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LCQ7: Primary healthcare services
     Following is a question by the Hon So Cheung-wing and a written reply by the Secretary for Health, Professor Lo Chung-mau, in the Legislative Council today (November 30):
     The Chief Executive has pointed out in the 2022 Policy Address that the Government will publish the Primary Healthcare Blueprint (the Blueprint) within this year. Regarding the specific implementation of the Blueprint, will the Government inform this Council:
(1) as it has been reported that the wastage of local healthcare workers persists, with the wastage rates of doctors and nurses being about 8.3 per cent and 10.1 per cent respectively last year, of the effective measures to be taken by the Government to improve such situation;
(2) whether transparent and clear performance indicators for the development of primary healthcare will be formulated in the Blueprint, so as to enable various parties to follow up the progress of primary healthcare development and review the effectiveness of services, thereby enhancing the coordination and management of primary healthcare services; and
(3) whether it will strengthen the role and functions of District Health Centres (DHCs) in the provision of primary healthcare services, including the adoption of the following measures: (i) providing centralised procurement services for DHCs in various districts, and (ii) standardising the salaries of healthcare workers across the territory, so as to avoid vicious competition for professionals among DHCs and between DHCs and the Hospital Authority?
     Our present healthcare system relies more on treatment than prevention. Expenditure on public hospital services accounts for over 80 per cent, while less than 20 per cent is spent on primary healthcare. Not only are resources skewed heavily towards public hospitals, the pressure exerted on them is also huge. With an ageing population and increasing prevalence of chronic diseases, the sustainability of Hong Kong's public healthcare system is facing major challenges. The Government will revamp the healthcare system. Our aim is to shift the emphasis of the healthcare system from its current treatment-oriented, hospital-based structure to a prevention-focused, community-based system, by investing additional resources to promote primary healthcare.
     My reply to various parts of the question raised by the Hon So Cheung-wing is as follows:
(1) The Hospital Authority (HA) has been actively recruiting and retaining suitable and experienced healthcare professionals through various channels to relieve the manpower shortage situation. Apart from recruitment of local medical graduates and non-locally trained doctors (NLTD) who have passed the Licensing Examination of the Medical Council of Hong Kong, the HA has also been recruiting NLTD through Limited Registration and Special Registration. The HA will continue to recruit more suitable NLTD according to the mechanisms.
     Besides, the HA has also been implementing a series of staff retention measures recently to cope with the rising service needs. They include the implementation of the Extending Employment Beyond Retirement policy to allow currently employed healthcare professionals to continue to work after retirement up to the age of 65; the establishment of the extra promotion mechanism of Associate Consultants and the addition of Associate Nurse Consultant posts to provide more promotion opportunities; the establishment of the Locum Office; the provision of more training opportunities, such as increasing the sponsorship quota of Enrolled Nurse to Registered Nurse Conversion Programmes; the launch of the Home Loan Interest Subsidy Scheme; and more flexibility in terms of work arrangement to retain the frontline professional staff who are unable to work full-time temporarily due to short-term special needs.
     The HA will continue to closely monitor the manpower situation and actively adopt measures to attract, train and retain talents to support the overall service needs and development of the HA.
     In the longer term, the Government will continue and strive to enhance the supply of healthcare manpower. In fact, the Government has all along been adopting various strategies to strengthen training for local healthcare professionals. In respect of local training, the Government has allocated substantial resources to keep increasing the number of training places of local healthcare professionals and enhance healthcare-related teaching facilities.
     In order to secure a stable supply of public healthcare services and allocation of manpower, the Government plans to explore different ways, including legislation, to mandate qualified healthcare professionals to serve in the public healthcare institutions for a specified period. Such proposal is still in its preliminary conceptual stage. Upon formulation of the proposal's framework, we will consult relevant stakeholders with a view to formulating concrete details of the proposal.
     Meanwhile, in order to address the manpower shortage of dentists and nurses in the public healthcare system, the Government plans to take reference from the experience of amending the Medical Registration Ordinance (Cap. 161) last year and create new pathways for admission of qualified non-locally trained dentists and nurses through legislation under the overarching principle of not sacrificing the professional standard and the well-being of patients. We will press ahead with the formulation of specific details of the relevant proposal and consult relevant stakeholders afterwards. Subject to the progress of discussion, we will strive to submit the legislative proposal to the Legislative Council within 2023.
(2) The Government will publish the Primary Healthcare Blueprint (Blueprint) within this year. With District Health Centres (DHCs) as the hub for co‑ordinating primary healthcare services for citizens, we will partner with the private healthcare sector to promote the concept of "family doctor for all" and collaborate with various healthcare professions to provide comprehensive, sustainable and family‑centric primary healthcare services in the community. Some of the initiatives have been announced in the 2022 Policy Address, including establishing the Primary Healthcare Authority, launching the Chronic Disease Co‑Care Pilot Scheme and enhancing the Elderly Health Care Voucher Scheme.
     The Government has set various indicators (including key performance indicators) to monitor the progress and effectiveness. Relevant indicators relating to primary healthcare development initiatives were reported to the Legislative Council's Panel on Health Services on November 11, 2022. An extract of the relevant parts is listed in Annex for reference.
     Regarding the specific recommendations and action plan in the Blueprint, upon the launch of the Blueprint, we will continue to invite relevant stakeholders to discuss and formulate detailed implementation plans in the short, medium and long term under the various working groups of the Steering Committee on Primary Healthcare Development. The Health Bureau will also formulate relevant mechanisms to measure the effectiveness of respective initiatives in the Blueprint.
(3) In accordance with the recommendations of the Blueprint to be launched, the Government will continue to promote the role of DHCs as the hub for co-ordinating primary healthcare services for the public and is determined to strengthen the roles and functions of DHCs through various policies and measures.
     At present, the Government appoints DHC operators through open tenders with a view to ensuring the service quality and cost-effectiveness of the bidders. The 2022 Policy Address announced the setting-up the Strategic Purchasing Office for co-ordinating the primary healthcare services to be provided to citizens through the private healthcare sector so as to echo the upcoming Blueprint. We will explore how the Strategic Purchasing Office can support the work of DHCs in the future.
     The Government will continue to review the service purchasing model and plans for relevant initiatives, including those of DHCs. We will also strive to optimise the overall DHC initiative and actively review the positioning and effectiveness of DHCs, with a view to strengthening their role as the co-ordinator of community primary healthcare services and case manager, so as to provide comprehensive primary healthcare services to the public in the community.
Ends/Wednesday, November 30, 2022
Issued at HKT 16:25
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