Following is a question by the Hon Chan Han-pan and a written reply by the Secretary for Food and Health, Professor Sophia Chan, in the Legislative Council today (August 25):
Question:
I have received complaints from some members of the public that the dental treatment services provided for members of the public by the 11 government dental clinics under the Department of Health (commonly known as "general public dental sessions" (GP dental sessions)) are grossly inadequate, and as such services cover only pain relief and teeth extraction, they fail to meet the dental treatment needs of members of the public (especially the elderly). Regarding dental services and training for dental healthcare personnel, will the Government inform this Council:
(1) whether it will consider afresh increasing the consultation quota of GP dental sessions and expanding the service scope to cover services such as dental filling, fitting of dentures and root canal treatment; and
(2) as the mobile dental clinic services provided by some community groups and under the Kwai Tsing Signature Project Scheme of the Kwai Tsing District Council are well received by the elderly, whether the Government will study the provision of such kind of services by the public healthcare system; if so, of the details and the timetable; if not, the reasons for that;
(3) whether it has reviewed (i) private dentists' current participation in (a) the Elderly Health Care Voucher Scheme and (b) the Community Care Fund Elderly Dental Assistance Programme, and (ii) if the amounts of the subsidies concerned are sufficient to meet the dental expenses incurred by the elderly; if so, of the outcome; and
(4) whether it will further increase the numbers of training places for dental healthcare personnel, so as to meet the future demand for dental services in Hong Kong; if so, of the details; if not, the reasons for that?
Reply:
President,
The reply to the four parts of the question is as follows:
(1) The Government's policy on dental care seeks to improve oral health and prevent dental diseases by raising public awareness of oral health and encouraging proper oral health habits through promotion and education.
Under the civil service terms of employment, the Government is obliged to provide dental benefits for civil servants/pensioners and their eligible dependents. Dental clinics under the Department of Health are established primarily for fulfilling this obligation and dental services thereat are essentially provided for the above groups. Currently, government dental clinics are running at full service capacity with close to 100 per cent of the appointment slots occupied. The Government has no plans to expand the service scope of general public dental sessions.
The provision of comprehensive dental services for the community at large requires substantial financial resources. In accordance with the prevailing policy, the Government mainly undertakes publicity, education (including the School Dental Care Service), promotion of oral health and provision of emergency dental services to the public, and takes forward initiatives targeting at persons with special dental care needs, in particular elderly persons with financial difficulties and persons with difficulties accessing general dental services. In recent years, the Government has implemented a series of initiatives to take particular care of persons in need of special dental treatment. Of these, a three-year programme named "Healthy Teeth Collaboration" was launched in July 2018 and extended for another three years to provide free oral check-ups, dental treatments and oral health education for adult persons aged 18 or above with intellectual disability. In parallel, the Government provides dental care support for low-income elderly persons with special needs through, inter alia, the Outreach Dental Care Programme for the Elderly and the Community Care Fund Elderly Dental Assistance Programme. Besides, the Elderly Health Care Voucher (EHCV) Scheme also allows the use of vouchers for the payment of private dental services.
(2) The concept of mobile dental clinics is to provide dental services for persons with limited access to such services (e.g. those living in remote and rural areas) by means of well-equipped vehicles. In Hong Kong, public transportation is relatively convenient and dental clinics are easily accessible. Moreover, the scope of service of mobile dental clinics has its limitations. Given the fragility and limited mobility of elderly persons residing in residential care homes or receiving services at day care centres, we consider it more cost-effective to provide dental care services to these elderly persons through the Outreach Dental Care Programme for the Elderly.
(3) The Government implemented the EHCV Scheme to provide subsidies for elderly persons aged 65 or above to choose private primary healthcare services that best suit their health needs in their local communities. EHCVs can be used for healthcare services provided by medical practitioners, Chinese medicine practitioners, dentists, nurses, physiotherapists, occupational therapists, radiographers, medical laboratory technologists, chiropractors and optometrists with Part I registration under the Supplementary Medical Professions Ordinance (Cap. 359).
Currently, each eligible elderly person is provided with an annual voucher amount of $2,000. There is no restriction on the number of years that one may carry forward the unspent voucher amount subject to an accumulation limit of $8,000, providing flexibility for choosing suitable services.
The Government has been actively promoting the EHCV Scheme among private healthcare service providers through various channels. As regards dentists, the Department of Health conducts such promotion through seminars organised by the Hong Kong Dental Association (HKDA) for members and its newsletter with a view to encouraging more dentists in the private practice to enrol in the Scheme. In the past few years, the number of dentists enrolled under the Scheme has been increasing. As at July 31, 2021, 1 271 dentists (representing around 66 per cent of the total number of dentists in the private practice) practising at more than 2 500 locations across 18 districts in Hong Kong accept the use of EHCVs by eligible elderly persons.
The scope of subsidy under the Elderly Dental Assistance Programme (the Programme) of the Community Care Fund was expanded in July 2021 to cover more subsidised dental treatment items so that eligible elderly persons in need may receive more targeted dental services on the fitting of removable dentures and related dental care. New treatment items include the removal of bridges or crowns and the provision of root canal treatment, as well as free removable dentures and related dental services for a second time for elderly persons aged 75 or above who received dental services under the Programme at least five years ago.
As at the end of July 2021, a total of about 580 private dentists and nearly 70 dental clinics operated by non-government organisations (involving about 80 dentists) have joined the Programme, accounting for a quarter of all registered dentists in Hong Kong. On the basis of past implementation of the Programme, the projected number of applicants upon the launch of the expanded Programme in July 2021, as well as the number of new cases currently served by the Community Care Dentists / Dental Clinics in a month, it is estimated that the number of dentists participating in the Programme will meet the service demand of target beneficiaries.
In addition, the Government and the implementing agent will continue to assist to invite more dentists to participate in the Programme. Efforts in this area include releasing the latest information of the Programme through the HKDA newsletter, organising briefing sessions for interested dentists to explain the workflow and key points of the Programme, as well as meeting with the dental profession by actively engaging in the Hong Kong International Dental Expo and Symposium to further promote the Programme and introducing how the Programme can benefit the daily living of elderly persons. Besides, dentists already participating in the Programme will be encouraged to provide services for more eligible elderly persons.
(4) According to the Strategic Review of Healthcare Manpower Planning and Professional Development (Strategic Review) promulgated by the Food and Health Bureau in 2017, there will be a shortage of dentists in the medium to long-term. In the light of the outcome of the Strategic Review, the Government has increased the annual intake of University Grants Committee (UGC)-funded first-year-first-degree training places in dentistry from 73 to 80 in the triennium from 2019/20 to 2021/22. During the same period, the Government has also provided 20 UGC-funded taught postgraduate places in dentistry per year.
The Government conducts the manpower projection exercise once every three years to update the demand and supply projection of healthcare professions, including dentists and dental hygienists. The results of the Healthcare Manpower Projection 2020 show that there will be a shortage of dentists in the short and medium-term but it will be less significant towards the end of the projection horizon due to the measures implemented to increase the supply of dentists. As for dental hygienists, there will be an adequate supply. The Government will further consider the need to increase the number of relevant healthcare training places in the next triennium (i.e. from the 2022/23 to 2024/25 academic year) having regard to the results of the latest manpower projection.
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