Replies to LegCo questions
LCQ13: Health assessment and medical services for the elderly
Following is a question by the Dr Hon Joseph Lee and a written reply by the
Secretary for Health, Welfare and Food, Dr York Chow, in the Legislative Council
today (February 23):
Question:
Regarding health assessment and medical services for the elderly persons, will
the Government inform this Council:
(a) whether it will make plans as early as possible to introduce services on
eyesight and hearing protection as well as dental health for the elderly;
(b) whether it has plans to provide annual comprehensive health assessments for
the elderly; if it will, of the details; if not, the reasons for that; and
(c) of the measures to ensure that elderly patients in public hospitals have the
right to make an informed choice of drugs upon the introduction of a Standard
Drug Formulary by the Hospital Authority, and that they will not be deprived of
drugs outside the drug formulary for lack of financial means?
Reply:
Madam President,
The HKSAR Government places great emphasis on the health of the elderly. Through
the Department of Health (DH) and the Hospital Authority (HA), the Government
has been providing the elderly with health education, health assessments
(including body checks), health and medical care, prevention of diseases, and
services promoting healthy living. It is estimated that about $14 billion was
spent on public health care services for the elderly in 2003/04.
Public resources should be used effectively in providing patients with medical
services. Elderly patients who are recipients of the Comprehensive Social
Security Assistance (CSSA) are waived medical charges for public health care
services. Elderly patients who have financial difficulties but are not CSSA
recipients can apply for a medical fee waiver, either one-off or valid for a
period of time.
Our replies to the specific questions raised by Dr Hon Joseph Lee are as below:
(a) DH regularly carries out health education in the community. Elderly are
provided with information on eye protection, in particular the early symptoms of
common eye diseases, so that they will be alert to eye diseases and may seek
early treatment. Moreover, the 18 Elderly Health Centres (EHCs) of DH located
throughout the territory regularly conduct eye checks for elderly members,
providing treatment to them or referring them to the specialist out-patient
clinics for treatment.
EHCs also conduct regular ear checks for elderly members and provide treatment
and advice to those with hearing problems, or refer them to the specialist
out-patient clinics. Where necessary, elderly CSSA recipients can apply to the
Social Welfare Department (SWD) for special grants to purchase hearing aid.
DH's Oral Health Education Unit has been actively promoting oral hygiene among
the elderly and the general public. There are 11 dental clinics run by DH which
provide the elderly and the general public with emergency dental treatment free
of charge. In addition, there are seven dental clinics in public hospitals which
provide specialist dental care services to individuals with special oral health
care needs (including the elderly). Where necessary, elderly CSSA recipients
will be given special grants to cover dental treatment charges. In 2003/04, SWD
spent about $8 million on providing elderly CSSA recipients with special grants
to cover dental treatment charges.
The Government will keep in view the medical needs of the elderly, and provide
them with appropriate services through various means.
(b) The 18 EHCs provide integrative primary health care to elderly members,
including comprehensive annual health assessment. In 2004/05, more than 40 000
elders received health assessments in the EHCs. Also, DH is collaborating with
various elderly centres, to train them to use the health assessment tool to
conduct health assessments for their elderly members under a trial scheme.
However, regular body checks do not guarantee that all hidden illnesses can be
identified. Therefore we keep reminding the elders that they should seek medical
consultation when they are not feeling well. Also, we will continue to
strengthen the geriatric training of public and private family doctors and
community doctors, so that more elders will be able to receive comprehensive
primary health care.
(c) In accordance with the normal process in clinical management in public
hospitals, clinicians will explain to the patients their treatment options
(including drug therapy), which are determined on the basis of the patients'
clinical indications. This practice will continue after the introduction of a
Standard Drug Formulary by the HA.
A handful of drugs outside the Standard Drug Formulary are proven to be of
significant benefits but extremely expensive for the HA to provide as part of
its subsidised service. They are usually new drugs for treating advanced stages
of diseases and are beyond existing modalities of standard treatment. To make
efficient use of the finite public resources and maximise the benefits of
medical care to the public, patients requiring treatment involving these
expensive drugs and can afford to pay will have to bear the charges under the
targeted subsidy principle. However, patients who have difficulties in paying
for the drugs may seek financial assistance under the Samaritan Fund. Depending
on their financial situation, individuals may receive a partial or full subsidy
on their drug expenses.
Other drugs outside the Standard Drug Formulary can be divided into three main
groups, namely (i) drugs with preliminary medical evidence only; (ii) drugs with
marginal benefits over available alternatives but at significantly higher costs;
and (iii) life style drugs. Since the therapeutic objectives of these drugs fall
outside the scope of public medical services, patients who choose to use these
drugs will be required to purchase them at their own expenses.
Ends/Wednesday, February 23, 2005
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