LCQ12: General out-patient services provided by the Hospital Authority

     Following is a question by Dr the Hon Priscilla Leung and a written reply by the Secretary for Food and Health, Professor Sophia Chan, in the Legislative Council today (January 27):
 
Question:
 
     Currently, three District Council Districts, namely Sham Shui Po, Yau Tsim Mong and Kowloon City, have a total population of about 1.16 million. However, among the general out-patient (GOP) clinics provided by the Hospital Authority (HA) in these districts, only one (i.e. the Yau Ma Tei Jockey Club General Out-patient Clinic (Yau Ma Tei Clinic)) provides GOP services in the evening and on Sundays and public holidays (non-office hours). As such, those residents of these districts who need to seek consultation during non-office hours but are unable to secure an appointment under the quotas of Yau Ma Tei Clinic have to seek consultation at GOP clinics in other districts, accident and emergency departments of public hospitals or private clinics. The situation has shown no improvement since I raised a relevant question in 2016. In this connection, will the Government inform this Council:
 
(1) whether it knows the respective annual attendances of Yau Ma Tei Clinic from 2016 to 2020 (i) during the daytime from Mondays to Saturdays and (ii) during non-office hours; whether the HA has assessed if the consultation services currently provided by the Clinic during non-office hours can meet the demand;
 
(2) whether it will revise the Hong Kong Planning Standards and Guidelines to stipulate in detail that the following planning standard applies to all hours of the day: one general clinic/health centre to be provided for every 100 000 persons;
 
(3) whether it knows if the HA will consider afresh making arrangements to enable the GOP clinics in Sham Shui Po and Kowloon City districts to provide GOP services during non-office hours; and
 
(4) of the progress made by the authorities in the development of the following three primary care facilities: the construction of a community health centre (CHC) complex at the original site of the Shek Kip Mei Health Centre, the provision of a GOP clinic in the Treasury Building in Cheung Sha Wan, and the provision of a CHC at the ex-Mongkok Market site; as the Government indicated in February 2016 that the HA would consider at a later stage whether to provide non-office hours GOP services in the three facilities upon commissioning, of the outcome of the HA's consideration?
 
Reply:
 
President,
 
     In consultation with the Hospital Authority (HA), the Government provides a consolidated reply to the various parts of the question raised by the Dr the Hon Priscilla Leung as follows:
      
     The service of the HA's General Out-patient Clinics (GOPCs) is primarily used by the elders, low-income individuals and patients with chronic diseases. Patients under the care of GOPCs comprise two major categories: chronic disease patients with stable medical conditions, and episodic disease patients with relatively mild symptoms. As GOPCs are not intended for the provision of emergency services, patients with severe and acute symptoms should attend the accident and emergency departments where necessary manpower, equipment and ancillary facilities are in place to provide comprehensive and appropriate treatment and support.
      
     Currently, there are three GOPCs in Yau Tsim Mong District under the HA, namely Kwong Wah Hospital General Out-patient Department, Li Po Chun GOPC and Yau Ma Tei Jockey Club GOPC. Evening clinic services are provided in all three clinics, whereas Sunday and public holiday clinic services are provided in Yau Ma Tei Jockey Club GOPC. As for Sham Shui Po District, there are five GOPCs, namely Caritas Medical Centre Family Medicine Clinic, Cheung Sha Wan Jockey Club GOPC, Nam Shan GOPC, Shek Kip Mei GOPC, and West Kowloon GOPC, among which evening clinic services are provided in Cheung Sha Wan Jockey Club GOPC. In Kowloon City District, there are four GOPCs, namely Central Kowloon Health Centre, Hung Hom Clinic, Shun Tak Fraternal Association Leung Kau Kui Clinic and Lee Kee Memorial Dispensary. Evening clinic services are provided in Central Kowloon Health Centre.
      
     In regard to the consultation quotas, the numbers may vary among clinics depending on the geographical location and the scale of the clinic. While the service volume of the various clinics is relatively stable, the daily service volume of individual clinics may be slightly adjusted with regard to manpower and operational reasons. Since 2016, the HA had been uploading the average numbers of consultation quotas of individual GOPCs for the preceding four weeks by district on its GOPC webpage (www.ha.org.hk/gopc), so that members of the public can obtain an overview of the number of consultation quotas and the general service capacity of individual clinics. According to records, the daily average numbers of consultation quotas of the three GOPCs in Yau Tim Mong District, including Kwong Wah Hospital General Out-patient Department, Li Po Chun GOPC and Yau Ma Tei Jockey Club GOPC, for the preceding four weeks (i.e. December 27, 2020 to January 23, 2021) are as follows. Consultation quotas of the clinics have been fully utilised all along.
 

 
     Generally speaking, the smooth operation of a clinic relies on the teamwork of a team, which comprises doctors, nurses, pharmacists, dispensers, patient services assistants, clerical staff, supporting staff and may as well involve allied health professionals while the number of staff may be adjusted according to the service volume. To ensure the effective use of the resources of GOPCs, it is considered that clinics in the same district would be complimentary to each other for better synergy effects. It is therefore considered more cost-effective to focus on increasing the quotas for consultation in evenings/on Sundays and public holidays in the clinics which are currently providing relevant services.
      
     Recognising the enormous demand for public primary healthcare services in the community, the HA endeavors to enhance the services and has reserved sites in different districts for the long term development of primary healthcare.
      
     For Sham Shui Po District, taking the opportunity of the Shek Kip Mei Estate Phase 6 Redevelopment project, the HA plans to redevelop the Shek Kip Mei Health Centre and reprovision the dilapidated Shek Kip Mei GOPC in-situ by developing a new Community Health Centre (CHC) building. The CHC will consolidate the public primary healthcare services and facilities in the district in order to provide one-stop and diversified primary healthcare service to the public. As the CHC project is still at a preliminary planning stage, the HA will take into account various factors to plan the services of the CHC before its service commissioning. In addition, the HA will provide a GOPC in the Treasury Building under construction at the junction of Tung Chau Street and Tonkin Street West in Cheung Sha Wan. The new GOPC would further enhance the synergy effect brought by the service co-ordination of various GOPCs in Sham Shui Po District, thereby enhancing the service standard of the primary healthcare facilities there. The construction works of the Treasury Building is expected to complete in the second quarter of 2022. The HA will prepare for the service commissioning of the GOPC in accordance with the project timeline of other relevant government departments.
      
     As for Yau Tsim Mong District, since the Development Bureau (DEVB) has decided not to include the ex-Mong Kok Market site in the Land Sale Programme at the moment, while the Food and Health Bureau (FHB) is keen to set up District Health Centre (DHCs) in all districts early to enhance district-based primary healthcare services, upon studies by the FHB, the DEVB and the Urban Renewal Authority (URA), the URA would transform the interior of the ex-Mong Kok Market building through renovation works for the provision of Yau Tsim Mong DHC. The FHB consulted Yau Tsim Mong District Council on the relevant plan on September 3, 2020. Therefore, the plan to develop a CHC in the ex-Mong Kok Market Site has been replaced. The HA would identify another suitable site for the provision of the CHC.
      
     In planning for the provision of public primary healthcare services, the Government takes into account a number of factors, including primary healthcare service delivery model, demographic changes, distribution of the target groups, the provision of primary healthcare services in the district, and the demand for public primary healthcare services, etc. The Government will assess whether there is any need to review the relevant planning standard at appropriate times in view of the society development and the actual needs among districts. The HA will continue to pay close attention to the demand for public primary healthcare services within the district and tie in with the overall policy development of the Government, and explore various feasible options to ensure that primary health care services could be appropriately provided to our major service users under limited resources.