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Following is a question by the Hon Chan Hak-kan and a written reply by the Secretary for Labour and Welfare, Mr Matthew Cheung Kin-chung (in the absence of the Secretary for Food and Health), in the Legislative Council today (May 23):
Question:
Recently, quite a number of residents in Tai Po and the North District have relayed to me that at present the North District Hospital does not provide paediatric in-patient service, causing the sick children in the North District having to be admitted to Alice Ho Miu Ling Nethersole Hospital (Nethersole Hospital) in Tai Po, but the population in the district is increasing, and quite a number of children from the Mainland cross the border to seek medical treatment in Hong Kong, resulting in the hospital beds in Nethersole Hospital being fully occupied from time to time. They have pointed out that as such, some sick children living in Tai Po District have to go to Prince of Wales Hospital in Shatin to seek medical treatment, causing inconvenience to the sick children and their parents. In this connection, will the Government inform this Council:
(a) whether it knows the respective numbers and average occupancy rates of the paediatric beds in Prince of Wales Hospital and Nethersole Hospital in the past five years, and the numbers of in-patient children who were not Hong Kong residents;
(b) of the anticipated numbers of people aged 18 or below in Shatin, Tai Po and the North District respectively in the next five years;
(c) if it knows the factors and criteria based on which the Hospital Authority (HA) at present considers whether to provide paediatric in-patient service in a hospital; when such factors and criteria were formulated and whether they are reviewed on a regular basis;
(d) whether it knows if HA has assessed the impact of children crossing the border to seek medical treatment in Hong Kong on the paediatric in-patient service in the New Territories East Cluster (NTEC); and
(e) whether it knows if HA will conduct a comprehensive review of the paediatric in-patient service in NTEC to facilitate the formulation of improvement plans; if it will, the details; if not, the reasons for that?
Reply:
President,
To reduce duplication for more effective utilisation of resources, the Hospital Authority (HA) provides its services on a cluster basis. As the bed occupancy rate of the paediatric wards of the North District Hospital and the Alice Ho Miu Ling Nethersole Hospital (Nethersole Hospital) remained below 60% continuously in 2002 and 2003, the New Territories East (NTE) Cluster decided to re-organise its services in 2004 by combining the paediatric in-patient services of the two hospitals into one unit and centralising the provision of paediatric services at the Nethersole Hospital with a view to fully utilising the relevant facilities and healthcare manpower.
At present, paediatric specialist out-patient services are provided at the Prince of Wales Hospital, Nethersole Hospital and North District Hospital under the NTE Cluster to serve residents of Shatin, Tai Po and the North District. And paediatric and neonatal in-patient beds are also provided at the Prince of Wales Hospital and Nethersole Hospital to take care of the local patients in accordance with the complexity and severity of their medical conditions.
On the other hand, the Government has taken various measures to tackle the problem of non-eligible persons delivering in Hong Kong in order to ensure that Hong Kong residents are accorded priority for quality obstetric services. As for the measures taken by HA, these include ceasing the acceptance of bookings from non-local women for delivery in 2013 and raising the charge from $48,000 to $90,000 for delivery by emergency admission through Accident and Emergency Departments without prior booking. We believe that these measures would help alleviate pressure on the obstetric and gynaecological services as well as neonatal services in various HA clusters.
My reply to various parts of the question regarding the paediatric services in NTE is as follows:
(a) The number and average occupancy rate of the paediatric and neonatal beds in the Nethersole Hospital and Prince of Wales Hospital in the past five years are at Table 1.
The overall paediatric admissions and the admissions of "non-eligible" paediatric patients in the NTE Cluster in the past five years are at Table 2.
(b) Projections of geographical distribution of population by districts over a ten-year period are prepared on a need basis by the interdepartmental Working Group on Population Distribution Projections under the co-ordination of the Planning Department. According to the latest set of population distribution projections released in 2010, the projected mid-year population figures for the age group of 18 or below for 2012-2016 in Shatin, Tai Po and the North District are at Table 3.
(c) HA conducts assessment on the demand for its various services on a regular basis and undertakes reviews on the healthcare service delivery models so as to meet the needs of the community. As in other countries with a more well-developed healthcare system, HA has, in designing the provision of its paediatric services, adopted the guiding principle that where necessary, medical cases are centralised for management to achieve greater effectiveness and where feasible, services are provided in respective districts to facilitate the public to access the services.
HA has adopted an internationally-accepted demand projection model to forecast the future service needs in order to determine the demand for hospital beds. These forecast figures are updated regularly based on the projected Hong Kong resident population provided by the Census and Statistics Department and the projections of population distribution provided by the Planning Department. In making such a forecast, factors like the service delivery models adopted, the growth of population and changes in demographic profiles, as well as the trend of service outputs by age groups and specialties have been taken into account. These figures are calculated on a cluster basis.
HA will continue to strengthen its paediatric services where necessary in order to provide patients with appropriate care at different stages of treatment.
(d) and (e) As at early May 2012, there were a total of 64 and 170 hospital beds in the Paediatric and Neonatal Care Units of the Nethersole Hospital and the Prince of Wales Hospital respectively to serve the residents in the NTE.
To meet the additional service demand, the Prince of Wales Hospital will enhance the high dependency care for its paediatric service and open an additional neonatal intensive care bed in 2012-13, making the total number of neonatal intensive care beds in NTE to 22. As for the Nethersole Hospital, an additional Advanced Practice Nurse will be recruited in 2012-13 to support the operation of its paediatric ward. The NTE Cluster will closely monitor the rate and trend of utilisation of its paediatric services and, considering the overall supply of healthcare manpower, make appropriate resources planning.
Ends/Wednesday, May 23, 2012
Issued at HKT 12:42
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