Provisional Legislative Council

PLC Paper No. CB(2)640
(These minutes have been
seen by the Administration)

Ref : CB2/PL/HS

Provisional Legislative Council
Panel on Health Services

Minutes of meeting held on Thursday, 9 October 1997 at 8:45 am in the Chamber of the Legislative Council Building

Members present :

Dr Hon TANG Siu-tong, JP (Chairman)
Dr Hon LEONG Che-hung, JP (Deputy Chairman)
Hon WONG Siu-yee
Hon Henry WU
Hon CHAN Yuen-han
Hon Howard YOUNG, JP

Members Absent :

Hon CHEUNG Hon-chung
Hon MOK Ying-fan

Members Attending :

Hon LEE Kai-ming
Hon YUEN Mo
Hon CHAN Choi-hi
Hon TAM Yiu-chung, JP

Public Officers Attending :

For all items

Mrs Katherine FOK, JP

Secretary for Health and Welfare

Ms Jennifer CHAN

Principal Assistant Secretary for Health and Welfare

Mr Derek B GOULD

Principal Assistant Secretary for Health and Welfare

Dr Margaret CHAN, JP

Director of Health

Dr E K YEOH, JP

Chief Executive, Hospital Authority

Clerk in Attendance :

Ms Doris CHAN

Chief Assistant Secretary (2) 4

Staff in Attendance :

Mrs Justina LAM

Assistant Secretary General 2

Mr Stanley MA

Senior Assistant Secretary (2) 7

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Briefing by the Administration on the Chief Executive's Policy Address 1997

The Secretary for Health and Welfare (SHW) briefed members on the progress of major policy programmes and important new initiatives on health care services as set out in the Policy Address 1997 focusing on the following four programme areas -

1. public health protection;
2. prevention of diseases;
3. curative care; and
4. promotion of health.

2.Members in principle welcomed the new initiatives proposed in the Policy Address and exchanged views with the Administration on the following issues.

Review of the health care system in 1998

3.Responding to Mr CHAN Choi-hi's enquiry, SHW clarified that the comprehensive review of the existing health care system was mainly aimed at examining the relationship between primary, secondary and tertiary health care to strike an appropriate balance and reviewing the respective roles of the public and private sectors in the provision of health care services to the community, and the interface between them. The report of the review would be publicized for public consultation and subject to the support of the community, the recommendations of the report, which would largely determine the Government's long term policies and community expenditure in the provision of health care services, would be implemented.

4.In response to Dr LEONG Che-hung's enquiries, SHW said a consultant would be appointed shortly to construct a "National Health Account" and conduct a review of the existing health care system in Hong Kong with reference to health care systems adopted in overseas countries. The estimated time for completion of the review was 12 months after appointing the selected consultant. As for the financing of public health care services, she reiterated that an exhaustive consultation exercise on the recommendations of the consultant's report would be conducted before the adoption of any financing policies. She added that in making the recommendations, the consultant would compare the merits and demerits of the different health care systems in other countries and proposed a list of options for consideration.

Elderly Health Centres

5.The Director of Health (DH) briefed members on the Administration's new commitment of setting up 12 Elderly Health Centres (EHCs) with integrated services in 1998/99 and another six in 1999-2000 to provide preventive and curative medical services to the elderly (persons aged 65 or above). In addition, 12 visiting health teams would be established in 1998/99 and another six in 1999/2000 to provide preventive and promotive care services to the elderly living in the community and support services to their careers. She stressed that the two new commitments were proposed after considering the feedback of elderly who had used the services of the existing EHCs. These additional services would help elderly people to live at home for as long as possible.

6.Miss CHAN Yuen-han enquired about the charges to be made by the 12 new EHCs which would provide both preventive and curative services to the elderly. DH replied that charges were being worked out and would be presented to PLC as soon as practicable. She added that special consideration would be given to elderly patients who were receiving comprehensive social security assistance and to those who had financial difficulties. Responding to Dr LEONG's enquiries, DH clarified that the 12 new EHCs for 1998/99 included the existing seven EHCs which would be improved to provide the same range of services available in the other five new EHCs. She reiterated that the Administration's target was to provide an EHC in each of the 18 Districts in 2000 and the services available at these EHCs would be planned in the light of the operational experiences of the existing EHCs. Supplemented by the corresponding 18 visiting health teams and the various community support services provided to the elderly by the Social Welfare Department and subvented non-governmental organizations, it was anticipated that a better social networking for the elderly could be established. Subject to the approval of the Finance Committee, resources for the provision of necessary medical, nursing and allied medical staff for the smooth operation of the 12 EHCs in 1998/99 would be available in due course. With improved scope of service at EHCs, better publicity programmes and social networking, it was hoped that a better utilization rate of the 12 new EHCs could be achieved.

7.Responding to Mr WONG Siu-yee's enquiry, DH replied that the current age requirement of 65 and above for eligibility of service at the 12 new EHCs would continue. As regards the experience level of doctors working at EHCs, DH assured members that doctors with relevant training and experience would be posted to EHCs.

8.Referring to the limited service of general out-patient (GOP) clinics, Mr TAM Yiu-chung was concerned about the service availability of the future EHCs. DH responded that for elderly enrolled in the EHCs, there would not be a daily quota for out-patient consultation like the GOP clinics. In this respect, a mechanism would be established to allow these eligible elderly persons to visit the EHC for such service. As elderly patients might prefer the service of GOP clinics, the two systems would run in parallel during the initial operation of EHCs. A review of the operation of both systems would be conducted at a later stage.

Review of clinical audit and monitoring in public hospitals

9.In response to members' concerns, Chief Executive of Hospital Authority (CE/HA) said that in the light of the recent cases of medical incidents, HA was conducting comprehensive reviews on the following aspects of clinical audit and professional accountability -

1. a review of the existing clinical audit systems to examine methods of enhancing their effectiveness;

2. a study on risk management in public hospitals was underway and proposals to minimize and manage clinical risks would be made;

3. a review had been initiated to examine how clinical supervision of junior doctors and nurses including trainees could be reinforced. The involvement of clinical staff in management and administrative duties had been revised with the aim of ensuring the optimal contribution of Chiefs of Service and Nursing Managers in clinical supervision and patient services; and

4. a review of the workload of front-line medical and nursing staff and work processes in clinical service areas with the most acute pressure to ensure the provision of quality patient care services.

He added that results of the above reviews would be referred to the PLC Panel on Health Services for comments	Adm

Traditional Chinese Medicine

10.In reply to Dr LEONG's enquiry on the work progress of the incorporation of traditional Chinese medicine (CM) practitioners and proprietary CM and herbs into the public health care system, SHW said that the Administration would, subject to positive outcome of public consultation on the recommendations of the report of the Preparatory Committee on CM (the Committee), proceed with the legislative process necessary for registration of qualified CM practitioners. The Administration would then coordinate the provision of proper training and development courses in local educational institutions for in-service CM practitioners and dispensers. The categorization of proprietary CM and Chinese herbs would also be arranged as soon as practicable. Responding to the Chairman's and Mr WONG Siu-yee's follow up questions, DH supplemented that subject to the approval of the future Legislative Council on the proposals of the Committee, the registration of CM practitioners would begin in the year 2000. The Committee had thoroughly discussed the use of traditional CM in public health care system and agreed that the registration and categorization as well as the on-going control of existing and new proprietary CM and Chinese herbs was a complex process which should be implemented by phases. The provision of appropriate training and development programmes for in-service and new CM practitioners and dispensers would be carefully planned and coordinated in due course. Referring to the regulatory mechanisms for the control of CM practitioners and proprietary CM and Chinese herbs in mainland China, Mr YUEN Mo enquired about plans to make the best use of traditional CM and CM practitioners in Hong Kong. DH responded that as there was no established mechanism for monitoring the use of CM and herbs and the practice of CM practitioners hitherto, the Committee had recommended to let the current practices continue to operate until such time when integration of Chinese and Western medicine in public health care system was considered appropriate by both professions.

11The meeting ended at 9:40 am.

Provisional Legislative Council Secretariat
19 November 1997