LCQ18: Provision of medical treatment to patients with Coronavirus Disease 2019
It has been reported that the consultation quotas at the general out-patient clinics (GOPCs) of public hospitals are currently insufficient to meet the needs of persons infected with the Coronavirus Disease 2019 (COVID-19), and that some private doctors have refused to treat COVID-19 patients or charged them higher consultation fees. In this connection, will the Government inform this Council:
(1) whether it knows if the Hospital Authority (HA) will further increase the numbers of GOPC consultation quotas for patients with episodic diseases and reserved quotas in day and evening clinic sessions, or even reopen the designated clinics for COVID-19 confirmed cases, so that COVID-19 patients can receive appropriate medical treatment; if HA will, of the details; if not, the reasons for that;
(2) whether it has compiled statistics on the daily number of COVID-19 patients seeking consultation at accident and emergency departments since the arrangement of issuing isolation orders to COVID-19 patients according to the Prevention and Control of Disease Regulation (Cap. 599A) was cancelled (with a breakdown by the severity of the patient's symptoms); if not, the reasons for that;
(3) whether it has studied if the refusal of private doctors to treat COVID-19 patients will breach the relevant requirements under the Disability Discrimination Ordinance (Cap. 487); if it will, how the Government will follow up the matter; if not, the reasons for that;
(4) whether it has compiled statistics on the number of private clinics whose doctors have refused to treat COVID-19 patients or charged them high consultation fees; if so, of the details; if not, whether it will compile statistics and conduct investigation in this regard; of the measures in place to ensure that private clinic doctors will not refuse to treat COVID-19 patients, and will only charge such patients the same consultation fees as those charged to patients suffering from cold and influenza; and
(5) as it has been reported that some private clinics which are provided with free COVID-19 oral drugs by the Department of Health have allegedly charged COVID-19 patients for drug fees of these drugs in violation of the stipulations, whether the Government has investigated if illegal acts were involved in the incident; if it has investigated and the outcome is in the affirmative, of the penalties which may be imposed on the offenders, and the measures in place to combat such acts; if it has not investigated, the reasons for that?
In consultation with the Constitutional and Mainland Affairs Bureau and the Hospital Authority (HA), the reply to the various parts of the question raised by the Hon Yang Wing-kit is as follows:
(1) In line with the Government's cancellation of issuing isolation orders since January 30, 2023, the HA has strengthened its services to sustain support for COVID-19 infected persons in the community. At present, all 65 General Out-patient Clinics (GOPCs) provide treatments for COVID-19 infected persons, including prescribing COVID-19 oral drugs for those suitable. The HA has increased the consultation quota for patients with episodic illnesses including COVID-19 infected persons, and has reserved consultation quotas for infected persons with higher risks to make appointments. Infected persons can make appointments for consultation service through the "BookCOVID" function of the "HA GO" mobile application or the GOPC Telephone Appointment System. In addition, if infected persons have medical related enquiries, they may also call the HA support hotline 1836 115. The hotline staff will provide appropriate assistance to relevant persons, including referring high-risk infected persons in need to GOPCs for treatment. For the previous week, infected persons constituted about eight per cent of the GOPC attendances from patients with episodic illnesses. The current consultation quota reserved for infected persons is sufficient to meet the service demand. The HA will continue to align with the Government's policies and closely monitor different service demands, and flexibly deploy resources according to the situation to meet the needs and support infected persons in need.
(2) The total number of patients attending the Accident and Emergency Departments (A&Es) of public hospitals has remained stable in recent days. For the period from the cancellation of issuing isolation orders on January 30 to February 14, 2023, the daily average of the total number of A&E attendances is less than 5 000.
The HA does not maintain data regarding breakdown of the number of patients attending A&Es due to COVID-19 infection.
(3) The Equal Opportunities Commission (EOC) is responsible for the implementation of the four anti-discrimination ordinances, including the Disability Discrimination Ordinance (Cap. 487) (DDO). According to the EOC, the DDO defines "disability" as, amongst others, the presence in the body of organisms causing disease or illness. Hence, patients infected with viruses such as COVID-19 are protected under the DDO. In examining whether service refusal is unlawful or allowable as exceptions stipulated in the DDO would be subject to the merits of individual cases and may not be conclusive. In general, factors for consideration include the type/ nature of services, transmission risk (for example the size and partition of clinics, anti-epidemic equipment, whether the infected persons and others present have worn masks during waiting time and consultation, and whether other patients are highly vulnerable to infection), and the availability of alternative arrangements (for example, tele-consultation service instead of in-person consultation, specified consultation time when there are no other patients). Members of the public who suspect that they have been discriminated against may make enquiries or complaints to the EOC. The EOC appeals to private doctors to accord top priority to the well-being of patients by proactively offering various services options, and to join hands in helping our society return to full normalcy on the basis of mutual understanding and accommodation.
(4) The Government has no plan to compile statistics on the number of patients who visit private clinics for seeking medical consultation due to COVID-19. Under the current situation where private clinics are not required to use the Electronic Health Record Sharing System (eHealth) for uploading patients' medical records, collecting the relevant data will be very difficult and labour intensive. Furthermore, the current legislation does not empower the Government to mandate licensed private healthcare facilities to provide specified services at specified price level under specific circumstances.
(5) At present, private doctors can directly purchase from drug suppliers the two COVID-19 oral antiviral drugs already registered in Hong Kong for suitable patients. The Government also allows doctors who have registered in eHealth to provide the COVID-19 oral antiviral drugs procured by the Government to eligible and suitable patients free of charge. If private doctors want to prescribe the COVID-19 antiviral drugs supplied by the Government, they have to join eHealth and record the drug prescriptions for relevant infected persons in the COVID-19 antiviral drug register.
When considering drug prescriptions, doctors should take reference from current laws, professional as well as clinical guidelines. The Government has been closely monitoring the utilisation of COVID-19 antiviral drugs supplied by the Government, including drug prescription records entered by private doctors. The Government will continue to take appropriate measures and follow up with private doctors on relevant cases as necessary, such as requesting explanations from relevant private doctors. Appropriate actions will be taken if suspected illegal acts are identified.
Registered doctors should always comply with relevant laws and regulations as well as codes of professional conduct, including proper prescription of COVID-19 antiviral drugs.
Ends/Wednesday, February 22, 2023
Issued at HKT 15:00
Issued at HKT 15:00