Replies to LegCo questions
LCQ5: Hospital Authority frontline doctors
Following is a question by the Dr Hon Kwok Ka-ki and an oral reply by the Secretary for Health, Welfare and Food, Dr York Chow, in the Legislative Council today (February 15):
Question:
Some frontline doctors of the Hospital Authority (HA) have told me that they
have to face situations of heavy work pressure, disparity in pay among doctors
performing the same duties and low morale. In this connection, will the
Government inform this Council whether it knows:
(a) the respective average weekly working hours and on-call frequencies of
doctors in various HA departments and resident doctors in various HA hospitals
in each of the past three years; and in the ten HA departments with doctors
working the longest hours at present, the changes in their doctors' average
weekly working hours and on-call frequencies as compared to those over the past
three years, and the reasons for such changes;
(b) the respective numbers of doctors who left and newly joined HA in the past
three years, with a breakdown by hospital and rank; and among such new recruits,
the respective numbers of those who have been deployed to alleviate the workload
of other doctors, to replace doctors who had left, and to provide new or
additional services; and
(c) the specific proposals and plans HA has regarding the provision of
reasonable remuneration, parity, and improvement in the work environment, in
order to attract, motivate and retain frontline doctors?
Reply:
Madam President,
(a) The Government and Hospital Authority (HA) have been paying close attention
to the workload and working hours of doctors in public hospitals. In the past
few years, the HA has been working towards improving the working conditions of
doctors through the deployment of additional staff and rationalization of work
arrangements. The HA conducted two internal surveys on the working conditions of
frontline doctors in 2000 and 2005 respectively. Generally speaking, the working
hours and frequency of on-call duties of frontline doctors vary from one
specialty to another due to differences in the nature of their work and
variations in the demand for different specialist services. The surveys revealed
that the average weekly working hours of frontline doctors (i.e. the sum of
normal daytime working hours and resident on-call hours at nights and during
weekends) improved considerably in the past five years. A breakdown of the
survey findings by major specialties showed that only the working hours of
doctors in Pathology increased slightly over the 5-year period. The working
hours of all other specialties decreased by 2.2% to 23.2%.
The two surveys also revealed that there were overall improvements in the
frequency of on-call duties by frontline doctors. Owing to operational needs for
attending to patients with emergency and acute medical needs, hospitals will
usually draw up a roster for doctors to take turn in serving on-call duties at
night. Most of the specialties have doctors serving on-call duties within
hospital premises, but there are also arrangements where the on-call doctors do
not remain in the hospital and only return upon request when an emergency
arises. The workload of on-call doctors is not fixed and is unpredictable. When
an on-call doctor is free, he can rest in the hospital. All public hospitals
have rest facilities for use by on-call doctors. According the surveys, doctors
in the majority of specialties were arranged to serve on-call duties once every
4 to 5 days in 2000. In 2005, the frequency of on-call duties in the majority of
specialties has reduced to once every 4 to 7 or 8 days.
The survey findings on the weekly working hours and on-call frequencies of the
frontline doctors broken down by major specialties are set out in Annex A.
(b) In the past three years (i.e. from 2003-04 to 2005-06 (up to December
2005)), the numbers of new resident doctors recruited by HA each year were 312,
297 and 297 respectively. The numbers of doctors who departed HA for various
reasons within the same time periods were 252, 298 and 240 respectively. Most of
the new recruits had been deployed to replace departed staff. The rest were
mainly for strengthening services relating to infectious disease and development
of family medicine.
Generally speaking, the HA would fill vacancies at the levels of Consultants,
Senior Medical Officers and Associate Consultants through internal promotions.
The numbers of promoted staff, new recruits and staff departures at HA in the
past three years broken down by ranks and hospital clusters are set out in Annex
B.
(c) The HA has already formulated some concrete plans to further improve the
working conditions of frontline doctors in public hospitals and to address the
issue of pay disparity amongst contract frontline doctors.
In response to the situation where some doctors work over 70 hours a week, HA is
planning to implement a number of initiatives to reduce the working hours of
doctors within three years with the target of keeping the work hours under 65
hours per week.
As for the issue of pay disparity amongst frontline doctors, the HA is planning
to improve the remuneration packages of contract frontline doctors in April
2006, with a view to narrowing the disparity in pay amongst frontline doctors
over the next few years and to providing contract doctors with greater job
security. The aim of implementing these measures is to reward and retain quality
doctors with good performance. The main features of the improvement measures
include -
* Awarding doctors with good performance an annual salary point increment from
the beginning of their fourth year of service;
* Awarding one salary point increment to doctors who have successfully passed
the intermediate examination for their specialist qualification and two salary
points increment for the exit examination;
* Retaining contract resident doctors with good performance for a total of 9
years, so that they can pursue their specialist training with peace of mind and
to give them the opportunity to gain more experience in public hospitals after
attaining their specialist qualification; and
* Offering longer-term employment to doctors who have successfully secured the
Resident Specialist posts, subject to service needs and the financial
constraints of the HA.
It is the HA's hope that through the above measures it could become more
effective in providing frontline doctors with the appropriate incentive and
motivation for good performance and in retaining high caliber doctors within the
public medical sector.
Ends/Wednesday, February 15, 2006
Issued at HKT 14:31
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