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Following is a question by the Dr Hon Pan Pey-chyou and a reply by the Secretary for Food and Health, Dr York Chow, in the Legislative Council today (June 27):
Question:
I have received a complaint from the Hong Kong Professional Pharmaceutical Employees Association (HKPPEA) that the Hospital Authority (HA) has, since 2003, made applications to the Department of Health on its own volition for some dispensers to be appointed as "approved persons", without informing such dispensers nor obtaining their consent or authorisation, and asked them to undertake and perform the duties of pharmacists in-charge, which should be performed by registered pharmacists. HKPPEA has pointed out that those dispensers who hold the status of "approved persons" are not registered pharmacists and HKPPEA is worried that drug safety may be affected. In this connection, will the Government inform this Council if it knows:
(a) the numbers of additional pharmacists and dispensers employed by HA in each of the past nine year to cope with the manpower needs of its dispensaries and the average waiting time for patients of the general out-patient clinics and specialist out-patient clinics of the various clusters of HA to collect medicine; whether HA had ever withheld the recruitment of pharmacists because there was a sufficient number of dispensers holding the status of "approved persons" since HA has assigned such dispensers to perform the duties of pharmacists in-charge in 2003; whether HA had consulted the dispensers and their staff associations before implementing the "approved persons" system in 2003; whether the system had been reviewed and enhanced in the past nine years; if not, the reasons for that;
(b) whether HA had informed the dispensers concerned in advance before making applications for them to be appointed as "approved persons"; whether it had given copies of the appointment and other related letters to such dispensers for their retention after application; how such appointments and recognition of qualifications are of use to the experience and qualifications of the dispensers; whether HA had, at the time of making applications for appointment of these dispensers, provided them with additional training and opportunities for further studies, and improved their remuneration packages to enable them to cope with the additional workload and duties; and
(c) given that the employees in the trade and members of the public have strong reservations about assigning dispensers who have been appointed as "approved persons" to perform the duties of registered pharmacists, whether HA will immediately put the system on hold (including immediately re-assigning registered pharmacists who meet the qualification requirements to take up the posts of pharmacist in-charge currently taken up by "approved persons") and expeditiously employ additional staff for both grades so as to ease the pressure of the workload in the dispensaries and to shorten the waiting time for patients to collect medicine; whether HA will also review the duties, scope of work and promotion ladder of the different grades of staff in the dispensaries so as to enhance the procedures and efficiency in dispensing medicine in the dispensaries under HA and reduce medicine incidents?
Reply:
President,
Under the Dangerous Drugs Ordinance (Cap.134) and the Pharmacy and Poisons Regulations (Cap. 138A), pharmacies of hospitals and outpatient clinics are required to have a registered pharmacist or a person approved by the Director of Health to possess and supply dangerous drugs and to supervise the dispensing of poisons. Before the Hospital Authority (HA) took over 59 General Outpatient Clinics (GOPCs) from the Department of Health (DH) in July 2003, senior dispensers and dispensers had all along been in charge of the GOPC pharmacies and were responsible for possessing and supplying dangerous drugs and supervising the dispensing of poisons. This is referred to as the "Approved Person" arrangement. After taking over the GOPCs, HA has continued to adopt the "Approved Person" arrangement and recruited 45 additional pharmacists to manage the operation of GOPC pharmacies.
At present, HA applies to the Director of Health on a regular basis for extending the "Approved Person" status of some senior dispensers and dispensers working in the GOPCs, so that they can continue to perform dispensing-related duties in accordance with the aforesaid Ordinance and Regulations. HA has already, for each of the GOPCs, deployed pharmacists to be in charge of the pharmacies and be responsible for the management of the daily operation of the GOPC pharmacies. The "Approved Persons" are not required to be in charge of the GOPC pharmacies but they have to perform the duties of "Approved Persons", including possession and supply of dangerous drugs as well as supervising the dispensing of poisons, in the absence of on-site pharmacists and when there is a service need. The "Approved Person" arrangement is an established practice adopted from the Department of Health and has been operating effectively. The extension of the "Approved Person" status with the Director of Health's written approval also complies with the law. In fact, the duties of "Approved Persons" are part of the daily and professional duties of the dispenser grade staff. The work arrangement is consistent with that when they worked in the GOPC pharmacies under DH's management in the past. At present, all dispensers trained by the Hong Kong Institute of Vocational Education have obtained the Higher Diploma in Pharmaceutical Technology and received vocational training in uses of drugs and drug dispensing practice. After they joined HA, dispensers will receive a variety of continuous professional development training every year, covering the pharmacy practice, drug knowledge as well as personal and career development etc., to cope with the service needs. Therefore, dispenser grade staff of HA have the professional qualification and knowledge and are competent to perform dispensing-related duties in the GOPC pharmacies. HA will continue to uphold the principle of appointment by merit and arrange both pharmacists and dispensers to work together in the GOPC pharmacies so as to meet service needs.
My reply to the various parts of the question is as follows:
(a) The number of pharmacists and dispensers recruited by HA every year varies according to service development and operational needs. In each of the past nine years, HA took on additional pharmacists (maximum 53 in one year) and additional dispensers (maximum 32 in one year). Detailed figures are at Table 1 of the Annex. In recent years, the average waiting time for drug dispensing services for patients attending HA's specialist out-patient clinics (SOPCs) has been maintained at about 40 minutes. Detailed figures are at Table 2 of the Annex.
After taking over the GOPCs, HA has continued the "Approved Person" arrangement in the GOPCs for operational reasons. As a matter of fact, the duties of "Approved Persons" are within the scope of daily duties of the dispenser grade staff, and the number of "Approved Persons" has been gradually decreasing from 93 in 2003 to 34 in July 2012. The 34 "Approved Persons" whose status have been extended are all senior dispensers who are experienced and professionally competent to perform dispensing-related duties. On the other hand, since 2011-12, HA has been recruiting and deploying over 20 pharmacists to work at the GOPCs to strengthen the overall manpower support and enhance the overall efficiency of GOPC pharmacy services. HA has been communicating closely with the concerned staff and the dispenser staff associations on the need to extend the "Approved Person" status of some of the dispenser grade staff.
(b) Since 2009, HA has issued written notice to the concerned staff on the Director of Health's approval for extending their "Approved Person" status in the GOPCs. The "Approved Persons" with their status extended in the past were all senior dispensers and experienced dispensers. As mentioned above, HA provides a variety of continuous professional development training, covering pharmacy practice, drug knowledge as well as personal and career development etc., for pharmacy staff every year (including dispenser grade staff working in both hospitals and out-patient clinics) so as to meet service needs.
(c) HA understands the concerns of some dispensers about their roles as "Approved Person". However, to ensure that the operation of the GOPC pharmacies will not be affected, HA assesses that there is still a need to maintain the "Approved Person" arrangement for senior dispensers in the near future.
In recent years, HA has been recruiting more pharmacist and dispenser grade staff to shorten the waiting time and improve workflow in drug dispensing services. HA will keep in view the service development and operational needs and deploy its manpower flexibly and determine the appropriate staff mix in order to deliver efficient and safe pharmaceutical services to meet patients' needs.
Ends/Wednesday, June 27, 2012
Issued at HKT 17:32
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