LCQ2: Dental services provided to general public
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Question:
The Chief Executive indicated in the Policy Address delivered in October last year that a steering committee on primary healthcare development (the steering committee) would be set up to comprehensively review the existing planning of primary healthcare services and to draw up a development blueprint. However, the Policy Address has not put forward any measures to improve the dental services provided to the general public to dovetail the development of primary healthcare services. On the other hand, the ratio of dentist to population in Hong Kong has remained at 0.3 dentist per 1 000 persons since 1996, a ratio far lower than those of quite a number of economies with levels of economic development comparable to Hong Kong. In this connection, will the Government inform this Council:
(1) whether the steering committee will study the role of dental treatment and oral care services in primary healthcare services;
(2) given that the emergency dental services currently provided to the general public by the dental clinics under the Department of Health only cover extraction and pain relief, whether the Government will consider expanding the public dental services to provide general dental treatment and oral care services to the general public; if so, of the details; if not, the reasons for that; and
(3) whether it has considered raising the ratio of dentist to population in Hong Kong; if so, of the short-term and long-term target ratios; if not, the reasons for that?
Reply:
President,
My reply to the various parts of the question raised by the Hon Wu Chi-wai is as follows:
(1) and (2) The Steering Committee on Primary Healthcare Development (Steering Committee), established in late November 2017, is formulating development strategy and blueprint for primary healthcare services. Regarding the scope of services of District Health Centres (DHCs), the Steering Committee opines that the pilot project in Kwai Tsing District should direct resources to the treatment of the most prevalent chronic diseases that consume substantial medical resources and explore how to manage their conditions through risk management and early intervention, thereby reducing the unwarranted use of hospital services. The Government will provide the necessary resources for the provision of relevant services through the DHCs and their networks.
In the area of dental care, prevention has more long-term benefits than cure. The Government's policy on dental care seeks to raise public awareness of oral hygiene and encourage proper oral health habits for the purpose of preventing dental diseases through focusing resources on promotion, education and prevention efforts. To enhance the oral health of the public, the Department of Health (DH) has, over the years, implemented oral health promotion programmes targeted at different age groups and disseminated oral health information through different channels.
At present, public dental services in Hong Kong mainly focus on the provision of emergency dental services for the public as well as special oral care services for in-patients and persons with special oral healthcare needs. Apart from free emergency dental treatments provided for the public through designated sessions in 11 government dental clinics, the DH also provides specialist treatments in the Oral Maxillofacial Surgery and Dental Units of seven public hospitals for referred patients. The Hospital Authority (HA), meanwhile, provides dental services in four public hospitals, where referred in-patients, patients with special oral healthcare needs and patients with dental emergency needs can receive treatments.
In addition, primary school students in Hong Kong may join the School Dental Care Service (SDCS) of the DH to receive annual check-ups at a designated school dental clinic. The scope of service covers oral care advice, oral examination, basic dental treatments and preventive treatment, such as scaling and polishing, filling and extraction. Dentists will also provide more complex dental treatment depending on the needs of individual students. Students with intellectual disabilities and/or physical disabilities who are studying in special schools may join the SDCS until the age of 18. The SDCS also helps educate students on the importance of maintaining good oral hygiene and preventive care at the early stage.
As for curative dental care services, they are mainly provided by the private sector and non-governmental organisations (NGOs). Apart from publicity, education, promotion and prevention, the Government has to prioritise the allocation of the limited public resources, focus on providing emergency dental services (including General Public Sessions) for the public, and to take care of people with special needs. Relevant initiatives are highlighted below:
(i) The Community Care Fund (CCF) launched a programme in September 2012 to provide free removable dentures and related dental treatment services including X- ray, scaling and polishing, fillings and extractions for low-income elderly persons who are users of the home care service or home help service subvented by the Social Welfare Department. To enable more elderly persons who have financial difficulties but are not receiving Comprehensive Social Security Assistance to enjoy the above dental services, the programme was expanded in phases in 2015, 2016 and 2017 to cover Old Age Living Allowance recipients aged 80 or above, aged 75 or above and aged 70 or above respectively.
(ii) In 2011, the Government launched a three-year pilot project to subsidise the setting up of outreach dental teams by NGOs to provide free basic dental care services covering dental examination, scaling and polishing and emergency dental treatment for elderly persons living in residential care homes or using the services of day care centres. The pilot project was converted into a regular programme implemented by the DH in October 2014 with an expanded scope of dental treatments to cover fillings, extractions and dentures.
(iii) In August 2013, the Government provided funding for the implementing organisations to launch the Pilot Project on Dental Service for Patients with Intellectual Disability. Immediately following the Pilot Project, the Government will provide about $54 million to launch a new three-year project in mid-2018 with the participation of more NGOs to provide free oral check-ups, dental treatments and oral health education for adults with intellectual disability. It is estimated that about 5 000 quotas will be available for eligible persons.
(iv) The Elderly Health Care Voucher (EHCV) Scheme was launched in 2009. The elderly can, according to their needs, use the health care vouchers for services provided by medical practitioners, Chinese medicine practitioners, dentists, chiropractors,etc. We have progressively increased the annual voucher amount for an eligible elderly person from the initial sum of $250 to $2,000, and the eligibility age for the EHCV Scheme has been lowered from 70 to 65.
In the 2018-19 Budget, the Government proposed to raise the accumulation limit of health care vouchers from $4,000 to $5,000 and providing, on a one-off basis, an additional $1,000 worth of vouchers for each eligible elderly person. It is expected that 1.2 million or so elderly persons will benefit from these enhancement measures.
As at the end of December 2017, there were 895 dentists participating in the EHCV Scheme and providing services at more than 1 570 places of practice across the 18 districts of Hong Kong for eligible elderly persons using health care vouchers.
(3) Over the past decade, the number of registered dentists in Hong Kong has been on the rise, from 2 025 as at end 2007 to 2 500 as at end 2017, representing an increase of 23.5 per cent. According to the latest provisional figures released by DH, the ratio of dentist to population has also significantly improved, from 1:3 433 in 2007 to 1:2 964 in 2017.
The Government published the report of the Strategic Review on Healthcare Manpower Planning and Professional Development in June last year. According to the projection results, it is projected that there will be a general shortage of dentists in the medium to long term. The public demand for subsidised dental services (note) has been taken into account in projecting the demand for dental manpower.
Considering the future manpower shortage of dentists, starting from the 2016/17 academic year, the Government has increased the number of University Grants Committee (UGC)-funded training places for dental students around 40 per cent from 53 to 73. The Government is discussing with UGC to further increase the number of training places. It is expected that the increase can help ease the manpower shortage of dentists.
Note: These include the Outreach Dental Care Programme for the Elderly, the CCF Elderly Dental Assistance Programme and the Pilot Project on Dental Service for Patients with Intellectual Disability.
Ends/Wednesday, March 21, 2018
Issued at HKT 15:35
Issued at HKT 15:35
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