LCQ4: Healthcare services in Kowloon Central Cluster
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Question:
There are views pointing out that quite a number of problems are found in the healthcare services in Kowloon Central Cluster (KCC). Taking Wong Tai Sin (WTS) District as an example, the problem of a lack of public accident and emergency (A&E) services has been bothering the residents for years, and the growth and ageing of population in the district will put a further strain on healthcare services in the future; and residents in Yau Tsim Mong District may also face the problem of a shortfall in services as the services of Queen Elizabeth Hospital will gradually be relocated to the New Acute Hospital at Kai Tak Development Area which is expected to be commissioned in 2025. In this connection, will the Government inform this Council:
(1) of the respective average and longest time taken from WTS residents' calling for ambulance services to their arrival at A&E departments in the past three years, and the relevant figures for the 18 districts in Hong Kong as a whole;
(2) whether it has assessed the future demand for healthcare services in KCC, such as comparing the ratios of hospital beds to the population in the cluster, as well as the ratios of hospital beds to the elderly population in the cluster, at present and in the coming 10 or 20 years; if so, of the details; if not, the reasons for that; and
(3) given that the Government had in the past repeatedly refused to provide A&E services in Our Lady of Maryknoll Hospital on the grounds that the hospital was constrained by topographical environment and hospital site area, under what conditions the authorities will consider identifying a site in WTS District for the construction of a general hospital with A&E services, so as to address the ever-increasing demand for healthcare services in the district?
Reply:
President,
In consultation with the Security Bureau and the Hospital Authority (HA), our reply to the question raised by the Hon Chan Hoi-yan is as follows:
(1) Firstly, in respect of ambulance service, the Fire Services Department (FSD) is responsible for providing emergency ambulance service to members of the public.
Many steps are involved during the process from the FSD's receipt of a call for ambulance service to the patient's arrival at the hospital by an ambulance. These include the deployment of ambulance resources prior to the arrival of an ambulance at scene, the ambulance responding to the scene immediately, ambulance personnel conducting certain assessment and providing treatment or even first aid to the patient at the scene upon arrival thereat, at the same time conveying the patient to ambulance for hospital, and while on the way to hospital, monitoring the condition of the patient, and providing treatment to the patient subject to their situation and maintaining communication with the Accident and Emergency (A&E) department, up until conveying the patient to the triage station of the A&E department of the hospital and handing over the patient to healthcare professionals.
The entire process of providing emergency services is affected by many factors, including, among others, some unforeseen circumstances. Examples of these circumstances include traffic conditions, the condition or even the wish of the patient. There are more impacts on duration for calls for special services (e.g. mountain search and rescue, cases threatening to jump), etc. Under normal circumstances, the average time taken from the FSD's receipt of a call for ambulance service to the patient being conveyed to the A&E department is about 40 minutes.
On the figures requested by the Hon Chan, in fact, the epidemic situation was volatile in the past three years and in particular during the raging fifth wave of the epidemic, with the number of emergency calls and non-emergency calls increasing drastically. Services were also inevitably and considerably affected under the epidemic with the extremely tight ambulance resources, and resources need to be directed to focus on dealing with urgent cases. Under these exceptional circumstances, the average time taken from receipt of call to the ambulance's arrival at the A&E department actually increased from 41 minutes on average in 2020 to 48 minutes on average in 2022. The A&E services in Wong Tai Sin District are provided by three major acute hospitals, namely Kwong Wah Hospital (KWH), Queen Elizabeth Hospital (QEH), and United Christian Hospital (UCH). In the past three years, in Wong Tai Sin District, the average time taken for the FSD's receipt of call to the ambulance's arrival at the A&E department of a hospital was around 54 minutes, while for the overall situation in the 18 districts in Hong Kong, the average time taken was around 44 minutes. The longest time taken for non-emergency cases in Wong Tai Sin District from receipt of call to the ambulance's arrival at the A&E department was around 37 hours (with the reason for the call as loss of appetite and sore throat, which is relatively mild and not a genuine case of emergency). As for the situation in the 18 districts in Hong Kong, the longest time taken for non-emergency cases was about 39 hours (similarly, with the reason for the call as mild dizziness). I would like to emphasise that our A&E services are co-ordinated under the seven clusters in the HA's system. Figures in certain communities show that the average time for individual community, such as Sham Tseng, is relatively long. The average time in Sham Tseng is 51 minutes.
(2) For the second question, the catchment districts of the HA's Kowloon Central Cluster (KCC) include Kowloon City District, Yau Tsim Mong District and Wong Tai Sin District. The cluster has the largest number of healthcare institutions among the seven clusters and there are nine hospitals and healthcare institutions, including QEH, KWH, Tung Wah Group of Hospitals Wong Tai Sin Hospital, Our Lady of Maryknoll Hospital, etc. The Kai Tak Hospital with services to be commissioned will also be under KCC. In 2022-23, the number of general beds for KCC was 5 353, and the figure has not taken into account beds for infirmary, psychiatry and the mentally-handicapped, as well as those of the Hong Kong Children's Hospital. Based on the population of around 1.15 million in Kowloon Central, the number of general beds per 1 000 persons in the service areas concerned was 4.3. In comparison, the HA's overall number of general beds per 1 000 persons in the whole of Hong Kong was 3.2. As such, the ratio of number of beds to population for KCC is the second highest among the seven clusters. The number of beds in KCC will increase to 8 700 under the First Ten-year Hospital Development Plan (HDP), and the number of beds per 1 000 persons will become 6.9.
In terms of demographics, the population in the service areas of KCC is about 1.15 million and as at 2022, persons aged 65 or above accounted for 21 per cent of the population, while the corresponding ratio for the whole of Hong Kong was 20 per cent. In the next 10 to 20 years, there may be a relatively large drop in population projected for Kowloon Central, however, with ageing of the population, the relevant population proportion of elderly persons for both Hong Kong and the service areas of KCC will gradually increase, and may bring about an increase in service demands. Apart from considering the changes in population, population proportions and demographics in service planning, the HA will also take into account the synergistic effect of the services provided by the various clusters. In particular, due to the proximity of the clusters in the Kowloon area, a relatively high proportion of patients may choose to travel to other districts and clusters and receive treatment in the latter.
(3) At present, the HA's services are organised into clusters so that patients may receive a continuum of care within the same area. The operation of hospitals in each cluster is rationalised and supplementary to one another such that a comprehensive and complementary range of services can be delivered to the community in a co-ordinated manner. Under the cluster arrangement, it is inevitable that the distance between individual areas and different service sites within the cluster may vary. As the HA plans and develops public services on a cluster basis, it will take into account a myriad of factors, including the population growth and demographic changes, rising prevalence of chronic diseases, technology advancement, manpower availability as well as service utilisation and referral arrangements of the various clusters and hospitals.
In the face of future service demands, the HA has formulated the Clinical Services Plan for KCC, under which A&E services will be provided by the New Acute Hospital (NAH) at the Kai Tak Development Area and KWH. According to the First Ten-year HDP, most of the services of QEH, including A&E services, will be relocated to that new hospital upon the latter's completion. Located in the central part of Kowloon, the NAH will provide 2 400 in-patient beds and other facilities. The gross floor area (GFA) of its A&E Department will be about three times of that of the existing A&E Department of QEH. When planning the NAH, we have also taken into account the KCC areas and the neighboring Kwun Tong District in the Kowloon East Cluster as one of the considerations in projecting service demands.
The HA is redeveloping KWH and expanding UCH to meet the long-term needs of overall A&E services in Kowloon. Upon completion of both projects, the GFA of both A&E departments would be about three times of that of the existing ones. It is expected that the service provided by the above-mentioned three acute hospitals will be able to cope with the demand for A&E services in the relevant service areas.
We understand the public's aspirations for the setting up of an A&E department in Wong Tai Sin District. When planning A&E services, we will ensure that the A&E department is located within a reasonable distance from its service area(s). Moreover, as we further plan the Second HDP, we will review with the HA the development direction of KCC of which Wong Tai Sin is a part. In the process, the Government's latest population statistics and the projection of service needs, as well as the utilisation and demand of healthcare services in KCC, including that after the commencement of operation of the NAH and redevelopment of KWH, will be considered, with a view to providing an optimal healthcare model and facilities to meet the long-term needs of the public.
Thank you, President.
Ends/Wednesday, May 10, 2023
Issued at HKT 21:18
Issued at HKT 21:18
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