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Following is a question by the Dr Hon Joseph Lee and a reply by the Secretary for Food and Health, Dr York Chow, in the Legislative Council today (March 30):
Question:
The Government has planned to launch a three-year pilot project in April this year under which non-profit-making organisations will provide outreach primary dental care and oral health care services (such as dental check-up, scaling, polishing, pain relief and emergency dental treatment) to elderly people in residential care homes and day care centres for the elderly, but excluding crowning or tooth-filling services. In view of the fact that the dental out-patient services provided by the Department of Health fall short of the demand, those elderly people who cannot benefit from the pilot project can only continue to seek dental treatment from the private sector and as a result have to bear very high costs. In this connection, will the Government inform this Council:
(a) as elderly recipients of Comprehensive Social Security Assistance may apply for grants to cover costs of dental treatment, of the number of elderly people who had received such grants in the past five years, the total amount of grants approved and the types of dental services received by them; whether the authorities will reconsider including crowning or tooth-filling services in the scope of the pilot project; if so, of the details; if not, the reasons for that;
(b) as there have been comments that with only 11 dental clinics under the Department of Health in Hong Kong at present, many elderly people need to seek treatment from dental clinics in other districts, coupled with the fact that the service capacity is insufficient and the coverage of the services is limited to emergency treatment, whether the authorities have considered expanding the existing capacity and coverage of services, so that more elderly people in need can use the services; if so, of the details; if not, the reasons for that; and
(c) whether the authorities have compiled statistics or conducted surveys on a regular basis to assess the dental health of elderly people in Hong Kong; if so, of the details; if not, the reasons for that; whether the authorities have reviewed the current dental services for elderly people in Hong Kong to see if these services are comprehensive, adequate and appropriate; if so, of the details; if not, whether the authorities will consider conducting such a review and making improvement?
Reply:
President,
(a) The Government's policy on dental services seeks to improve oral health and prevent dental diseases through promotion and education, thereby raising public awareness of oral health, and facilitating the development of proper oral health habits.
To cater for the needs of those with financial difficulties, under the Comprehensive Social Security Assistance (CSSA) Scheme, dental grant would be given to CSSA recipients who are old or medically certified to be disabled or in ill-health to cover their expenses on dental services. The grant covers dental treatments including scaling and polishing, filling, extraction, dentures, crowns, bridges and root canal treatment. Eligible CSSA recipients can approach the 47 dental clinics designated by the Social Welfare Department (SWD) for dental examination and estimate of cost. After undergoing dental examination and obtaining the cost estimate at the designated dental clinic, CSSA recipients can apply for the dental grant from SWD. Upon receiving approval of the dental grant, CSSA recipients are free to choose any registered dentists for the relevant treatment service.
In the past five years, the number of CSSA recipients given the dental grant has been on the increase each year as shown at Annex.
In addition, we will launch a Pilot Project, in partnership with non-government organisations (NGOs) for a period of three years starting from April 2011, to provide elderly people residing in residential care homes (RCHEs) or receiving services in day care centres (DEs) with outreach primary dental care and oral health care services free of charge, including dental check-up, scaling, polishing and any other necessary pain relief and emergency dental treatments. The costs of such outreach primary dental care and oral services provided by the participating NGOs will be covered by the subvention to the NGOs from the Government.
For elderly people identified as having the need for and considered suitable for receiving follow-up curative treatments (e.g. replacement of missing teeth, fillings), participating NGOs under the Pilot Project will arrange for the necessary treatments, including applying on behalf of those who are recipients of CSSA for dental grant under the CSSA Scheme. For those who have financial difficulties but not receiving CSSA, the NGOs will provide or arrange to provide financial assistance to meet the cost of the further curative treatments. The dentist in charge of the case will make his/her clinical professional judgement to determine whether further follow-up curative dental treatments are necessary.
We expect that 17 NGOs will participate in the Pilot Project providing more than 100,000 attendance through 27 outreach teams benefiting some 80,000 elderly in RCHEs and DEs over the three-year pilot period. The total amount of subvention to the NGOs for the three-year Pilot Project is estimated to be about $88 million. The Government will monitor the implementation of the Pilot Project, and conduct an interim review on its effectiveness after we have gained enough experience from the operation of the Pilot Project.
(b) At present, we focus our efforts on providing emergency dental services for the public. The Department of Health (DH) provides free emergency dental services, covering treatment of acute dental diseases, prescription for pain relief, treatment of oral abscess and teeth extraction through its 11 government dental clinics. DH's dentists would also give professional advice with regard to the individual needs of patients.
In addition, DH provides specialist oral maxillofacial surgery and dental treatment to the referred hospital in-patients, patients with special oral health care needs and dental emergency in the Oral Maxillofacial Surgery and Dental Units (OMS&DUs) of seven public hospitals. The provision of specialist dental care service in the OMS&DUs is by referral. Members of the public in need of these services can be referred through hospitals/out-patient clinics/centres under the Hospital Authority or any registered dentists or medical practitioners. The dental clinics will arrange appointments for them according to urgency of their conditions. Patients with emergency needs, such as cases of dental trauma, will be provided with immediate consultation and treatment.
As regards curative dental services, they are mainly provided by the private sector and NGOs. The Government has launched the Elderly Health Care Voucher Pilot Scheme since January 2009 for a period of three years, under which elderly people aged 70 or above are provided with health care vouchers. The health care vouchers can be used for dental services provided by private dental clinics and dental clinics operated by NGOs. We have completed an interim review of the Scheme and proposed to extend the Scheme for a further period of three years, and double the value of health care vouchers to $500 per person per year. The Financial Secretary has committed to allocating $1 billion to implement this proposal.
(c) DH will conduct the territory-wide oral health survey from May 2011 to February 2012 to continuously monitor the oral health status and assess the oral health behaviours and habits of our population. The information collected could facilitate the planning and evaluation of various oral health programmes as well as formulation of objectives for oral health services.
The oral health survey will be conducted in accordance with the criteria and recommendations of the World Health Organisation. The targets of the survey are members of the key index age groups, including:
i) 5-year-old children
ii) 12-year-old children
iii) 35 to 44-year-old adults
iv) 65 to 74-year-old non-institutionalised elderly people
v) 65 and above elderly people receiving long term care services in RCHEs and receiving community care services at home and in DEs
Among the above key index age groups, 65 and above elderly people who are receiving community care services at home and in DEs are the new target groups of the oral health survey.
According to the survey conducted by DH in 2001, the oral health status of the Hong Kong population was found to be in the same ranking as many other developed countries. The level of tooth decay among the 12-year-old students was among the world's lowest but their gum condition needed more attention. As for the non-institutionalised elderly people aged 65 to 74, the percentage of them who are edentulous (i.e. the percentage of people with no teeth) among people in the respective age group was 9%, which was far lower than the 26% to 31% in the United States.
Ends/Wednesday, March 30, 2011
Issued at HKT 16:42
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