Replies to LegCo questions
LCQ1: Number of medical beds in public hospitals
Following is a question by the Dr Hon Leung Ka-lau and a reply by the Secretary
for Food and Health, Dr Ko Wing-man, in the Legislative Council today (January
7):
Question:
I have recently received complaints that the management personnel of a public
hospital reduced the number of medical beds in that hospital on their own
volition without seeking their supervisors’ prior approval, thereby affecting
the services provided to patients. In this connection, will the Government
inform this Council:
(1) whether it knows the actual numbers of medical beds providing inpatient care
in various public hospitals at present, as well as whether there is any
difference between such numbers and the planned numbers of such beds; of the
relevant numbers in each of the past five years;
(2) whether it knows if the Hospital Authority (HA) will conduct an
investigation into the aforesaid incident of reduction in the number of medical
beds and assess the impact of the incident on the services provided to patients,
including whether patients in the Accident and Emergency Department waited for a
longer time before admission to the medical wards as a result; if HA will
conduct such an investigation, of the details; if HA will not, the reasons for
that; and
(3) how the Government monitors if the actual numbers of various types of
inpatient beds in public hospitals differ from the respective planned numbers,
for instance, whether a Hospital Chief Executive is required to report to the
Chief Executive of HA and the Secretary for Food and Health prior to reducing
the number of inpatient beds of a particular specialty; if there is such a
requirement, of the details; if not, the reasons for that?
Reply:
President,
The Hospital Authority (HA) manages all public hospitals in Hong Kong. It is
projected that HA will be providing a total of 27 645 hospital beds as at March
31, 2015. Beds may be classified, in terms of types, into general beds,
infirmary beds, beds for the mentally ill and beds for the mentally handicapped.
General beds are further classified into beds for major specialties (e.g.
medicine, surgery, gynaecology, obstetrics, paediatrics, orthopaedics and
otorhinolaryngology) and beds for other sub-specialties like oncology,
neurosurgery and emergency medicine.
HA will assess the demand for different types of beds as well as the demand for
beds among different specialties having regard to the number of patients, types
of diseases and severity of patients' conditions. HA will then allocate hospital
beds taking into account the actual circumstances and the healthcare model to
cater for the needs of patients.
Given the varying seasonal demand, HA will temporarily provide additional beds
as appropriate. For example, HA is planning to provide 282 additional beds
during winter surge this year to meet extra demand.
Concomitant with the growth and ageing of population, we understand that the
demand for healthcare services in the community, especially the demand for
hospital beds, will continue to increase. Over the years, HA has rolled out
various measures to reduce public demand for inpatient services. For example,
outreach services are provided for elderly patients residing in residential care
homes and the community; transitional integrated support services are provided
for high-risk elderly patients who have been discharged from hospital but may
need emergency hospital readmission any time. The Community Health Call Centre
of HA also provides support services for discharged high-risk elderly patients
living in the community through communications by telephone.
Moreover, we are planning to embark on a number of projects, including the
construction of Tin Shui Wai Hospital and Hong Kong Children's Hospital; the
redevelopment of United Christian Hospital, Kwong Wah Hospital, Queen Mary
Hospital and Kwai Chung Hospital; and the planning for a general acute hospital
in the Kai Tak Development Area, so as to enhance service capacity and provide
more hospital beds to cater for public needs.
I note that Dr Hon Leung Ka-lau points out, in the preamble of the question,
that he has received a complaint involving a certain public hospital reducing
the medical beds on its own volition without seeking proper prior approval. I
have verified the issue with HA, which has confirmed that it has not received
the relevant complaint. As the question has neither mentioned the hospital
involved nor provided any specific information regarding the complaint, I can,
in such circumstances, only give an overall and general reply to various parts
of the question. If Dr Hon Leung has more specific information, I am happy to
follow up separately later.
(1) The number of medical beds provided by various clusters of HA in the past
five years is set out at Table 1 in the written reply distributed to Members.
Overall speaking, the total number of medical beds provided by HA in the past
five years has increased on a year-on-year basis from 8 261 in 2010 to 8 660 in
2014, representing an increase of 5 per cent. Over these five years, the number
of medical beds in six clusters has all recorded increase. The only cluster
which has recorded a slight drop in the number of medical beds is Kowloon
Central. The reason for such a slight drop includes the need to transfer some
beds in medicine to orthopaedics in the Hong Kong Buddhist Hospital to
facilitate the establishment of the Joint Replacement Centre; and the
classification of 24 beds in the Special Observation Wards in the Queen
Elizabeth Hospital from medicine to mixed specialties to more accurately reflect
the mixed operation model of the beds concerned (it should be noted that such
change in classification had no effect on the actual service provision).
Individual clusters might add or reduce the number of medical beds during
certain periods having regard to the actual operational needs and changes in
healthcare models. However, any adjustment on the number of beds and any
re-allocation of beds among specialties are undertaken with formal approval in
accordance with procedures. And if the number of medical beds is reduced, the
number of beds for other specialties will be increased correspondingly through
re-allocation. As such, the total number of beds provided by HA has remained
unchanged and the overall services provided for patients has not been reduced.
(2) and (3) Hospital beds are crucial medical resources. HA has put in place a
mechanism to monitor the operation of hospital beds in the clusters. The use and
allocation of hospital beds must be approved by the Cluster Chief Executives
concerned and reported to HA Head Office. HA is required to regularly report the
overall number of hospital beds to the Food and Health Bureau (FHB) via the
Controlling Officer's Report. FHB will also set out the number of hospital beds
provided by HA in its Controlling Officer's Report under the relevant Head in
the annual Estimates for inspection by the Legislative Council and the public.
All in all, HA attaches great importance to the use of such crucial medical
resources as hospital beds, and has put in place a mechanism to ensure that
these resources are used properly to meet actual needs. I would reiterate that
should Dr Hon Leung have any specific information regarding any incident of the
reduction in medical beds without proper prior approval, he could convey the
information to us and I will ask HA to follow up and conduct a thorough
investigation.
Ends/Wednesday, January 7, 2015
Issued at HKT 15:55
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LCQ1 Annex