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Following is a question by the Hon Leung Yiu-chung and a written reply by the Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council today (June 10):
Question:
Recently, quite a number of residents of the Tsuen Wan and Kwai Tsing (Tsuen Kwai) districts have relayed to me that there is a shortfall in the daily consultation quotas available for advance booking at the public general out-patient clinics (clinics) in the districts. They have also pointed out that, with the completion of new public housing blocks in the Tsuen Kwai districts one after another in the coming few years, the population of the two districts will increase significantly, aggravating the burden on the public healthcare system in these districts. In this connection, will the Government inform this Council:
(1) whether it knows the consultation quotas of the various clinics in the Tsuen Kwai districts in each of the past three years (set out in the table below);
Clinic 2012 2013 2014
Ha Kwai Chung General
Out-patient Clinic
Mrs Wu York Yu General
Out-patient Clinic
North Kwai Chung General
Out-patient Clinic
South Kwai Chung Jockey Club
General Out-patient Clinic
Tsing Yi Cheung Hong General
Out-patient Clinic
Tsing Yi Town General
Out-patient Clinic
Lady Trench General Out-patient
Clinic
Yan Chai Hospital General
Practice Clinic
(2) whether it knows (i) the average daily number of attendances and (ii) the average consultation time per patient in respect of each of the clinics set out in (1) last year (set out in table form);
(3) whether it knows the unused quotas of each of the clinics set out in (1) in each month of last year (set out in table form);
(4) whether it knows the factors considered by the Hospital Authority (HA) in setting the daily consultation quotas to be allocated by various clinics, and how the number of doctors actually staffed at the clinics on a particular day affects the consultation quotas that day; whether there is a mechanism to review if such quotas are sufficient to meet the demand; if so, of the details, and how often such a review is conducted; and
(5) whether it will request HA, apart from uploading the relevant information onto its web site, to announce the consultation quotas and unused quotas of various clinics each day by other means (e.g. by posting notices at various clinics or through the existing General Out-patient Clinics Telephone Appointment System), so that members of the public may identify more quickly the clinics at which treatment services are available?
Reply:
President,
My reply to the question raised by the Hon Leung Yiu-chung is as follows:
(1) Primary care services in Hong Kong are provided mainly by the private sector. In the public sector, the general outpatient clinics (GOPCs) of the Hospital Authority (HA) are primarily targeted at serving the elderly, the low-income group and the chronically ill. In 2014-15, the 73 GOPCs under HA recorded a total of over 5.9 million attendances (provisional figure).
Patients under the care of HA's GOPCs comprise two major categories, namely chronic disease patients with stable medical conditions (such as those with diabetes mellitus or hypertension) and episodic disease patients with relatively mild symptoms (such as those suffering from influenza, cold and gastroenteritis). Episodic disease patients can book, through HA's telephone appointment system, consultation timeslots at GOPCs for the next 24 hours. As for chronic disease patients requiring follow-up consultations, they will be assigned a visit timeslot after each consultation and do not need to call to make separate appointments.
HA has been taking active steps to improve its GOPC services, including renovating and upgrading the facilities of ageing clinics to streamline patient flow, improve the waiting environment for patients and increase the space for consultation, thereby meeting the development needs of general outpatient (GOP) services. In respect of the eight GOPCs in Kwai Tsing and Tsuen Wan districts, the HA has completed/is carrying out the following improvement works ¡V
(a) partial improvement works of the North Kwai Chung GOPC was completed in 2012-13;
(b) total interior renovation of the Ha Kwai Chung GOPC was completed in 2013-14;
(c) expansion of the South Kwai Chung Jockey Club GOPC is underway with a view to providing more consultation rooms;
(d) reprovisioning of the General Practice Clinic of the Yan Chai Hospital was completed in February 2015, as part of the hospital's redevelopment project, to improve its clinic environment and increase service capacity; and
(e) HA is planning for a total interior renovation of the Lady Trench GOPC in 2015-16 to improve its quality of service.
With various measures, HA provided more than 500 000 additional attendances in the period from 2012-13 to 2014-15. The Kowloon West Cluster alone recorded an increase of over 100 000 attendances in the same period and this is expected to further increase by about 16 000 in 2015-16.
The number of consultation quotas of the eight GOPCs under HA in Kwai Tsing and Tsuen Wan districts in the past three years are listed in Annex 1.
(2) and (3) The usage of GOP services is always a concern for HA. Through the telephone appointment system, consultation quotas of different GOPCs are now pooled together in a network so that patients do not need to visit clinics in person to queue for an appointment. Moreover, the system can optimise the use of consultation quotas within a district.
However, in the case that a patient cancels his/her booking only shortly before the scheduled consultation timeslot, even though the telephone appointment system can release the quota for booking immediately, it is unlikely for the quota to be taken up by other patients because they may not be able to come to the GOPC concerned within a short period of time. As a result, some quotas will be left unused. In view of this, HA has developed a mechanism for reducing quota wastage caused by patients who do not show up. For patients who make their booking through the telephone appointment system, their use of the telephone appointment services will be suspended if they fail to attend an appointment without prior cancellation for three separate occasions within two months. These patients have to visit the clinics in person to go through necessary procedures should they wish to continue using GOP services in future. This can effectively address the problem of patients failing to show up for scheduled consultations.
In 2014-15, the total number of medical attendance at the GOPCs in Kwai Tsing and Tsuen Wan districts are 360 000 and 200 000 respectively.
As regards the average number of unused quotas of each GOPC in Kwai Tsing and Tsuen Wan districts, taking into account that the service capacity of the GOPCs concerned is relatively stable, the relevant figures for the last four weeks of December 2014 (i.e. from December 1 to 28, 2014) are set out in the Annex 2 for reference.
(4) Given the large volume of GOP services provided by HA, the consultation quota may vary among the 73 clinics due to their location and operation. The daily service capacity of a GOPC is subject to slight adjustments having regard to manpower availability and operational needs. However, the service capacity of these clinics is relatively stable.
Recognising that there is an increasing demand for GOP services in the community, the operation of GOPCs and usage of services have always been a concern for HA. Over the years, HA has been monitoring regularly the percentage of target users who secure a consultation timeslot successfully through the telephone appointment system, so as to get a more thorough understanding of the service demand. On the whole, over 90 per cent of patients could secure a consultation timeslot at GOPCs in 2014. The situation of Kwai Tsing and Tsuen Wan districts is in line with HA's overall figures.
HA will continue to closely monitor the effectiveness of various measures for improving the provision of GOP services. HA will continue to recruit more staff whilst the situation regarding shortage of doctors persists. Where manpower and resources allow, the service capacity of its GOPCs will be further increased for the purpose of providing appropriate primary care services for targeted users of GOPCs.
(5) Having regard to the trend in recent years that more and more people (including the elderly and/or their families) search for information on the Internet, HA has been enriching the information on GOP services available from its website, including the provision of brief description of GOP services and clinic information, for reference by members of the public.
HA has recently made available on its website consultation quota of the clinics, so that members of the public can have a better understanding of GOP services without visiting the clinics in person. The website provides the average number of quota of each GOPC in the preceding four weeks by districts and the information is updated on a weekly basis. The information allows the public to have a better idea of the general service capacity of each clinic, which facilitates their search of a suitable clinic near their residence or work place.
HA appreciates that episodic disease patients are concerned about the quota of the clinics. Therefore, the telephone appointment system has built in a number of features to cater for their need. For example, the system will, subject to the availability of remaining quotas, allocate the earliest available consultation timeslot to the caller on a sequential basis. When a particular clinic has run out of consultation timeslots, the system will automatically locate the remaining quotas of other clinics nearby and alert the caller accordingly. The system will give the caller a clear indication when quota is available only in one timeslot. If the clinic in question and those nearby have run out of consultation timeslots, the system will immediately inform the caller that the quota is full.
Ends/Wednesday, June 10, 2015
Issued at HKT 16:52
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