**************************************************
Following is a question by the Hon Paul Tse and a written reply by the Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council today (January 27):
Question:
The Government has planned to launch the Colorectal Cancer Screening Pilot Programme (the Pilot Programme) in the middle of this year to subsidise members of the public of specific age groups for receiving colorectal cancer screening. However, the Government has not announced the details of the Pilot Programme. In this connection, will the Government inform this Council:
(1) why it has not announced the details of the Pilot Programme;
(2) whether the original estimated expenditure of $420 million for the Pilot Programme needs to be revised; if so, of the details; whether there is any change in the target population and estimated number of beneficiaries under the Pilot Programme; if so, of the details;
(3) given that colonoscopy services will be provided by private healthcare institutions under the Pilot Programme, of the average amount of fee per attendance for such services, and the amount of subsidy to be funded by public money in such a fee, as estimated by the authorities; and
(4) given that the fees for colonoscopy services currently provided by private healthcare institutions vary greatly (for instance, individual clinics may charge a fee of as low as about $5,000, which is far lower than those charged by private hospitals), whether the authorities will, when implementing the Pilot Programme in future, require various private healthcare institutions participating in the Pilot Programme to publicise details and fee levels of their services, so as to enhance transparency and boost competition, thereby enabling members of the public to make informed choices; if they will, of the details; if not, the reasons for that?
Reply:
President,
In view of a growing and ageing population, the Government anticipates that the number of new colorectal cancer cases and related healthcare burden will continue to increase. To handle the rapidly increasing healthcare burden arising from colorectal cancer, the Government decided to allocate around $420 million in the five years starting from 2014/15 for the study and implementation of a pilot programme to provide subsidised colorectal cancer screening for specific age groups.
(1) To allow the early implementation of the Colorectal Cancer Screening Pilot Programme (the Pilot Programme), the Department of Health (DH) embarked upon the relevant study and planning work in January 2014. A multi-disciplinary taskforce, which comprises representatives from various medical associations and professional bodies, academic institutions and non-governmental organisations, was established to carry out the planning, implementation, publicity and evaluation work of the Pilot Programme, including determining the criteria for participation, method of screening, funding model and operational logistics. We also submitted an information paper in December 2014 to brief the Legislative Council Panel on Health Services the progress of the Pilot Programme. As mentioned in the Policy Agenda of the 2016 Policy Address, the Pilot Programme is expected to be launched in mid-2016 the earliest.
(2) The Pilot Programme aims at assessing the implementation of population-based screening and its implications on the healthcare system. As such, the target users must be sufficiently representative and the current service capability should not be overloaded. After due consideration, the taskforce has agreed to invite eligible Hong Kong residents aged 61 to 70 to undergo faecal immunochemical test (FIT) screening by batches over three years. Arrangements will be made for FIT positive participants to undergo colonoscopy.
With reference to the relevant demographic data, the Government estimates that around 30 per cent of the eligible persons from the age group of 61 to 70 will participate in the Pilot Programme, and around 90 per cent of those who are FIT positive (assuming that about 4.5 per cent of the participants are FIT positive) will be willing to undergo colonoscopy. According to the above projection and the latest population statistics, the DH estimates that the Pilot Programme will attract around 300 000 participations in FIT screening and around 10 000 colonoscopies for FIT positive cases. This is similar to the projection made in the information paper submitted to the Legislative Council Panel on Health Services in December 2014. Hence, there is no need to revise the original estimated expenditure of $420 million for the Pilot Programme.
(3) To encourage the public to actively participate in the Pilot Programme and complete the screening process, the Government will provide subsidised FIT screening for participants. It will also subsidise those who are found to be FIT positive to undergo colonoscopy. In this connection, the Pilot Programme will adopt the public-private partnership model. Participants will first receive subsidised FIT service provided by participating private primary care doctors. For participants whose stool samples are found to contain occult blood, they will be referred by their primary care doctors for subsidised colonoscopy conducted by private specialists who have participated in the Pilot Programme. Private colonoscopists participating in the Pilot Programme must fulfil the specified requirements in terms of qualification, premises and facilities, as well as service quality and standard. In the planning process, the DH has maintained close communication with various stakeholders in the medical sector in order to enlist the support and active participation of private doctors and private healthcare facilities.
When determining the amount and details of subsidy of the Pilot Programme, the Government will take into consideration factors including market practice, experience of existing healthcare subsidy schemes, fairness and equity of charges as well as affordability and accessibility of service. The Government will announce relevant information in due course.
(4) To facilitate public understanding of the details of the Pilot Programme and enhance market transparency, the DH will, on its website which disseminates information about colorectal cancer prevention, provide detailed information on the scope of the subsidised colonoscopy service, whether there is a charge payable to each participating specialist after deduction of the government subsidy and the respective amount. Participating clinics or private healthcare facilities must display posters in their premises, showing the charges for easy reference of the participants of the Pilot Programme.
Ends/Wednesday, January 27, 2016
Issued at HKT 13:52
NNNN