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LCQ15: Public-private partnership pilot projects in healthcare
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     Following is a question by the Hon Cheung Man-kwong and a written reply by the Secretary for Food and Health, Dr York Chow, in the Legislative Council today (July 6):

Question:

     Regarding the public-private partnership programmes in healthcare (PPP programmes), will the Government inform this Council:

(a) of the PPP programmes which are being implemented at present as well as those which are planned to be implemented in the next two years covering the scope of hospital services; of the public expenditure incurred, the partners from the private sector and their number, the service targets and number of beneficiaries;

(b) whether the authorities have, prior to the implementation of the PPP programmes, assessed the pros and cons of injecting resources into these programmes vis-j-vis the improvement of public healthcare services, in terms of the cost, government expenditure, fairness as well as the manpower requirement and mobility of healthcare staff involved in each programme; if they have, of the criteria for and results of the assessment for implementing the programmes; if not, the reasons for that; and

(c) given that the authorities have launched the PPP programme of "Cataract Surgeries Programme" in February 2008 to, on the one hand, provide a fixed amount of subsidy to patients who chose to receive surgeries in the private sector and, on the other hand, to increase the number of such surgeries conducted in public hospitals so as to shorten patients' waiting time, whether they know the difference between the number of healthcare staff required for a cataract surgery carried out in private medical service institutions and that for conducting such surgery in public hospitals; of the wastage rate of healthcare staff in the ophthalmic service of the Hospital Authority (HA) as well as the ranks of those staff departed since 2008; of the measures HA has in place to retain its staff, and the expenditure so incurred; in view of the expanding ageing population in the future and the increasing number of patients who need to receive cataract surgery, whether the authorities have assessed the additional places for cataract surgeries need to be provided and the additional number of relevant healthcare staff need to be recruited by HA in the next five years in order to meet the new service demand; if they have, of the results; if not, the reasons for that?

Reply:

President,

(a) The Administration has launched two public-private partnership (PPP) pilot projects, through the Hospital Authority (HA), covering hospital services (excluding specialist out-patient and general out-patient services) as in Annex A.

     In 2011-12, we plan to launch another pilot project to strengthen radiological imaging services through PPP for specific groups of cancer patients who meet the relevant clinical criteria. This pilot project is still at the preparatory stage. We plan to select suitable private providers through open tender. We estimate that some 10 000 radiological imaging checks would be provided under the project.

     We estimate that the expenditure required for implementation of these PPP projects in 2011-12 is around $50 million. We are not in a position to provide specific figures for 2012-13 and beyond as adjustments may be made to the scale and expenditure of these projects in the light of public response and their effectiveness.

(b) Promotion of PPP in healthcare is a key element of healthcare reform proposed in 2008. It aims at offering more choice of services for individuals, promoting healthy competition and cooperation, and making better use of resources in both the public and private sectors through collaboration between the two sectors to provide healthcare infrastructure or services. PPP also helps benchmark the efficiency and cost-effectiveness of healthcare services, and facilitates cross-fertilisation of expertise and experience among healthcare professionals. We wish to stress that the Government's commitment to healthcare will not decrease because of promoting PPP.

     In developing each PPP project, we will have regard to the aforesaid policy direction of healthcare reform and set clear project objectives, identify appropriate target groups, determine the feasible and suitable PPP model, monitor the quality of services provided to the public under the projects and assess carefully their cost effectiveness in order to ensure that members of the public can benefit from the projects. Generally speaking, factors to be considered for implementation of individual projects include: whether there is a pressing need for the service; the feasibility of the PPP model; the capacity of the public and private sectors and the quality of the services provided; whether cost effectiveness can be achieved and service outcome can be enhanced; and other potential pros and cons of the projects.

     The Administration will review each and every PPP project and evaluate its efficacy, cost-effectiveness, service quality, public's participation rate and satisfactory level as well as other achievements. Adjustments will be made as appropriate in light of the evaluation results to ensure efficient use of resources.

(c) HA has implemented since February 2008 the Cataract Surgeries Programme (CSP) to subsidise patients to receive surgeries in the private sector. Under CSP, patients who choose to receive surgeries in the private sector will receive a fixed subsidy of $5,000, subject to a co-payment of no more than $8,000 by the patient. HA has at the same time increased the number of surgeries conducted in HA hospitals.  The Administration has reported to the Legislative Council Panel on Health Services the details and review of CSP in June 2010. In general, CSP is able to provide needy patients waiting for cataract surgeries at public hospitals with a choice for quality private service through the provision of a subsidy, and make better use of the capacity of public and private sectors for cataract surgeries, thereby enhancing the overall service throughput in a cost-effective way.

     In 2011-12, HA will enhance its facilities (including establishment of a new cataract centre at the Tseung Kwan O Hospital) to perform 3 000 additional cataract surgeries in its public hospitals. It will at the same time provide subsidies to 3 000 patients for cataract surgeries in the private sector under CSP. With the above measures, it is projected that HA can handle about 31 000 cataract surgeries in 2011-12. As HA has projected that there will be about 22 000 to 25 000 new cataract cases per year, HA should be able to meet the service needs with the above capacity.

     HA does not have the relevant information about the difference in the number of healthcare staff required for each surgery performed in the public and private sectors. The turnover figures of HA's ophthalmologists and nurses in ophthalmic department in 2008-09, 2009-10 and 2010-11 are set out in Annex B.

     The turnover rates of ophthalmologists and nurses in ophthalmic department are respectively 5.8% and 2.8% on average. HA has deployed additional resources over the past few years to address manpower issues. Apart from recruiting additional healthcare staff to cope with increase in demand, HA has been striving to enhance the professional training of its healthcare staff, provide them with better working environment, promotion prospect and remuneration package so as to attract and retain talents.

Ends/Wednesday, July 6, 2011
Issued at HKT 12:41

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