LCQ20: Healthcare services for Islands District
***********************************************
Question:
According to the findings of the 2021 Population Census, the population of the Islands District in 2021 has already exceeded 180 000. Furthermore, upon the completion of the Tung Chung New Town Extension project, Tung Chung will be able to accommodate over 180 000 new population. However, currently there are only two hospitals in the district, the North Lantau Hospital (NLH) and St John Hospital (the two Hospitals), which provide services to residents in the district. In this connection, will the Government inform this Council:
(1) given that among the two Hospitals, only NLH provides six specialist outpatient services to residents in the district, whether it knows the respective numbers of residents in Cheung Chau, Mui Wo, Peng Chau and Lantau who needed to travel to (i) Queen Mary Hospital, (ii) Princess Margaret Hospital, (iii) Pamela Youde Nethersole Eastern Hospital, (iv) Grantham Hospital, and (v) Tung Wah Hospital to receive specialist outpatient services in each of the past three years, together with a breakdown by the specialist outpatient service involved; of the average travelling time needed for the residents in each of the aforesaid areas to travel to each of the aforesaid hospitals, and the average waiting time needed for receiving diagnosis and treatment after their arrival at each of the specialist outpatient clinics;
(2) whether it knows if the Hospital Authority (HA) will provide all of the 15 specialist outpatient services at NLH; if HA will, of the timetable;
(3) whether it knows the current establishment of healthcare personnel at NLH; whether HA has assessed if NLH has sufficient manpower currently and for the coming five years; if HA has assessed and the outcome is in the negative, of the manpower shortfall and the grades involved;
(4) as it is learnt that NLH is unable to provide outreach medical services due to insufficient manpower, and the elderly in residential care homes for the elderly (RCHEs) in the district need to travel a long distance to hospitals located in urban areas for follow-up medical appointments, whether it knows the number of RCHEs in the district not provided with such services in each of the past three years; whether HA will consider allocating additional resources to provide such services; if HA will, of the details and timetable; and
(5) given that there are currently seven general outpatient clinics under HA in the Islands District, but some of them do not provide services at weekends and in the evenings, whether it knows if HA has plans to enhance outpatient services in the district and redevelop North Lamma General Outpatient Clinic; if HA has, of the details?
Reply:
President,
In consultation with the Hospital Authority (HA), the reply to the various parts of the question raised by Hon CHAN Hok-fung is as follows:
(1) to (3) The HA plans its services on a cluster basis. In planning and developing various public healthcare services, the HA takes into account a number of factors, such as the projected demand for healthcare services based on population growth and demographic changes, increased prevalence in chronic diseases, advancement of medical technology, manpower situation as well as the service arrangement in each cluster and hospital, etc. The HA monitors the utilisation of its various healthcare services and plans public healthcare services according to the population projection across different districts in Hong Kong and development plan of the Government. In term of manpower, the HA provides healthcare services through multi-disciplinary teams comprising doctors, nurses, allied health professionals and supporting grade staff. At present, all the planned projects for Phase 1 development of the North Lantau Hospital (NLTH) have been put into service, and necessary staff have been recruited according to operational needs. The second phase of the hospital development plan has also been included in the second 10-year Hospital Development Plan. The HA will assess the manpower needs from time to time and deploy manpower flexibly to meet service and operational needs.
For the Specialist outpatient services in public hospitals, the NLTH currently provides Medicine and Geriatrics, Orthopaedics and Traumatology, Surgery, Urology, Paediatrics and Adolescent Medicine, Gynaecology and Psychiatry. The HA does not have breakdown on the average time of residents in different districts (including Cheung Chau, Mui Wo, Peng Chau and Lantau Island as specified in the question) going to various specialist out-patient clinics (SOPCs) and the average waiting time for receiving services therein.
The HA has been committed to continuously improving the specialist outpatient services of public hospitals in each cluster, and will fully implement the measures announced in "The Chief Executive's 2022 Policy Address" with the view to shorten the waiting time for SOPCs by adapting a multi-pronged approach. This includes (i) allocate more resources for new cases; (ii) streamline referral arrangements for cross-specialty cases; (iii) set up integrated clinics to provide multi-disciplinary support to minimise patients' waiting time for multiple specialists; and (iv) enhance downloading of patients in stable condition to primary healthcare. In addition, the HA has set up the key performance indicators to improve the flow of patients visiting the SOPCs under the HA. The goal is to complete the process from registration to doctor consultation for 75 per cent of the specialist outpatients within 60 minutes by March 31 next year, and to complete the process from registration to medicine collection within 120 minutes.
(4) The HA has been striving to strengthen services of the "Community Geriatric Assessment Team" (CGATs) to provide support to elderly patients in need. Through regularly visits to residential care homes for the elderly (RCHEs), the CGATs provide healthcare treatment for the residents suffering from more serious or complicated conditions who are unable to attend appointments at SOPCs due to difficulties in mobility. At the same time, the CGATs will also enhance training for carers to enhance their capability in taking care of elderly patients living in RCHEs.
Currently, there are six RCHEs in Tung Chung and Mui Wo, and the CGAT of the NLTH has provided outreach services to five of them. The team has also been keeping in touch with and providing support to the RCHEs in the district. In particular, in accordance with the Government's anti-epidemic strategy, the team provides immediate COVID-19 assessment for residents in the six RCHEs during the COVID-19 epidemic to facilitate early isolation and treatment.
The HA will review the service arrangements and resource allocation from time to time. If there is any development on further expansion of services, the hospital will notify the RCHEs as soon as possible.
(5) The general out-patient clinics (GOPCs) of the HA is committed to providing community-based primary health care services, service users are mainly the elders, low-income individuals, and patients with chronic diseases. Patients under the 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 cold and gastroenteritis etc.). As the GOPCs are not intended for provision of emergency services, patients with severe and acute symptoms should go to the accident and emergency departments of hospitals where the necessary staffing, equipment and ancillary facilities are in place to provide comprehensive and appropriate treatment and care for them.
At present, the HA has seven GOPCs (Note 1) in the Islands District. Among them, the North Lantau Community Health Center on the third floor of the NLTH provides night outpatient services. The other four GOPCs (Note 2) provide 24-hour first aid services to residents of the islands.
In order to improve the public primary healthcare services, the HA has implemented various measures on enhancing service capacity of clinics, including renovate and modernise the facilities to streamline patient flow, improve clinic environment for waiting patients and increase clinical space. As for the North Lamma General Outpatient Clinic, the HA will closely monitor the operation and service utilisation of the clinic. On one hand, it will study the feasibility of refurbishing the clinic, and on the other hand, it will flexibly deploy different resources in order to respond to the increasing demands of services of the residents on the island.
In planning for the provision of public primary healthcare services, the Government take into account a number of factors, including primary healthcare service delivery model, demographic changes, distribution of the target groups, the provision of primary healthcare services in the district, and demand for public primary healthcare services, etc. In the long run, the HA will tie in with the policy development of the Government and continue to closely monitor the demand for public primary healthcare services in the district, so as to provide appropriate general outpatient services for major service users with limited resources.
The Government understands the demands of residents of Islands District for public primary healthcare services. At present, the demand for general outpatient services varies from district to district. The utilisation of services in urban areas has been consistently high, while it is relatively low in outlying islands. The HA needs to balance the service needs of various districts and factors including manpower supply in planning services. The HA has no plan to increase outpatient services during non-office hours in the Islands District.
Note 1: They are Mui Wo General Out-patient Clinic, North Lamma General Out-patient Clinic, North Lantau Community Health Centre, Peng Chau General Out-patient Clinic, Sok Kwu Wan General Out-patient Clinic, St John Hospital General Out-patient Department and Tai O Jockey Club General outpatient clinic.
Note 2: Mui Wo General Out-patient Clinic, North Lamma General Out-patient Clinic, Peng Chau General Out-patient Clinic and Tai O Jockey Club General Out-patient Clinic.
Ends/Wednesday, December 7, 2022
Issued at HKT 15:55
Issued at HKT 15:55
NNNN