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Following is a question by the Hon James To and a written reply by the Secretary for Food and Health, Dr York Chow, in the Legislative Council today (July 6):
Question:
The original intention of implementing the Telephone Appointment Booking Service (Telephone Appointment Service) of general outpatient clinics (GOPCs) is to prevent patients from having to visit clinics in person and spend much time on waiting for consultation quotas, as well as to alleviate the crowded queueing conditions in clinics. In recent years, it has been reported that the consultation quotas allocated through telephone booking were often full, resulting in longer waiting time. It has also been reported that although the quotas reserved for civil servants in some GOPCs have not been fully allocated, the GOPCs do not release such unallocated quotas for the general public to book. In this connection, will the Government inform this Council whether it knows:
(a) the number of consultation quotas allocated by the various GOPCs in Kowloon West Cluster in each of the past three years; among them, the quotas reserved for civil servants and the average utilisation rate; the number of appointments cancelled by civil servants on their own initiative; and how unallocated quotas for civil servants are handled by GOPCs;
(b) given that various clinics have different number of unallocated consultation quotas each day and the public have no way of knowing whether they can be allocated such quotas, how the authorities dispose of the unallocated quotas; if a notification mechanism will be put in place to announce the number of unallocated quotas through web site or hotlines;
(c) the number of complaint cases received in each of the past three years in which the complainants were not able to get through to the Telephone Appointment Service hotlines; if there are channels for compiling statistics on the number of unsuccessful booking; given that it has been reported that such hotlines were always busy, if the authorities have assessed if the present 500 odd telephone lines are adequate in meeting the demand;
(d) given that some chronic patients complained that they were not able to receive timely treatment because the consultation quotas booked through telephone were full, if the authorities have any plan to assist them in securing the unallocated quota; and
(e) focusing on the complicated instructions of the Telephone Appointment Service System, what improvement measures the authorities have; what changes are actually made as the authorities have indicated that they would streamline the procedures?
Reply:
President,
The service of public general outpatient clinics (GOPCs) of the Hospital Authority (HA) is primarily targeted at the low-income and underprivileged groups, including the chronically ill, frail and vulnerable or disabled elders, and low-income families. Patients taken care of by GOPCs can be broadly divided into two main categories, namely chronic disease patients with stable conditions (e.g. patients with diabetes mellitus (DM) or hypertension (HT)) and episodic disease patients with relatively mild symptoms (e.g. patients who have fever or suffer from influenza, gastroenteritis, etc). In order to enable civil servants to return to work as early as possible after treatment, GOPCs offer priority consultation quotas to civil servants at specified periods (half an hour in the morning and afternoon).
Since 2006, HA has introduced a Telephone Appointment Service (TAS) for individuals to book a consultation timeslot at GOPCs, in order to improve the crowded queuing situation, reduce the risk of cross-infection at GOPCs and make the best use of GOPC consultation quotas. HA has been keeping in view the use of the TAS by different groups of the public. It also regularly reviews the operation mode of the appointment system and implements corresponding improvement measures with a view to optimising the use of resources and providing high quality services.
My reply to the respective parts of the question is as follows:
(a) At present, there are 23 GOPCs in the Kowloon West Cluster (KWC) of HA, offering consultation quotas to the public through the TAS system. KWC also offers priority consultation quotas to civil servants at specified periods. In 2009, KWC offered more than 1.5 million consultation quotas in total, and currently about 500 priority consultations quotas per day are allocated to civil servants. Civil servants will receive consultation as soon as they are allocated a consultation quota, and, in general, a cancellation of allocated quota is unlikely to occur. To make better use of consultation quotas, priority quotas not being allocated will be released immediately to the public via the TAS system after the specified periods for civil servants. In 2009, the overall utilisation rate of the GOPCs in KWC was about 97%.
(b) The TAS system is designed to link the GOPCs in the same cluster together to form a network. When the consultation quotas of a particular clinic are full, the system will automatically connect to the nearby clinics in the same cluster and identify remaining consultation quotas for members of the public to choose via the TAS, with a view to making better use of the unallocated GOPC quotas. The TAS system will also adjust consultation quotas according to various factors, such as quotas cancelled by the public, allocation of manpower, unallocated civil servant priority quotas, etc., to achieve better utilisation of consultation quotas. HA has also uploaded a report on the unused quotas of particular GOPCs on average for the preceding four weeks at its website for public information. In 2009, the overall utilisation rate of GOPCs over the whole territory was about 97%.
(c) and (d) The TAS is designed mainly for use by patients with episodic illnesses. Chronic disease patients requiring regular follow-up consultations are assigned the next timeslot after each consultation, and do not need to book appointments through the TAS for their follow-up consultations. Currently, there are a total of some 500 telephone lines which operate 24 hours a day and allow patients to reserve consultation quotas available in the next 24 hours. In order to ensure services are provided to primary service targets, the TAS accords priority to elderly people, Comprehensive Social Security Assistance (CSSA) recipients and people granted with medical fee waiver, and a mechanism has been put in place to prevent abuse of appointment (e.g. missing appointments repeatedly, etc.). Past records have indicated that the average proportion of utilisation of the TAS system telephone lines was not high. Nonetheless, circumstances regarding usage vary during different seasons and time periods, and it would be inevitable for lines to be relatively busy at certain days and time periods.
There are more than 2.5 million episodic illness consultation quotas offered by GOPCs in a year, and the number of complaints received is around 40 to 50 annually, including complaints concerning various administrative arrangements, as well as those concerning failure to connect to the TAS or acquire a consultation quota. HA will continue to monitor the usage of telephone lines of the TAS system. To better utilise unallocated quotas, HA has also produced short clips to educate patients the procedures in cancelling a consultation appointment, so that those patients who are not in need will release the quota allocated to him/her for others' use. In 2009, 93% of elderly patients were allocated a GOPC timeslot within two working days through the TAS.
(e) Since the introduction of the TAS in 2006, HA has been conducting review and rolled out enhancement measures to streamline the telephone appointment process making the system more user-friendly. These measures include simplifying data entry procedures, increasing the number of telephone lines to more than 500 while operating 24 hours a day, offering priority quotas that focus on primary service targets, introducing reminder messages to assist patients to use the TAS system, etc. Since September 2010, people with hearing impairment can also make appointments by facsimile. Moreover, HA has provided assistance to the elderly to use the TAS through various channels. These include the issuance of a "Telephone Appointment Pocket Tips Guide" to clinics, offices of District Councillors and institutions providing service to the elderly, and collaboration with community organisations to guide and assist the elderly to use the TAS system. Besides, help desks have been set up in every GOPC to provide suitable assistance to the elderly and individuals who may encounter difficulties in using the TAS.
Ends/Wednesday, July 6, 2011
Issued at HKT 13:12
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