The following is issued on behalf of the Hospital Authority:
The Hospital Authority (HA) today (November 22) released the report of the Review Committee on the Management of the Public Hospital System (the Review Committee). The HA fully accepts the report and will gradually implement all recommendations as soon as possible to enhance governance, strengthen safety and actively promote reforms. With a spirit of innovation and change, the HA will strive to improve its services comprehensively. The HA will focus on strengthening governance, enhancing accountability, and fostering a safety culture to ensure thorough follow-up and effective implementation of measures to build a public hospital system that meets the needs of the community.
The Chairman of the HA, Mr Henry Fan, stated, "We express our profound gratitude to the Review Committee (Annex 1), led by Professor Fok Tai-fai, for conducting a comprehensive review of public hospital management matters. The Review Committee worked tirelessly. In addition to holding intensive meetings and reviewing documents, the Review Committee also visited public hospitals for on-site inspections several times and met with frontline staff, hospital management, patients, and relatives. The report is highly detailed, summarising the challenges faced by the HA into five key areas and proposing 31 improvement recommendations. Each recommendation is invaluable and will profoundly impact the future operations, governance, and patient safety of public hospitals."
Mr Fan emphasised that the HA fully understands that pursuing change and innovation to meet the needs of the public is the fundamental basis for the sustainable development of the public healthcare system and for enhancing the well-being of citizens. Therefore, the HA will align with the Government's direction and fully implement the Review Committee's recommendations as soon as possible.
The HA will establish a high-level Governance and Structural Reform Committee (Reform Committee) under the HA Board. This Reform Committee will be chaired by Mr Fan and include representatives from the Health Bureau, as well as members with extensive experience in corporate governance. The Reform Committee will provide advice on governance and structural reforms for the HA, guiding it to address challenges ahead. The remaining recommendations will be followed up and implemented through the existing structure of the HA. Departments and the Reform Committee will regularly report their progress to the Health Bureau and the HA Board.
The Chairman of the Review Committee, Professor Fok, remarked, "Over the past few months, the Review Committee has focused on reviewing governance issues in the public hospital system and providing forward-looking improvement recommendations. These suggestions aim to assist the HA in enhancing risk management, strengthening governance, and reinforcing safety to address future challenges."
The Review Committee acknowledged that the HA manages one of the world's largest and most complex healthcare systems. The rate of sentinel events in Hong Kong public hospitals was approximately 0.32 per 100 000 population, significantly lower than rates in the United States, the United Kingdom, Australia, and other countries. The Review Committee also recognised several strengths within the HA system, including a professional and dedicated healthcare workforce, an advanced incident reporting system, and proactive adoption of information technology.
The Review Committee proposed 31 improvement recommendations (Annex 2), which primarily focus on the following areas:
- Strengthening governance
- Clarify the roles, responsibilities, and authority of different levels of staff in relation to quality and safety;
- Clearly define the specific roles, responsibilities, and objectives of the Head Office, hospital clusters, individual hospitals, and departments regarding quality and safety.
- Enhancing accountability
- Develop a patient safety accountability framework for senior management, incorporating safety metrics into performance appraisals evaluations to hold senior leaders accountable for patient safety;
- Introduce a just culture framework where staff accountability is determined based on established guidelines that distinguish between human error, at-risk behaviour, and reckless conduct, with appropriate response protocols.
- Fostering a culture of safety
- Implement a safety culture programme that prioritises non-punitive reporting;
- Create a "speak-up" culture, provide staff training and develop an open communication environment;
- Promote a healthy risk culture, offer training to enhance their risk awareness and competency;
- Strengthen clinical supervision and guidance to improve junior staff's skills, competencies, and effectiveness, ensuring care safety.
- Other recommendations
- Establish a rapid incident response team;
- Design a spokesperson preparedness programme;
- Establish clear incident public disclosure guidelines;
- Align resources with service demand.
The HA will fully align with policy directions of the Government, formulate comprehensive plans, and monitor the progress and effectiveness of the implementation of the recommendations. This will enhance the HA's governance and safety, ensuring the continued provision of high-quality healthcare services to patients.
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