Replies to LegCo questions
LCQ19: Services of DH Maternal and Child Health centres
Following is a question by the Hon Frederick Fung and a written reply by the
Secretary for Health, Welfare and Food, Dr York Chow, in the Legislative Council
today (November 2):
Question:
Regarding services provided by maternal and child health centres of the
Department of Health (DH), will the Government inform this Council:
(a) of the number of complaints received by the authorities in the past three
years about such services and their main contents, and whether the authorities
have adopted corresponding improvement measures;
(b) as some women have complained that after giving birth in hospitals of the
Hospital Authority (HA), they are still required to fill in information on their
childbirth in the hospitals again when carrying their new-born babies to the
maternal and child health centres for treatment, whether the authorities have
assessed if this indicates inadequacies in the exchange of information between
HA and DH on the women giving birth and their babies (e.g. their medical
records); if there are inadequacies, whether improvements will be made by the
authorities;
(c) given that traditional whole cell vaccines, Hepatitis B vaccines and oral
polio vaccines, etc, used in the current infant immunization programme
administered by maternal and child health centres require several injections and
may cause such adverse reactions as swelling around the injection sites and high
fever among 30 to 50% of the infants injected with these vaccines, whether the
authorities have compared and studied the effects of the above vaccines and the
relatively new combined acellular vaccines; if they have, of the results;
whether the authorities will consider adopting these relatively new combined
acellular vaccines so as to reduce the number of injections required and adverse
reactions; and
(d) as the current infant immunization programme does not provide Haemophilus
influenzae type B vaccines which have been adopted by many countries in their
immunization programmes, whether the authorities will consider following the
practice of these countries; if not, the reasons for that?
Reply :
Madam President,
(a) 24, 36 and 52 complaints concerning the operation and service of the
Maternal and Child Health Centres (MCHCs) under the Department of Health (DH)
were received in the year 2002, 2003 and 2004 respectively. Over 90% of the
complaints concerned staff attitude and operation of the MCHCs like long waiting
time, insufficient or unclear explanation by staff etc. DH attaches great
importance to any complaint lodged, and the complaints in question are handled
jointly by DH's Custom Relations Division and the Service Head of MCHCs.
Investigation into many of these complaints revealed that there was room for
improvement in respect of staff communication skill and the service workflow of
the MCHCs. Corresponding improvement measures were implemented by DH.
(b) Parents of newborn babies seeking services at MCHCs are at the moment
required to fill out a First Registration Form. The Form bears particulars of
the parents and baby, including the name of the hospital in which the baby was
born, weight at birth and type of birth. If the child is born in public
hospitals, the Hospital Authority (HA) would have possessed such information. As
part of DH's continuous efforts in enhancing customer service, DH is aware of
the need to strengthen exchange of information with the HA, taking into account
privacy considerations. DH is now working closely with the HA in exploring the
feasibility of exchanging information through the use of IT.
(c) The current immunization programme against pertussis, hepatitis B and
poliomyelitis was developed in accordance with recommendations of the Expanded
Programme on Immunization of the World Health Organisation (WHO). Throughout the
years, the immunization programme has achieved very high coverage rates and has
attributed to the decline of pertussis and hepatitis B, as well as eradication
of poliomyelitis in Hong Kong.
DH is aware of the availability of combined acellular vaccine which has a
comparable level of efficacy compared with the vaccines currently being used.
The Scientific Committee on Vaccine Preventable Diseases (SCVPD), established
under DH's Centre for Health Protection (CHP) and comprising renowned academics
and pediatricians, is reviewing scientific information concerning the use of a
combined vaccine, among others, and will make recommendations in respect of
vaccine schedules and combinations among various options, having regard to their
relative performance and cost-effectiveness.
(d) In considering whether a new vaccine should be included in the routine child
immunization programme, health authorities need to consider a number of
scientific factors, an important one being local disease burden and epidemiology
such as incidence and fatality.
While Haemophilus influenzae b (Hib) conjugate vaccine is safe and effective,
local studies have shown that invasive Hib disease is much rarer in Hong Kong
compared with Western countries that require Hib vaccination (Note 1). As the
available data suggest that the local incidence of Hib infection is low and
hence the cost effectiveness of the vaccine in the local setting has not been
established, the Advisory Committee on Immunization(Note 2) has concluded that
there is insufficient justification to include Hib vaccine in the universal
immunization programme in Hong Kong. The situation will be kept under review in
light of new scientific studies.
Note:
(1) The incidence rate of invasive Hib disease in Hong Kong ranged from 0.9 to
8.3 per 100,000 children under 5 years, compared with 60 to 100 per 100,000
children in the United States before introduction of Hib vaccine in that
country.
(2) The Advisory Committee on Immuization was succeeded by Scientific Committee
on Vaccine Preventable Diseases (SCVPD) upon the setting up of the CHP in 2004.
Ends/Wednesday, November 2, 2005
Issued at HKT 15:47
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