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Following is a question by the Dr Hon Lam Tai-fai and a written reply by the Secretary for Food and Health, Dr York Chow, in the Legislative Council today (February 22):
Question:
Some members of the Chinese medicine industry (CM industry) in Hong Kong have relayed to me that the CM industry has all along been developing slowly although in 1999, the Chinese Medicine Ordinance (Cap. 549) was enacted and the Chinese Medicine Council of Hong Kong was established by the Government, and that the Government has neither attached enough importance nor provided sufficient support to the CM industry. In this connection, will the Government inform this Council:
(a) whether it will consider setting up a dedicated committee to formulate policies on promoting the development of the CM industry; if it will, of the details; if not, the reasons for that;
(b) given that the Government has indicated that it is actively implementing the plan to establish 18 public Chinese medicine clinics (CMCs) in Hong Kong in phases, and that 16 CMCs have been established so far, when the authorities plan to set up the remaining two CMCs, and whether they will consider further increasing the number of CMCs; if not, of the reasons for that;
(c) given that the Government has indicated that while the current operating hours of various CMCs are subject to district needs with a view to facilitating patients to seek treatment as convenient as possible under the premise of optimising the use of resources, it does not have any plan at present to extend their operating hours, whether the authorities have conducted any study or investigation to ascertain if the operating hours of CMCs in various districts have already met district needs and facilitated patients to seek treatment as convenient as possible; if they have, of the details; if not, why they do not consider extending such operating hours to facilitate the public;
(d) given that the Government has announced that in addition to revamping existing medical facilities, the redevelopment of Kwong Wah Hospital will also strengthen the Chinese and Western medicines shared care services of the hospital (including Chinese medicine in-patient service), whether it knows the details of the initiatives of the hospital in this respect (including the respective numbers of beds and Chinese medicine practitioners (CMPs) of the Chinese medicine in-patient service), and if the Hospital Authority has any plan to extend these initiatives to other hospitals;
(e) whether it will reconsider studying the establishment of a public Chinese medicine hospital; if it will, of the details; if not, the reasons for that;
(f) whether it has assessed if the authorities' initiatives in the past decade were able to incorporate Chinese medicine into the public healthcare system proactively; if it has assessed, of the details; if not, the reasons for that;
(g) of the measures in place to facilitate sustainable career development of CMPs with a view to promoting the development of the CM industry;
(h) of the measures or policies currently in place to attract Chinese medicine experts from the Mainland to Hong Kong to nurture local talents and lift the professional standard of the CM industry in Hong Kong;
(i) whether it will consider offering assistance (including creating special tax concessions in this respect) to small and medium-sized proprietary Chinese medicine manufacturers in terms of resources and financing to allay their burden in various aspects such as testing, research and development and plant improvement, etc., and to upgrade the quality of products; if it will, of the details; if not, the reasons for that;
(j) given that some members of the industry have indicated that under the insurance coverage provided by insurance companies at present, the amounts of compensation granted for claims made in respect of fees for treatment by CMPs are generally lower than those granted for claims made in respect of fees for treatment by medical practitioners, whether the authorities know the reasons for that; if they do, of the details; if not, whether they will seek an in-depth understanding of the matter; and
(k) given that Chinese medicine is outside the scope of medical benefits for civil service eligible persons at present, whether the authorities will consider including Chinese medicine in such scope so as to take the lead in promoting equality between CMPs and medical practitioners; if they will not, of the reasons for that?
Reply:
President,
The Government has been adopting a multi-pronged approach based on the concept of "evidence-based medicine" to facilitate the development of the Chinese medicine industry in Hong Kong.
The Chinese Medicine Ordinance (CMO) was enacted in 1999 to establish a regulatory regime for Chinese medicine so as to further safeguard public health, recognise the professional status of Chinese Medicine Practitioners (CMPs) and ensure the safety, quality and efficacy of Chinese medicines.
The Government has also taken proactive initiatives to help Hong Kong's Chinese medicine move towards internationalisation and cultivate an environment conducive to the development of the Chinese medicine industry. These initiatives include a research programme on the Hong Kong Chinese Materia Medica Standards launched by the Department of Health (DH) in 2002, to set standards, in terms of safety and quality, for Chinese herbal medicines which are commonly used in Hong Kong. The development of safety and quality reference standards for Chinese medicines can help bring about improvements in the raw materials for proprietary Chinese medicines and boost public confidence in Chinese medicines. It can further solidify the foundation for research on Chinese medicines, facilitate alignment with international requirements and expedite the modernisation and internationalisation of Chinese medicines as well as facilitating the Chinese medicines trade.
In addition, the Government also actively provides professional support to the World Health Organisation (WHO) on the development of traditional medicine, including international classification of traditional medicine and formulation of a strategy for traditional medicine for the next decade. DH has taken the initiative to organise several meetings on international classification of traditional medicine in collaboration with WHO. Through WHO, the Government has strengthened its ties with the international network, and established an adverse event notification mechanism on Chinese medicine and enhanced its information exchanges and cooperation on regulation of herbal medicine with other regions.
My reply to the various parts of the question is as follows:
(a) The Chinese Medicine Council of Hong Kong (CMCHK), established under CMO in September 1999, is responsible for implementing various regulatory measures relating to Chinese medicine so as to maintain the standard of practice and the conduct of CMPs and Chinese medicines traders, promoting and ensuring the proper use of traditional Chinese medicine, and ensuring the safety, quality and efficacy of proprietary Chinese medicines. This statutory regulatory body comprises practising CMPs, members of the trade of Chinese medicines, academics, lay persons and government officials.
Besides, the Government set up a Committee on Research and Development of Chinese Medicine (the Committee) in December 2011. It is chaired by the Commissioner for Innovation and Technology with the objective to achieve greater effectiveness in co-ordinating the collaboration of various stakeholders in the Chinese medicine sector in promoting research and development (R&D) and testing of Chinese medicine to meet the future needs of Hong Kong. The Committee will act as a platform to gauge views from various stakeholders on R&D of Chinese medicine in Hong Kong, formulate the broad direction in promoting R&D of Chinese medicine in Hong Kong, identify key areas of work, monitor progress and recommend areas of improvement where necessary. The Committee will facilitate sharing of R&D outcome and other collaboration among stakeholders to create synergy in R&D of Chinese medicine and to promote collaboration with organisations outside Hong Kong.
The Government has also set up a Steering Committee on Strategic Review on Healthcare Manpower Planning and Professional Development. The Steering Committee is chaired by the Secretary for Food and Health and held its first meeting in January 2012. The Steering Committee is tasked to conduct a strategic review of healthcare manpower planning and professional development in Hong Kong. The review will cover healthcare professionals in the 13 health professions currently subject to statutory regulation including CMPs. It will put forward recommendations on how to cope with anticipated demand for healthcare manpower, strengthen professional training and facilitate professional development having regard to the findings of the strategic review, with a view to ensuring the healthy and sustainable development of Hong Kong's healthcare system.
(b) & (c) To promote the development of "evidence-based" Chinese medicine, the Government has been actively taking forward the plan to establish 18 public Chinese medicine clinics (CMCs) in the territory by phases. So far, we have set up 16 CMCs which are respectively located in Central and Western District, Wan Chai District, Eastern District, Southern District, Kwun Tong District, Wong Tai Sin District, Sham Shui Po District, Kowloon City District, Tsuen Wan District, Tai Po District, Sai Kung District (Tseung Kwan O), Yuen Long District, Tuen Mun District, Kwai Tsing District, North District and Sha Tin District. We will continue to identify suitable sites in the Yau Tsim Mong District and Islands District for establishing the remaining two CMCs, so as to enhance Chinese medicine service in our public healthcare system. We are still taking forward the plan to establish public CMCs in the 18 districts in the territory and have no plan to further increase the number of public CMCs at this stage.
The service hours of CMCs depend on the demand of individual districts, with a view to facilitating patients to seek treatment as far as possible while effectively using resources. At present, CMCs are running smoothly and there is no plan to extend their service hours.
(d) to (f) The long-term goal of the Government in promoting the development of Chinese medicine is to develop, through an evidence-based approach, a model of collaboration between Chinese and Western medical practitioners that can meet the actual circumstances and needs of Hong Kong.
In view of the increasing demand for Chinese medicine services from members of the public, the Government is actively incorporating Chinese medicine services into the public healthcare system on an incremental basis. Since 2003, the Government has established CMCs in 16 districts, and the remaining two CMCs will be set up as soon as possible to promote the development of the Chinese medicine services. The Hospital Authority (HA) is now trying out different models of Chinese and Western medicines shared care services in more than 20 hospitals to combine the advantages of Chinese and Western medicine systems in the treatment of specific illnesses through enhancing communication between Chinese and Western medical practitioners so as to provide well-suited medical treatment to patients.
The Kwong Wah Hospital Redevelopment Project includes the development of Chinese medicine services with a major focus on the out-patient service, where conjoint consultations by a multi-disciplinary team (of CMPs and Western medical practitioners) will be provided for patients. Apart from a larger scale of Chinese and Western medicines shared care services, Chinese medicine in-patient service will also be provided. The initial plan is to provide a Chinese and Western medicines shared ward with 56 beds. As there is still some time before the Project is completed, a review will be carried out on such issues as the number and establishment of CMPs, and whether proposed services will be further expanded when the Project is close to completion.
At present, the Government does not have any plan to establish Chinese medicine hospitals. Organisations interested in setting up private Chinese medicine hospitals are welcome to put forward their detailed proposals to the Government for consideration.
(g) Chinese medicine practice has a long history in Hong Kong. Since the enactment of CMO in July 1999, Chinese medicine is officially put under statutory regulation and the statutory professional status of registered CMPs is established. CMO sets out the regulatory measures relating to CMPs and covers such matters as examination, registration and discipline. Moreover, CMO also specifies that upon renewal of practising certificates, registered CMPs must fulfill the requirements of continuing education in Chinese medicine as prescribed by the Chinese Medicine Practitioners Board under CMCHK in order to update their professional knowledge and keep themselves abreast of the latest developments.
At present, three local universities have provided full-time degree courses on Chinese medicine. In the long run, the local education institutions could produce an adequate pool of high calibre professionals to support Hong Kong's development as an international centre for Chinese medicine.
Besides, HA has been actively increasing the job and training opportunities for CMPs practising in public CMCs. Fresh graduates of local Chinese medicine degree programmes will be engaged as junior CMPs in the first year and as CMP trainees in the second and third years. Each public CMC is required to employ at least four part-time (or two full-time) senior CMPs and 12 junior CMPs/CMP trainees, thereby enhancing the job and training opportunities for CMPs significantly.
To assist Chinese medicine graduates in attaching to the Chinese medicine hospitals or CMCs on the Mainland, HA provided a Junior Scholarship in Chinese Medicine in July 2009 for CMPs with clinical experience of two years or more to further their study in renowned hospitals on the Mainland. The subjects for further study are selected according to the development trend and needs of Chinese medicine in Hong Kong. After completing the training, they need to return to Hong Kong to work in the public CMCs operated under the tripartite model among HA, a non-governmental organisation and a local university and assist in the promotion of Chinese medicine services. In addition, HA has provided a Senior Scholarship in Chinese Medicine since April 2010. Local CMPs with aspiration to promote the development of teaching and research in Chinese medicine and in possession of substantial qualification and experience will be selected to further their study in the Mainland's hospitals. They need to provide training for CMPs after returning to Hong Kong.
As Chinese medicine services are becoming more prevalent in Hong Kong, the professional status of CMPs and their services have obtained broad-based recognition from the public in recent years, which contributes significantly to the career development of CMPs.
(h) CMO provides for a system of limited registration of CMPs, as approved by CMCHK, to facilitate the engagement of Chinese medicine experts in performing clinical teaching and research in Chinese medicine in the specified institutions. Chinese medicine experts on the Mainland may come to Hong Kong to conduct clinical research and educational work in specified local universities and scientific research institutions through a limited registration system, which can help further enhance the professional competence of local CMPs. At present, six local universities and scientific research institutions can make limited registration applications for the Chinese medicine experts they hire. These six institutions are the University of Hong Kong, the Chinese University of Hong Kong, the Hong Kong Baptist University, the Hong Kong Polytechnic University, the City University of Hong Kong and HA. Currently, there are 70 registered CMPs with limited registration in Hong Kong.
(i) As for R&D, the Government provides funding support for local proprietary Chinese medicine manufacturers to carry out applied research projects relating to R&D and testing of Chinese medicine through various support programmes under the Innovation & Technology Fund. Among these programmes, the University-Industry Collaboration Programme aims to encourage enterprises to leverage on the expertise of the universities and carry out R&D projects jointly with them whereas the Small Entrepreneur Research Assistance Programme provides funding support for small and medium enterprises to carry out R&D projects on Chinese medicine so as to assist them in starting new businesses and conducting market validation. As for the General Support Programme under the Innovation & Technology Fund, it provides funding support for projects which can enhance and facilitate the development of Chinese medicine industry such as conferences, exhibitions, seminars, workshops, promotional activities, research and surveys.
As to testing and laboratory technology support, representatives of the Chinese Medicines Board under CMCHK and DH often organise briefings and sharing sessions with the trade where necessary, and attend meetings of the Chinese medicines trade association from time to time so as to offer appropriate technical support to the trade. Relevant information is also available on the website of CMCHK for reference by members of the trade.
(j) According to our understanding, insurance companies currently make reference to the median medical fees in the market in determining the amount of reimbursement for medical fees. According to the findings of market research conducted by insurance companies, the median medical fees for Chinese medicine services are lower than those for Western medicine services. For this reason, the amount of reimbursement for Chinese medicine services is in general lower than that for Western medicine services. Insurance companies will conduct market research on medical fees from time to time to ensure that the insurance coverage they provide can best meet the needs of the insurees. In case of special needs, insurees can also ask their insurance companies to enhance their protection by raising the amount of reimbursement for Chinese medicine services, but the amount of premium will also be adjusted accordingly.
(k) According to the current provisions laid down in the Civil Service Regulations (CSRs), civil service eligible persons are entitled to free medical treatment and medical services, X-ray examinations and medicines, but only when these benefits are provided by DH or the medical facilities of HA. Civil service eligible persons are required to pay for the charges applicable to hospital maintenance, dentures and dental appliances as provided for in CSRs.
At present, there are no CMCs under DH. As for CMCs under HA, they are operated under a tripartite model under which HA collaborates with a non-governmental organisation and a local university for provision of services to patients at each CMC. Unlike the general out-patient clinics under HA, these CMCs are operated on a self-financing basis. Hence the services provided at these CMCs fall outside the scope of medical benefits that civil service eligible persons are entitled to.
Ends/Wednesday, February 22, 2012
Issued at HKT 17:36
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