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Following is a question by the Hon James To and a written reply by the Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council today (May 7):
Question:
Some members of the public have relayed to me that the Pamela Youde Nethersole Eastern Hospital (PYNEH) under the Hospital Authority (HA) has implemented certain rules for in-patients of its psychiatric wards (including no entering or leaving the wards freely, a ban on the use of communications devices, and no discharge from the hospitals without the consent of their attending doctors) (in-patient rules). However, when PYNEH provides the "Application for reception as a voluntary patient" (the application form) for completion by patients being admitted, no leaflet stating such rules is attached to it. These rules are only posted in an inconspicuous place inside the wards. Regarding the services of the psychiatric wards in public hospitals (psychiatric wards), will the Government inform this Council if it knows:
(1) the general admission procedures of the psychiatric wards;
(2) the number of admissions to the psychiatric wards in the past five years and, among them, the respective numbers of cases in which the patients were admitted under the following circumstances: (i) the application forms were completed and lodged by the patients themselves, (ii) the application forms were completed and lodged by the patients' guardians, and (iii) the patients were detained for observation by the hospitals under the Mental Health Ordinance (Cap. 136), together with a tabulated breakdown by name of public hospital;
(3) whether the psychiatric wards of other hospitals have implemented in-patient rules and admission arrangements (including the arrangement for patients to sign the application forms in the general wards and the relevant in-patient rules to be posted inside the psychiatric wards only) similar to those of PYNEH; if they have, of the details, with a tabulated breakdown of such information by name of public hospital;
(4) whether HA has put in place measures to ensure that its hospitals will clearly explain the in-patient rules to the patients who are voluntarily admitted to the psychiatric wards, and to ensure that the patients understand the contents; if it has, of the details and the procedures;
(5) the longest and the shortest periods for which patients stayed in the psychiatric wards for observation in the past five years; among these patients, the respective numbers of them who were subsequently (i) discharged directly, (ii) referred to the Castle Peak Hospital or other psychiatric specialist hospitals, and (iii) referred to the psychiatric wards of other hospitals for continuous treatment, together with a tabulated breakdown by name of public hospital;
(6) among the patients admitted to the psychiatric wards for treatment in the past five years, the respective numbers of those who (i) had applied for discharge by themselves and were approved for discharge, and (ii) had applied for discharge by themselves but were considered by the hospitals concerned after assessment that continuous observation in the hospital was required, together with a tabulated breakdown by name of public hospital;
(7) whether HA received in the past five years any complaint about members of the public being misled into consenting to be admitted to the psychiatric wards; if it did, of the number of such complaints and how HA followed up such complaints, with a tabulated breakdown by name of public hospital;
(8) whether HA currently has any mechanism for handling complaints lodged by patients of the psychiatric wards about the treatments used, or the assessments of their mental condition made, by the attending doctors; if HA does, of the details; and
(9) whether HA has issued guidelines for its hospitals on the admission of patients to the psychiatric wards; if HA has, of the date on which such guidelines were last revised; whether HA has put in place measures to monitor the implementation of such guidelines by its hospitals; if HA does not have such guidelines, the reasons for that and whether HA will consider issuing such guidelines, so as to enhance the management of the administrative work of admitting patients to the psychiatric wards?
Reply:
President,
Generally speaking, patients in need of psychiatric inpatient services of the Hospital Authority (HA) will be sent to designated mental hospitals under the HA. The designated mental hospitals under the Mental Health Ordinance (Cap. 136B) are Castle Peak Hospital, Kwai Chung Psychiatric Observation Unit, Pamela Youde Nethersole Eastern Psychiatric Observation Unit, New Territories East Psychiatric Observation Unit and Kowloon Psychiatric Observation Unit.
For any patient who has been assessed by doctors of the HA to be in need of psychiatric inpatient services and has indicated his consent for hospitalisation, the HA will ask him or his parent/guardian (if the patient is under the age of 16) to sign the "Application for reception as a voluntary patient" (the application form) in accordance with section 30 of the Mental Health Ordinance (Cap. 136). Upon receipt of the application form, the medical superintendent of the respective mental hospital may admit such patient as a voluntary patient.
According to section 31 of the Mental Health Ordinance (Cap. 136), an application may be made by the HA to a District Judge or magistrate for detention of a patient who is suffering from mental disorder of a nature or degree which warrants his detention in a mental hospital for at least a limited period for observation in the interests of the patient's own health or safety or with a view to the protection of other persons. Patients detained in a mental hospital under section 31 of the Mental Health Ordinance (Cap. 136) may make an application to the Mental Health Review Tribunal for review of their cases according to section 59B of the Mental Health Ordinance (Cap. 136).
The number of admissions to psychiatric wards of the HA through the aforesaid means in the past five years is set out in Table 1 in the Annex.
The length of stay of patients admitted to psychiatric wards varies from a few days to more than a year depending on their conditions. Doctors will assess the patients' conditions from time to time and arrange services such as community rehabilitation for patients who are suitable for discharge. In the past five years, the number of patients discharged each year remained at around 16 000 to 17 000.
For patients who need to be admitted to psychiatric wards, the healthcare personnel will explain to them and their family members the contents of the application form and the operation of the psychiatric wards, including rules that patients must comply with and the procedures and arrangements for discharge, etc. The healthcare staff of respective psychiatric ward will also explain the details to patients upon their admission and provide them with information such as hospitalisation notes and Patients' Charter, so as to ensure that the patients and their family members understand the relevant inpatient arrangements.
Members of the public who are dissatisfied with the services of the HA, including those who believe that they have been misled into signing the application form or those who are not satisfied with the treatments or mental assessments by the attending doctors during their stay in the hospital, may lodge their complaints with the HA.
The HA has put in place a two-tier complaint mechanism for handling public complaints against its hospitals. At the first tier, all complaints will first be handled by the respective public hospitals. Upon receipt of a complaint case, the Patients Relations Officer will pass it to the department concerned for follow-up and investigation. The patient will be informed of the results after investigation. If the complainant is not satisfied with the investigation results or reply of the hospital, he may file an appeal to the HA's Public Complaints Committee (PCC) (i.e. the second tier of the complaint mechanism). The PCC, being a committee under the HA and comprising members from different sectors of the community, is tasked to handle and consider all appeals for the HA in an independent, fair and impartial manner.
The number of complaints from members of the public regarding being misled into giving consent for admission to psychiatric wards received by different hospital clusters of the HA in the past five years is set out in Table 2 in the Annex.
The HA issues guidelines on the operation and administration of wards (including psychiatric wards) from time to time so as to improve the management of hospital wards. The HA will continue to pay close attention to the operation and arrangement of inpatient psychiatric services, and make appropriate improvement as and when necessary.
Ends/Wednesday, May 7, 2014
Issued at HKT 15:54
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