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LCQ10: Resource allocation mechanism of Hospital Authority

     Following is a question by Professor Hon Joseph Lee and a written reply by the Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council today (May 21):


     Regarding the resource allocation mechanism of the Hospital Authority (HA), will the Government inform this Council if it knows:

(1) the criteria currently based on which HA determines the financial and manpower resources to be allocated to various public hospitals;

(2) whether HA has based on some criteria in determining the financial and manpower resources allocated to various public hospitals for the provision of nursing services; if so, of the details; if not, the reasons for that;

(3) the estimates of expenditure made by various public hospitals in respect of the provision of nursing services and the respective amounts of funding allocated to them in the past five years, and whether there was any surplus funding; if so, of the approach adopted for dealing with the surplus funding; and

(4) whether HA has considered establishing an independent funding allocation system for nursing services, so that the respective Cluster General Managers (Nursing) of the various hospital clusters can deploy and use the funding flexibly to assist the hospitals in need and the relevant departments in enhancing their nursing services; if so, of the details; if not, the reasons for that?



(1) The Hospital Authority (HA) is responsible for managing the public hospital system and providing quality and affordable public health services to the public.  HA's services are organised through seven clusters according to geographical locations so as to facilitate the integration of services and enhance the continuity of various kinds of services with a view to achieving economy of scale.

     The mechanism of resource allocation to individual clusters in HA originates from its annual planning work.  The annual planning process is a participative approach with bottom-up and top-down contributions from HA staff of various ranks, including the collection of views from frontline clinical staff, cluster management and Head Office executives.  Every year, the resource requirements for new services as well as that for specific pressure areas of individual departments at hospital level are submitted for consideration of additional funding through the annual planning exercises of respective clusters.  All proposed programmes submitted by clusters, and those from clinical/specialty groups and Head Office, will be deliberated at the annual planning forums where inputs from stakeholders across all clusters will also be considered.

     Based on the above annual planning process, HA will formulate its Annual Plan, incorporating all new programmes that are approved for implementation for the year, including territory-wide and specialty-based programmes, as well as cluster/hospital/department-specific initiatives.  HA will also set targets for its Annual Plan for necessary monitoring.

     With the Government's notification of the total recurrent funding available to HA for the year, HA will determine the resource allocation to clusters (including manpower, equipment, facilities and other operating needs) having regard to the following considerations -

(a) the resources needed to sustain the baseline operations of respective clusters, including their core primary and secondary services as well as any specialised or centralised services under their management;

(b) additional resources required to deliver the new services and priority initiatives that have been supported during the annual planning process; and

(c) any other resources needed to address specific pressure areas/gaps.

     Within the agreed parameters and targets set under the Annual Plan, cluster management is responsible for ensuring operational efficiency.  They will likewise work out a service plan for its cluster taking into account the baseline operations that need to be maintained, new services to be introduced and pressure areas of its hospitals/departments that need to be enhanced, and make necessary service reorganisation and rationalisation to deliver the agreed Annual Plan targets while ensuring optimal deployment of resources.  

(2) The mechanism and considerations in formulating resource allocation (including nursing service and manpower distribution) to various clusters have been provided in part (1) of the reply. As regards manpower for nursing services, HA will evaluate manpower deployment having regard to service needs, modes of nursing care and supply of healthcare personnel. It will also take into account manpower wastage and estimate the nursing manpower requirements according to the workload assessment model.

(3) and (4) Resources of each cluster are essentially allocated having regard to the service programmes and targets defined in the process of formulating the Annual Plan, and are allocated to the clusters in the form of a block vote.  Moreover, as most of HA's services are provided through multi-disciplinary teams, hospitals will flexibly deploy manpower according to service needs.  HA has not set up an independent funding allocation system for nursing or other grade of staff.

     In the past five years (from 2009-10 to 2013-14), the number of nurses in various clusters increased each year, with details set out in the Annex.

Ends/Wednesday, May 21, 2014
Issued at HKT 16:42


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