LCQ10: Security arrangements of public hospital wards

     Following is a question by the Hon Yung Hoi-yan and a written reply by the Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council today (February 8):

     It has been reported that a male patient each in Kowloon Hospital (KH) and United Christian Hospital (UCH) were allegedly sexually assaulted by other male patients in the psychiatric wards therein.  Those incidents have aroused public concern about the security of public hospital wards and the safety of inpatients.  In this connection, will the Government inform this Council:

(1) given that KH has set up an expert group to follow up on the issue, whether the Government knows (i) the size and composition, work schedule and terms of reference of the group, and (ii) if the report to be submitted by the group will be made public; if the report will be made public, when it will be submitted; 

(2) whether it knows if UCH will set up an expert group to follow up on the issue; if UCH will not, of the reasons for that and how the hospital follows up on the issue; if UCH will, (i) the size and composition, work schedule and terms of reference of the group, and (ii) if the report to be submitted by the group will be made public; if the report will be made public, when it will be submitted;

(3) as the Secretary for Food and Health said that the Hospital Authority (HA) would call urgent meetings to discuss the implementation of short and long term measures, in terms of facilities, procedures, guidelines and manpower, in public hospitals to enhance the protection for psychiatric patients who lack the ability to care for themselves, whether the Government knows if HA has formulated such measures; if HA has, of the details and the additional manpower and expenditure involved;

(4) whether it knows the number of cases received by HA in each of the past three years about alleged sexual assaults of patients; the details of each case, including (i) the date and location of the incident, (ii) the age and mental health condition of the victim, (iii) the type to which the alleged offender belonged (a patient, a healthcare worker or others), (iv) the time taken to complete the handling of the case, and (v) the follow-up measures taken by HA;

(5) given that sexual assault is one of the reportable incidents under the Advanced Incident Reporting System implemented by HA since 2007, whether the Government knows if HA has conducted a comprehensive review of the effectiveness of the system; if HA has, of the date and results of the last review, and whether follow-up and improvement measures have been formulated; if HA has not conducted such a review, whether and when HA will conduct such a review; and

(6) whether it knows if HA will conduct a comprehensive review of (i) the adequacy of the current operating procedures and security measures in public hospital wards for safeguarding the safety of patients, and (ii) the adequacy of the manpower for implementing such security measures; if HA will, of the details and timetable; if not, the reasons for that?



     My reply to the questions concerning the security arrangements of public hospital wards raised by the Hon Yung Hoi-yan is as follows:

(1) and (2) The Kowloon Hospital (KH) and the United Christian Hospital (UCH) are highly concerned about the recent alleged cases of patients being sexually or indecently assaulted in their psychiatric wards.  They have set up their respective independent review panels consisting of relevant experts to identify the causes of the incidents and make recommendations on viable and sustainable improvement measures in order to prevent and address the problems concerning psychiatric inpatients being sexually assaulted or indecently assaulting others.  The investigation reports will be completed in eight weeks for submission to the Hospital Authority Head Office (HAHO) for consideration and appropriate follow-up actions.

     The members and composition of the expert groups set up by the KH and the UCH are detailed in Annexes 1 and 2 respectively.
(3) As for the recent alleged cases of patients being sexually or indecently assaulted in the psychiatric wards of the KH and UCH, the HAHO held two urgent meetings in January this year to discuss and explore short and long term follow-up measures.  The short term measures which have been confirmed and taken immediately include strengthening the identification of high-risk patients; improving the protection of patients incapable of self-care through enhancing staff communication and patient education and providing necessary support; deploying manpower to step up regular patrols and conduct special patrols on a need basis in psychiatric wards; evaluating the adequacy of existing monitoring equipment in psychiatric wards and installing additional surveillance equipment (including CCTV system and convex mirrors) as appropriate; reviewing the present assessment criteria for admission of patients with clinical needs to single rooms to ensure their safety and privacy; and reviewing the prevailing clinical guidelines for mixed-gender wards and those for admission of child patients to adult wards for ensuring the safety of patients.
     On January 27, the HAHO instructed hospitals in all clusters to put in place the short term measures with immediate effect.

     In the long term, the HA's expert group will thoroughly examine the overall operating procedure and manpower arrangement of psychiatric wards, and plan to invite independent experts to participate in the comprehensive review as soon as possible.

(4) The psychiatric departments of the HA reported five alleged cases of inpatients being sexually or indecently assaulted to the Police from 2014 to 2016.  Details of the cases are set out in Annex 3.

(5) Since 2007, the HA has launched the Advanced Incident Reporting System (AIRS), under which sexual assault is categorised as one of the reportable incidents.  Apart from reporting to his/her immediate supervisor, the staff member concerned is also required to report through the AIRS to the hospital management and the HAHO so that they are made aware of the incident as soon as possible and, where necessary, can take appropriate actions to safeguard patients' interests.  The HA has also established the Committee on Hospital Security (the Committee) to review various aspects of the security issues of hospitals, including potential security problems associated with sexual assault cases.  Members of the Committee include representatives from the Quality and Safety Division, Business Support Services Department, Nursing Services Department and Corporate Services Division of the HAHO, as well as the seven hospital clusters.  The Committee seeks to formulate standards, policies and guidelines for security service, monitor the security work of hospitals, and implement security-related improvement measures to ensure patients' safety and dignity.

     The HA has put in place a regular review mechanism to enhance the AIRS and upgrade the data analysis capabilities to facilitate effective monitoring and tracking of incidents to improve patients' safety.

(6) Apart from clinical monitoring and providing treatment, the operating procedures of psychiatric wards also require regular monitoring of patients’ activities therein.  A patient will be admitted to a single room if there is a clinical need to ensure his/her safety and privacy.

     In devising security management measures, HA hospitals are mindful that members of the general public, particularly patients, should have reasonable access to HA facilities which provide round-the-clock service.  The HA must therefore ensure that the security measures imposed will not create any undue obstacles to the patients' right to access healthcare services or to the efficient delivery of clinical services.  To strike a balance between protecting the security of patients and facilitating their access to healthcare services, the HA's security management strategy comprises such key elements as establishing a robust governance and organisational structure, installing suitable security facilities, and maintaining sound security services and management.  On security management front, the HA has established a robust two-tiered governance structure at cluster frontline and corporate levels. 

     The HA has installed risk-commensurate security facilities at appropriate locations of the premises having regard to the criticality and vulnerability of the locations concerned.  Examples of the facilities installed are the Central Security Control Room fitted with a CCTV system, the Access Control System that controls access by means of access cards or combination locks and requires staff to wear their staff ID cards for easy identification, the Carpark Management System and Intercom, and the panic alarm and intruder alarm system. 

     Moreover, the HA has also maintained sound security services and management. These include setting up a security unit in each hospital to provide round-the-clock security services and deploy security guards to conduct regular inspections on all parts of hospitals in accordance with the security guidelines set by the hospitals, providing on-site support at the wards when needs arise, assigning competent personnel to take up security duties, providing induction training for all newly appointed security guards and on-the-job refresher training on a regular and as-needed basis, implementing the security guidelines and procedures laid down by the HAHO in various clusters, conducting risk assessments and security audits on a regular basis, and launching the AIRS for reporting of hospital incidents.  All hospitals will also review the adequacy of their security personnel on a regular basis to ensure that sufficient manpower is available to carry out the necessary security measures.

Ends/Wednesday, February 8, 2017
Issued at HKT 20:28