LCQ8: Medical support for women in relation to child birth
Some women have relayed to me that the assisted-reproduction services, prenatal screening services and postnatal support (e.g. the provision of lactation rooms and babycare rooms) currently provided by public healthcare institutions for women are inadequate and lag behind those in other places. In this connection, will the Government inform this Council:
(1) as some women have relayed that in recent years, women in Hong Kong tend to get married at an older age and, as a result, female infertility has become more common, whether it knows the details of the subfertility and assisted-reproduction services currently provided by the Family Planning Association of Hong Kong and public hospitals, including the number of public hospitals providing those services, as well as the quotas, waiting time and charges for those services; in respect of those services in each of the past three years: (i) the average waiting time, (ii) the number of persons waiting for the services, (iii) the age distribution of service users, and (iv) the public expenditure involved;
(2) whether it knows if the Hospital Authority (HA) will provide centralised oocyte cryopreservation service; if HA will, of the details; if not, the reasons for that;
(3) whether it knows the methods currently adopted by public hospitals for conducting prenatal screening for Down's syndrome for pregnant women; in respect of each screening method, (i) the service quota for the current year, and (ii) the number of persons currently waiting for the service and their waiting time (set out such information in a table);
(4) whether it knows the factors based on which public hospital doctors determine whether the safeT21 test (T21 test) or amniocentesis should be adopted for conducting prenatal screening for Down's syndrome for pregnant women;
(5) whether it knows the current number of public hospitals providing T21 testing service, and the average waiting time of pregnant women for the service in each hospital;
(6) whether it knows the unit cost of and the charge for T21 test, as well as the amount of estimated expenditure set by HA for the current financial year for conducting T21 tests;
(7) whether it knows if HA will consider completely replacing amniocentesis with T21 tests for conducting prenatal screening for Down's syndrome for pregnant women in future; if HA will, of the details and timetable; if not, the reasons for that;
(8) of the number of newborn babies in each of the past two years who had been breastfed after discharge from hospital; among the various Government facilities (including office buildings, cultural and recreational facilities under the Leisure and Cultural Services Department such as sports grounds and libraries, as well as public markets), of the number and percentage of those in which lactation rooms and babycare rooms are provided;
(9) whether it will introduce legislation or formulate guidelines to require that separate lactation rooms and babycare rooms be provided in newly set up public places; if so, of the details; if not, the reasons for that; and
(10) of the new measures in place to encourage or promote the provision of more lactation rooms and babycare rooms in private commercial buildings and public places (e.g. MTR stations, shopping malls)?
(1) Consultation services are available at hospitals of the Hospital Authority (HA) for women who have difficulties in conception, including body check-ups and necessary tests (e.g. semen analyses and fallopian tube patency tests). Reproductive surgeries and artificial insemination by husband treatments can also be provided where necessary. In-vitro fertilisation (IVF) services are available at the HA's Queen Mary Hospital (QMH), Prince of Wales Hospital (PWH) and Kwong Wah Hospital (KWH).
KWH provides IVF treatments as a public service, with around 100 cases each year. Private IVF services are not available at KWH. As for the two teaching hospitals (PWH and QMH), IVF is provided as either a public or private service. The total number of cases each year is around 500 for PWH and 800 for QMH.
Currently, the waiting time for IVF is about five to 18 months for public patients, and about two months for private patients.
On age distribution, the maximum age for public patients to receive the treatment is 40 while no limits are set on the age or treatment cycles for private patients.
Regarding the existing IVF services at public hospitals, public patients are charged at the standard fees and charges of public hospitals, i.e. in respect of in-patient and out-patient fees. Examinations and tests not available at public hospitals and self-financed drugs are charged separately. Service fees for private patients are determined with reference to the cost and market prices.
(2) The HA does not provide centralised oocyte cryopreservation service at present. Nevertheless, the two teaching hospitals (i.e. PWH and QMH) will provide, on the basis of medical needs, oocyte cryopreservation service for women who have been clinically assessed to be suitable for receiving IVF, and for private patients suffering from cancer.
(3) Since July 2011, public hospitals have been providing a series of free prenatal services for all local pregnant women with a residential hospital booking, including screening for Down's syndrome carried out before 20 weeks of pregnancy. On average, over 35,000 pregnant women received such service per year. Basic blood test will be provided during the first prenatal check-up, and ultrasound examination will be arranged if there is a clinical need. For suspected cases, which account for around 6 per cent (2,000-odd cases) of the total per year, amniocentesis or chorionic villus sampling will be offered to identify Down's syndrome in foetuses.
(4) to (7) At present, the HA does not provide safeT21 (T21) testing service and thus there is no statistics on the service and the expenditure involved. The HA has earlier discussed the development and effectiveness of T21 tests at the relevant Coordinating Committee. The HA is now exploring the facilities required for the introduction of T21 testing in Hong Kong Children's Hospital as a second tier screening test for Down's syndrome and building the human capital in this respect.
(8) The Department of Health (DH) regularly monitors the local trend of breastfeeding and conducts a breastfeeding survey on a biennial basis. Apart from collecting information of ever breastfeeding rates at hospital discharge from public and private hospitals with maternity wards, the DH also conducts breastfeeding surveys in its maternal and child health centres. According to the surveys conducted in 2015 and 2017, the breastfeeding rates of children born in 2014 and 2016 are as set out in table 1 of annex.
The Government has been proactively promoting the provision of babycare facilities in Government premises and public venues. The Food and Health Bureau , together with the Architectural Services Department, DH, Government Property Agency, Buildings Department and Housing Department formulated the Advisory Guidelines on Babycare Facilities in August 2008 to encourage incorporation of desirable babycare facilities in public venues managed by the Government. As at June 2017, there were a total of 290 babycare rooms in Government premises, as listed in table 2 of annex.
A list of babycare rooms in Government premises with location details is available on the website of Family Health Service of the DH.
(9) and (10) The Government has all along been promoting and supporting breastfeeding. The Practice Note on the Provision of Babycare Rooms in Commercial Buildings was issued in February 2009 to encourage and facilitate the provision of babycare rooms in private commercial premises. To further facilitate the establishment of breastfeeding friendly premises in the private sector, the DH formulated the Guide to Establishing Breastfeeding Friendly Premises in May 2015 for reference by private organisations interested in promoting breastfeeding friendly environment in their public premises. Due to an increased awareness of the need for promoting breastfeeding friendly environment in recent years, babycare and breastfeeding facilities have been made available in many shopping malls, large department stores, hotels and public transport facilities.
To provide more babycare facilities and lactation rooms for the public, the Government is working to include a mandatory requirement for the provision of lactation rooms and babycare facilities in the sale conditions of Government land sale sites for new commercial developments comprising office premises and/or retail outlets, eating places, etc. The Government will also take corresponding measures to mandate the provision of babycare facilities and lactation rooms in certain new Government premises.
Ends/Wednesday, November 8, 2017
Issued at HKT 18:00
Issued at HKT 18:00