LCQ12: Manpower for public healthcare
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Question:
There are views pointing out that with manpower shortages faced by Hong Kong's public healthcare system, it has become a norm for frontline healthcare personnel to work overtime and this not only affects their physical and mental wellbeing but also the quality of healthcare services. In this connection, will the Government inform this Council:
(1) whether it knows the average weekly working hours, overtime hours, frequency of duty shifts and on-site call duties of healthcare personnel in the public healthcare system in the past three years, with a breakdown by grade;
(2) whether it knows the details of the current overtime compensation mechanism in the public healthcare system; the respective numbers of healthcare personnel of various categories who received overtime allowance or compensation, and the amounts involved, in the past three years; and
(3) of the latest status of the implementation of various measures (including the recruitment of non-locally trained healthcare professionals) introduced by the Government as an effort to alleviate the pressure arising from manpower shortages in the public healthcare system (particularly among healthcare personnel in public hospitals); how the efficiency of healthcare personnel as a whole can be enhanced through smart healthcare and multi-disciplinary collaboration?
Reply:
President,
In consultation with the Hospital Authority (HA), the consolidated reply to the question raised by the Hon Tony Tse is as follows:
With our high-quality healthcare professionals and highly efficient healthcare system, Hong Kong boasts a number of world-leading health indicators. We are among one of the regions with the longest life expectancies (note 1) and lowest infant mortality rate in the world (note 2). The public current health expenditures in Hong Kong only accounted for 4.1 per cent (note 3) of its Gross Domestic Product in 2022-23. Compared with other economies with a similar degree of population ageing, Hong Kong's related expenditure ratio is among the lowest. On the other hand, we were able to provide nearly 90 per cent of the city's healthcare services and achieve a high service quality on par with international standards, demonstrating the remarkable efficiency of our public healthcare system.
Nevertheless, our healthcare system is facing various structural challenges. Longevity has led to an overall ageing population and a surging prevalence of chronic diseases in Hong Kong. Quality public healthcare services at affordable prices have attracted huge service demand, exerting immense pressure on the city's healthcare system. In light of the above, the HA is actively implementing various measures to attract and retain manpower, while leveraging information technology to enhance efficiency.
(1) Under the HA's existing policy, the conditioned hours of work for all employees are 44 hours gross per week. Regarding staff's rostering arrangements, individual departments allocate shifts according to operational needs. Furthermore, overtime work refers to any work undertaken over and above an employee's conditioned hours of work, and should normally be recompensed by time-off in lieu. The HA does not maintain centralised records for the above data, but individual departments maintain records of overtime hours worked due to operational needs. Regarding on-call duties, the HA provides the Fixed Rate Honorarium to recognise the efforts and contributions of doctors whose job nature requires sustained long working hours.
The HA has been closely monitoring the manpower situation and has introduced a host of measures within the overall budget to attract, train and retain talents, including increasing the quotas of resident trainees to recruit local medical graduates; recruiting non-locally trained doctors (NLTDs) to complement the local recruitment; enhancing promotion opportunities for staff retention; recruiting part-time healthcare staff (e.g. through the recruitment of locum staff); providing flexible full-time working arrangements; rehiring suitable retirees; enhancing the Home Loan Interest Subsidy Scheme, and establishing the HA Academy to enhance training opportunities for different grades of staff members.
The HA's manpower situation has been steadily improving. The number of doctors working in the HA has increased from 4 617 in 2006-07 to 6 807 in 2023-24. The average number of weekly working hours for HA doctors has seen a reduction from about 55 hours in 2006-07 (note 4) to about 48.9 hours in 2023-24. The proportion of doctors working over 65 hours per week has also fallen from about 18 per cent in 2006-07 to about 3.1 per cent (note 5) in 2023-24. Meanwhile, the attrition rate of doctors has also decreased from 6.3 per cent in 2006-07 to 5.2 per cent in 2023-24.
(2) Unlike the general practice of recompensing overtime work through time-off, the HA has also in place the Special Honorarium Scheme (SHS). Staff members who join the SHS outside normal work hours on a voluntary basis shall receive a special honorarium calculated at an hourly rate of 1/140 of their current basic salary. SHS aims to alleviate short-term staffing shortages and respond promptly to emergencies, while facilitating the provision of extra service sessions under special programmes to meet operational needs.
The numbers of medical and nursing staff receiving payment for SHS and the amounts involved (note 6, 7, 8) for 2022-23, 2023-24 and 2024-25 are set out in the following tables:
2022-23
| Staff Group | Number of Staff | Payment for SHS ($ million) |
| Medical | 4 375 | 424.1 |
| Nursing | 16 250 | 407.3 |
2023-24
| Staff Group | Number of Staff | Payment for SHS ($ million) |
| Medical | 4 446 | 483.1 |
| Nursing | 14 868 | 429.3 |
2024-25
| Staff Group | Number of Staff | Payment for SHS ($ million) |
| Medical | 4 169 | 401.8 |
| Nursing | 12 731 | 325.3 |
(3) Apart from recruiting local medical graduates, the HA also actively recruits NLTDs and engages professional healthcare talent through different global platforms for exchange programmes in Hong Kong. This serves to expand the talent pool of the public healthcare system so as to support the HA's service demands and development. As of August 31, 2025, a total of 330 NLTDs have worked or participated in exchange programmes within the HA. The HA has also earlier completed the indicator set out in "The Chief Executive's 2024 Policy Address" to "have no less than 250 NLTDs working in the HA by end-2024".
Regarding the recruitment of non-locally trained nurses (NLTNs), subsequent to the passage of the Nurses Registration (Amendment) Ordinance in July 2024, the HA has launched a series of promotional campaigns to attract NLTNs from around the world to join the HA. In addition, the HA is actively developing nurse exchange programmes with various non-local partner institutions. As of August 31, 2025, a cumulative total of 324 NLTNs have practised or participated in exchange programmes within the HA.
Meanwhile, the HA has been actively advancing smart healthcare by leveraging technologies such as AI, smart wards, smart clinics, smart support and digital workspaces to optimise the clinical and administrative workflows, thereby enhancing the healthcare service quality and operational efficiency. For example, the HA is strengthening the clinical application of AI to assist doctors in drafting medical reports, imaging analysis of Computed Tomography, and providing real-time interpretation services during patient consultations. Regarding smart wards, the HA utilises electronic displays and paperless workflows to provide real-time patient information and improve safety. As for smart clinics, specialist out-patients clinics and general out-patients clinics under the HA have in place the "e-Vitals" systems to enable patients to self-report vital signs data, thereby streamlining follow-up procedures and reducing data entry errors. As for smart support, the HA employs digital dashboards and Internet of Things (IoT) technologies to enhance operational management, while deploying multifunctional robots to assist with administrative tasks, alleviating the workload of healthcare staff. Furthermore, the HA has established digital workspaces to facilitate multi-platform real-time communication, ward management and office automation as well as foster cross-departmental collaboration. These measures have improved efficiency, reduced patient waiting times and rationalised hospital admission processes.
Note 1: Provisional figures for average life expectancy at birth in 2024 were 82.8 for male and 88.4 for female.
Note 2: Provisional figures for the infant mortality rate in 2024 were 1.7 deaths per 1 000 registered live births.
Note 3: Excluding identified COVID-19 expenditures.
Note 4: The HA has maintained relevant data since 2006-07.
Note 5: Comprehensive monitoring of all specialties has been conducted biennially since 2011. Therefore, the HA is unable to provide the average weekly working hours of doctors in 2024-25. The HA is in the process of data collection for the average weekly working hours of doctors in 2025-26, thus relevant data cannot be provided at the moment.
Note 6: The number of staff receiving SHS payment in 2022-23, 2023-24 and 2024-25 is calculated based on headcounts as at March 31, 2023, March 31, 2024 and March 31, 2025 respectively.
Note 7: The "Medical" group includes Consultants, Senior Medical Officers/Associate Consultants, Medical Officers/Residents, Visiting Medical Officers, Interns and Dental Officers.
Note 8: The "Nursing" group includes Senior Nursing Officers, Department Operations Managers, Ward Managers/Nursing Officers/Advanced Practice Nurses, Registered Nurses, Enrolled Nurses and Midwives, etc.
Ends/Wednesday, October 8, 2025
Issued at HKT 17:35
Issued at HKT 17:35
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