Author Archives: hksar gov

     Following is a question by Dr the Hon Fernando Cheung and a reply by the Secretary for Food and Health, Professor Sophia Chan, in the Legislative Council today (May 29):
 
Question:
 
     Regarding the provision of palliative care to terminally ill patients, as well as their giving advance directives and seeking euthanasia, will the Government inform this Council if it knows:
 
(1) the details of the palliative care provided by public hospitals in each of the past five years, including the number of hospital beds, the attendance of the service, the manpower of healthcare workers and social workers involved, as well as the support received by the patients and their family members; whether the Hospital Authority conducted last year any study on improving this type of service;
 
(2) the number of public hospital patients making enquiries about advance directives in each of the past five years; whether the Government has drawn up a legislative timetable in respect of advance directives; and
 
(3) the number of public hospital patients seeking euthanasia in each of the past five years, with a breakdown by the disease suffered by the patients and the age group to which they belonged; whether the Government will study enacting legislation to permit the administration of euthanasia?
 
Reply:
 
President,
 
     Hong Kong is facing an ageing population and rising prevalence of chronic and complicated diseases. A holistic approach in the provision of healthcare services, therefore, should become more and more important. Such an approach gives terminally ill patients a greater degree of autonomy to manage their own health as well as the full respect they deserve. In this context, the Government recognises the need to promote the development of services for the elderly, particularly to strengthen palliative care services for persons facing terminal illness.
 
     Currently, palliative care services in Hong Kong are mainly provided by the Hospital Authority (HA) led by palliative care specialists, under the specialties of Medicine and Oncology. In the past, palliative care services of the HA focused mainly on the care of advanced cancer patients. In the last decade, palliative care services have been gradually extended to cover patients with other diseases, such as patients suffering from end-stage organ failure.

     To allow terminally ill patients more options of their own treatment and care arrangements, the Government will consult the public in the second half of 2019 on arrangements of advance directives (ADs) and relevant end-of-life care.

     My reply to the various parts of the question raised by Dr the Hon Fernando Cheung is as follows:
 
(1) With the aim to provide holistic care for patients, the HA has been providing palliative care services with a comprehensive service model for terminally ill patients and their families through a multi-disciplinary team of professionals, including doctors, nurses, medical social workers, clinical psychologists, physiotherapists and occupational therapists, etc. Palliative care services provided by the HA include inpatient, outpatient, day care and home care services and bereavement services, etc.
 
     Currently, palliative care services are provided by the HA in all seven clusters to support terminally ill patients and their families. At present, more than 40 doctors, 300 nurses and 60 allied health professionals (calculated on a full-time equivalent basis) provide the relevant services.
 
     Palliative care inpatient services are mainly for terminally ill patients with severe or complex symptoms and needs. As at December 31, 2018, the HA has over 360 palliative care beds. Besides, if necessary, some terminally ill patients admitted to other specialties who are in need of palliative care services can also receive treatment from the palliative care teams.

     Statistics on utilisation of palliative care services in the past five years are at Annex.

     To plan and further improve the quality and sustainability of HA’s palliative care services as well as to cope with increasing demand, the HA has developed the “Strategic Service Framework for Palliative Care” in 2017 to guide the development of palliative care services in the coming five to 10 years and formulate strategic directions for improving adult and paediatric palliative care.

     In fact, since 2018-19, the HA has further enhanced palliative care services provided by the multi-disciplinary team, including strengthening palliative care consultative service in hospitals, enhancing palliative care home care service and strengthening end-of-life care for elderly patients in residential care homes for the elderly as well as strengthening the competency of nursing staff supporting terminally ill patients beyond palliative care setting through training. The HA will regularly review the demand for various medical services (including palliative care services) and plan for the development of its services according to factors such as population growth and changes, advancement of medical technology and healthcare manpower, and collaborate with community partners to better meet the needs of patients.
 
(2) The Government consulted the public on matters relating to the introduction of the concept of ADs in Hong Kong in 2009. Most of the submissions showed no objection to introducing the concept of ADs by non-legislative means in Hong Kong. The HA formulated a guideline together with standardised form on ADs in July 2010. Since August 2012, the Clinical Management System has marked the ADs witnessed by HA’s doctors as a reminder to assist clinical communication. A total of 5 561 ADs have been signed by HA’s patients since August 2012. However, the HA does not maintain statistics regarding patients making enquiries on ADs in public hospital.
 
     As mentioned above, the Government will consult the public in the second half of 2019 on arrangements of ADs and relevant end-of-life care. We will study the way forward for ADs in accordance with the results of the consultation.
 
(3) ADs and euthanasia are not the same. The purpose of ADs is to state explicitly the specific situation where patients can refuse life-sustaining treatment when they are no longer capable to make decision during end-of-life, whereas under the Code of Professional Conduct of the Medical Council of Hong Kong, euthanasia is defined as “direct intentional killing of a person as part of the medical care being offered”.
 
     Euthanasia involves a third party’s acts of intentional killing, manslaughter, or aiding, abetting, counselling or procuring the suicide of another, or an attempt by another to commit suicide, which are unlawful acts according to the laws of Hong Kong, possibly liable to criminal offence(s) under Offences against the Person Ordinance (Cap. 212).

     Euthanasia is a highly complex and controversial issue involving implications on various dimensions, such as medical, social, moral, ethical and legal aspects. Any subject matters concerning life must be treated with care and caution. The Code has made it clear that euthanasia is “illegal and unethical”. The Government currently has no plans to carry out any studies or consultations on the issue of legalising euthanasia. The HA also does not maintain statistics regarding patients in public hospital wishing for euthanasia. read more

     Following is a question by the Hon Holden Chow and a reply by the Secretary for Food and Health, Professor Sophia Chan, in the Legislative Council today (May 29):
 
Question:
 
     Currently, among the dental clinics under the Department of Health, 11 of them provide the public with free emergency dental treatment (commonly known as “general public dental session” (GP dental session)). The service includes pain relief and teeth extraction only but not other dental treatment. In this connection, will the Government inform this Council:
 
(1) of the consultation quota and attendance of the GP dental sessions provided by each of the 11 aforesaid dental clinics in the last financial year;
 
(2) whether it will consider afresh expanding the scope of the GP dental session to cover fillings and dentures; and
 
(3) given that Tung Chung Dental Clinic currently provides dental treatment to civil servants or their dependants only, and ordinary residents in Tung Chung need to travel a long distance to Tsuen Wan Dental Clinic in order to attend the GP dental sessions, whether the Government will consider making arrangements for Tung Chung Dental Clinic to set aside time slots for providing GP dental sessions for ordinary residents in Tung Chung?
 
Reply:
 
President,
 
     The Government’s current policy on dental services aims to raise public awareness of oral health and encourage the public to develop proper oral health habits through promotion and education. Curative dental care services are mainly provided by the private sector and non-governmental organisations (NGOs). Over the years, the Oral Health Education Unit of the Department of Health (DH) has implemented oral health promotion programmes targeting different age groups and disseminated oral health information through various channels to enhance oral health of the community. Apart from making efforts to promote oral health and prevent oral problems, the Government also provides emergency dental services for the public and special oral care services for in-patients and persons with special oral healthcare needs.
 
     Government dental clinics are mainly responsible for providing dental benefits for civil servants/pensioners and their eligible dependents as required of the Government as terms of employment for civil servants, and therefore civil servants/pensioners and their eligible dependents are the major service targets of these clinics. Nonetheless, the Government provides free emergency dental treatments for the public through designated sessions (i.e. general public sessions) in 11 government dental clinics of the DH.
 
     My reply to the question raised by the Hon Holden Chow is as follows:
 
(1) The consultation quota and attendance of general public sessions provided by each of the 11 government dental clinics in 2018-19 are set out in Annex.
 
(2) and (3) As providing comprehensive dental services for the public would require substantial amount of financial resources, it is necessary for the Government to focus resources on providing emergency dental services for the public. At present, free emergency dental services are provided for the public through general public sessions in the 11 government dental clinics of the DH. These services mainly cover emergency dental treatments, including treatment of acute dental diseases, prescription for pain relief, treatment of oral abscess and teeth extraction. Professional advice is also given by dentists to patients with regard to their individual needs. In addition, the DH provides specialist treatments in the Oral Maxillofacial Surgery and Dental Units of seven public hospitals for referred patients. The Hospital Authority also provides dental services in four public hospitals for referred in-patients, patients with special oral healthcare needs and patients with dental emergency needs. As for curative dental care services, they are mainly provided by the private sector and NGOs. 
 
     Currently, government dental clinics are operating at their full capacity, with a usage rate of almost 100 per cent for all appointment time slots. It is therefore not possible for the DH to allocate more time slots for general public sessions on top of the existing service provided at government dental clinics, including Tung Chung Dental Clinic.
 
     Apart from general public sessions, there are also other measures to take care of persons with special needs, including the School Dental Care Service for primary school students, and dental care support for the low-income elderly with special needs, such as the Outreach Dental Care Programme for the Elderly and Community Care Fund Elderly Dental Assistance Programme. Besides, the Elderly Health Care Voucher Scheme allows Hong Kong elderly persons aged 65 or above to use the vouchers for private dental services. To better meet the dental service needs of persons with intellectual disability, the Government launched a three-year project on July 16, 2018 for persons with intellectual disability named Healthy Teeth Collaboration to provide free oral check-ups, dental treatments and oral health education for adults aged 18 or above with intellectual disability. read more

     Following is a question by the Hon Charles Mok and a written reply by the Secretary for Innovation and Technology, Mr Nicholas W Yang, in the Legislative Council today (May 29):   Question:      &nb… read more

     Following is a question by the Hon Chu Hoi-dick and a reply by the Secretary for the Environment, Mr Wong Kam-sing, in the Legislative Council today (May 29):

Question:

     Last month, a socio-political movement called “Extinction Rebellion” staged a large-scale demonstration in London, putting forward the following three demands to the Government of the United Kingdom (UK): (1) the Government must tell the truth about the climate and wider ecological emergency, reverse inconsistent policies and work alongside with the media to communicate with citizens; (2) the Government must enact legally binding policy measures to reduce carbon emissions to net zero by 2025 and to reduce consumption levels; and (3) a national Citizens’ Assembly should be set up to oversee the changes, as part of creating a democracy fit for the purpose. On the other hand, a global environmental assessment report published early this month by an organisation under the United Nations (UN) has pointed out that a million species are threatened with extinction due to the destruction inflicted by human beings on the natural environment, and thus only “transformative changes” across the globe on various aspects may reverse this situation. Some environmentalists have pointed out that if the Hong Kong Government does not make transformative changes to its current policies for addressing climate change and protecting biodiversity, it can hardly satisfy the three aforesaid demands nor meet the UN Aichi Biodiversity Targets. In this connection, will the Government inform this Council:

(1) whether it will pledge to the public that it will devote all its efforts to satisfying the three demands of the Extinction Rebellion movement; if so, of the transformative changes to be made in respect of its policies for addressing climate change; if not, the reasons for that;

(2) given that the Parliament and dozens of local councils of cities and towns in UK have declared a climate emergency, whether the Hong Kong Government will make such declaration; if so, of the details; if not, the reasons for that; and

(3) whether it will study what transformative changes to the policies on protecting biodiversity are needed in Hong Kong; if so, of the details; if not, the reasons for that?

Reply:

President,

     My reply to the three parts of the question is as follows:

(1) and (2) There is no time to waste in combating climate change. The Paris Agreement agreed that all Parties should take appropriate measures based on the principle of “common but differentiated responsibilities and respective capabilities” in order to tackle this imminent challenge together. Hong Kong has responded positively when the Paris Agreement came into effect in 2016. We set up the Steering Committee on Climate Change under the chairmanship of the Chief Secretary of Administration to steer and co-ordinate climate actions among various bureaux and departments in the whole Government; and released the Hong Kong’s Climate Action Plan 2030+ in 2017, setting out the target to reduce Hong Kong’s carbon intensity by between 65 per cent and 70 per cent by 2030 compared with the 2005 level and detailing the key measures to be taken. These actions are in line with the Paris Agreement to hold the increase in global average temperature to well below 2 degrees Celsius above pre-industrial levels. The Government will also review our climate actions every five years as required by the Paris Agreement.

     As electricity generation contributes to about two thirds of Hong Kong’s carbon emissions, improving the fuel mix is the prime consideration. For this, the two power companies will use more natural gas in the coming ten years to replace the coal-fired generating units which will gradually retire. At the same time, the Government will continue to take the lead in developing renewable energy (RE). For example, we have earmarked $2 billion to implement relevant projects at government premises, and will install solar generation systems of a larger scale at suitable reservoir and landfill locations. Beyond the Government, we have introduced Feed-in Tariff (FiT) and implemented different facilitation measures, including suitably relaxing the restrictions on “village house” rooftop installations, launching Solar Harvest to assist eligible schools and welfare non-governmental organisations in installing solar photovoltaic panels, etc. There were only dozens of private RE systems connected to the power grids in the past, but in the past year alone, the two power companies have already received about 3 000 FiT applications.

     In addition, the Government unveiled in 2015 “the Energy Saving Plan for Hong Kong’s Built Environment 2015~2025+”, setting a target of reducing energy intensity by 40 per cent (compared with 2005) by 2025. To date, our overall energy intensity has decreased by more than 28 per cent, putting us in the lead among members of the Asia-Pacific Economic Cooperation. We have implemented a number of measures to enhance our energy efficiency, including (a) taking the lead in saving energy and developing green buildings; (b) raising statutory standards; (c) providing tax incentives; (d) constructing district cooling systems; (e) promoting retro-commissioning; (f) expanding the Mandatory Energy Efficiency Labelling Scheme; and (g) harnessing technology and innovation, etc. After implementing all these measures, we expect that our annual carbon emission will be reduced by 1.7 million tonnes. Using the carbon emission level of 2016 as reference, this would be equivalent to a carbon reduction of about 4 per cent.

     Energy saving is also a key element of the post-2018 Scheme of Control Agreements (SCAs) we signed with the power companies. The two power companies have implemented different programmes under the SCAs to assist the community in participating in energy saving. In the future, smart meters will be used to provide electricity consumption information to all customers in Hong Kong to help save energy and implement demand response schemes.

     We are also developing Organic Resources Recovery Centres (ORRCs) in phases to turn food waste into biogas. Phase 1 of ORRC was commissioned in 2018, while Phases 2 and 3 are under planning. Moreover, the first Food Waste/Sewage Sludge Anaerobic Co-digestion Trial Scheme that is carried out jointly by the Environmental Protection Department and Drainage Services Department is just being conducted at Tai Po Sewage Treatment Works. This allows proper recycling of food waste and turning waste into energy, while reducing carbon emissions at the same time.

     The transport sector accounts for around 20 per cent of Hong Kong’s carbon emissions. Upon the completion of the Shatin to Central Link, the railway service will cover more than 70 per cent of the local population. The Government will continue to promote “Walk in HK” to encourage people to walk more, and to foster a “bicycle-friendly environment”. 

     With the successive implementation of various measures, we are moving steadily towards the 2030 target of reducing per capita carbon emissions from 5.7 tonnes in 2016 to less than 4.5 tonnes in 2020 and within 3.3 to 3.8 tonnes by 2030. Pursuant to the Paris Agreement, the Hong Kong Special Administrative Region (HKSAR) shall formulate, by 2020, our long-term decarbonisation strategy up to 2050. To this end, the Council for Sustainable Development has accepted the Government’s invitation to launch a public engagement next month. In the process, the Council will, as usual, adopt a bottom-up approach, providing a platform to gauge the views of the community and help build consensus. We encourage all sectors of the community to take this opportunity to express their views.

(3) In the face of various global challenges for biodiversity, the HKSAR Government launched the first city level Biodiversity Strategy and Action Plan (BSAP) for Hong Kong in 2016. The four major areas under BSAP include enhancing the existing conservation measures; mainstreaming biodiversity; improving knowledge and enhancing public participation in biodiversity. There are 67 specific actions under BSAP, many of which are related to mitigating and adapting to climate change.

     At present, various work under the four major areas of BSAP has been progressing, and actions are being implemented by relevant bureaux and departments in accordance with the timetable.

     Thank you, President. read more

     The Centre for Food Safety (CFS) of the Food and Environmental Hygiene Department today (May 29) announced that the test results of about 50 rice dumpling samples collected under a recently completed seasonal food surveill… read more