LCQ10: Public dental services
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Question:
Regarding public dental services, will the Government inform this Council:
(1) given that under the Outreach Dental Care Programme for the Elderly, 22 outreach dental teams have been set up by 11 non-governmental organisations to provide outreach dental services for eligible elderly people, of (i) the establishment of each outreach team, (ii) the details of the dental services (e.g. oral care training and oral health assessment), and (iii) the average duration of and average number of elderly people receiving services in each service session at present;
(2) given that the Pilot Project on Dental Service for Patients with Intellectual Disability is due for completion in August 2017 and the authorities are now studying the way forward to continue to provide dental service for patients with intellectual disability, of the details and latest progress of the study;
(3) as the Director of Audit pointed out in his Report No. 68 published in April this year that there were a number of problems with public dental services (e.g. outdated oral health goals, low overall participation rate of eligible elderly people in the Elderly Dental Assistance Programme launched under the Community Care Fund, a number of students who made appointments through the School Dental Care Service not attending scheduled appointments, under-utilisation of the emergency dental services in General Public Sessions), whether the authorities will conduct a review of the public dental services in the light of those problems and make improvements; if so, of the details; if not, the reasons for that;
(4) as it was pointed out in a research report published in December last year that there were only 2.13 dentists per 1 000 elderly people in Hong Kong, and such ratio lagged behind those in advanced countries (e.g. the relevant figures in Sweden, the United States, the United Kingdom and Japan were 8.84, 4.16, 3.60 and 3.15 per 1 000 elderly people respectively), whether the Government will set a target on elderly population/dentist ratio and, based on such target, train up a sufficient number of dentists; and
(5) whether the Government will, in the long run, formulate policies on the provision of comprehensive public dental services; if so, of the details; if not, the reasons for that?
Reply:
President,
My reply to the Dr Hon Kwok Ka-ki's question is as follows:
(1) The Outreach Dental Care Programme for the Elderly (ODCP), which was launched in October 2014, aims to provide free outreach dental care services to elders residing in residential care homes and using services of day care centres and similar facilities; promote the oral care and oral health to the elders, their family members and caregivers; and provide oral care training to caregivers in residential care homes and day care centres for the elderly to enhance their ability and knowledge in providing daily oral care services to the elders.
Currently, a total of 22 outreach dental teams from 11 non-governmental organisations (NGOs) have been set up under the ODCP. Each outreach dental team comprises at least one dentist and one dental surgery assistant. The outreach dental teams will co-ordinate with the residential care homes and day care centres in arranging the dates and time of providing the services.
Between October 2014 and March 2017, about 68 300 elders (involving about 115 700 attendances) received annual oral check and dental treatments under the ODCP. Dental treatments received include scaling and polishing, denture cleaning, fluoride application, X-ray and other curative treatments such as fillings, extractions, dentures, etc.
(2) The Government understands the oral health problems faced by patients with intellectual disability (ID) and is concerned about their dental care needs. The Pilot Project on Dental Service for Patients with Intellectual Disability (the Pilot Project) launched by the Government aims to explore a cost-effective model to provide appropriate dental services for adult patients with ID and with financial difficulties. Since the launch in August 2013, the Pilot Project has already provided dental services to over 1 800 eligible adult patients with ID.
The Government will continue to subsidise the organisations participated in the Pilot Project to provide the relevant dental service in the coming year to meet the service needs of patients with ID who are on the waiting list. The Government fully recognises that the dental service concerned should be continued and is now following up on how the provision of appropriate dental care service for adult patients with ID after completion of the Pilot Project should be continued.
(3) The Food and Health Bureau and the Department of Health (DH) accept the Director of Audit's recommendations, and will, where feasible, actively implement the recommendations made by the audit report which mainly include:
Oral health goals
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The Government's policy on dental care seeks to raise public awareness of oral hygiene and encourage proper oral health habits through promotion and education. Therefore, the DH will formulate appropriate oral health promotion measures according to the results of the Oral Health Surveys conducted every 10 years (including the surveys conducted in 2001 and 2011 respectively).
Based on the recommendations by the Director of Audit, the DH has also planned to set up an expert group comprising academics and experts of dental public health specialty, as well as representatives from other relevant fields as appropriate. The expert group will, taking into account the report of Oral Health Survey 2011 and the local situation, review and formulate appropriate oral health goals for the population of Hong Kong. The DH will also consider publishing the level of attainment against various oral health goals in the report of the Oral Health Survey 2021.
Student Dental Care Service (SDCS)
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Regarding the recommendation to encourage Primary six students' attendance at scheduled dental appointments, the SDCS is now exploring with the participating schools on the feasibility of providing round-trip transport for Primary six students to attend school dental clinics for annual dental check-up. In addition, SDCS has planned to actively encourage the participating students and their parents to make use of the Student Internet Service which includes an automatic appointment reminder service by email, so that students can be reminded to attend their appointments as scheduled. We aim to implement the measures in 2017/18 school year.
General Public Sessions (GP Sessions)
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In 2015/16, among the 11 government dental clinics which provide GP Sessions, there were three dental clinics with relatively high rates of unutilised disc quota, namely Tai O Dental Clinic (74.7%), Cheung Chau Dental Clinic (50.0%) and Kennedy Town Community Complex Dental Clinic (25.2%).
To enhance utilised rate, the DH has stepped up effort to promote the service of the GP Session at Kennedy Town Community Complex Dental Clinic, including handing out clinic's information leaflet to encourage the public who are unable to obtain disc quota from other government dental clinics to visit the clinic. With the above promotional effort, and following the provision of MTR service in Kennedy Town, the percentage of unutilised disc quota has greatly dropped to 13.94% in 2016/17. We anticipate that the percentage of unutilised disc quota will continue to decrease.
As for the rates of unutilised disc quota for GP Sessions of Tai O Dental Clinic and Cheung Chau Dental Clinic, it is quite difficult to attract cross-district clients since these two clinics mainly serve the residents of Tai O and Cheung Chau and their locations are quite remote. However, there remains a need to maintain services of these two clinics to meet the service needs of the above two districts. To utilise the existing resources in a more flexible manner, the dentists deployed to Tai O GP Sessions and Cheung Chau GP Sessions will be on duty at other government dental clinics during the period other than the above GP Sessions.
The DH will closely monitor the utilisation rate of the GP Sessions and review the service in a timely manner.
Community Care Fund Elderly Dental Assistance Programme (the Programme)
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The Programme provides free removable dentures and related dental services for eligible elders. The Hong Kong Dental Association (HKDA) is the implementing agent of the Programme. Currently, 180 district service units (comprising 160 elderly centres, five community centres and 15 NGO dental clinics that accept direct applications) have participated in the Programme for processing applications from elders who are Old Age Living Allowance recipients. The Government will continue to work with the HKDA to further promote the Programme on various fronts and encourage more elders to join the Programme. We will also invite more district service units to participate in the Programme so as to assist the eligible elders in making applications and scheduling dental appointments.
(4) To ensure the sustainable development of our healthcare system, the Government is conducting a strategic review on healthcare manpower planning and professional development in Hong Kong (the Strategic Review), which aims to formulate recommendations on ways to meet the projected demand for healthcare manpower and foster professional development. The Strategic Review covers 13 healthcare disciplines which are subject to statutory regulation, including dentists.
Based on the manpower projection conducted by the University of Hong Kong, there is a shortage of dentists in the short to medium-term. To meet the anticipated demand for dentist manpower, the Government has increased the number of University Grants Committee-funded degree places in dentistry by 20 (amounting to about 40%) from 53 to 73 in the 2016/17 school year - 2018/19 school year triennium. It is expected that the increase will help alleviate the manpower shortage of dentists.
(5) As mentioned above, the Government's policy on dental care mainly seeks to raise public awareness of oral hygiene and encourage proper oral health habits through promotion and education. To enhance the oral health of the public, the Oral Health Education Unit of the DH has, over the years, implemented oral health promotion programmes targeted at different age groups and disseminated oral health information through different channels.
We wish to point out that only a few countries around the world can meet all the dental care needs of their citizens solely with public resources. Citizens in some countries may even have to bear higher medical insurance cost. As for Hong Kong, providing comprehensive dental care services to the public will involve substantial financial resources. In this regard, apart from promotion, education (including SDCS) and publicity, the Government has focused resources to provide emergency dental services for the public including GP Sessions, as well as accorded priority to people with special needs, especially elderly with financial difficulties. As such, in recent years, the Government has launched a series of initiatives, including the Outreach Dental Care Programme and Community Care Fund Elderly Dental Assistance Programme, to provide dental care service support to low-income elders with special needs. Besides, eligible elders may also use Elderly Health Care Vouchers for private dental services.
Ends/Wednesday, May 31, 2017
Issued at HKT 17:50
Issued at HKT 17:50
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