LCQ14: Services of accident and emergency departments of public hospitals

     Following is a question by the Hon Michael Tien and a written reply by the Secretary for Health, Professor Lo Chung-mau, in the Legislative Council today (October 18):
 
Question:
 
     The extension of the accident and emergency department (AED) of Tuen Mun Hospital officially commenced service in June this year. However, the current waiting time at that AED is frequently criticised by residents in the district as overly long. Regarding the services of the AEDs of public hospitals, will the Government inform this Council if it knows:
 
(1) the respective attendances and staffing establishments of the AEDs of the 18 public hospitals under the Hospital Authority (HA) in the past three years (set out in a table);
 
(2) the projected and actual population served by the AED of Tuen Mun Hospital;
 
(3) the respective average waiting times for non-urgent patients at the AED of Tuen Mun Hospital in the three years preceding its expansion and since its expansion;
 
(4) the respective average waiting times at the AEDs of Pok Oi Hospital and Tin Shui Wai Hospital under the New Territories West Cluster in the past three years; and
 
(5) whether HA has studied how to shorten the waiting time at the AED of Tuen Mun Hospital?
 
Reply:
 
President,
 
     In consultation with the Hospital Authority (HA), the reply to the various parts of the question raised by the Hon Michael Tien is as follows:
 
     At present, there are 18 public hospitals under the HA providing Accident and Emergency (A&E) services for the critically ill or seriously injured people and victims of disasters. To ensure that citizens with urgent needs can receive timely services, A&E departments implement a patient triage system under which patients are classified into five categories, namely Critical, Emergency, Urgent, Semi-urgent and Non-urgent based on their clinical conditions, and will receive treatment as prioritised by their urgency category. The HA's service target specifies that Critical patients will receive immediate treatment, and most Emergency (95 per cent) and Urgent (90 per cent) patients will be treated within 15 or 30 minutes respectively.
 
     Tables 1 and 2 below show the number of A&E attendances and manpower deployment of A&E departments in the 18 public hospitals under the HA over the past three years (Note):
 
Table 1: Number of A&E attendances from 2020-21 to 2022-23
 

Cluster Hospital 2020-21 2021-22 2022-23
Hong Kong East Pamela Youde Nethersole Eastern Hospital 96 651 104 604 102 608
Ruttonjee Hospital 51 825 60 506 56 652
St. John Hospital 6 591 7 354 7 299
Hong Kong West Queen Mary Hospital 98 145 107 820 100 469
Kowloon Central Kwong Wah Hospital 93 032 101 485 102 823
Queen Elizabeth Hospital 145 318 166 131 155 064
Kowloon East Tseung Kwan O Hospital 93 262 103 913 99 970
United Christian Hospital 124 778 140 273 132 023
Kowloon West Caritas Medical Centre 98 338 108 148 96 465
North Lantau Hospital 63 007 79 889 71 653
Princess Margaret Hospital 92 055 109 389 100 105
Yan Chai Hospital 100 572 112 240 97 029
New Territories East Alice Ho Miu Ling Nethersole Hospital 76 884 86 503 81 241
North District Hospital 71 733 76 342 78 810
Prince of Wales Hospital 121 640 143 163 141 250
New Territories West Pok Oi Hospital 76 996 82 447 82 498
Tuen Mun Hospital 126 828 142 785 141 892
Tin Shui Wai Hospital 102 798 107 037 93 240
Total 1 640 453 1 840 029 1 741 091

 
Table 2: Number of A&E doctors calculated on full-time equivalent basis from 2020-21 to 2022-23
 

Cluster Hospital 2020-21 2021-22 2022-23
Hong Kong East Pamela Youde Nethersole Eastern Hospital 38 35 33
Ruttonjee Hospital 19 19 17
St. John Hospital 6 5 5
Hong Kong West Queen Mary Hospital 32 30 26
Kowloon Central Kwong Wah Hospital 30 31 33
Queen Elizabeth Hospital 48 53 52
Kowloon East Tseung Kwan O Hospital 26 28 28
United Christian Hospital 47 47 44
Kowloon West Caritas Medical Centre 29 27 31
North Lantau Hospital 31 28 27
Princess Margaret Hospital 34 33 36
Yan Chai Hospital 34 33 30
New Territories East Alice Ho Miu Ling Nethersole Hospital 23 23 23
North District Hospital 21 21 22
Prince of Wales Hospital 33 39 38
New Territories West Pok Oi Hospital 24 22 23
Tuen Mun Hospital 43 43 47
Tin Shui Wai Hospital 26 25 25
Total* 545 543 540

 
* Figures are rounded to the nearest whole number and may not add up to the total due to rounding
           
     At present, the HA provides services according to clusters, among which the New Territories West Cluster (NTWC) provides public hospital services for residents of Tuen Mun and Yuen Long. According to the latest population estimates by the Census and Statistics Department and the Planning Department, the mid-year population of the Tuen Mun and Yuen Long districts in 2022 was 1 167 000.
 
     Hospitals under the NTWC include Tuen Mun Hospital (TMH), Pok Oi Hospital (POH), Castle Peak Hospital, Siu Lam Hospital and Tin Shui Wai Hospital (TSWH), among which TMH, POH and TSWH provide A&E services for residents. 
 
     Tables 3 to 5 below show the average waiting time of A&E services for each triage category of the NTWC over the past three years (Note).  When comparing the throughput of services provided by the HA across the years, it should be noted that in view of the COVID-19 epidemic situation, the HA adjusted its services in response to the epidemic since early 2020:

Table 3: Average waiting time of A&E services for each triage category of the NTWC in 2020-21 (minutes)
 

Hospital Priority 1
(Critical)
Priority 2
(Emergency)
Priority 3
(Urgent)
Priority 4
(Semi-urgent)
Priority 5
(Non-urgent)
POH 0 6 19 125 161
TMH 0 6 24 150 156
TSWH 0 4 13 83 104

 
Table 4: Average waiting time of A&E services for each triage category of the NTWC in 2021-22 (minutes)
 

Hospital Priority 1
(Critical)
Priority 2
(Emergency)
Priority 3
(Urgent)
Priority 4
(Semi-urgent)
Priority 5
(Non-urgent)
POH 0 7 20 156 191
TMH 0 7 27 151 154
TSWH 0 5 14 132 165

 
Table 5: Average waiting time of A&E services for each triage category of the NTWC in 2022-23 (minutes)
 

Hospital Priority 1
(Critical)
Priority 2
(Emergency)
Priority 3
(Urgent)
Priority 4
(Semi-urgent)
Priority 5
(Non-urgent)
POH 0 6 19 118 156
TMH 0 7 26 135 136
TSWH 0 6 15 136 168

 
     Overall, the average waiting time for Critical, Emergency, Urgent patients in each acute hospital of the NTWC meets the service targets specified by the HA.
 
     To further improve the service quality and waiting time of A&E services, the HA has actively implemented a series of measures including:
 
(1) Strengthening manpower for doctors, nurses, allied health professionals and supporting staff, and continuously implementing measures including the Special Honorarium Scheme, leave encashment, etc. to enhance manpower of A&E departments so as to increase service capacity; 

(2) Enhancing support to A&E departments from geriatric departments and setting up observation areas in A&E departments to reduce unnecessary hospital admissions; and 

(3) Centrally publishing the waiting time of A&E departments of public hospitals through multiple platforms, including the HA website, "HA Go" mobile application and A&E registration counters, to strengthen communication with the public and manage public expectations about the waiting time of A&E departments, such that patients with mild illnesses can obtain information on the overall service situation of A&E departments before setting off to A&E departments or registering and hence decide whether to seek medical treatment in A&E departments. 

     The HA will continue to keep a close watch on the needs of Tuen Mun and Yuen Long residents for public healthcare services, and regularly look into the complementation of healthcare resources and manpower with a view to developing various services as necessary. Meanwhile, the Government will continue to encourage citizens to make more use of primary healthcare and family doctor services in the community with a view to relieving the pressure on public A&E services effectively, such that A&E departments can better focus on management of critical cases and emergency service while serving as a safety net for all.
 
Note: This refers to the financial year, i.e. from April 1 to March 31 of the following year.