong Tai Sin district, which tends to be closer to Kowloon Central Cluster (KCC) in physical location, from Kowloon West Cluster (KWC) to KCC by adjusting the cluster boundaries of KWC and KCC, which may bring about greater benefits and convenience to patients. The HA should also maximise coherence on vertical integration of services to ensure continuity of care for patients within the same cluster.
* The HA Head Office (HAHO) should strengthen overall co-ordination on service provision.
(2) Resource Management
* The HA should adopt a refined population-based resource allocation model. Under the proposed model, resources will be allocated on the basis of the population of the areas served by the clusters, with additional resources allotted to the hospitals providing tertiary and quaternary healthcare services as required.
* The HA should work to improve and simplify the procedures of bidding for new resources by clusters for new or improved services, and enhance transparency of the resource bidding and allocation processes.
(3) Cost Effectiveness and Service Management
* The HA Board, being a managing board, should play a more active role in setting key standards and targets to monitor the overall performance and service provision for public accountability.
* Regarding the issue of long waiting time, the HA should implement a comprehensive plan to shorten waiting time for specialist outpatient clinics and accident and emergency services with a view to enabling timely access to medical services and minimising cross-cluster variance in waiting time.
* The HA should co-ordinate with relevant specialties to address the serious access block problem in the Accident and Emergency Departments in the hospitals concerned.
* To cope with an ageing population, the HA should review its service delivery model and enhance service capacity by strengthening step-down care and ambulatory services, enhancing partnership with non-governmental organisations and the private sector, and actively working with the Department of Health and the welfare sector on healthcare services to promote and enhance primary care and rehabilitation services in non-hospital settings.
* The HA should ensure an effective mechanism is in place to take into account patients' feedback for service planning and improvement.
(4) Staff Management and Training
* The HAHO should enhance its co-ordinating role to ensure greater consistency, fairness and parity in human resources management and practices in and between the clusters. The HAHO should be able to assume the central co-ordinating role of staff deployment within the organisation when a situation so warrants, such as in response to a large emergency situation, staff shortage or a surge in service demand. In particular, the HA should exercise greater central co-ordination in the annual recruitment of Resident Trainees and their placement to different specialties.
* The HA should set up a high-level central training committee under the HA Board to set overall training policy to nurture the next generation of healthcare professionals who are capable of shouldering important missions.
* The HA should strengthen its staff development programme for senior managerial and clinical staff whereby senior staff will be given wider exposure through different postings. The HA should also strengthen the rotation arrangement for trainees as part of their training programme.
(5) Overall Management and Control
* The HA should strengthen the roles of Coordinating Committees on clinical governance, including the development of clinical practice guidelines, clinical outcome audits, services standards, introduction of new technology and service development plans, to improve service quality and ensure patient safety.
* In examining the root cause for the occurrence of a medical incident, the HA should strengthen the sharing of lessons learnt among clusters to minimise the possibility of its recurrence, and consider measures to enhance communication with and support for patients.
The Steering Committee and the general public are concerned that manpower shortage is the major cause for the insufficient level of services. The successful implementation of a number of recommendations made by the Steering Committee hinges on a sufficient supply of manpower.
The Steering Committee agrees with the HA's move to address the manpower shortage problem by re-employing suitable retirees of those grades and disciplines which are facing a severe staff shortage problem. For retiring medical staff, it is proposed that they would only be re-employed for clinical duties and not management roles, so as to help relieve staff shortage on the service front without blocking normal career progression. The re-employment of retirees would also help retain experienced staff for coaching of new recruits, providing staff relief for training and enhancing staff training.
For the longer term, in line with the Government's strategy, the HA has adopted a higher retirement age of 65 for new recruits commencing employment on or after June 1, 2015. This will also help relieve manpower shortage.
Dr Ko said the services provided by the HA in the past 20 years have been well received by Hong Kong people. He is confident that the implementation of the recommendations in this report, coupled with the additional resources provided by the Government, will help the HA plan ahead and get prepared to cope with future challenges.
The Steering Committee is chaired by Dr Ko and its members include healthcare professionals, academics and representatives from the welfare sector and patient groups. The Steering Committee's report has been uploaded to the website of the Food and Health Bureau (www.fhb.gov.hk).
Ends/Tuesday, July 14, 2015
Issued at HKT 19:05
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