Legislative Council

LC Paper No. CB(2)1348/98-99
(These minutes have been seen
by the Administration)

Ref : CB2/PL/HS

LegCo Panel on Health Services

Minutes of meeting
held on Monday, 14 December 1998 at 8:30 am
in Conference Room A of the Legislative Council Building

Members Present :

Hon Michael HO Mun-ka (Chairman)
Dr Hon LEONG Che-hung, JP (Deputy Chairman)
Hon HO Sai-chu, JP
Hon Cyd HO Sau-lan
Hon CHAN Yuen-han
Dr Hon YEUNG Sum
Hon YEUNG Yiu-chung
Dr Hon TANG Siu-tong, JP
Hon LAW Chi-kwong, JP

Member Absent:

Hon Mrs Sophie LEUNG LAU Yau-fun, JP

Public Officers Attending :

For All Items

Mr Gregory LEUNG, JP
Deputy Secretary for Health and Welfare

Mr William TSUI
Assistant Secretary for Health and Welfare

Item III - Progress of employing extra 580 nurses

Ms Jennifer CHAN
Principal Assistant Secretary for Health and Welfare

Deputy Director (Operations)/Hospital Authority

Ms Susie LUM
Senior Executive Manager (Nursing)/Hospital Authority

Item IV - Legislation of Chinese Medicine

Deputy Director of Health

Assistant Director of Health (TCM)

Item V - Dis-establishment of the Hospital Services Department

Ms Jennifer CHAN
Principal Assistant Secretary for Health and Welfare

Deputy Director of Health

Administrator/Hospital Services Department

Clerk in Attendance :

Ms Doris CHAN
Chief Assistant Secretary (2) 4

Staff in Attendance :

Mr LEE Yu-sung
Senior Assistant Legal Adviser

Mrs Eleanor CHOW
Senior Assistant Secretary (2) 4

I. Confirmation of minutes of special meeting held on 23 November 1998
(LC Paper No. CB(2)816/98-99)

The minutes of the special meeting held on 23 November 1998 were confirmed.

II. Date of next meeting and items for discussion

2. Members agreed to discuss the following items at the next meeting to be held on 11 January 1999 at 8:30 am -

  1. Consultancy Study on Financing Hong Kong's Health Care System;

  2. Subsidiary legislation under the Chiropractors Registration Ordinance; and

  3. Registration of ancillary dental personnel.

III. Progress of employing extra 580 Nurses
(LC Papers Nos. CB(2) 857/98-99(02) and 865/98-99(01))

3. The Deputy Director (Operations)/Hospital Authority (DD(O)/HA) introduced LC Paper No. CB(2) 857/98-99(02) which reported on the progress in addressing the nursing manpower situation in HA hospitals.

4. Members noted that there had been an increase of 1 290 nurses since the end of March 1997. Miss CHAN Yuen-han said that even with the increase in the number of nurses, she doubted whether there were enough nurses in public hospitals. In response, DD(O)/HA said that the increase in workload and patients' expectations as well as more complex medical procedures had all put additional pressure on public hospital staff. For that reason, the HA had implemented a number of measures as described in paragraph 7(b) of the paper to relieve the work pressure, e.g. the introduction of an integrated assessment sheet in wards which could achieve a saving of about 38 minutes per patient He added that initially more time might be needed by the staff concerned to get used to the improvements in practices.

5. Dr LEONG Che-hung referred to paragraph 3 of the submission from the Association of Hong Kong Nursing Staff (LC Paper No. CB(2) 865/98-99(01)) and asked whether an extra 500 nurses were required in addition to the shortfall of 580 assessed in the review report discussed by the Panel in January 1997. DD(O)/HA confirmed the figure.

6. The Chairman noted that the total of 20 209 nurses in the table in paragraph 4 of the Administration's paper was an estimated figures only. He asked DD(O)/HA to provide the actual confirmed figure when it was available. The Chairman also noted that there had been instances in the past when not all the vancancies for nurse had been filled and asked the HA to pay particular attention to the matter.HA

7. Miss CHAN Yuen-han observed that while in an intensive care ward with six beds, several nurses were provided, in a general ward with over twenty beds, only one nurse and one Health Care Assistant were available during meal time She considered that nursing manpower in public hospitals was very stretched and wished to know whether the situation was caused by the HA's inability to employ more staff or due to its belief that present number of staff was sufficient. DD(O)/HA explained that hospital services were very labour-intensive and the HA could only make the best use of available resources. He agreed that there was still room for improvement and therefore the HA would continue with its efforts to improve the effective deployment of nursing resources through re-engineering of work practices and enhancement of support systems for nurses in the wards. The Deputy Secretary for Health and Welfare (DSHW) pointed out that as 82% of the HA's budget was spent on staff costs already, it was necessary for the HA to continue to carry out management reforms to reduce unnecessary work procedures.

IV. Legislation of Chinese Medicine
(LC Paper No. CB(2) 857/98-99(03))

8. DSHW brief the Panel on the progress of the legislation and outlined the main provisions of the Chinese Medicine Bill for members' information.

9. After declaring interest as a member of the Preparatory committee on Chinese Medicine, Dr LEONG Che-hung asked whether there would be sufficient training facilities for providing continuing education. DSHW said that there should be no problems as continuing education could be provided in many forms including seminars. As regards Dr LEONG's question on control of proprietary Chinese medicine, he pointed out that as the subsidiary legislation on the subject would not be ready until year 2000, the registration of such medicine could only commence in 2000. Dr LEONG expressed concern about the late timing.

10. Mr LAW Chi-kwong emphasized the need for professional autonomy. He noted that except for the Director of Health who would be an ex-officio member, all members of the Chinese Medicine Council would be appointed by the Chief Executive. He suggested that after a period of one to two years, the Council should have elected members. He also suggested that the number of lay persons, which should normally constitute 20% of the total membership, should be reviewed. Referring to the composition of the Chinese Medicines Board, he asked the Administration to consider the inclusion of a pharmacist. In response, DSHW said that elected membership would be considered in the future development of the Council. As regards the percentage of lay members, he pointed out that the two persons from educational institutions would also be lay members, making a total of five or 26% of the membership. As to the composition of the Chinese Medicine Board, he said that a pharmacist could come from the lay person category.

11. Dr TANG Siu-tong asked whether there would be an appeal mechanism to deal with matters relating to the cut-off date and the continuing education requirement. DSHW said that the cut-off date had yet to be decided, depending on the progress of the registration and licensing work. As regards continuing education, he considered that the three years allowed for the practitioners concerned to acquire the necessary continuing education should be sufficient. In reply to a question from the Chairman on the present position of the Bill, DSHW said that the Administration planned to introduce the Bill into the Legislative Council in February-March 1999.

V. Dis-establishment of the Hospital Services Department
(LC Paper No. CB(2) 857/98-99(04))

12. The Chairman referred to paragraphs 6 and 7 of the paper and asked the Administration to clarify whether the civil servants in the HA would be looked after by the same group of staff presently in the Hospital Services Department (HSD) or by Department of Health staff. DSHW said that initially the present HSD headquarter staff would stay and carry on as usual. In time, allocation of work would be adjusted with a view to achieving savings but the services provided would not be affected.

13. In reply to a question from Mr LAW Chi-kwong regarding the amount of savings, DSHW said that a D2 post as head of the HSD would be deleted from October 1999 and other additional savings would be identified later.

VI. Any other business

14. Dr LEONG Che-hung referred to the paper on Chiropractors registration provided by the Administration and asked the Administration to provide more information on the outstanding issues mentioned in the paper. The Administration agreed to provide the requested information before the next meeting.Adm

15. The meeting ended at 9:15 am.

Legislative Council Secretariat
26 February 1999