LCQ16: Centre of Excellence in Neuroscience and neurological services
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      Following is a question by the Hon Tang Ka-piu and a written reply by the Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council today (December 18)

Question:

     The Government indicated in the Policy Agenda of the 2007-2008 Policy Address that it would explore the establishment of multi-partite medical centres of excellence in paediatrics and neuroscience, so as to put together clinical services, medical research and professional training, and to concentrate professional knowledge, advanced technology and cases of complex illnesses in one place, thereby enhancing the competency of the two specialties. It is learnt that while the construction of the Centre of Excellence in Paediatrics has been confirmed and will be completed in 2017, there has been no further news on the development of the Centre of Excellence in Neuroscience (CEN) to date. In this connection, will the Government inform this Council:

(a) of the latest plan and construction timetable of CEN;

(b) given that the Government has set up a steering committee to explore the establishment of CEN in Hong Kong, of the conclusions of the studies of the steering committee; whether the Government has accepted the recommendations of the committee; if it has, of the details; if not, the reasons for that;

(c) of the existing medical institutions which provide diagnostic services and treatments to neurological patients, as well as the respective numbers of doctors currently serving in such specialist services of public and private hospitals; of the number of such patients and the attendance of such specialist services, as well as their average waiting time, in the past decade; whether it has assessed the future demand for medical services of such patients; if so, of the details; if not, the reasons for that;

(d) whether it knows if the local medical institutions conducted any research in respect of the treatment methods, medical prescriptions and rehabilitation services for neurological illnesses in the past decade; if they did, of the research findings; and    

(e) as the Government indicated in the middle of this year that it was considering the construction of a general hospital on a site in the Kai Tak Development Area, which was the site originally selected for CEN, of the latest site identified for CEN?   
 
Reply:

President,

     My reply to the question raised by the Hon Tang Ka-piu is as follows:

(a), (b) and (e) The Administration announced in 2007 to study the establishment of medical centres in paediatrics and neuroscience, and reserved a suitable site in the Kai Tak Development Area for the purpose. With the funding approval of the Finance Committee of the Legislative Council, construction works for the Centre of Excellence in Paediatrics (CEP) have commenced in August this year.

     To meet the long-term demand for healthcare services and facilities in Kowloon, we have requested the Hospital Authority (HA) to conduct a strategic review of the development of a new public general hospital on relevant sites in the Kai Tak Development. We hope to complete the review in 2014, after which we will proceed with detailed planning and design of the hospital and consultation with stakeholders. The newly proposed Kai Tak general hospital will be an acute general hospital providing clinical services of major specialties, including accident and emergency services. To better utilise resources, a centre in neuroscience will be set up under this new general hospital.  

     Under the detailed design of the Kai Tak general hospital, the HA will take into consideration the comments raised and discussed by the Steering Committee on CEN. The HA will arrange staff and deploy neurology experts from its hospitals to provide services in the CEN.

(c) According to the information of the Medical Council of Hong Kong, there are about 160 registered specialists in neurology and neurosurgery in Hong Kong.

     Patients suffering from neurological diseases may seek medical consultation at the specialist out-patient (SOP) clinics for medicine and neurosurgery under the HA. The number of doctors in medicine and neurosurgery and the number of attendances in SOP clinics for medicine and neurosurgery from 2003-04 to 2012-13 are tabulated at Annexes 1 and 2 respectively.

     The HA has implemented a triage system for all new SOP referrals to ensure that patients with urgent conditions requiring early intervention are accorded priority in treatment. Under the current triage system, new referrals are usually first screened by a nurse and then by a specialist doctor of the relevant specialty for classification into priority 1 (urgent), priority 2 (semi-urgent) and routine categories. The HA's target is to maintain the median waiting time for cases under priority 1 and priority 2 within two weeks and eight weeks respectively.  So far, the HA has been able to meet these pledges.

     The median waiting time for new cases in SOP clinics for medicine and neurosurgery from 2003-04 to 2012-13 is set out at Annex 3. As the triage system for new cases in SOP clinics was introduced in April 2006, we cannot provide information on the waiting time for new cases by triage category in 2003-04 and 2005-06. Moreover, the triage system is not applicable to new cases of neurosurgery.

     At present, patients suffering from neurological diseases may receive treatment under different specialties including medicine, neurosurgery and paediatrics. In planning for the services of various specialties, the HA has taken into consideration a number of factors including population growth and demographic changes, the utilisation and estimated growth rate of services of individual specialties, possible changes in healthcare services utilisation pattern, etc.  

     The HA will regularly monitor the utilisation rate and trend of various healthcare services and ensure that the services can meet public demand through continued restructuring of hospital service delivery modes, hospital development projects and implementation of other suitable measures.  

     In general, all private hospitals provide neurological and/or neurosurgical services, including SOP, rehabilitative (physiotherapy) and in-patient services. The Department of Health has not specifically conducted any statistical surveys on the number of patients receiving such services in private hospitals.

(d) Experts of the HA have kept in view the development of treatment methods, medical prescriptions and rehabilitation services for various kinds of diseases. Seminars are conducted every year to invite renowned scholars worldwide to share their experience and research findings. The HA will also exchange views with the medical schools of the local universities on the latest medical technologies and research outcome.

     As for neurology, the HA has introduced the appropriate methods and drugs to enhance the quality of treatment. HA introduced the Deep Brain Stimulation treatment for suitable patients with advanced Parkinson's disease; provided in phases in HA's hospitals 24-hour intravenous thrombolytic service and transient ischaemic attack clinics for stroke patients; and provided genetic tests for patients with epilepsy to reduce the risk of drug-related harm.

Ends/Wednesday, December 18, 2013
Issued at HKT 19:25

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