Replies to LegCo questions
LCQ11: Obstetric services
Following is a question by the Hon Chan Hak-kan and a written
reply by the Acting Secretary for Food and Health, Professor Gabriel
Leung, in the Legislative Council today (May 4):
Question:
At present, most of the babies born in private hospitals who are in
need of intensive care will be transferred to neonatal intensive care
units (NICUs) of public hospitals, bringing workload and pressure on these
units. In this connection, will the Government inform this Council
whether:
(a) it knows the number and percentage of newborn babies in each private
hospital who were transferred to NICUs of public hospitals for treatment
in the past three years, and provide the breakdown in table form by the
names of the private hospitals;
(b) it knows the wastage and turnover rate of healthcare staff in the NICU
of each public hospital in the past three years, and provide the breakdown
in table form by the names of the public hospitals;
(c) it has assessed the impact of capping the total number of deliveries
in this and next year in Hong Kong at last year's level of around 88 000
on the demand for neonatal intensive care services, and if there is a need
to increase the number of beds and healthcare staff in NICUs; of the
impact on the demand for beds and healthcare manpower when the total
number of deliveries exceeds the aforesaid level; and whether it knows the
measures public hospitals have put in place to cope with such
circumstances;
(d) the Department of Health (DH), which is responsible for monitoring
private hospitals, has assessed the current capacity of various private
hospitals to treat babies with health problems; whether DH will introduce
a requirement for private hospitals to strengthen the services of their
high dependency units as a condition for re-registration; if it will, of
the details; if not, the reasons for that; and
(e) it has considered requiring mainland pregnant women giving birth in
Hong Kong to undergo more antenatal checks, so as to reduce the risk of
their newborn babies having health problems; if it has, of the details; if
not, the reasons for that?
Reply:
President,
It is the Government's policy to ensure that Hong Kong residents are
given proper and adequate obstetric services. The Government is very
concerned about the surge of demand for obstetric services in Hong Kong by
non-local women (including Mainland women) in recent years, which has
caused tremendous pressure on the overall obstetric service and manpower
in Hong Kong. To ensure that local pregnant women are given proper
obstetric services and the priority to use such services, the Hospital
Authority (HA) would reserve sufficient places in public hospitals for
delivery by local pregnant women and would only accept booking from
non-local pregnant women when spare service capacity is available. The
private hospitals have also agreed not to expand their maternity services
in the short term. HA and the private hospitals will also review their
respective training programmes for nurses at obstetric and neonatal
services to ensure they can cope with the demand of our community in the
medium and long term.
Our replies to various parts of the question are as follows:
(a) The numbers of referrals from private hospitals to neonatal intensive
care units (NICUs) of public hospitals for in-patient treatment in the
past three years are as follows:
Year Total
2008 281
2009 312
2010* 354
* Provisional figure
HA does not keep statistical breakdown of the number of referrals of
newborns to NICUs of public hospitals for treatment by each of the private
hospitals.
(b) The turnover figures and turnover rates of paediatricians and
paediatric nurses in public hospitals in the past three years are as
follows:
07/08 08/09 09/10
Doctors 17 (5.8%) 20 (6.6%) 11 (3.5%)
Nurses 64 (5.7%) 73 (6.5%) 66 (6.0%)
Note: The figures include retirees and other departed staff.
(c) The capacity of obstetric service in public hospitals has already been
fully reached in 2010. If the total number of deliveries in the territory
in 2011 and 2012 stays at the level of 88 000 cases as in 2010, the demand
for obstetric beds and manpower will continue to be tense. HA will monitor
the local birth rate and trend, the number of non-local pregnant women
giving birth in Hong Kong in 2011 and 2012, as well as the demand and
supply of healthcare professionals and the supporting hardware, to adjust
the capacity of obstetric services of public hospitals when necessary.
(d) The Department of Health (DH) registers private hospitals which have
met the requirements relating to accommodation, staffing and equipment in
accordance with the Hospitals, Nursing Homes and Maternity Homes
Registration Ordinance (Cap.165). DH requires all private hospitals
providing obstetric services to have in place arrangements for provision
of neonatal clinical service, including appropriate staffing (for example,
having paediatricians on duty) and equipment, as well as availability of
special care units, intensive care units or arrangements for referral to
public hospitals, etc. In processing applications from private hospitals
for registration, re-registration or expansion of obstetric services, DH
will take into account whether the hospitals concerned are provided with
the necessary supporting facilities, services and staffing as described
above.
(e) The Administration has all along encouraged all pregnant women, local
or otherwise, to receive regular antenatal checkups and reminded them to
seek medical attention promptly if any abnormal condition or discomfort
occurs. As for antenatal checkups required to be received by pregnant
women (including the type and number of checkups), it should be a matter
of clinical judgement for doctors who will make such arrangements
according to prevailing medical evidence or relevant clinical protocols
having regard to the clinical conditions of the pregnant women.
As regards the non-local pregnant women who intend to have deliveries
in Hong Kong, they should undergo antenatal checks by obstetricians in
Hong Kong at an appropriate stage. Non-local pregnant women having normal
pregnancy condition are allowed to have deliveries in Hong Kong. For
high-risk pregnancies, the pregnant women in question are not suitable to
give birth in Hong Kong as the health of themselves and their fetuses may
be affected due to travels and other factors. Currently, HA's obstetric
service package for non-local pregnant women includes one antenatal
checkup at HA's specialist outpatient clinics. This serves to reduce the
risk of difficult labour, unrecognised congenital anomalies for the babies
and infection for healthcare workers and to deter dangerous behaviour by
non-local pregnant women who have not received any antenatal checkup in
public hospitals in seeking last-minute hospital admission before delivery
through the Accident and Emergency Departments. Non-local pregnant women
can receive more than one antenatal checkup at their own expense in public
hospitals as appropriate to their conditions. They are required to pay the
charges applicable to non-local people (i.e. Non-eligible Persons).
Besides, an antenatal shared-care programme is provided by the
Maternal and Child Health Centres (MCHCs) under DH in collaboration with
obstetrics departments of public hospitals to cater for the needs of
pregnant women during their pregnancy and delivery process. Under this
antenatal care programme, pregnant women are provided with services such
as routine checkups, blood tests and health education related to
pregnancy, delivery and care for newborn babies. MCHCs will accept
bookings for antenatal services from non-local pregnant women only if they
have already made their first antenatal service registration with a public
hospital and can present a Certificate on Confirmed Antenatal and Delivery
Booking issued by HA. Non-local pregnant women have to pay for the charges
applicable to non-local persons (i.e. Non-eligible Persons) before
receiving antenatal services provided by MCHCs.
Ends/Wednesday, May 4, 2011
Issued at HKT 14:17
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