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LCQ14: Primary healthcare services
     Following is a question by the Hon Tommy Cheung and a written reply by the Secretary for Food and Health, Professor Sophia Chan, in the Legislative Council today (January 10):


     Some patient groups have recently pointed out that the healthcare systems of many western countries place equal emphasis on the prevention and treatment of diseases, and provide people-oriented primary healthcare services (e.g. home care).  However, Hong Kong's healthcare system overemphasises the treatment of diseases, and hence it is necessary for Hong Kong to catch up expeditiously.  The Chief Executive, when addressing this Council on her Policy Address in October last year, indicated that she would give full support for planning and drawing up a blueprint for the development of primary healthcare services.  The Steering Committee on Primary Healthcare Development (Steering Committee), established by the Government at the end of November of last year, will develop a blueprint for the sustainable development of primary healthcare services.  In this connection, will the Government inform this Council:

(1) whether the authorities have drawn up a definition of "primary healthcare" which is applicable to Hong Kong; if so, of the details, and whether the authorities have made reference to overseas practices when drawing up such a definition; if they have not yet drawn up such a definition, whether they will assign the task to the Steering Committee; if so, of the details; if not, the reasons for that;

(2) of the medical and nursing manpower, as well as that of other relevant sectors, required for the systematic development of primary healthcare services as estimated by the authorities; whether the manpower projections for healthcare professionals set out in the Report of Strategic Review on Healthcare Manpower Planning and Professional Development published in the middle of last year has taken into account the manpower required for the development of primary healthcare services in Hong Kong; if not, whether they will conduct manpower planning afresh for the development of primary healthcare services; if so, of the details; if not, the reasons for that; and

(3) whether it knows in relation to the sustainable development of primary healthcare services, the Steering Committee's specific work plan and timetable for submitting a blueprint?



     My reply to the question raised by the Hon Tommy Cheung is as follows:

(1) As stated in the Declaration of Alma Ata, which was passed by the World Health Organization (WHO) in 1978, primary care is the key to "Health for All".  This set the scene for international efforts to promote primary care and formally acknowledged the pivotal role of a robust primary care system.  The need to enhance primary care was reaffirmed in the WHO's World Health Report 2008 - Primary Health Care: Now More Than Ever, and further stressed by the 2009 World Health Assembly's resolution on primary care policies.

     In Hong Kong, as indicated in both the Report of the Working Party on Primary Health Care issued in 1990 and the Primary Care Development in Hong Kong: Strategy Document published by the Food and Health Bureau (FHB) in December 2010, primary care is the first point of contact for individuals and families in a continuing healthcare process which entails the provision of accessible, comprehensive, continuing, co-ordinated and person-centred care in the context of family and community.

     The Government has taken steps to improve primary care services in the public system since 1990.  Community health promotion and disease prevention services for specific sub-groups of the population have also been strengthened through the services of the Department of Health (DH) (e.g. the Student Health Service, the Women Health Service and the Elderly Health Service).  Since the publication of the Strategy Document, DH has introduced an array of primary care initiatives, including formulating primary care conceptual models and reference frameworks, devising a Primary Care Directory, setting up community health centres, and introducing the Elderly Health Care Voucher Scheme and the Vaccination Subsidy Scheme.  In planning and implementing such primary care services, we have taken reference from the WHO's relevant documents and recommendations.

(2) In mid-2017, the Government published the Report of Strategic Review on Healthcare Manpower Planning and Professional Development.  On manpower planning, the Steering Committee on Strategic Review on Healthcare Manpower Planning and Professional Development commissioned the University of Hong Kong (HKU) to conduct manpower projections for 13 healthcare professions subject to statutory registration in Hong Kong.  In this connection, HKU has developed a generic manpower projection model that suits the local circumstances and is adaptable to changing parameters to cater for differences in utilisation patterns among individual professions.  The manpower projection model seeks to quantify the difference between the projected demand for and supply of healthcare professionals.  Apart from the requirements of the healthcare, social welfare and education sectors, the model has also taken into account the demand for primary, secondary and tertiary care services.

     Specifically, HKU made use of historical data on the utilisation of healthcare services and the projected demographic in Hong Kong to project age- and gender-specific utilisation volumes of population sub-groups on the basis of the existing service level and model.  These projected volumes were subsequently adjusted for externalities and policy interventions (including the latest development of public and private hospitals, as well as the known and planned projects in the public and subvented sectors).  The utilisation of services in the social welfare sector (including programmes for elderly and rehabilitation services) and the education sector (including programmes for special education services) have also been taken into account in projecting the demand for various healthcare professionals.

     As an ongoing initiative to monitor the manpower of healthcare professionals, the Government will conduct manpower planning and projections for healthcare professionals once every three years in step with the triennial planning cycle of the University Grants Committee.  The three-year manpower projections for the 2019/20 to 2021/22 academic years will be conducted later in 2018.  In conducting manpower planning, FHB will, in collaboration with relevant policy bureaux and departments, assess the manpower situations of various healthcare professionals by taking into account all the known and planned services/development (including the latest development of primary care services) as far as possible and consulting the relevant stakeholders of healthcare professions.

(3) In formulating development strategy and devising blueprint for primary healthcare services, the Steering Committee on Primary Healthcare Development will consider various aspects such as manpower and infrastructure planning, collaboration model, community engagement as well as planning and evaluation framework.  The Steering Committee will review the efficiency and effectiveness of the software and hardware for the delivery of primary healthcare services, enhance co-ordination among various medical and social sectors and public-private partnership, encourage the public to take precautionary measures against diseases, strengthen their capabilities in self-care and home care, raise their health awareness and promote health management.  The Steering Committee will also exploit the use of big data to devise strategies which best fit the needs of the community with a view to enhancing primary healthcare services at the district level.  On the other hand, to further give play to the effectiveness of medical-social collaboration, FHB has set up a working group to prepare for the launch of the District Health Centre Pilot Project in Kwai Tsing District in two years' time.
Ends/Wednesday, January 10, 2018
Issued at HKT 15:40
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