LegCo Paper No. CB(2) 602/95-96
[These minutes have been seen by
LegCo Panel on Health Services
Minutes of Meeting held on Monday, 7 October 1996 at 5:00 p.m.
in the Legislative Council Chamber
Members Present :
Hon Michael HO Mun-ka (Chairman)Members Absent :
Dr Hon LEONG Che-hung, OBE, JP (Deputy Chairman)
Hon Howard YOUNG, JP
Hon CHAN Yuen-han
Dr Hon LAW Chi-kwong
Hon Zachary WONG Wai-yin
Hon IP Kwok-him
Dr Hon HUANG Chen-ya, MBE*Public Officers Attending :
Dr Hon YEUNG Sum*
Hon MOK Ying-fan*
Health and Welfare Branch
Clerk in Attendance :
- Mrs Katherine FOK
- Secretary for Health and Welfare
- Mr Clement CHEUNG
- Deputy Secretary for Health and Welfare 1 (Acting)
- Mrs Maureen CHAN
- Principal Assistant Secretary for Health and Welfare (Medical) 1
- Ms Winnie NG
- Assistant Secretary for Health and Welfare Department of Health
- Dr Margaret CHAN
- Director of Health Hospital Authority
- Dr Lawrence LAI
- Chief Executive Officer, Hospital Authority (Acting)
Staff in Attendance :
- Ms Doris CHAN
- Chief Assistant Secretary (2)4
- Mrs Justina LAM
- Assistant Secretary General 2
- Mr Alfred CHAU
- Senior Assistant Secretary (2)4
I. Briefing by the Secretary for Health and Welfare on the Governors Policy Address
1.The Chairman welcomed representatives of the Administration and asked Mrs Katherine FOK to brief members on the Policy Address.
2. Mrs Katherine FOK highlighted the salient points of the Policy Address on Health Services focusing on the following three main programme areas -
- preventing disease;
- treating disease; and
- improving the quality of service.
3. She further introduced the following two immediate issues on Health Services -
- traditional Chinese medicine; and
- medical social services.
In conclusion, she said that a comprehensive review of our existing health care system would be completed by 1998 and would report to the Panel on the progress of the review.
II. Members questions
Comprehensive review of the health care system
4. Members recalled that they were previously informed that the review would be completed by the end of 1997 and asked why it was now scheduled for completion by 1998.
5. Mrs FOK explained that the Panel was informed that the review would take 18-24 months to complete. Many issues were involved which required time for detailed study and consultations with the public, private hospitals, and other interested parties and it would not be possible to complete the review in 1997.
6. Miss CHAN Yuen-han requested the Administration to increase the transparency of the review by making progress reports to the Panel.
7. Mrs FOK agreed to make periodic reports to the Panel on the progress of the review and the first report would be made at the end of 1996.
|8. Dr LEONG Che-hung commented that the delay in the completion of the comprehensive review until 1998 would mean that new plans would not function until after 2000. He pointed out that the growth in HAs work was such that it might not be able to meet the demand. He therefore requested the Administration to consider expediting the review.||Adm|
9. The Chairman asked Mrs FOK to explain what would be achieved on the completion of the review e.g. whether a White Paper would be produced. He also wished to know whether there would be a consultation paper as he noted that an additional D2 post had been created in the Health and Welfare Branch for the purpose.
10. Mrs Katherine FOK said that the exact form of the documents to be produced was not as important as the contents of the reviews. She added that there would be consultation and discussion with the Panel and the review would be completed as soon as possible. She also pointed out that many other countries faced the same problem which could not be solved by just injecting more manpower into the review.
Waiting times at accident and emergency (A & E) departments
11. Referring to paragraph 13 of the Governors Policy Address regarding cutting waiting times at A & E departments from 60 minutes to less than 30 minutes, Dr LEONG Che-hung pointed out that the average waiting time now was 40 minutes and asked the Administration what was being done to improve the situation.
12. Dr Lawrence LAI said that the Hospital Authority (HA) had introduced a triage system to accord priority to patients requiring urgent treatment and had deployed additional staff to A & E departments in public hospitals during extended holidays. The Hong Kong Medical Association, in cooperation with the HA had offered an information hot line to the public. He added that the HA had been educating the public on A & E services. Dr LAI said that an average waiting time of 30 minutes was an objective to be achieved as far as possible. He admitted that the objective could not be met when the A & E attendances were unusually high, for instance, during extended holidays.
13. Mr Zachary WONG Wai-yin said that he was not satisfied with the Administrations reply. He pointed out that the 30 minutes target was not met in some hospitals in the New Territories because there were insufficient out patient services provided by DH at night and on extended holidays, and that there was no mention of any plan in the Policy Commitments to improve.
14. Mrs Katherine FOK said that when additional resources were available, DH would increase the number of doctors at out-patient clinics and the number of clinics in newly developed districts.
15. Dr Margaret CHAN pointed out that the DH clinics service over extended holidays was not fully utilised despite the publicity efforts through various channels. She said that three new clinics would be completed in the New Territories to provide more service and there would be redeployment of doctors among existing holiday clinics to better meet the demand. She also informed the Panel that DH and HA had included in their respective education programmes the topic on the proper use of emergency services. She agreed to make periodical reviews of the issue.
16. Miss CHAN Yuen-han observed that the coordination of DH and HA regarding the provision A & E services and out-patient services in order to reduce the long waiting time in some A & E clinics was important.
17. Mr Zachary WONG Wai-yin noticed that temporary beds for patients were still found in some hospitals. He also found that the average length of stay in some hospitals dropped from seven days to five days. He asked whether there were not enough beds in hospitals to meet the demand.
18. Mrs FOK explained that the length of stay of patients in hospitals depended on their medical conditions and was not affected by the availability of beds. There were also a number of capital projects in the pipeline providing additional beds to cope with projected demand.
19. Dr Lawrence LAI pointed out that in some situation, additional beds were used to meet special operational needs of hospitals, such as a sudden surge of admissions. He said that it was a global trend for the length of stay in hospitals to decrease due to advancement of medical technology and the establishment of network clusters for continued care. He further stated that HA had increased 2800 beds since 1991 and with new hospitals being built, there would be an annual increase of 800-900 beds.
Traditional Chinese medicine
20. Dr LEONG Che-hung requested the Administration to study and position alternative medicine in the health care system.
21. Mrs FOK replied that the Administration was committed to introducing a framework to regulate, develop and promote the proper use of traditional Chinese medicine. There was no plan for developing other alternative medicine at the present time. Responding to Dr LEONGs further question, Mrs FOK agreed that the subject might be discussed at Panel meetings but pointed out that the Administration would put more emphasis on traditional Chinese medicine first.
22. Dr LEONG Che-hung requested the Administration to study and establish health indicators in Hong Kong.
23. Dr Margaret CHAN pointed out that DH selected appropriate indicators at a macro level for Hong Kong from a list of health indicators recommended by the World Health Organization. Those health indicators measured the joint contribution of different government departments, towards the health of the community, including the provision of medical and health services improvement in environmental sanitation, promotion of education and so on. She added that both HA and DH had their own indicators at a micro level which were set as targets for improvement. The Chairman suggested and Dr CHAN agreed to submit a list of indicators at both levels to the Panel.
Preparing for the transition
|24. Dr LEONG Che-hung asked why there was not an item on "Preparing for the Transition" under the section on Health of the Policy Address.||Adm|
25. Mrs FOK explained that medical and health services were provided to all Hong Kong residents and on that basis, the Administration had prepared for the transition by planning the provision of medical and health care services based on the projected population for Hong Kong as a whole and by districts.
26. Dr LAW Chi-kwong asked why nursing manpower was not mentioned in the Policy Address.
27. Mrs FOK said that the recruitment and the retention of nurses had improved recently but the Administration would keep the situation under review. The Chairman was concerned that some hospitals did not have sufficient resources to recruit student nurses, and suggested that HA should strengthen the recruitment exercises in October 1996. In reply, Dr LAI said that the HA was in need of nursing staff due to its expansion. He would check on the position and report to the Panel.
Community rehabilitation network
|28. Dr LAW Chi-kwong asked why the community rehabilitation network was not mentioned in the Policy Address.||Adm|
29. Mrs FOK commended the services of the community rehabilitation network and said that the Administration would continue to support the services. Any further expansion would be subject to resources available.
Medical social workers
30. Dr LAW Chi-kwong asked when the review of medical social workers in public hospitals be completed and whether medical social workers would be involved in the review.
31. Mrs FOK admitted that there were two groups of medical social workers in public hospitals providing quality services and a study was jointly carried out by the Administration and HA on integrating those two groups with an aim to provide better services to patients. There was no recommendation yet and consultations with interested parties would be arranged. The Chairman suggested and the Administration agreed to report to the Panel on the progress of the study.
Student Health Services
|32. Miss CHAN Yuen-han asked why the Administration did not implement the two schemes of Student Health Service together despite the request made by the Panel.||Adm|
33. Dr Margaret CHAN pointed out that the Administration had explained to the Panel that the old School Medical Service scheme was abolished when the new Student Health Service scheme was implemented. In 1996-97, the Student Health Service was extended to secondary schools which was well received. Moreover, the new service was in line with Governments direction of placing strong emphasis on health promotion and disease prevention and it was therefore unlikely to revert to the old scheme.
34. Miss CHAN said that at previous Panel meetings the Administration agreed to consider members views to amalgamate the two schemes. She said that the proposal would relieve parents of expensive medical charges of private doctors and asked why it was not implemented.
35. Dr Margaret CHAN said that those students who were suffering from chronic diseases would be referred to specialists for further treatment. A recent survey showed that under the new system, there was no indication that the General Out Patients Departments (GOPD) were overloaded. The survey also showed that about 70% of the patients would bring their children to private doctor. Dr CHAN saw an emerging community effort to provide medical care services to children at reasonable costs. She regarded the new system as cost-effective and well-received by parents whose participations in the growth of their children was encouraged.
Non-emergency ambulance services
36. Mr Howard YOUNG asked which department was responsible for the provision of non-emergency ambulance services upon request in restricted areas at the airport.
|37. Mr Clement CHEUNG said that as far as he understood, the Fire Services Department (FSD) was responsible. The Chairman asked and Mr CHEUNG agreed to follow up with the Security Branch and to inform the Panel. To address Mr YOUNGs concern that FSD might not provide the service, Mr CHEUNG agreed to clarify the policy with FSD.||Adm|
38. The meeting ended at 6:20 p.m.
2 December 1996
Last Updated on 19 August 1998