***********************************************
Following is a question by the Dr Hon Leung Ka-lau and a reply by the Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council today (November 27):
Question:
It has been learnt that there are currently quite a number of doctor vacancies to be filled in the accident and emergency (A&E) departments of public hospitals, and such shortage of manpower has resulted in exceedingly long waiting time for A&E services for patients triaged as semi-urgent and non-urgent. Some of these patients had to wait for more than 20 hours. I have also learnt that the Secretary for Food and Health has urged public and private doctors to participate in the scheme to work part-time in A&E departments of public hospitals in order to alleviate the situation of manpower shortage. However, the hourly salary of part-time doctors in A&E departments at present is merely around 70% of that of full-time doctors. In this connection, will the Government inform this Council whether it knows:
(a) the respective average weekly working hours of full-time doctors of various ranks in A&E departments of public hospitals at present, as well as the respective median hourly salary (including basic salary and regular allowances) of doctors of various ranks calculated on the basis of the aforesaid working hours;
(b) the respective median hourly salary of part-time doctors of various ranks in A&E departments of public hospitals at present, as well as the criteria for determining the relevant salary level; and
(c) if the Hospital Authority conducted open recruitment of part-time doctors for A&E departments in the past three years; if so, when and how the recruitment was conducted; if not, of the reasons for that?
Reply:
President,
With an ageing population, advances in medical technology and an increasing demand for healthcare services in the community, the manpower requirement for healthcare personnel grows commensurately. In the past few years, the Hospital Authority (HA) has always been concerned about the manpower supply and implemented a series of measures to address manpower issues. Recruiting part-time doctors is certainly one of the measures. Besides, in 2013-2014, the HA expects to recruit about 300 full-time doctors. The HA started the recruitment of non-local doctors to practise with limited registration since 2012 as one of the additional and short-term measures to address the manpower problem. In addition, in recent years, the HA has created additional promotion posts, strengthened professional training and relieved the workload of its frontline healthcare workers by re-engineering work processes and streamlining work procedures with a view to boosting staff morale and improving staff retention. Such measures have reaped positive results and the turnover rate of full-time doctors dropped from about 5% in 2010-11 to 3.8% in 2013-14 (October 2012 to September 2013). Besides, the Government has taken steps to tackle the healthcare manpower shortage problem at source by implementing a number of measures, including the allocation of an additional $200 million for the triennial cycle starting from 2012 to increase the number of first-year first-degree places in medicine by 100 to 420 per year. The HA expects to see an increase in the total number of doctors when 320 and 420 medical graduates complete their internship in 2015-16 and 2018-19 respectively. The Medical Council of Hong Kong has also decided to increase the number of licensing examinations from once to twice a year from 2014, with a view to facilitating those overseas-trained Hong Kong residents to return to have examination and practise in Hong Kong.
In tandem with the said measures, the HA enhanced the remuneration package of part-time doctors and allowed greater flexibility for their employment in early 2012 to increase doctor manpower in the short term. Without affecting the promotion of other young doctors, the HA has made proactive efforts to retain some of the doctors who have retired or left the HA. In 2011, there were about 60 retired or departed doctors continuing to serve in public hospitals on a part-time basis. As at the end of September 2013, there were 301 part-time doctors working in the HA, of which 247 are retired, departed or changed from full-time to part-time employment, providing support equivalent to about 117 full-time doctors.
My reply to the various parts of the question is as follows:
(a) The conditioned work hours of doctors working in Accident and Emergency (A&E) departments of the HA are 44 hours gross per week (hours of on-call duties not included). The HA employs full-time staff on a monthly-rated basis. Mid-point monthly basic salary according to Notional Annual Mid-point Salary (NAMS), monthly allowance and fixed-rate honorarium of various ranks of full-time doctors are as follows:
(i) Mid-point monthly basic salary of a Resident is $70,490. Monthly allowance is $17,330. Fixed-rate honorarium of A&E Residents is $4,750 per month;
(ii) Mid-point monthly basic salary of an Associate Consultant is $96,150. Monthly allowance is $33,119. Fixed-rate honorarium of A&E Associate Consultants is $4,750 per month; and
(iii) Mid-point monthly basic salary of a Consultant is $136,550. Monthly allowance is $47,047. Fixed-rate honorarium of A&E Consultants is $2,750 per month.
(b) Since the implementation of the new part-time employment scheme introduced in January 2011, there is no need for part-time doctors to take up on-call duties. Part-time doctors employed under the new scheme are hence offered remunerations at 70% of those of full-time doctors of the same rank (including monthly salary based on the unified pay point and monthly allowance for the rank) and the calculation is based on the number of service sessions.
If the doctor concerned chooses to perform on-call duties on a part-time basis, the remuneration for such duties will be calculated according to that of a full-time doctor of the same rank who has similar qualification and experience (including monthly salary based on the salary point which is determined by the relevant experience in the rank, monthly allowance and fixed-rate honorarium) and the calculation of salary per month is based on the number of service hours per week.
(c) The HA will recruit part-time doctors (including part-time doctors for A&E departments) through open recruitment and through regular invitation by issuing letters to doctors who have retired or resigned for three months and those who are about to leave the HA. The HA will also recruit part-time doctors through other means of referral. From January 2011 when the HA has enhanced the part-time doctor scheme to end of September 2013, the number of part-time doctors for A&E departments has increased from 8 to 30. Private doctors can apply to be HA's part-time doctors through open recruitment, other means of referral and self-nomination. The HA will continue to recruit full-time and part-time doctors for A&E departments through various means to meet operational needs.
In the face of challenges posed by an ageing population and increasing demand for healthcare services, the Government has set up a high-level steering committee to conduct a strategic review of the healthcare manpower planning and professional development in Hong Kong. The review covers healthcare professionals from 13 professions which are subject to statutory regulation. The steering committee will assess manpower needs in these healthcare professions and put forward recommendations on how to cope with the anticipated demand for healthcare manpower, strengthen professional training and facilitate professional development having regard to the findings of the strategic review, with a view to ensuring the sustainable development of Hong Kong's healthcare system.
Ends/Wednesday, November 27, 2013
Issued at HKT 16:41
NNNN
