LCQ16: Long-term planning and positioning of Chinese medicine
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Question:
According to the existing codes of practice or legislation applicable to the supplementary healthcare professions, practitioners of supplementary healthcare professions (e.g. medical laboratory technologists and radiographers), except optometrists, under normal circumstances may only perform examination for or provide treatment to patients who have been referred to them by prescribed persons (e.g. doctors). However, the classes of persons who may make such referrals do not include registered Chinese medicine practitioners. Some registered Chinese medicine practitioners have relayed that the aforesaid referral requirement has rendered them unable to make good use of modern medical technologies in their diagnoses. They have also pointed out that the Chinese medicine outpatient clinics set up under the Hospital Authority have not been fully incorporated into the public healthcare system, and the remuneration packages for the Chinese medicine practitioners of such clinics are far inferior to those of the western medicine practitioners in public hospitals. The aforesaid situation has discouraged talents from joining the Chinese medicine profession, and hampered the long-term development of Chinese medicine and integrated Chinese-Western medicine. In this connection, will the Government inform this Council:
(1) whether it has compiled statistics on the number of complaints received by the authorities in each of the past five years about practitioners of the supplementary healthcare professions who allegedly contravened the aforesaid referral requirement (with a breakdown by profession);
(2) whether it knows the criteria and considerations based on which the authorities determined the classes of persons who may make referrals;
(3) whether it will consider (i) providing resources to train registered Chinese medicine practitioners to make proper referrals, (ii) requiring relevant local institutions to incorporate such training into their Chinese medicine undergraduate programmes, and (iii) amending the classes of prescribed persons who may make referrals, so as to enable registered Chinese medicine practitioners who have received such training to make referrals; if so, of the details and timetable; if not, the reasons for that; and
(4) whether it has drawn up specific work plans for promoting the long-term development of Chinese medicine and integrated Chinese-Western medicine; if so, of the details; if not, the reasons for that; whether it will consider fully incorporating Chinese medicine services into the public healthcare system and establishing Chinese medicine hospitals that receive public funding on a par with that for western medicine services; if so, of the details; if not, the reasons for that?
Reply:
President,
In consultation with the Department of Health and the Hospital Authority (HA), I provide a consolidated reply to the four parts of the question as follows:
The Supplementary Medical Professions Council (SMPC) and its five Boards (namely the Occupational Therapists Board, Physiotherapists Board, Medical Laboratory Technologists Board, Optometrists Board and Radiographers Board) are statutory bodies established under the Supplementary Medical Professions Ordinance (Cap 359).
Under the principle of professional autonomy, the SMPC and its five Boards currently set out practical operational procedures and referral mechanisms for their respective professions by issuing codes of practice. According to the existing codes of practice or legislation applicable to the supplementary healthcare professions, under normal circumstances, patients should be referred to these professions (except optometrists) for examination or treatment by prescribed persons such as registered medical practitioners. This is to ensure that medical referrals are made for valid reasons based on diagnosis given through legal medical services. Otherwise, the practitioners will be deemed to be in breach of the established codes of practice and subject to disciplinary actions taken by the SMPC and the Boards concerned.
The SMPC and its five Boards have not received any complaints regarding non-compliant referrals (i.e. referrals made by non-prescribed persons) in the past five years.
It is learnt that the Chinese Medicine Practitioners Board under the Chinese Medicine Council of Hong Kong has looked into the issue of referral with the Radiographers Board, but no consensus has been reached.
The Government is aware of the long-standing public concern about the long-term planning and positioning of Chinese medicine. With the growing recognition of Chinese medicine, the Government considers that there is a need to establish a dedicated unit for the overall policy planning and co-ordination of the development of Chinese medicine. We will set up a Chinese Medicine Unit under the Food and Health Bureau (FHB), which will be responsible for maintaining close liaison with the Chinese medicine sector as well as co-ordinating and implementing the strategies and measures for promoting the development of Chinese medicine in Hong Kong.
As regards whether and how Chinese medicine should be incorporated into the public healthcare system, the Government needs to give comprehensive, prudent and thorough consideration to various aspects, including the public demand for Chinese medicine services, long-term development of the industry, salaries and training of Chinese medicine practitioners and professions related to Chinese medicine services, as well as the recurrent financial commitments of the Government involved in subsidising Chinese medicine services.
The Government is now conducting a study with the HA on the positioning of Chinese medicine in the local healthcare system. Upon completion of the study report, the Government will formulate policies for the development of Chinese medicine to meet the needs of society, and enhance the role and involvement of Chinese medicine in the promotion of public health, with regard to the overall development of the industry and the development plan for the Chinese medicine hospital (CMH).
Regarding the planning and development of the CMH, the Government has commissioned an international consultant through the HA earlier to consult local stakeholders and overseas experts on various aspects, including the mode of operation of the hospital. Upon completion of the analysis of the report, the Government expects to announce in the first half of 2018 the positioning of the CMH and the development framework for the key aspects. Meanwhile, the Government and the HA have also commissioned a consultant to conduct a detailed study on the possibilities of financial arrangements for the CMH, including the level of service charges and financial risk assessment.
As for the development of integrated Chinese-Western medicine (ICWM), the Government has commissioned the HA to implement the ICWM Pilot Programme, with a view to gaining experience in ICWM and the operation of Chinese medicine in-patient services, as well as serving as the basis for formulating the mode of operation of the CMH.
Phases I and II of the Pilot Programme commenced on September 22, 2014 and December 21, 2015 respectively. Under the Pilot Programme, ICWM treatment covering in-patient services and follow-up Chinese medicine out-patient services for in-patients of three selected disease areas (namely stroke care, low back pain care and cancer palliative care) is provided in seven HA hospitals. Phase III of the Pilot Programme will commence in April 2018, and a new disease area, i.e. shoulder and neck pain, will be included. The HA has commissioned an external party to carry out an evaluation study on the Pilot Programme. It is expected that a report will be completed and submitted in 2018-19 for the FHB's further consideration on the long-term development of Chinese medicine.
Ends/Wednesday, March 21, 2018
Issued at HKT 12:50
Issued at HKT 12:50
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