Replies to LegCo questions
LCQ15: Public-private partnership pilot projects in healthcare
Following is a question by the Hon Cheung Man-kwong and a written reply by the
Secretary for Food and Health, Dr York Chow, in the Legislative Council today
(July 6):
Question:
Regarding the public-private partnership programmes in healthcare (PPP
programmes), will the Government inform this Council:
(a) of the PPP programmes which are being implemented at present as well as
those which are planned to be implemented in the next two years covering the
scope of hospital services; of the public expenditure incurred, the partners
from the private sector and their number, the service targets and number of
beneficiaries;
(b) whether the authorities have, prior to the implementation of the PPP
programmes, assessed the pros and cons of injecting resources into these
programmes vis-�j-vis the improvement of public healthcare services, in terms of
the cost, government expenditure, fairness as well as the manpower requirement
and mobility of healthcare staff involved in each programme; if they have, of
the criteria for and results of the assessment for implementing the programmes;
if not, the reasons for that; and
(c) given that the authorities have launched the PPP programme of "Cataract
Surgeries Programme" in February 2008 to, on the one hand, provide a fixed
amount of subsidy to patients who chose to receive surgeries in the private
sector and, on the other hand, to increase the number of such surgeries
conducted in public hospitals so as to shorten patients' waiting time, whether
they know the difference between the number of healthcare staff required for a
cataract surgery carried out in private medical service institutions and that
for conducting such surgery in public hospitals; of the wastage rate of
healthcare staff in the ophthalmic service of the Hospital Authority (HA) as
well as the ranks of those staff departed since 2008; of the measures HA has in
place to retain its staff, and the expenditure so incurred; in view of the
expanding ageing population in the future and the increasing number of patients
who need to receive cataract surgery, whether the authorities have assessed the
additional places for cataract surgeries need to be provided and the additional
number of relevant healthcare staff need to be recruited by HA in the next five
years in order to meet the new service demand; if they have, of the results; if
not, the reasons for that?
Reply:
President,
(a) The Administration has launched two public-private partnership (PPP) pilot
projects, through the Hospital Authority (HA), covering hospital services
(excluding specialist out-patient and general out-patient services) as in Annex
A.
In 2011-12, we plan to launch another pilot project to strengthen radiological
imaging services through PPP for specific groups of cancer patients who meet the
relevant clinical criteria. This pilot project is still at the preparatory
stage. We plan to select suitable private providers through open tender. We
estimate that some 10 000 radiological imaging checks would be provided under
the project.
We estimate that the expenditure required for implementation of these PPP
projects in 2011-12 is around $50 million. We are not in a position to provide
specific figures for 2012-13 and beyond as adjustments may be made to the scale
and expenditure of these projects in the light of public response and their
effectiveness.
(b) Promotion of PPP in healthcare is a key element of healthcare reform
proposed in 2008. It aims at offering more choice of services for individuals,
promoting healthy competition and cooperation, and making better use of
resources in both the public and private sectors through collaboration between
the two sectors to provide healthcare infrastructure or services. PPP also helps
benchmark the efficiency and cost-effectiveness of healthcare services, and
facilitates cross-fertilisation of expertise and experience among healthcare
professionals. We wish to stress that the Government's commitment to healthcare
will not decrease because of promoting PPP.
In developing each PPP project, we will have regard to the aforesaid policy
direction of healthcare reform and set clear project objectives, identify
appropriate target groups, determine the feasible and suitable PPP model,
monitor the quality of services provided to the public under the projects and
assess carefully their cost effectiveness in order to ensure that members of the
public can benefit from the projects. Generally speaking, factors to be
considered for implementation of individual projects include: whether there is a
pressing need for the service; the feasibility of the PPP model; the capacity of
the public and private sectors and the quality of the services provided; whether
cost effectiveness can be achieved and service outcome can be enhanced; and
other potential pros and cons of the projects.
The Administration will review each and every PPP project and evaluate its
efficacy, cost-effectiveness, service quality, public's participation rate and
satisfactory level as well as other achievements. Adjustments will be made as
appropriate in light of the evaluation results to ensure efficient use of
resources.
(c) HA has implemented since February 2008 the Cataract Surgeries Programme (CSP)
to subsidise patients to receive surgeries in the private sector. Under CSP,
patients who choose to receive surgeries in the private sector will receive a
fixed subsidy of $5,000, subject to a co-payment of no more than $8,000 by the
patient. HA has at the same time increased the number of surgeries conducted in
HA hospitals. The Administration has reported to the Legislative Council Panel
on Health Services the details and review of CSP in June 2010. In general, CSP
is able to provide needy patients waiting for cataract surgeries at public
hospitals with a choice for quality private service through the provision of a
subsidy, and make better use of the capacity of public and private sectors for
cataract surgeries, thereby enhancing the overall service throughput in a
cost-effective way.
In 2011-12, HA will enhance its facilities (including establishment of a new
cataract centre at the Tseung Kwan O Hospital) to perform 3 000 additional
cataract surgeries in its public hospitals. It will at the same time provide
subsidies to 3 000 patients for cataract surgeries in the private sector under
CSP. With the above measures, it is projected that HA can handle about 31 000
cataract surgeries in 2011-12. As HA has projected that there will be about 22
000 to 25 000 new cataract cases per year, HA should be able to meet the service
needs with the above capacity.
HA does not have the relevant information about the difference in the number of
healthcare staff required for each surgery performed in the public and private
sectors. The turnover figures of HA's ophthalmologists and nurses in ophthalmic
department in 2008-09, 2009-10 and 2010-11 are set out in Annex B.
The turnover rates of ophthalmologists and nurses in ophthalmic department are
respectively 5.8% and 2.8% on average. HA has deployed additional resources over
the past few years to address manpower issues. Apart from recruiting additional
healthcare staff to cope with increase in demand, HA has been striving to
enhance the professional training of its healthcare staff, provide them with
better working environment, promotion prospect and remuneration package so as to
attract and retain talents.
Ends/Wednesday, July 6, 2011
Issued at HKT 12:41
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