LC: Speech by CS in presenting Government Minute in response to Report No. 82 of Public Accounts Committee

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     Following is the speech (translated from Chinese) by the Chief Secretary for Administration, Mr Chan Kwok-ki, in presenting the Government Minute in response to Report No. 82 of the Public Accounts Committee in the Legislative Council today (October 23):

President, 

     Laid on the table today is the Government Minute (GM) responding to Report No. 82 of the Public Accounts Committee (PAC) presented to the Legislative Council (LegCo) on July 17, 2024.

     I welcome the Report of the PAC and am grateful for the time and efforts devoted by the Chairman of the PAC, Mr Shiu Ka-fai, and members of the PAC. The Government accepts all the PAC's various recommendations and sets out in detail in the GM the specific responses of the relevant bureau and departments (B/Ds). The PAC conducted public hearings on the chapters on "Emergency dental services and elderly dental care support" and "Provision and monitoring of Rehabus services". I would like to highlight the key follow-up measures taken and progress made by the Government and relevant organisations in response to the recommendations.

     Regarding improvements to the services of the General Public (GP) Sessions, the Department of Health (DH) has adjusted the preliminary registration time at nine dental clinics to prevent elderly persons from waiting until midnight. Among these, the time of disc distribution and formal registration at the Mona Fong Dental Clinic have also been adjusted so that patients can receive service after formal registration as soon as possible. The DH will roll out an online electronic disc distribution and registration system before the end of this year. By then, members of the public will no longer need to queue in person for obtaining discs, and will receive real-time information on the remaining disc quotas, i.e. they will know the number of disc quotas remaining on a real-time basis, so as to ensure that all quotas can be fully utilised. The system will give registration priority to elderly persons aged 65 or above. In addition, the Government will enhance emergency dental services targeting the underprivileged groups with financial difficulties in collaboration with non-governmental organisations (NGOs) under a new service model in 2025. The target is to provide additional service capacity which will be at least two times the current capacity of GP sessions. To ensure limited resources can be deployed to those in need (in particular the underprivileged groups), the Government will examine the cost-effectiveness and service arrangement of the GP sessions, and consider the need of introducing means tests or other eligibility criteria for emergency dental services, or other proposals such as replacement by provision of services to underprivileged groups in need by NGOs. This is to ensure the effective use of public healthcare resources.

     Regarding dental services in public hospitals, the DH has convened joint service meetings with the Hospital Authority (HA) and maintained relevant information as recommended in the Report. The HA also regularly monitors the achievement of targets on the waiting time for new case appointments at its Oral Maxillofacial Surgery and Dental Clinics, and assess patients' conditions in a timely manner so as to arrange their first appointments as soon as possible. Furthermore, the DH and the HA have initiated discussions on the merging of hospital dental services and will take into account the observations and recommendations in the Audit Report.

     To alleviate the manpower shortage, the DH is conducting the year-round recruitment of local full-time and part-time dentists, provides incremental credits based on the applicants' work experience, and relaxes the Chinese language proficiency entry requirements for the positions. The latest batch of 10 part-time contract dentists took office sequentially from July to September 2024, and 42 full-time dentists took office in September 2024. In addition, following the passage of the Dentists Registration (Amendment) Bill 2024 by the LegCo on July 10, 2024, the DH has been working with the Dental Council of Hong Kong to admit the first batch of non-locally trained dentists to Hong Kong through the new mechanism in the first quarter of 2025 so as to serve the public.

     As for elderly dental care support, the DH has further ascertained the reasons for non-participation in the Outreach Dental Care Programme for the Elderly (ODCP) of residential care homes for the elderly (RCHEs), day care centres for the elderly, and NGOs. The DH has also established a new mechanism with the Social Welfare Department to follow up with non-participating RCHEs and strengthen promotional work in encouraging the RCHEs to join the ODCP. Moreover, the DH has taken measures to ensure the participating NGOs' fulfilment of their responsibilities according to the funding and service agreement terms. Except for during the COVID-19 epidemic when there were restrictions on visits to the RCHEs, the overall target number of service in 2023-24 were met.

     The DH has encouraged more private dentists to enrol in the Elderly Health Care Voucher Scheme (EHVS) through various means, such as introducing the EHVS at meetings or events organised by the Hong Kong Dental Association. The DH will continue to send reminder notifications and messages through the eHealth System (Subsidies) to healthcare service providers enrolled in the Scheme regularly, reminding them to update their enrolment particulars. Upon receiving notifications of change of particulars from healthcare service providers, the DH will process them and update the information on the website of the EHVS as soon as practicable. In addition to making use of private dental services in Hong Kong, eligible elderly persons may make use of the Elderly Health Care Vouchers (EHCVs) to pay for outpatient dental services at the University of Hong Kong-Shenzhen Hospital (HKU-SZH) and its Huawei Li Zhi Yuan Community Health Service Center (Huawei CHC) since 2015 and 2023 respectively. Moreover, the Government launched the Elderly Health Care Voucher Greater Bay Area Pilot Scheme (Pilot Scheme) in 2024. From June to September this year, the Pilot Scheme has been implemented in seven integrated services medical institutions or dental healthcare institutions that provide dental services in Guangzhou, Nansha, Zhongshan, Dongguan and Shenzhen, and eligible Hong Kong elderly persons may choose from more service points. Together with the two service points at the HKU-SZH and the Huawei CHC, elderly persons may pay for outpatient dental service fees with the EHCVs at a total of nine services points of the medical institutions in Mainland cities within the Greater Bay Area.

     Regarding the Elderly Dental Assistance Programme (EDAP) funded by the Community Care Fund, the services under the programme have been optimised from July 2, 2024 with the essential requirement of fitting removable dentures relaxed. This allows eligible elderly persons to receive dental services specified under the EDAP even if they are not suitable for dentures. This enhancement measure aims to encourage eligible elderly persons to manage dental diseases at an early stage by opting for preventive and curative dental services, thereby retaining their natural teeth as much as possible and avoiding tooth extractions and denture fittings. To further encourage the elderly persons to apply for services under the EDAP, the Health Bureau (HHB) is promoting the above programme through district service units. The implementing agent has held briefing sessions to introduce the EDAP to dentists and encourage their participation. Apart from strengthening its communication with the implementing agent, the HHB has taken measures to ensure that improvements have been made to the EDAP implementation, including enhancing the eligibility checking mechanism to cover all eligibility criteria, publishing a list of participating dentists and dental clinics, and revising the guidelines provided to service units to specify the appointment scheduling process for applicants who have not indicated their preferred dentist and dental clinic. To expedite the processing of long outstanding cases, the implementing agent has amended the guidelines issued to dentists and dental clinics to clearly include the time limit for claiming fees, and has increased manpower and enhanced computer performance.

     Based on the recommendations of the Working Group on Oral Health and Dental Care, the Government will strive to develop and promote primary dental care services in the future to help citizens manage their oral health, and to put prevention, early identification, and timely intervention of dental diseases into practice. The Government will also explore how to continue developing appropriate dental care services targeted at the underprivileged groups, including persons with financial difficulties, persons with disabilities or special needs and high risk groups. The target of the Working Group is to issue the Final Report before the end of its term by late 2024, and to present to the Government recommendations on implementing various policy directions and the development of dental services.

     Regarding Provision and monitoring of Rehabus services, the Labour and Welfare Bureau (LWB) and the Transport Department (TD) have actively followed up on the comments and recommendations made by the Audit Commission and the PAC on the provision and monitoring of Rehabus services.

     The TD is collecting data on the travelling needs of persons with disabilities through the Rehabus operators (the operators) for assessing the demand for Rehabus services. The LWB will review the policy and models of service delivery of Rehabus services upon receipt of relevant data and assessment. The TD is also reviewing the existing arrangement of signing Memoranda of Understanding (MOUs) with the operators and considering the adoption of other legally binding regulatory approaches for more effective monitoring of Rehabus services.

     To monitor the performance of the operators, the TD implemented various measures to ensure the operators' strict compliance with the requirements stipulated in MOUs, including convening meetings of the Rehabus Management Committee and the Users' Liaison Group as required, submitting the financial documents in a timely manner, etc. The TD also increased its regular meetings with the operators from once every quarter to once a month, and will conduct service reviews on an annual basis and set additional performance pledges.

     Regarding the procurement of vehicles, the TD updated the relevant procurement guidelines with the operators and formulated an action checklist to ensure that staff concerned strictly comply with the relevant procurement requirements and procedures.

     As regards the provision of scheduled route service, the TD is closely monitoring the operator's review of the existing services and progress of route consolidation. In addition, as per the TD's advice, the operator has provided connecting services to nearby railway stations or interchanges since September 2024 as an option for applicants who have been waiting for the service for some time. This arrangement will help reduce the number of applicants for the service, hence will shorten the waiting time as well.

     As for the provision of dial-a-ride (DAR) service, the TD urged the operator to step up its efforts in recruiting drivers. The shortage of drivers has improved, and the rate of rejected orders of DAR service due to insufficient drivers also dropped. The TD is also closely monitoring the operator's adoption of the new integrated computer system in arranging shared-use service, with a view to exploring the feasibility of further enhancing the shared-use arrangement.

     Regarding the provision of feeder service, the TD reviewed with the operator the hospital routes and recreational routes with low patronage, and will continue to consolidate and enhance the service to improve operational efficiency. Subject to the manpower arrangement of drivers, the TD is also exploring with the operator the feasibility of further shortening the booking time of recreational route service.  Furthermore, the TD explored with the operators the setting of a limit on the maximum number of carers for DAR service and feeder service, and will consult the stakeholders in due course. The TD will continue to monitor the operator's implementation of various service enhancement pledges, increase the number of monitoring surveys, step up spot checks on the operator and accounting records, etc.

     President, I would like to thank the PAC again for its efforts and suggestions. The B/Ds concerned will strictly adhere to their responses and implement various improvement measures as set out in the GM with full efforts.

     Thank you, President.

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