LCQ18: Public healthcare services and manpower

     Following is a question by the Hon Wu Chi-wai and a written reply by the Secretary for Food and Health, Professor Sophia Chan, in the Legislative Council today (November 28):

Question:

     Regarding public healthcare services and manpower, will the Government inform this Council:

(1) of the overall per capita cost of the dental services provided by the Department of Health (DH) in each of the years from 2015 to 2017 and the per capita costs of the following two items among such services: (i) dental services at General Public Sessions (i.e. pain relief and teeth extraction), and (ii) oral check-ups and scaling and polishing services provided to civil servants, their dependants and civil servant pensioners;

(2) of the respective attendances, as at October 31, 2018, for the optometric/ocular examination service and dental care service launched under the Signature Project Scheme by the Kwai Tsing District Council;

(3) as DH has advised that ordinary people should receive oral check-up by a dentist at least once a year and that preventing dental diseases is more cost-effective than curing them, but preventive dental services (e.g. oral check-ups and scaling and polishing) are not provided for the public at government dental clinics, whether the Government will consider offering "dental care vouchers" to members of the public or, with reference to the Colorectal Cancer Screening Programme, subsidising members of the public to receive preventive dental services from the private sector, with a view to improving the oral health of the public; if so, of the details; if not, the reasons for that;

(4) of the respective numbers of registered dentists employed by DH, the Hospital Authority (HA) and Prince Philip Dental Hospital as at October 31 this year; among them, the respective numbers of those who are dentist graduates of last year and this year;

(5) of the number of registered dentists in private practice as at October 31 this year;

(6) of the respective numbers of dentists expected to be employed by DH and HA to fill the manpower gap in each of the next three years;

(7) given that since the cataract centres providing day surgery service at Grantham Hospital and Tseung Kwan O Hospital came into operation, the waiting time for cataract surgeries in the Hong Kong West and Kowloon East Clusters has been shortened drastically, whether the Government will request HA to consider setting up similar surgery centres in other hospital clusters; if so, of the details; if not, the reasons for that; and

(8) given that with an ageing population, the number of hip fracture cases has increased in recent years, whether the Government will request HA to not only perform operations on elderly persons suffering a hip fracture at acute general hospitals but also provide such service at HA's community hospitals, so as to reduce the mortality rate of those elderly persons; if so, of the details; if not, the reasons for that?

Reply:

President,

(1) The Department of Health (DH) provides free emergency dental treatments (generally referred to as General Public Sessions) for about 40 000 persons per year through its 11 government dental clinics. Regarding dental services for civil servants and eligible persons, the number of civil servants and eligible persons receiving such services was over 70 000 per year. Civil servants and eligible persons are entitled to dental treatment services free of charge, save for the charges applicable to dentures and dental appliances as provided for in the Civil Service Regulations. The DH does not have information on the costs of the above services.

(2) As at October 31, 2018, the Signature Project Scheme launched by the Kwai Tsing District Council recorded 10 589 service visits for the optometric/ocular examination service and 14 409 service visits for the dental care service.

(3) The Government's policy on dental services aims to raise public awareness of oral health and encourage people to develop proper oral health habits through publicity and education.

     Providing comprehensive dental services for the public requires substantial financial resources. Besides publicity, education (including the School Dental Care Service) and promotion on oral health, Government's resources are prioritised for persons with urgent dental care needs, in particular the elderly with financial difficulties. The Government has implemented a series of initiatives in recent years to provide dental care support for persons with special dental treatment needs. Among them, the Government has provided dental care support to low-income elderly persons with special needs. These initiatives include the Outreach Dental Care Programme for the Elderly and the Community Care Fund Elderly Dental Assistance Programme. Besides, the Elderly Health Care Voucher Scheme also allows elderly persons using the Voucher to receive private dental services.

     At present, the Elderly Health Care Voucher Scheme subsidises eligible elderly persons aged 65 or above to use various private primary care services, including dental services, by offering an annual voucher amount of $2,000 to each eligible elderly person. To provide them with greater flexibility, the accumulation limit of such vouchers was raised to $5,000 in June this year. As at the end of October this year, around 1 030 dentists have registered to join the Scheme, where they would accept vouchers from eligible elderly persons at around 1 890 practice locations in the 18 districts of Hong Kong.

     To give support to persons with financial difficulties, the Comprehensive Social Security Assistance (CSSA) Scheme provides a dental grant for its recipients who are aged 60 or above, disabled or medically certified to be in ill-health to cover their actual expenses on dental treatment. Eligible CSSA recipients may approach the 67 dental clinics designated by the Social Welfare Department (SWD) for dental examination and cost estimation for the dental services they need, after which they may choose to receive the relevant dental treatments from SWD's designated dental clinics or any registered dentists from dental clinics not designated by the SWD.

(4) As at October 31, 2018, a total of 343 registered dentists were employed by the DH. Among them, 18 and 17 are 2017 and 2018 dental graduates respectively.

     In addition, the Hospital Authority (HA) currently provides specialist dental services in four public hospitals, namely Alice Ho Miu Ling Nethersole Hospital, the Caritas Medical Centre, Kwong Wah Hospital and United Christian Hospital, where referred in-patients, patients with special oral healthcare needs and patients with emergency dental needs may receive oral maxillofacial surgery and specialist dental treatments by dentists employed by the HA. As at September 30, 2018, a total of 8.11 dentists (Note) were employed by the HA.

Note: The manpower figure is calculated on a full-time equivalent basis including permanent, contract and temporary staff in the HA.

(5) According to the records of the Dental Council of Hong Kong, as at October 31 this year, the total number of dentists on the Register of Dentists of Hong Kong was 2 553. The Council does not have records of registered dentists in Hong Kong by type of practice.

(6) The number of Dental Officers to be employed is affected by many factors such as staff wastage, the number of applicants for the posts and the progress of preparatory work for new dental clinics. It is therefore difficult for the DH to make an estimate of the number Dental Officers to be recruited in the coming three years. The DH will continue to step up recruitment efforts for Dental Officers, including engaging full-time or part-time contract dentists, to fill the vacancies.

     The HA will also regularly review the dental service and manpower situation, and make appropriate arrangement on manpower planning taking into consideration service needs and development, staff wastage and manpower supply.

(7) Apart from monitoring the waiting time for cataract surgeries for patients in various clusters, in order to increase the transparency of hospital services, the HA also publishes the anticipated waiting time for cataract patients in various clusters in a timely manner. To cater for the needs of various kinds of ophthalmic patients and for the principle of fairness, ophthalmic units in various hospitals also allocate resources to provide ophthalmic services other than those for treating cataracts. The Government currently has no plans to set up cataract centres providing day surgery service in other clusters similar to those in the Hong Kong West and Kowloon East clusters.

(8) Regarding hip fracture surgeries for the elderly, the HA will, according to the needs of patients in various districts, seek resources from the Government through its annual plan to increase the number of sessions of day surgery operating theatres for handling hip fracture cases, so as to gradually enhance day surgery services for such cases in hospitals with comprehensive multi-disciplinary team services, where accident and emergency department, orthopaedic, anaesthesiology and operating theatre services are available, with the aim to reduce the mortality rate of the elderly.