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LCQ9: Obstetric services in Sai Kung District
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     Following is a question by Hon James Tien Pei-chun and a written reply by the Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council today (February 6):

Question:

     The Government sought funding from the Finance Committee of this Council in 2008 for the expansion of Tseung Kwan O Hospital (TKOH), and planned to provide obstetric services in TKOH in 2013-2014.  However, the Hospital Authority (HA) has recently decided not to provide obstetric services in that hospital on the basis that the birth projection for Sai Kung District (SKD) in the coming few years will be lower than the planning reference set by HAs Expert Committee on Obstetric and Gynaecology Services years ago for the provision of such services in a public hospital (which is 3 000 delivery per annum), making it necessary for the pregnant women in the district to continue to obtain delivery services from the United Christian Hospital in Kwun Tong.  In this connection, will the Government inform this Council:

(a) given that HA has projected that the number of births in public hospitals in SKD for the coming few years is only 2 300 to 2 500 per annum, whether it knows the formula based on which the projection was calculated;

(b) whether it knows how the Expert Committee on Obstetric and Gynaecology Services formulated the aforesaid planning reference;

(c) given that the 2011 Population Census published by the Census and Statistics Department revealed that women in the age group of 25 to 44, who have a higher fertility rate, constitute around 35% of the women population in SKD, whether the Government has taken this factor into consideration in assessing the demand for obstetric services of SKD residents; if it has, of the details; if not, the reasons for that;

(d) whether it has assessed the healthcare manpower needed for the provision of obstetric services in TKOH as originally planned; if it has, of the details; if not, the reasons for that;

(e) whether it has assessed the impact of the pregnant women in SKD having to obtain delivery services from other districts on the demand for and quality of obstetric services of hospitals in these districts, as well as the impact on the safety of such pregnant women; if it has, of the details; if not, the reasons for that;

(f) of the maximum capacity and utilisation of obstetric services of public hospitals in the past five years (set out the annual figures by each public hospital providing obstetric services); and

(g) given that the authorities indicated in the paper submitted to the Panel on Health Services of this Council last month that HA would constantly review the timeline for the provision of delivery services and services of the neonatal intensive care units in TKOH, of the details of the latest timeline?

Reply:

President,

     At the meeting of the Legislative Council Panel on Health Services held on January 21, 2013, we explained to Members the overall healthcare needs of the Tseung Kwan O district as well as the considerations for the timeline in providing obstetric services in the Tseung Kwan O Hospital (TKOH).  In considering the detailed arrangement (including the timing) for provision of obstetric services in TKOH, we have to take into account a number of factors such as the overall demand for services, the supply of healthcare personnel and the overall allocation of healthcare resources.  However, these factors, in the current state, do not justify the provision of obstetric services in TKOH in the next three years.

     Nevertheless, we recognise that there may be a need for such services in TKOH in the longer term.   With due regard to manpower constraint and the safety issue in connection with the provision of delivery and neonatal intensive care units (NICU) services, the Hospital Authority (HA) will continue to make plan for the provision of manpower to prepare for the opening of obstetric services in TKOH at an opportune time as and when sufficient manpower is available and safety standard can be assured.

     My reply to the various parts of the questions is as follows:

(a) and (c) HA's projection of the number of deliveries in the Sai Kung District (SKD) is based on the following information:

(i) the number of births in Hong Kong obtained from the latest population projection (using 2011 as the benchmark) compiled by the Census and Statistics Department;

(ii) the projection of population distribution by District Council district/New Town and age (using 2009 as the benchmark) compiled by the Planning Department; and

(iii) the fertility rates by district in 2011 (the estimation of which is based on the known number of live births and the number of women aged between 15 and 49 in each district).

     HA has duly taken into account the future residential development projects and the population growth in SKD based on the Planning Department's projection of population distribution.  The relatively higher proportion of fertile couples in SKD has already been reflected in the fertility rate of that district and taken into consideration in the projection.

(b) To ensure service safety and quality, HA's Co-ordinating Committee in Obstetrics and Gynaecology Service has, based on expert advice, set a planning reference, which advises that a public hospital in general will only provide obstetric services when the number of births at that hospital is projected to reach 3 000 per year.  This planning reference aims to ensure that the healthcare personnel can accumulate sufficient clinical experience to handle the possible sudden changes of clinical conditions of the pregnant patients.

(d) If obstetric services are to be provided, TKOH must also provide a complete set of supporting facilities for the delivery services and for the care of newborn babies in order to ensure the provision of safe obstetric and neonatal care services.  These facilities include NICU, Special Care Baby Unit, delivery rooms, operating theatres and other supporting services such as laboratory tests and allied health services etc.  The total manpower required for providing the aforesaid services includes more than 30 doctors and 120 nurses.

(e) According to HA's records, for the local pregnant women in SKD who chose to give birth in public hospitals in 2012, more than 70% gave birth in the United Christian Hospital, which is also under the Kowloon East Cluster as TKOH.  The use of delivery services provided by hospitals in other districts is not serious.  It has not brought extra heavy pressure on other hospitals either.

     As for pre-natal and post-natal services, pregnant women and babies in SKD may use the relevant services provided by TKOH.

(f) The numbers of delivery cases in public hospitals for the past five years are set out in Annex.

(g) At present, the situation regarding the provision of obstetric services in TKOH remains more or less the same as that when we briefed the Legislative Council Panel on Health Services in January.  HA will constantly review the timeline for the provision of delivery and NICU services in TKOH and continue to communicate with the stakeholders on the progress.

Ends/Wednesday, February 6, 2013
Issued at HKT 14:38

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