Replies to LegCo questions
LCQ15: Improvements to general out-patient service
Following is a question by the Hon Albert Chan and a written reply by the
Secretary for Health, Welfare and Food, Dr York Chow, in the Legislative Council
today (May 25):
Question :
Recently I have received complaints from many members of the public that a
number of clinics under the Hospital Authority (HA), such as Lady Trench
Polyclinic, have substantially reduced the number of chips allotted per day, and
many members of the public are unable to receive timely out-patient services
because of their failure to obtain a chip. In this connection, will the
Government inform this Council whether it knows:
(a) the number of chips allotted by each clinic each month over the past three
years;
(b) the reasons for the recent substantial reduction in the number of chips
allotted per day by some clinics; and
(c) if HA has any measures to ensure that all of its clinics have the capacity
to meet the public demand for out-patient services during the peak influenza
season; if so, of the details; if not, the reasons for that?
Reply :
Madam President,
(a) The quota provided to the public vary from day to day according to the
number of scheduled appointments, and the unused priority chits for civil
servants and the elderly (which can be re-distributed to the public). Besides,
the number of doctors available may change as some may be on sick leave or
redeployed for other urgent services. The clinic staff will adjust the daily
quota flexibly based on utilization patterns in past weeks in order to meet
changing seasonal demands.
(b) Since the transfer of general outpatient clinics (GOPCs) from the Department
of Health (DH) to the Hospital Authority (HA) in July 2003, HA has introduced
various improvements to the GOPC service. The most notable ones are the
introduction of individual patient records and family medicine training and
service.
The introduction of individual patients' records enables a comprehensive record
of patient's health status and problems and the doctor's diagnoses and
treatments prescribed to be maintained and retrieved for reference in subsequent
consultations. The use of information technology also makes patients' records
retrievable by any GOPC. The input of accurate data by doctors and nurses
inevitably requires extra time for each consultation. The introduction of family
medicine, which emphasizes continuing, comprehensive and holistic care for the
patient, also results in longer consultation time. Despite the injection of
additional resources to the GOPC service (additional 42 per cent more doctors,
21 per cent more nurses, 27 per cent more pharmacy staff, and 6 per cent more
supporting staff in the GOPCs), the number of patients that can be seen as a
result has to be reduced in some clinics. Each GOPC doctor is now seeing a
maximum of 85 patients during the day sessions (four hours a session and two
sessions in a day) and 50 patients during the evening session (four hours).
However, the reduction in the number of patients seen does not mean
deterioration in the service. On the contrary, the above measures have brought
about better understanding of the patients' problems and better documentation of
patients' clinical information. As a result, patients will not only enjoy
quality treatment upfront but will also need fewer subsequent consultations.
Other improvements to the GOPC service include-
(i) provision of essential pharmacist support to the clinics;
(ii) enhancement of service linkage with other HA clinical services through
implementation of the Clinical Information System; and
(iii) introduction of community-based specialist and nursing consultation
sessions to improve quality of chronic illness management.
(c) The Government's strategy is to prevent outbreak of infectious disease where
possible. DH has all along provided immunisation to infants for better
protection against a range of infectious diseases. For influenza, DH and HA have
jointly provided vaccination to vulnerable groups such as elderly patients over
65 with chronic diseases attending public clinics and disabled persons staying
in institutions. In the case of an outbreak of an infectious disease, HA's
priority will be to minimize the spread of disease among the general public.
Under such circumstances, members of the public are most likely to be advised to
stay away from crowds and busy public places such as clinics where possible.
GOPC's roles will be that of case finding, triaging of those patients who need
hospital management and symptomatic treatment of those other patients who do not
need hospitalization. As part of our contingency plan, depending on the nature
of the disease, there may be a need to designate some GOPCs as medical centres
in each district to attend to patients affected by the prevailing infectious
disease. Normal GOPC services to walk-in patients might need to be scaled down
and limited to the follow-up of patients with chronic diseases. The Government
will also work closely with the private medical sector to ensure sufficient
capacity for treating patients in the event of an infectious disease outbreak.
Ends/Wednesday, May 25, 2005
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