LCQ11: Obstetric services

     Following is a question by the Hon Chan Hak-kan and a written reply by the Acting Secretary for Food and Health, Professor Gabriel Leung, in the Legislative Council today (May 4):


     At present, most of the babies born in private hospitals who are in need of intensive care will be transferred to neonatal intensive care units (NICUs) of public hospitals, bringing workload and pressure on these units. In this connection, will the Government inform this Council whether:

(a) it knows the number and percentage of newborn babies in each private hospital who were transferred to NICUs of public hospitals for treatment in the past three years, and provide the breakdown in table form by the names of the private hospitals;

(b) it knows the wastage and turnover rate of healthcare staff in the NICU of each public hospital in the past three years, and provide the breakdown in table form by the names of the public hospitals;

(c) it has assessed the impact of capping the total number of deliveries in this and next year in Hong Kong at last year's level of around 88 000 on the demand for neonatal intensive care services, and if there is a need to increase the number of beds and healthcare staff in NICUs; of the impact on the demand for beds and healthcare manpower when the total number of deliveries exceeds the aforesaid level; and whether it knows the measures public hospitals have put in place to cope with such circumstances;

(d) the Department of Health (DH), which is responsible for monitoring private hospitals, has assessed the current capacity of various private hospitals to treat babies with health problems; whether DH will introduce a requirement for private hospitals to strengthen the services of their high dependency units as a condition for re-registration; if it will, of the details; if not, the reasons for that; and

(e) it has considered requiring mainland pregnant women giving birth in Hong Kong to undergo more antenatal checks, so as to reduce the risk of their newborn babies having health problems; if it has, of the details; if not, the reasons for that?



     It is the Government's policy to ensure that Hong Kong residents are given proper and adequate obstetric services. The Government is very concerned about the surge of demand for obstetric services in Hong Kong by non-local women (including Mainland women) in recent years, which has caused tremendous pressure on the overall obstetric service and manpower in Hong Kong. To ensure that local pregnant women are given proper obstetric services and the priority to use such services, the Hospital Authority (HA) would reserve sufficient places in public hospitals for delivery by local pregnant women and would only accept booking from non-local pregnant women when spare service capacity is available. The private hospitals have also agreed not to expand their maternity services in the short term. HA and the private hospitals will also review their respective training programmes for nurses at obstetric and neonatal services to ensure they can cope with the demand of our community in the medium and long term.

     Our replies to various parts of the question are as follows:

(a) The numbers of referrals from private hospitals to neonatal intensive care units (NICUs) of public hospitals for in-patient treatment in the past three years are as follows:

Year          Total
2008           281
2009           312
2010*          354
* Provisional figure

     HA does not keep statistical breakdown of the number of referrals of newborns to NICUs of public hospitals for treatment by each of the private hospitals.

(b) The turnover figures and turnover rates of paediatricians and paediatric nurses in public hospitals in the past three years are as follows:

            07/08          08/09          09/10
Doctors    17 (5.8%)      20 (6.6%)      11 (3.5%)
Nurses     64 (5.7%)      73 (6.5%)      66 (6.0%)

Note: The figures include retirees and other departed staff.

(c) The capacity of obstetric service in public hospitals has already been fully reached in 2010. If the total number of deliveries in the territory in 2011 and 2012 stays at the level of 88 000 cases as in 2010, the demand for obstetric beds and manpower will continue to be tense. HA will monitor the local birth rate and trend, the number of non-local pregnant women giving birth in Hong Kong in 2011 and 2012, as well as the demand and supply of healthcare professionals and the supporting hardware, to adjust the capacity of obstetric services of public hospitals when necessary.

(d) The Department of Health (DH) registers private hospitals which have met the requirements relating to accommodation, staffing and equipment in accordance with the Hospitals, Nursing Homes and Maternity Homes Registration Ordinance (Cap.165). DH requires all private hospitals providing obstetric services to have in place arrangements for provision of neonatal clinical service, including appropriate staffing (for example, having paediatricians on duty) and equipment, as well as availability of special care units, intensive care units or arrangements for referral to public hospitals, etc. In processing applications from private hospitals for registration, re-registration or expansion of obstetric services, DH will take into account whether the hospitals concerned are provided with the necessary supporting facilities, services and staffing as described above.

(e) The Administration has all along encouraged all pregnant women, local or otherwise, to receive regular antenatal checkups and reminded them to seek medical attention promptly if any abnormal condition or discomfort occurs. As for antenatal checkups required to be received by pregnant women (including the type and number of checkups), it should be a matter of clinical judgement for doctors who will make such arrangements according to prevailing medical evidence or relevant clinical protocols having regard to the clinical conditions of the pregnant women.

     As regards the non-local pregnant women who intend to have deliveries in Hong Kong, they should undergo antenatal checks by obstetricians in Hong Kong at an appropriate stage. Non-local pregnant women having normal pregnancy condition are allowed to have deliveries in Hong Kong. For high-risk pregnancies, the pregnant women in question are not suitable to give birth in Hong Kong as the health of themselves and their fetuses may be affected due to travels and other factors. Currently, HA's obstetric service package for non-local pregnant women includes one antenatal checkup at HA's specialist outpatient clinics. This serves to reduce the risk of difficult labour, unrecognised congenital anomalies for the babies and infection for healthcare workers and to deter dangerous behaviour by non-local pregnant women who have not received any antenatal checkup in public hospitals in seeking last-minute hospital admission before delivery through the Accident and Emergency Departments. Non-local pregnant women can receive more than one antenatal checkup at their own expense in public hospitals as appropriate to their conditions. They are required to pay the charges applicable to non-local people (i.e. Non-eligible Persons).

     Besides, an antenatal shared-care programme is provided by the Maternal and Child Health Centres (MCHCs) under DH in collaboration with obstetrics departments of public hospitals to cater for the needs of pregnant women during their pregnancy and delivery process. Under this antenatal care programme, pregnant women are provided with services such as routine checkups, blood tests and health education related to pregnancy, delivery and care for newborn babies. MCHCs will accept bookings for antenatal services from non-local pregnant women only if they have already made their first antenatal service registration with a public hospital and can present a Certificate on Confirmed Antenatal and Delivery Booking issued by HA. Non-local pregnant women have to pay for the charges applicable to non-local persons (i.e. Non-eligible Persons) before receiving antenatal services provided by MCHCs.

Ends/Wednesday, May 4, 2011
Issued at HKT 14:17