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LCQ15: Co-ordination mechanism in large-scale incidents

     Following is a question by the Hon Miriam Lau Kin-yee and a written reply by the Secretary for Security, Mr Ambrose S K Lee, in the Legislative Council today (December 2):


     A serious vehicle accident which happened in Tseung Kwan O on November 9 this year resulted in 36 casualties among the passengers.  It was reported that at first only five ambulances were dispatched to the scene after the accident.  Some of the injured did not receive immediate treatment after admission to the hospital even though they were in unstoppable bleeding, and an injured person with "fractured bones" even had to wait for two to three hours to receive treatment.  Some family members of the injured are of the view that the incident has revealed that there is room for improvement on the rescue operations in respect of large-scale unexpected incidents and the medical services in Tseung Kwan O District are seriously inadequate.  In this connection, will the Government inform this Council:

(a) whether it has plans to review within a short period the co-ordination mechanism put in place between the Hospital Authority and the Fire Services Department as well as the other relevant government departments in dealing with serious accidents, so as to improve the efficiency of rescue operations; if it has, of the specific plan; if not, the reasons for that;

(b) of the respective ratios of the numbers of in-patients and emergency services attendances to the numbers of relevant healthcare personnel at Tseung Kwan O Hospital in each of the past three years; whether it has plans to enhance the emergency rescue services at that hospital including increasing its manpower before the completion of the expansion project for Tseung Kwan O Hospital in 2012; if so, of the specific plan; if not, the reasons for that; and

(c) whether it will review the ambulance deployment mechanism in Tseung Kwan O District and increase the number of ambulance depots and ambulances on duty in that district; if it will increase such numbers, of the earliest time for implementing the relevant arrangements?



(a) The Fire Services Department (FSD) and the Hospital Authority (HA) have been working in accordance with an established co-ordination mechanism in the triage, on-the-spot rescue operations and conveyance of injured persons to hospitals in large-scale incidents.  According to the existing mechanism, in the event of accidents with many casualties, the ambulance personnel at scene will determine the priority of on-the-spot treatment and conveyance by triage according to the conditions of the injured.  If necessary, the ambulance incident officer at scene would request HA to send medical control officer(s) and medical team(s) to help provide treatment to the injured at the scene.  The duty officer of the Major Incident Control Centre (MICC) of HA will also activate immediately the nearby hospitals with Accident and Emergency (A&E) services to prepare for receiving the injured, so that the injured persons can be provided with timely treatment after being sent to hospitals.  In addition, a mobile casualty treatment centre (MCTC) will be dispatched to the scene for reinforcement.  Doctors of the medical team(s) may use the equipment on the MCTC for providing first-aid treatment to the injured at the scene.

     In the serious traffic accident in Tseung Kwan O on November 9, the FSD and HA have activated the aforementioned co-ordination mechanism.  After the traffic accident, FSD has dispatched 24 ambulances in total to convey causalities to five hospitals.  Injured patients are provided with timely treatment on arrival at the hospitals.  HA has also dispatched a medical team to assist in treating the injured at the scene.

     HA and FSD review the above co-ordination mechanism from time to time to ensure that injured patients receive proper treatment.

(b) The ratio of healthcare personnel to the number of inpatient discharges and deaths and the ratio of healthcare personnel to the number of attendances at the A&E Department of Tseung Kwan O Hospital (TKOH) in the past three years are as follows:

Year  Ratio of    Ratio of    Ratio of    Ratio of
      doctors     nurses      doctors     nurses
      (excluding  (excluding  to the      to the
      doctors of  nurses of   number of   number of
      A&E         A&E         attendances attendances
      Department) Department) at A&E      at A&E
      to the      to the      Department  Department
      number of   number of
      inpatient   inpatient
      discharges  discharges
      and deaths  and deaths
----  ----------  ----------  ----------  -----------
2006-07   1:21       1:8.8       1:473       1:230

2007-08   1:17       1:7.5       1:462       1:236

2008-09   1:18       1:7.9       1:466       1:270

Note: As the condition of each patient and complexity of each case varies, the workload of healthcare staff cannot be assessed simply by looking at the ratio of the number of healthcare staff to the number of patient attendances.

     HA and TKOH have in place an established mechanism for co-ordination and handling of unexpected disasters and incidents.  After the emergency response mechanism is activated, the hospital will deploy healthcare and supporting staff on duty in other clinical departments to the A&E Department to assist in providing emergency services.  The hospital will also inform healthcare staff of the A&E Department and other specialties who are on call to return to the hospital at once to provide assistance.  The HA Head Office will also activate the relevant response and patient triage measures accordingly.  The existing arrangements are effective in providing emergency services to people in need.  The HA Head Office and its hospitals will continue to keep their disaster management measures under review and conduct the relevant drills from time to time.

     Before the completion of the whole expansion project of TKOH in 2013, HA will enhance the services of the Kowloon East Cluster and TKOH based on the demand for healthcare services in the district.  In 2009-10, TKOH will open 36 additional surgical beds and recruit additional healthcare staff to strengthen its emergency and other services.  HA and the Kowloon East Cluster will continue to closely monitor the service utilisation of TKOH with a view to making suitable adjustment to the services in the light of the needs of the district.

(c) In order to provide timely emergency ambulance services to patients and the injured, the current dispatch system of the FSD would automatically dispatch ambulance(s) which can handle the concerned call within the shortest timeframe.  In the circumstances of large-scale incidents, FSD would not only dispatch ambulances stationed at that area, but also dispatch immediately those in the vicinity to provide support. With the increasing demand for emergency ambulance services in Tseung Kwan O District, FSD has increased the number of ambulances on-duty at Po Lam Ambulance Depot since June this year from four shifts to five shifts during daytime, and two shifts to three shifts during night time.  On the other hand, additional resources have been granted to FSD to create 121 new ambulancemen posts in 2009-10.  The newly recruited ambulancemen will undergo six-month induction training by batches.  When they complete their training, FSD would increase the number of ambulance personnel in areas with greatest service demand, including Tseung Kwan O District.

Ends/Wednesday, December 2, 2009
Issued at HKT 14:35


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