Replies to LegCo questions
LCQ18: Specialist out-patient services
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 (May 3):
Question:
Regarding the specialist out-patient services at public hospitals, will the
Government inform this Council whether it knows:
(a) the ten specialist out-patient services with the longest average waiting
time for new cases at present, and the reasons for the relatively longer waiting
time required;
(b) for each of the above ten specialist out-patient services in each of the
past three years, the respective numbers of new cases in Hong Kong as a whole
and in each hospital cluster, the average and longest waiting time for new
cases, the patients' absence rate for scheduled appointments, and the ratio of
medical practitioners and nurses to new cases; and
(c) if the Hospital Authority plans to shorten the relevant waiting time; if so,
of the details of the plan?
Reply:
Madam President,
(a) At the Specialist Outpatient (SOP) Departments of the Hospital Authority
(HA), the ten specialties with the longest median waiting time in 2005 in
descending order were Surgery (SUR); Orthopaedics & Traumatology (ORT); Medicine
(MED); Ear, Nose and Throat (ENT); Gynaecology (GYN); Psychiatry (PSY);
Paediatrics and Adolescent Medicine (PAE); Neurosurgery (NS); Ophthalmology (OPH);
and Obstetrics (OBS).
After the implementation of a triaging system for SOP services in 2004, SOP
cases are classified into Priority 1 (urgent), Priority 2 (semi-urgent), and
Routine categories according to the urgency of the patients' clinical condition.
This is to ensure patients with urgent conditions are given the appropriate
medical attention in a timely manner. The triaging system benefits patients with
urgent conditions by shortening their waiting time. Nevertheless, the waiting
time for patients with non-urgent conditions has lengthened as a result, hence
the increase in the median waiting time in the past two years.
(b) The number of new cases booked for the ten specialties above, the median
waiting time and the waiting time at the 99th percentile for such bookings in
the past three years are set out in Table 1.
A breakdown of the median waiting time for Priority 1, Priority 2, and Routine
cases for SUR, ORT, MED, ENT, GYN, PSY, PAE and OPH in 2005 are shown in Table
2. The breakdown figures for NS and OBS are not readily available.
The total number of first SOP attendances handled by each hospital cluster in
the past three years is set out in Table 3.
The default rate (or rate of absence) of new cases for SOP attendance for the
ten specialties above in the past three years are set out in Table 4.
Since doctors and nurses are deployed to provide healthcare services in both the
inpatient and outpatient settings, we are not able to provide meaningful ratios
of the number of doctors and nurses to new SOP cases.
(c) The HA has taken a number of measures to alleviate the waiting time problem
at SOP Departments. These include -
(i) implementing the triage system to differentiate patients into Priority 1,
Priority 2 and Routine cases, and ensure timely attendance for patients with
urgent medical needs;
(ii) deploying specialists on sessional basis at General Out-patients Clinics to
support the management of chronically ill patients;
(iii) setting up 18 Family Medicine Specialist Clinics to take up the patients
triaged as non-urgent cases and act as the gatekeeper for SOPCs;
(iv) reducing unnecessary referrals by the distribution of referral and triage
guidelines to relevant doctors in both the public and private sector;
(v) establishing protocols for the discharge of medically stable patients to be
followed up at the primary care level; and
(vi) developing shared care externally with private practitioners and
non-governmental organizations, and internally between doctors and nurses /
physiotherapists.
Ends/Wednesday, May 3, 2006
Issued at HKT 13:00
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Annex:
Tables to LCQ18