Following is a question by the Hon Tang Ka-piu and a written reply by the Secretary for Health, Professor Lo Chung-mau, in the Legislative Council today (March 26):
Question:
Regarding primary healthcare services, will the Government inform this Council:
(1) of the following information on the District Health Centres (DHCs) in Hong Kong (set out by the 18 districts across the territory):
(i) the contract expiry date of the existing service contractors (contractors); and
(ii) the planned timetable and arrangements for the new round of tendering of contractors;
(2) of the following information on the relevant assessment of DHCs' service performance:
(i) the assessment methods, specific indicators and assessment standards;
(ii) the assessment cycle (i.e. the average interval of years between assessments);
(iii) whether there were cases in the past in which the service performance of the contractors was not up to standard; if so, of the details (including the measures taken at that time and their effects); and
(iv) whether channels are available for the public to access the performance ratings of various DHCs;
(3) of the respective assessment details of DHCs/DHC Expresses in the Kwun Tong district and Wong Tai Sin district in the past (including the service performance of these DHCs/DHC Expresses);
(4) given that the Secretary for Health indicated at the meeting of the Panel on Health Services of this Council on May 10 last year that priority would be accorded to the reorganisation of services in Elderly Health Centres and Woman Health Centres, of the following information on the relevant service reorganisation:
(i) the current numbers of members of these centres, with a breakdown by age group and gender;
(ii) the timetable for service reorganisation, and set out the specific timelines and targets for each phase; and
(iii) the service transitional arrangements for the current users of these centres and details of the support measures during the period; and
(5) whether it has compiled statistics on the current number of community pharmacies (including those operated by profit-making and non-profit-making organisations) in Hong Kong, and the districts in which such pharmacies are mainly located?
Reply:
President,
The Government released the Primary Healthcare Blueprint (Blueprint) in December 2022, setting out a series of reform initiatives to strengthen primary healthcare services in Hong Kong. One of the recommendations in the Blueprint is to develop a district-based family-centric community healthcare system based on the District Health Centre (DHC) model. To this end, the Government set up DHCs and interim DHC Expresses (DHCEs) of a smaller scale (hereafter collectively referred to as DHCs) in all districts across the city by the end of 2022, thereby attaining the interim goal of covering all 18 districts. As a primary healthcare services and resource hub, DHCs provide services including chronic disease screening and management, family doctor pairing, health promotion, health risk factors assessment and community rehabilitation.
In consultation with the Primary Healthcare Commission (PHC Commission) and the Department of Health (DH), the replies to the respective parts of the question raised by the Hon Tang Ka-piu are as follows:
(1) to (3) The PHC Commission was established in July 2024 to oversee primary healthcare service delivery, standard setting, quality assurance, etc, under one roof. Regarding the services of DHCs, the PHC Commission appoints non-governmental organisations as operators through open tender. The relevant operation service contracts have specified the facilities and service requirements, including the qualifications and relevant experience of key staff, the districts and number of ancillary centres/service points to be set up, and the staffing establishment of the centres. Regarding the operation period, the initial operation period of the DHC operation service contracts is three years from the date of operation with an option for extension of up to further three years, whereas the initial operation period of the DHCE operation service contracts is three years with option for multiple contract extensions. The PHC Commission will, in accordance with the terms of the contract and subject to the performance of the operator, arrange for contract renewal or conduct an open tender exercise to identify an operator before the expiry of the initial operation period. The DHCs' service commencement dates are set out in Annex I.
The PHC Commission continuously reviews the services of DHCs, with a view to strengthening their role as the co-ordinators of community primary healthcare services and case managers. As such, the PHC Commission has adjusted the operating service contracts of DHCs, including adjusting the categorisation of service targets to tie in with the enhancement of DHC services, such as the pairing of family doctors with citizens and the provision of nurse clinic services. Also, operators are required to achieve or exceed the predetermined service targets within the contract period to be eligible for contract gratuities and incentive payment to encourage the operators to actively enhance their service standards. The contract also states that the Government shall have the right to terminate the contract if an operator fails to comply with the contract requirements.
The PHC Commission is preparing to upgrade the DHCEs in Central and Western District, Eastern District and Yau Tsim Mong District into DHCs within this year. The construction works of the DHCs in Wan Chai, Kwun Tong, Sai Kung and North District are in progress, and they will be upgraded to DHCs upon completion in the next few years. Tenders will be invited to identify operators in due course. Depending on the progress of the construction works of the DHCs or the expiry date of the operation service contracts, the PHC Commission will enter into new or renewed operation service contracts with the operators and include new assessment indicators, including those relating to the participation of new members in the Chronic Disease Co-Care Pilot Scheme. At present, the operators of the Central and Western DHC and Sham Shui Po DHC have signed new service contracts. Tenders are being conducted for the service contracts of the Eastern, Yau Tsim Mong and Kwai Tsing DHCs, and the contracts of the DHCEs in other districts are being renewed. The PHC Commission will incorporate the assessment indicators as appropriate.
The PHC Commission uploaded the DHC performance indicators, including "DHC new members received information and knowledge on life course preventive care (LCPC) together with individualised LCPC health advice" and "Seasonal flu vaccination rate", onto the DHC website for public access in December 2024. In addition, the PHC Commission is progressively enhancing the performance monitoring mechanism of the DHCs by regularly reviewing a number of quantitative and qualitatively related aspects, including service volume, operational effectiveness and health-related outcomes, to assess the performance of the DHCs, and to make timely recommendations to the operators for improvement. The PHC Commission will take into account the relevant assessment results when renewing the operating service contracts.
(4) Integration of woman and elderly health services under the DH into the district health network of the PHC Commission aims to utilise resources more effectively and expand the multidisciplinary primary healthcare service network. The overview of persons who have registered for services at Woman Health Centres (WHCs) and designated Maternal and Child Health Centres (MCHCs), as well as those who are members of Elderly Health Centres (EHCs) under the DH, is at Annex II.
The PHC Commission will begin the integration of women's health services within this year in an orderly manner, whereby a non-governmental organisation appointed through open tender will provide women's primary healthcare services through three service points named Women Wellness Satellites (WWS). The three WWSs located in Chai Wan, Lam Tin, and Tuen Mun are expected to commence operation gradually within this year to replace the WHCs of DH. The Chai Wan WWS will commence operation in the second quarter, while the other two in Lam Tin and Tuen Mun will commence operation in the third quarter.
The three WHCs (namely the Chai Wan WHC, Lam Tin WHC, and Tuen Mun WHC) and four designated MCHCs (namely the Ap Lei Chau MCHC, Yaumatei MCHC, Fanling MCHC, and Ma On Shan MCHC) under the DH have ceased accepting new appointments for women's health services since January 24, 2025. During the transition period of service integration, those who have already made appointments or have paid their annual fee and are still within the service period will continue to receive relevant services from the DH.
Regarding EHCs, the PHC Commission plans to start preparing for the integration of the relevant services into the district health network in phases from 2025-26, with a view to enhancing service synergy and minimising service duplication. The details, including the transitional arrangements, will be announced in due course.
(5) According to the Pharmacy and Poisons Ordinance (Cap. 138), only "Authorised Sellers of Poisons" (ASP) (commonly known as "pharmacies") are allowed to conduct the relevant retail business of selling poisons including poisons listed in Part 1 and Part 2 of the Poisons List at Schedule 10 to the Pharmacy and Poisons Regulations (Cap. 138A). As at December 31, 2024, there are a total of 643 ASP, with 131, 226 and 286 of them located on Hong Kong Island, in Kowloon and in the New Territories respectively.
The Government intends to launch the community pharmacy programme (CPP) by phases starting from the fourth quarter of 2026 to help the public to obtain affordable primary healthcare drugs more conveniently through central purchasing and the community network, thereby reducing their over-reliance on the public healthcare system. The services of the CPP will cover all 18 districts across Hong Kong, with at least four to five community pharmacies expected to operate in each district. The Government will, through a competitive process, select service providers that meet the set requirements and cost-effectiveness standard to join the CPP.
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