LCQ2: The overloaded public healthcare system

     Following is a question by the Hon Wilson Or and a reply by the Secretary for Food and Health, Professor Sophia Chan, in the Legislative Council today (February 20):
     It is learnt that the public healthcare system has been overloaded for a long period of time, resulting in deterioration in the quality of healthcare services and healthcare workers being overstretched. During the recent influenza surge in Hong Kong, the number of medical inpatients in public acute hospitals exceeded the number of medical inpatient beds by 10 per cent in total and even by 20 per cent in respect of the two acute hospitals in the Kowloon East Cluster. In this connection, will the Government inform this Council:
(1) of the new measures put in place to tackle influenza outbreaks so as to alleviate the overcrowding situation in public hospitals and shorten the waiting time of patients, as well as to lower the death rates arising from influenza-related complications;
(2) whether it knows if the Hospital Authority (HA) has taken targeted measures to solve the overcrowding problem in the acute hospitals in the Kowloon East Cluster; if HA has, of the details; if not, the reasons for that; and
(3) whether it has formulated long-term plans and measures (e.g. enhancing the medical public-private partnership programmes and allocating resources to provide additional beds and healthcare manpower in public hospitals) to alleviate the pressure on the public healthcare system and to enhance both the quality and quantity of public healthcare services?
     My reply to the various parts of the question raised by the Hon Wilson Or is as follows:
(1) The Hospital Authority (HA) has formulated a series of measures to enhance service capacity, increase manpower and expedite the turnover of hospital beds to meet the service demand during the winter surge in 2018-19.
     To enhance service capacity, the HA opened 574 regular beds under its Annual Plan 2018-19, and will open time-limited beds and ad hoc beds in response to the increased service demand.  To provide additional manpower, the HA launched the Locum Recruitment Website in November 2018 to enhance the flexibility and efficiency of recruitment, with a view to attracting more healthcare professionals to provide part-time services in public hospitals. The HA also implemented additional relief measures, including increasing the rate of the Special Honorarium Scheme (SHS) allowance by 10 per cent, to address the manpower shortage during the period from January 28 to April 30, 2019.
     To expedite the handling of cases and shorten the waiting time of patients, the HA provides rapid flu test for patients with influenza symptoms seven days a week and provide test results within 24 hours so as to expedite patient management decisions. Moreover, extra healthcare staff have been recruited through the Accident & Emergency (A&E) Support Session Programme to handle semi-urgent and non-urgent cases categorised under the A&E Triage System. Different clusters have also set up discharge lounges for centralised management of patients who are suitable for discharge to complete the procedures and wait for non-emergency ambulance transfer service, so that more beds can be vacated as soon as possible for admission of other patients. The HA has also collaborated with various government departments and external parties, including transferring suitable patients to private hospitals with low-cost hospital beds for completion of treatment. 
(2) The Kowloon East Cluster (KEC) of HA has implemented a series of measures to enhance service capacity during the winter surge, including opening 126 regular beds under its Annual Plan 2018-19 and 2 750 service quotas of General Outpatient Clinics, as well as providing extra clerical and supporting staff by extending the SHS so as to allow healthcare staff to focus more on clinical work. The KEC has also been actively recruiting part-time and temporary healthcare staff to cope with the additional demand during the winter surge period.
     In addition, discharge lounge in the KEC has undergone renovation in 2018/19 to expand the space and increase service capacity. The scope of discharge lounge service has extended from medicine to surgery and orthopaedics departments, and the service hours have also been extended to Saturdays and public holidays.
     The HA is implementing the First Ten-year Hospital Development Plan (HDP), which includes the expansion of United Christian Hospital and Haven of Hope Hospital in the KEC. It is anticipated that the KEC could better cope with the demand for public hospital services upon the completion of the HDP and recruitment of the necessary additional manpower.
(3) To increase healthcare manpower, the Government will, in the 2019/20 to 2021/22 University Grants Committee triennium, further increase the number of healthcare-related publicly funded first-degree intake places by over 150 each year in order to alleviate the shortage of healthcare professionals. The Government has also been closely liaising with the HA to formulate other short, medium and long term measures, including hiring full-time and part-time healthcare professionals and agency nurses, rehiring suitable retired healthcare staff, increasing the number of Resident Trainee posts and hiring of non-locally trained doctors to work in public hospitals under limited registration. The Government will continue to provide the HA with sufficient and appropriate resources to attract and retain staff.
     As regards healthcare facilities, the Government has earmarked a dedicated provision of $200 billion for the implementation of various hospital development projects in the next ten years. Over 5 000 additional public hospital beds will be provided under the First Ten-year HDP. The Government has also invited the HA to commence planning for the Second Ten-year HDP, which will involve about $270 billion. Upon the completion of the Second Ten-year HDP, there would be over 9 000 additional beds and other healthcare facilities that would more or less meet the projected service demand up to 2036.
     The HA has also introduced a number of public-private partnership (PPP) programmes in recent years to offer more choices of healthcare services to patients. The HA will continue to utilise the investment returns of the Hospital Authority Public-Private Partnership Fund to implement various PPP programmes. The HA will also continue to communicate with the public and patient groups and work closely with stakeholders in exploring the feasibility of introducing other PPP initiatives to meet the public's demand for healthcare services, and enhance the overall quality of healthcare services in the community.

Ends/Wednesday, February 20, 2019
Issued at HKT 14:50