LCQ19: Performing surgeries for cataract patients

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     Following is a question by the Hon Luk Chung-hung and a written reply by the Secretary for Health, Professor Lo Chung-mau, in the Legislative Council today (July 3):

Question:

     According to the latest statistics published by the Hospital Authority (HA), from April last year to March this year, the median waiting time of patients who had their cataract surgeries done in public hospitals was at least 11 months. It is learnt that as cataract patients often have to wait for a considerably long time before a surgery can be arranged for them, their vision may have deteriorated before the surgery and become so blurred that their daily lives are significantly affected. In this connection, will the Government inform this Council:

(1) as some ophthalmologists have reportedly pointed out that if a patient does not undergo a surgery until his cataract has reached a very "mature" stage, his vision may be seriously impaired and it will take him a relatively long time to recover after the surgery, whether it knows if HA has stipulated clear criteria for determining whether a patient is suitable for undergoing a surgery; if so, of the specific details, such as how those criteria have been stipulated and put into practice;

(2) whether it knows the average waiting time for a cataract surgery in each hospital cluster in each month over the past five years; whether there are special circumstances which will affect the waiting time; of the specific measures put in place by the Government to reduce the waiting time;

(3) whether it knows (i) the average attendance receiving cataract surgeries in public hospitals, as well as the average attendance of (ii) new ophthalmic stable cases, (iii) new ophthalmic semi-urgent cases and (iv) new ophthalmic urgent cases receiving treatments in public hospitals in each of the past five years, and set out the breakdown by hospital cluster in the table below; and
 

Hospital cluster (i) (ii) (iii) (iv)
         

(4) given that HA provides subsidies under the Cataract Surgeries Programme to patients on HA clusters' routine cataract surgery waiting lists, so as to offer them options to undergo cataract surgeries by private ophthalmologists, whether it knows the total number of invitation letters issued by HA, the number of patients who accepted the invitations and joined the Programme, and among them, the percentage of Waiver Eligible Patients who did not need to pay any co-payment in the past five years?

Reply:

President,

     In consultation with the Hospital Authority (HA), the consolidated reply to the question raised by the Hon Luk Chung-hung is as follows:

     Cataract is a common eye disease, the prevalence of which increases with age. It is expected that the demand for cataract surgery will continue to grow with the ageing population.

     Having regard to the above, the Eye Specialist Out-patient Clinics (SOPCs) under the HA have implemented arrangements since 2009 to ensure patients with conditions requiring early intervention are treated with priority. Patients waiting for cataract surgery are triaged into Priority 1 (urgent), Priority 2 (semi-urgent) and Routine (stable) categories according to the urgency of their situations and clinical conditions. Surgeries will be arranged as early as practicable for those triaged as priority cases.

     Specifically, Priority 1 (urgent) category includes patients with mature cataract in both eyes or severe visual impairment, who will generally be arranged to undergo surgeries in less than two months. Priority 2 (semi-urgent) category includes patients with special occupational needs or very poor vision in one eye. In general, they will be arranged to undergo surgeries within 12 months. Routine (stable) category includes patients with stable clinical conditions and relatively better vision. They will be arranged to attend follow-up consultations at Eye SOPCs for regular monitoring of their conditions and will undergo surgeries at an appropriate time.

     The HA and its Coordinating Committee in Ophthalmology also regularly review the scheduling for cataract surgery, taking into account data on the waiting time for various clusters.

     The number of new cases in Eye SOPCs, waiting time for cataract surgery and number of cases with cataract surgery performed in each hospital cluster of the HA from 2019-20 to 2023-24 are set out at the Annex.

     The HA launched the Cataract Surgeries Programme (the Programme) in February 2008. Under the public-private partnership model, general patients in the waiting list who are suitable for local anaesthetic surgery will be invited to receive cataract surgeries performed by designated private ophthalmologists. The HA provides a fixed subsidy of $8,000 for participating patients who are subject to a co-payment of not more than $8,000. Waiver eligible patients (Note) are entitled to the fee waiver arrangement under the Programme. In the past five years, the HA issued over 50 000 invitation letters under the Programme. More than 12 600 patients participated in the Programme, including about 25 per cent of whom are waiver eligible patients.

     The HA will continue to proactively shorten the waiting time for cataract surgery through various measures. Apart from the above public-private partnership programme, the HA has also launched a special scheme for cataract surgery under which allowances are provided to serving doctors to perform surgeries for patients outside their working hours, with a view to enhancing the capacity of relevant services. In addition, the HA has implemented a number of measures to attract, train and retain talents. These include enhancing recruitment of local graduates, re-hiring retired staff and recruiting non-locally trained doctors and part-time staff, while enhancing training and promotion opportunities as well as launching the Enhanced Home Loan Interest Subsidy Scheme. The healthcare personnel coming to Hong Kong under the Greater Bay Area Healthcare Talents Visiting Programmes also include ophthalmologists, helping alleviate the pressure of manpower shortage.

Note: Including recipients of the Comprehensive Social Security Assistance, certificate holders for Full Waiver of Medical Charges, Old Age Living Allowance recipients aged 75 or above, as well as voucher holders at Level 0 under the Residential Care Service Voucher Scheme for the Elderly

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