LCQ17: Governance of Hospital Authority
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Question:
A sentinel event has taken place recently in the Caritas Medical Centre in which a 75-year-old male patient with history of hypertension and dementia passed away unfortunately. The incident has aroused public concern about the overall governance capability of the Hospital Authority (HA). Regarding the governance of HA, will the Government inform this Council:
(1) whether it knows the number of patient relation officers currently working in HA who are responsible for handling complaints or enquiries from members of the public, as well as their respective departments and ranks;
(2) whether it knows which department and rank of HA officers who are currently responsible for classifying and following up the feedbacks and complaints from members of the public, and the details of their respective responsibilities; of the criteria for classification (i.e. appreciations, feedbacks, complaints and requests for assistance);
(3) whether it knows the number of retired doctors and nurses rehired by HA in the past five years, and their respective responsibilities and ranks; whether HA has formulated clear guidelines, evaluated the effectiveness and maintained complete records at present, so as to ensure that the rehired healthcare officers are able to effectively address the problem of healthcare manpower shortage; and
(4) as it is learnt that patients of the public hospitals under HA are currently allowed to consume takeaway food during their stay in the hospitals, of the existing meal service arrangements for patients of public hospitals; how HA ensures that the consumption of takeaway food by patients in the hospitals is in line with the existing meal arrangements, and how it closely monitors the impact of meals for patients on their treatment?
Reply:
President,
In consultation with the Hospital Authority (HA), the reply to the question raised by the Hon Doreen Kong, is as follows:
The safety of patients and staff is the primary concern of the Government and the HA. In view of the pressure on the healthcare system arising from an ageing population, increasing prevalence of chronic diseases and persistent increases in healthcare costs, the Government has to deepen the reforms on the systemic and structural issues relating to the overall management of public hospitals.
To manifest the commitment of the Government and the HA to the continuous improvement of the public healthcare system, the HA, as steered by the Health Bureau (HHB), established the Review Committee on the Management of the Public Hospital System (Review Committee) in 2024 to conduct a comprehensive systemic review. The Review Committee made a total of 31 improvement recommendations in five areas, namely, governance and accountability, safety culture, compliance and monitoring, incident management and enabling factors of the HA. The HA fully accepted the review report and set up a high-level Governance and Structure Reform Committee (Reform Committee) to take forward the recommendations in the report regarding governance, accountability and distribution of responsibilities of the HA, and relevant reform work. The HA is implementing various improvement measures in the review report, and the HHB will continue to monitor the implementation progress and effectiveness to ensure that the public healthcare system will continue to provide quality, safe and cost-effective healthcare services to the public.
(1) and (2) The HA attaches great importance to the opinion and enquiries of the public. Cluster Patient Relations Offices are set up under each Cluster's Service Director (Quality and Safety) in the HA. The Patient Relations Officers of hospitals act as a bridge of communication among the hospitals, patients and their families in the daily operation, co-ordinating and handling patients' and families' requests for assistance and complaints, responding to their enquiries and providing them with necessary assistance.
At present, the number and ranking of Patient Relations Officers in the HA, who are responsible for handling complaints or enquiries from members of the public, are set out in the table below (Note 1):
| Cluster | |||||||
| Staff Rank | Hong Kong East | Hong Kong West | Kowloon Central | Kowloon East | Kowloon West | New Territories East | New Territories West |
| Patient Relations Officer | 10.8 | 10.1 | 13.6 | 11.8 | 15.8 | 11.9 | 8.0 |
| Patient Relations Assistant | 5.8 | 3.5 | 7.4 | 6.0 | 7.5 | 6.0 | 7.0 |
| Total | 16.6 | 13.6 | 21.0 | 17.8 | 23.3 | 17.9 | 15.0 |
Patient Relation Officers categorise the cases received according to their nature and whether the specific contents of the cases are expressions of gratitude, feedback, dissatisfaction to the HA services or staff, or requests for assistance (i.e. cases of appreciation, feedback, complaint and request for assistance). Based on the categorisation of the cases and their contents, Patient Relation Officers obtain information from relevant departments for follow-up actions/investigations and making replies, in accordance with the established procedures. The numbers of cases regarding appreciation, feedback, complaint and request for assistance in the past three years received by the HA are set out below:
| Year | |||
| Case Category | 2021-22 | 2022-23 | 2023-24 |
| Appreciation | 37 739 | 32 879 | 43 468 |
| Feedback | 18 560 | 16 178 | 16 436 |
| Complaint | 1 637 | 2 162 | 2 097 |
| Request for assistance | 20 223 | 20 190 | 17 779 |
| Total | 78 159 | 71 409 | 79 780 |
(3) The HA Board endorsed the Extending Employment Beyond Retirement (EER) policy in September 2021 so as to attract more retirees who wish to continue to serve in the HA after retirement for training and knowledge transfer, as well as to alleviate the manpower issues. The numbers of staff working on a full-time (Note 2)/part-time (Note 3) terms after their retirement as at December in the past five years (i.e. from 2020 to 2024), by rank, are set out below:
| Staff Rank | December 2020 | December 2021 | December 2022 | December 2023 | December 2024 | |||
| Full-time | Full-time | Full-time | Part-time | Full-time | Part-time | Full-time | Part-time | |
| Doctor | 79 | 91 | 103 | 1 | 144 | 214 | 181 | 269 |
| Consultant | 60 | 63 | 70 | 1 | 97 | 161 | 118 | 211 |
| Dental Consultant | 1 | 1 | 1 | |||||
| Associate Consultant | 5 | 11 | 10 | 22 | 40 | 31 | 41 | |
| Resident | 14 | 17 | 22 | 24 | 13 | 31 | 17 | |
| Nurse | 156 | 182 | 263 | 4 | 427 | 378 | 565 | 502 |
| Nurse Consultant | 1 | 4 | 6 | |||||
| Associate Nurse Consultant | 1 | 1 | ||||||
| Chief Nursing Officer | 1 | 1 | ||||||
| Senior Nursing Officer | 3 | 12 | 9 | 17 | 9 | |||
| Senior Nursing Officer (Psychiatric) | 2 | 1 | ||||||
| Department Operations Manager | 1 | 1 | ||||||
| Ward Manager | 2 | |||||||
| Advanced Practice Nurse | 88 | 105 | 129 | 2 | 196 | 98 | 271 | 144 |
| Registered Nurse (General) | 43 | 51 | 74 | 1 | 125 | 188 | 137 | 250 |
| Registered Nurse (Psychiatric) | 10 | 1 | 20 | 22 | 54 | 23 | ||
| Enrolled Nurses (General) | 25 | 26 | 37 | 49 | 45 | 50 | 58 | |
| Enrolled Nurse (Psychiatric) | 8 | 19 | 14 | 25 | 17 | |||
| Total | 235 | 273 | 366 | 5 | 571 | 592 | 746 | 771 |
Note 3: With effect from December 1, 2022, retired staff who have been employed on part-time terms under the EER policy will be arranged in accordance with the remuneration and terms of employment under the EER policy. The "EER part-time staff" category will be separated from the "part-time staff" category for ease of calculation. The number of staff refers to the number of serving part-time staff whose employment was extended beyond retirement in various years in the past as at December 31 of each year.
Doctors and nurses whose employment was extended beyond retirement are mainly responsible for clinical services to alleviate the shortage of manpower and successors in the HA. Supervisors and hospital management will discuss with the retired staff and clearly set out the key duties and deliverables for extended employment, having regard to the service priorities and operational needs of the HA. The performance of the staff whose employment was extended beyond retirement will be regularly assessed by the HA, which would form one of the considerations for their contract renewal. In addition, the HA continues to closely monitor the operational needs and manpower situation, and review the EER policy from time to time with a view to supporting the overall service demand and development of the HA.
(4) The HA has all along been committed to delivering patient-centric services and has actively implemented measures to enhance patients' experience. To increase meal choices for in-patients, some of the hospital wards are progressively giving permission for patients with suitable conditions and without any dietary restriction to choose to order food from the hospital canteens, and allow in-patients to consume take-away food. These measures aim to provide greater flexibility and convenience to patients and their families, realising the patient centric value of healthcare services. Due to patient safety considerations, the food ordering service in hospital canteens is only applicable to patients with regular diet and those who do not have any special nutritional needs or dietary restrictions, and is not applicable to patients with swallowing difficulty or allergy to specific food items.
Meal services provided by the HA are managed by catering staff and dietitians, with safe and quality meals provided through the existing well-established ordering and distribution system.
Ends/Wednesday, April 16, 2025
Issued at HKT 19:22
Issued at HKT 19:22
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