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Following is a question by the Professor Hon Joseph Lee and a written reply by the Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council today (November 11):
Question:
Some members of the public have relayed to me that assessment and support services for children under 12 years of age with developmental or behavioural disorders are grossly inadequate. In this connection, will the Government inform this Council:
(1) in each of the past five years, of (i) the number of children referred by doctors or schools or through other channels to queue for assessments at the Child Assessment Centres (CACs) under the Department of Health, (ii) the number of children assessed at various CACs each year, and (iii) the average queuing time for children to receive assessments (with a breakdown of the three pieces of information by age of children and centre);
(2) of the current total number of healthcare personnel in various CACs (with a breakdown by rank); whether the authorities will consider increasing the manpower and other resources for various CACs so that children with developmental or behavioural disorders can receive assessments and treatment as soon as possible; if they will, of the details; if not, the reasons for that;
(3) of the respective numbers of children diagnosed with developmental or behavioural disorders, and the percentages of such numbers in the population of children of the same age group in the territory (with a breakdown by developmental or behavioural disorder) in each of the past five years; and
(4) of the support services provided for children diagnosed with developmental or behavioural disorders; the average queuing time for them to receive rehabilitation training and treatment services in the past five years?
Reply:
President,
(1) The Child Assessment Service (CAS) of the Department of Health (DH) provides clinical assessment for children under the age of 12 with suspected symptoms of developmental problems. New cases are referred from various channels, including Maternal and Child Health Centres (MCHCs), Hospital Authority (HA), private practitioners and psychologists etc. The channels of referral concerning new cases received by CAS for the past five years are set out in Annex 1.
In the past five years, nearly all new cases were seen within three weeks after registration. CAS has adopted a triage system to ensure that children with urgent and more serious conditions are accorded with higher priority in assessment with a view to enhancing service efficiency. The actual waiting time depends on the complexity and conditions of individual cases. In the period from 2011 to 2014, assessments for over 80 per cent of newly registered cases were completed within six months. Further breakdown of the above figures by children's age or by CAC is however not maintained by DH.
(2) The civil service establishment of CAS as at October 1, 2015 is shown in Annex 2.
In view that the demand for services provided by the CAS has surged continuously, the Government has allocated funding for 2015/16 and onwards for the conversion of 10 non-civil-service contract (NCSC) posts to civil service posts in order to strengthen the manpower support and enhance the service capacity to meet the rising number of referred cases. Among the abovementioned ten NCSC posts, two NCSC posts of speech therapist have already been converted to civil service posts, which have already been included in the civil service establishment table in Annex 2. The other eight NCSC posts would be converted to civil service posts of Medical and Health Officers (four posts) and Clinical Psychologists (four posts) in due course. Recruitment of these posts is underway.
In addition, CAS has adopted a triage system to ensure that children with urgent and more serious conditions are accorded with higher priority in assessment with a view to enhancing service efficiency. It is expected that, with strengthened manpower, CAS will be able to complete assessments for at least 90 per cent of the newly referred cases within six months.
(3) The numbers of newly diagnosed cases of developmental conditions in CAS from 2011 to 2014 are shown in Annex 3.
DH does not have statistics regarding the above cases as a percentage of the children population in Hong Kong.
(4) The CAS provides comprehensive assessment and diagnosis for children under 12 years of age who are suspected to have developmental problems. After assessment, follow-up plans will be formulated according to the individual needs of children. Children will be referred to other appropriate service providers for training and education support. While children await rehabilitation services, CAS will provide interim support to their parents, such as seminars, workshops and practical training etc., with a view to enhancing the parents' understanding of their children and community resources so that home-based training would be provided to facilitate the development and growth of the children.
The HA has a multi-disciplinary team of paramedical professionals, which provides early identification, assessment and treatment for children and youths with needs (including children with specific learning difficulties and behavioural problems). The HA has put in place an established triage system for new cases at child and adolescent psychiatric specialist out-patient (SOP) clinics to ensure that patients with urgent healthcare needs are given medical attention within a reasonable time. New cases received at psychiatric SOP clinics will be triaged into priority 1 (urgent), priority 2 (semi-urgent) and routine (stable) cases according to their severity and urgency to ensure that more urgent and severe cases are followed up promptly. The HA seeks to keep the median waiting time for first appointment at psychiatric SOP clinics for priority 1 and priority 2 cases within two and eight weeks respectively. This performance pledge has been fulfilled. The waiting time for new cases in non-urgent and stable condition is relatively longer as more patients are under this category. In 2012/13, 2013/14 and 2014/15, the median waiting time for new cases in stable condition at child and adolescent psychiatric SOP clinics were 23, 42 and 56 weeks respectively. The HA does not keep relevant data for 2010/11 and 2011/12. If a patient's mental condition deteriorates before the appointment, he or she may request the psychiatric SOP clinic concerned for re-assessment to determine whether his/her original appointment should be advanced. The patient may also consider seeking medical treatment from the emergency and accident department.
Comprising child psychiatrists, paediatricians, clinical psychologists, nurses, speech therapists and occupational therapists, the HA's multi-disciplinary team will provide a series of appropriate treatment and training, including hospitalisation, out-patient services, day-time rehabilitation training, as well as community support services, according to the severity of the condition of children and youths, with a view to enhancing their ability in communication, socialisation, emotion management, problem solving, learning and life skills. Knowledge about the diseases is also provided to the parents and carers concerned in order to enhance their understanding of the symptoms and treatment needs of the patients. At the same time, the HA's professional team maintains close liaison with related organisations, such as early training centres or schools, to provide appropriate support according to the development needs of the children and youths.
Pre-school children (aged six or below) diagnosed to have special needs are referred to receive pre-school rehabilitation services provided by the Social Welfare Department. The average waiting time for pre-school rehabilitation services in the past five years is set out as follows:
Year Average waiting time (month)
2010/11 10 - 14.9
2011/12 12.2 - 16.8
2012/13 12.7 - 16.9
2013/14 14.1 - 19
2014/15 13 - 19.6
The Government will continue to increase the provision of pre-school rehabilitation places. Sites have been reserved by the current-term Government to provide about 1 470 additional pre-school rehabilitation places. Moreover, it is expected that 3 800 additional places will be offered through the Special Scheme on Privately Owned Sites for Welfare Uses. The Government is also taking forward the Pilot Scheme on On-site Pre-school Rehabilitation Services. Non-governmental organisations are invited to provide on-site pre-school rehabilitation services in kindergartens and kindergarten-cum-child care centres. Programmes under the pilot scheme commenced service from November onwards, providing a total of more than 2 900 places. Furthermore, the Government provides a training subsidy for children on the waiting list from low-income families and in need of rehabilitation services to enable them to receive non-subvented rehabilitation services.
For school-age children, the Education Bureau has been providing schools with additional resources, professional support and teacher training to help them cater for students with special educational needs. Schools may pool together and deploy their resources flexibly to provide support services for the students based on their needs, including employing additional teachers/teaching assistants and hiring professional services such as speech therapy and other specialist services. There is no need for students to wait for the services.
Ends/Wednesday, November 11, 2015
Issued at HKT 17:52
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