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Following is a question by the Hon Chan Han-pan and a reply by the Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council today (November 7):
Question:
Given that the general out-patient clinics under the Hospital Authority (HA) provide evening out-patient services until 10pm only, members of the public seeking medical consultation in late nights may seek consultation only at private clinics offering overnight out-patient services or the accident and emergency (A&E) departments of public hospitals. However, since only 16 public hospitals across the territory have A&E departments, members of the public seeking medical consultation often have to wait for hours to receive treatment. In this connection, will the Government inform this Council:
(a) whether it will request HA to enhance the existing evening out-patient services, including extending the service hours to midnight and increasing the number of consultation quotas; if it will, of the details; if not, the reasons for that;
(b) whether it will request HA to implement overnight out-patient services in individual districts on a trial basis, with a view to alleviating the existing pressure on A&E departments; if it will, of the details of the plan; if not, the reasons for that; and
(c) given that some members of the public have relayed to me that as the demand for evening out-patient services is greater in some densely populated districts or districts with relatively more elderly residents (e.g. Tin Shui Wai), and there is no A&E department of public hospitals in such districts, great inconvenience has been caused to members of the public, whether the authorities will require HA to extend the service hours of the evening out-patient services provided in such districts or set up overnight out-patient services there, so as to enable patients to receive timely treatment?
Reply:
President,
My consolidated reply to the three parts of the question raised by the Hon Chan Han-pan is given below. Primary care services in Hong Kong are mainly provided by the private sector. Public primary care services including general out-patient services provided by HA are primarily targeted at low-income groups, elders and chronically ill patients. At present, HA operates a total of 74 general out-patient clinics (GOPCs) in Hong Kong, of which 23 provide evening out-patient services.
Patients under the care of GOPCs comprise two major categories: chronic disease patients with stable medical conditions, such as patients with diabetes mellitus or hypertension, and episodic disease patients with relatively mild symptoms, such as those suffering from influenza, cold, gastroenteritis, etc. For those with episodic diseases, consultation timeslots at GOPCs in the next 24 hours are available for booking through HA's telephone appointment system. As for chronic disease patients requiring follow-up consultations, they will be assigned a visiting timeslot after each consultation and do not need to make separate appointments by phone.
In 2011-12, the 74 GOPCs under HA have recorded around five million attendances involving more than 1.3 million patients. Over 90% of the target users of general out-patient services, including elders and recipients of Comprehensive Social Security Assistance and medical fee waiver, were able to secure a consultation timeslot successfully through the telephone appointment system within two working days.
To improve public primary care services, enhance support for chronic disease patients and raise the public's awareness of health issues, the Government has in recent years rolled out a series of primary care services through HA to strengthen the management of chronic diseases. These include the provision of health risk assessments and follow-up care for patients with diabetes mellitus or hypertension etc. by multi-disciplinary teams at GOPCs, and targeted treatment services for high-risk chronic patients by nurses and allied health professionals such as physiotherapists, occupational therapists and pharmacists. Through these measures, it is hoped that the risk of complications and the need for consultations can be reduced for chronic patients, thereby releasing consultation timeslots for patients with episodic diseases. At the same time, HA has been taking steps to renovate the premises and upgrading facilities of GOPCs to streamline patient flow and improve the clinics' environment. It is also trying to recruit additional staff as far as possible to increase the service capacity of GOPCs.
Regarding Tin Shui Wai, the Government and HA have over the years introduced various measures to enhance public healthcare services in the area. In February this year, the first community health centre (CHC) in the territory, which is located at Tin Yip Road, Tin Shui Wai and designed according to our primary care development strategy and service delivery model, came into operation to provide one-stop primary care services including general out-patient as well as nurse and allied health services for the public. HA envisages that the new CHC, together with the existing Tin Shui Wai Health Centre at Tin Shui Road, will be able to provide over 200 000 attendances of general out-patient services for the district on a yearly basis. HA has also launched the Tin Shui Wai Primary Care Partnership Project since 2008, under which patients suffering from specific chronic diseases with stable medical conditions in need of follow-up treatment at the Tin Shui Wai GOPCs can opt to receive out-patient services from private medical practitioners in the district with subsidies from the Government. This Project has now been extended to the entire Tin Shui Wai area, benefitting some 1 600 patients. At present, 24-hour accident and emergency (A&E) services are available at Pok Oi Hospital in Yuen Long. The planned Tin Shui Wai Hospital, which is scheduled to come into operation in 2016, will also provide A&E and other services including specialist out-patient services and ambulatory services to address the healthcare needs of the district.
As GOPCs are not intended for provision of emergency services, patients with severe and acute symptoms should go to A&E departments of hospitals where the necessary staffing, equipment and ancillary facilities are in place for appropriate treatment and comprehensive care. To ensure efficient use of GOPC resources, extending general out-patient services into the small hours or providing overnight services is not cost-effective and would create greater pressure on healthcare staffing. At this point, the Administration has no plan to operate general out-patient services at late nights or round-the-clock.
HA will continue to implement measures to enhance general out-patient services, including strengthening its staffing, renovating and expanding existing GOPCs, upgrading clinic facilities, etc. It will also closely monitor the operation and service utilisation of GOPCs, and deploy manpower and other resources flexibly to enhance the efficiency and quality of general out-patient services for meeting patients' needs for public primary care services.
Thank you, President.
Ends/Wednesday, November 7, 2012
Issued at HKT 13:11
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