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LCQ5: Services of Hospital Authority

     Following is a question by the Hon Chan Han-pan and a reply by the Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council today (December 18)


     It is learnt that some patients were triaged as semi-urgent when they sought treatments at the Accident and Emergency (A&E) Department of the Prince of Wales Hospital (PWH) and treated only after waiting for 26 hours. Meanwhile, given the ageing facilities and inadequate space in public hospitals, the Government is planning to apply to the Finance Committee of this Council for an allocation of $13 billion for carrying out minor works projects for public hospitals in the next five to 10 years with a view to improving their facilities. Regarding improvements to the services and facilities of public hospitals, will the Government inform this Council:

(a)  as some members of the public living in areas without overnight out-patient services can only seek treatments at the A&E departments of public hospitals when they fall ill at night and if they are triaged as semi-urgent and non-urgent patients, their illnesses might be aggravated because of the exceedingly long waiting time for treatments, whether the authorities will encourage private healthcare institutions to enhance overnight out-patient services, and consider afresh introducing overnight general out-patient services in public hospitals, so as to alleviate the burden on A&E departments; if they will, of the details; if not, the reasons for that;

(b)  given the large population covered by the New Territories West Cluster, and since Pok Oi Hospital (POH) in the cluster is not a general hospital and Tin Shui Wai Hospital will be completed and commissioned only after a few years, most patients seek treatments at Tuen Mun Hospital (TMH) resulting in TMH's services being unable to meet the demand, and coupled with a very tight supply of operating theatres in the cluster as POH has only eight operating theatres and TMH, as a general hospital, has only 11 operating theatres (compared with 16 operating theatres in PWH, which is also a general hospital), and that the equipment of the cardiac catheterisation room of TMH is also insufficient and its other facilities (such as drainage and electrical wiring) are ageing, of the amount earmarked by the authorities for TMH's improvement works in the $13 billion funding application, and the details of the improvement works concerned; and

(c)  given that in each year from 2015-2016 onwards, there will be more local medical students graduating than now, whether it knows if the Hospital Authority has any plan to make complementary arrangements in respect of clinical equipment and facilities, so as to avoid the situation of "having the software but without the hardware"; if HA has such a plan, of the details; if not, the reasons for that?



     We attach great importance to the public needs for healthcare services and we strive to improve various kinds of healthcare services.

     As regards Accident and Emergency (A&E) services, the Hospital Authority (HA) has adopted a triage system which classifies patients attending the A&E departments according to their clinical conditions.  In 2012-13, all patients triaged as critical and 97% of patients triaged as emergency were treated immediately and within 15 minutes respectively, which is a performance meeting HA's performance pledge.  This shows that the majority of patients with pressing medical needs are able to receive medical treatment in a timely manner.  Under such triage system, the waiting time for patients whose clinical conditions are relatively less urgent is longer.  To shorten the waiting time and relieve the work pressure of front-line staff, HA has rolled out in phases a pilot programme for support services in 12 acute hospitals starting from this year to recruit additional manpower for the A&E departments.  As at the end of September, HA has recruited a total of 792 healthcare staff, providing about 1 850 consultation sessions and handling over 33 000 additional cases.

     As for general out-patient (GOP) services, HA has been trying to recruit additional staff, renovate and expand the clinics as well as upgrade their facilities, so as to increase the service capacity of the GOP clinics as far as possible.  HA added 300 000 consultation quotas for GOP clinics in 2012-13.  It will provide about 85 000 additional quotas in 2013-14.

     In addition, HA manages about 300 buildings, with a total floor area of over 2.6 million square metres.  Over 56% of the buildings were completed more than 30 years ago and some are even aged over 85.  To ensure that the conditions of such aging buildings will not affect our services, we have submitted to the Finance Committee of the Legislative Council (LegCo) the funding proposal of a one-off grant of $13 billion to HA, so as to speed up the planned improvement works programmes over the coming ten years.

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

(a)  HA offer various services with different scope and different target groups.  Patients receiving GOP services comprise two major categories: chronic disease patients with stable medical conditions and episodic disease patients.  At present, HA operates 73 GOP clinics while 23 GOP clinics provide evening out-patient services from 6pm to 10pm, and 12 GOP clinics provide out-patient services on Sundays and public holidays.  

     Patients with severe and acute symptoms should go to A&E departments of hospitals. HA will enhance measures and services in the A&E departments subject to the availability of manpower.

     As patients under the care of the GOP clinics mainly comprise chronic disease patients with stable medical conditions and patients with relatively mild symptoms, they do not require 24-hour service.   In fact, the GOP clinics are not set up to provide emergency services.  Although such arrangement would be at some patients' convenience, it will further increase the pressure on healthcare manpower.

     As for private healthcare institutions , they may have different services according to their operation modes.  The Administration has been encouraging private healthcare institutions to strengthen overnight out-patient services.  To facilitate the members of the public, the Department of Health (DH) has set up the Primary Care Directory (the Directory).  Primary care providers and private healthcare institutions can provide their consultation information and opening hours in the Directory for the references of the members of the public.

(b)  To enhance the existing facilities in the Tuen Mun Hospital (TMH), HA launched about 25 minor works improvement projects in 2013-14. The total expenditure is over $100 million.  

     If the grant of $13 billion is approved by the Finance Committee, HA will, in the next few years, make use of the funding to continue the various minor improvement works projects in TMH.

     Regarding the need of a new operating theatre in TMH, as I have explained earlier in the LegCo Health Services Panel meeting, we will conduct a technical feasibility study given its larger scale.  If the technical feasibility has been established after the study, we will apply for funding separately.

(c)  To cope with the increasing demand for healthcare manpower, the Government has introduced a number of measures to improve the manpower supply. One of which is the allocation of an additional $200 million for the triennial cycle starting from 2012 to increase the number of first-year first-degree places in medicine by 100 to 420 per year.  It is expected that 320 and 420 medical students will graduate in 2015-16 and 2018-19 respectively.

     As regards hardware, a number of hospital redevelopment and expansion projects are now underway. I have briefed the LegCo Health Services Panel earlier about the blueprint for long-term development of hardware in hospitals.

Ends/Wednesday, December 18, 2013
Issued at HKT 18:11


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