Following is a question by the Hon Yim Kong and a written reply by the Secretary for Health, Professor Lo Chung-mau, in the Legislative Council today (April 2):
Question:
The Government released the Primary Healthcare Blueprint (the Blueprint) on December 19, 2022 to formulate the direction of development and strategies for strengthening Hong Kong's primary healthcare system to address the challenges brought about by an ageing population and the increasing prevalence of chronic disease, with a view to improving the overall health of the public and enhancing their quality of life. Regarding the implementation situation of the Blueprint, will the Government inform this Council:
(1) of the current progress of the authorities in fully implementing the initiative to set up District Health Centres in the 18 districts across the territory;
(2) given that the Government plans to make use of the platform of the Electronic Health Record Sharing System (eHealth) to develop a personalised eHealth account for all members of the public in Hong Kong, whether the Government will introduce support services, such as setting up offline manned support windows, for some elderly people who are unable to use the eHealth mobile application, so as to effectively enabling every member of the public to receive appropriate healthcare services; and
(3) given that there are views that the various proposed initiatives put forward in the Blueprint, while aimed at benefiting members of the public, will also increase the demand for healthcare service providers in Hong Kong, and according to the Healthcare Manpower Projection 2023 published by the Health Bureau last year, there is a persistent manpower shortage of doctors in the long term in Hong Kong, with a projected shortfall of 1 570 and 1 200 doctors in 2030 and 2040 respectively, whether the Government has considered incorporating artificial intelligence technologies to alleviate the manpower shortage of healthcare service providers, so that the initiatives proposed in the Blueprint can be effectively implemented?
Reply:
President,
In the face of the pressure brought by an ageing population and the increasing prevalence of chronic diseases, the Government released the Primary Healthcare Blueprint in December 2022, setting out a series of reform initiatives to strengthen primary healthcare services in Hong Kong. The Government is progressively taking forward various recommendations of the Primary Healthcare Blueprint over the short, medium and long term, with the vision of improving the overall health status of the population, providing coherent and comprehensive healthcare services, and establishing a sustainable healthcare system.
In consultation with the Primary Healthcare Commission (PHC Commission) and the Hospital Authority (HA), the replies to the respective parts of the question raised by the Hon Yim Kong are as follows:
(1) The PHC Commission was established in July 2024 to oversee primary healthcare service delivery, standard setting and quality assurance under one roof. The PHC Commission is actively implementing policy initiatives to promote the development of primary healthcare in accordance with the Primary Healthcare Blueprint, including continuing to take forward the plan to set up District Health Centres (DHCs) in various districts of Hong Kong. As primary healthcare resource hubs, DHCs/DHC Expresses (DHCEs) provide comprehensive, coherent and people-oriented multidisciplinary primary healthcare services including chronic disease screening and management, family doctor pairing, health promotion, health risk factors assessment and community rehabilitation.
The Government set up 7 DHCs and 11 smaller interim DHCEs in rented properties across the city in 2022, thereby attaining the interim goal of covering all 18 districts of Hong Kong. The Government will upgrade the three DHCEs in the Central and Western District, Eastern District, and Yau Tsim Mong District to DHCs within 2025. In April 2024, the Health Bureau launched a tender exercise for the operation of the Central and Western DHC and three women's health service points named Women Wellness Satellites in Chai Wan, Lam Tin, and Tuen Mun. A three-year operation service contract was subsequently awarded in January 2025. The Central and Western DHC is expected to commence operation in the third quarter of this year. In July 2024, the Health Bureau conducted tender exercises for the operation of the Eastern and Yau Tsim Mong DHCs. The operation service contracts for these two DHCs are expected to be awarded this year.
In addition, the funding proposals for the construction projects of Wan Chai, Kwun Tong, Sai Kung, and North District DHCs were approved by the Finance Committee of the Legislative Council (LegCo) in January and October 2021, and in April and July 2024 respectively. These projects will be completed gradually in the next few years. To achieve the long-term development goal of having DHCs in all 18 districts as early as possible, the Government is actively taking forward the plan to establish DHCs in the remaining four districts and will seek LegCo's funding approval in due course. Before the remaining DHCs are set up, the Government will continue to subsidise non-governmental organisations to operate DHCEs in those districts. The services provided by DHCEs will be migrated as appropriate to DHCs in respective districts at a later stage. The PHC Commission will, together with various operators, draw up and implement transition plans for upgrading DHCEs to DHCs to ensure a smooth transition of services.
(2) The Government has all along been committed to promoting the digital transformation of the healthcare system, introducing innovative technologies to improve the efficiency and quality of healthcare services, and including smart healthcare as part of the Smart City Blueprint for Hong Kong. Moreover, as proposed in the Primary Healthcare Blueprint , the Government will make good use of the survey results and patient/user health records of the Department of Health (DH), the HA, eHealth and DHCs, with a view to facilitating the overall health surveillance including evidence-based primary healthcare policy formulation and service planning.
Under the development of eHealth+, eHealth will serve as the core platform in supporting primary healthcare development, and gradually integrate the primary healthcare services provided by the DH, the HA and the PHC Commission, especially the co-ordination of data sharing, care journey management, service delivery, and health surveillance.
The Government is building a one-stop Strategic Health Service Operation Platform (SHSOP) by phases to support and standardise the workflow and documentation, both clinically and administratively, of all Government-subsidised healthcare programmes and related public and private healthcare services. For example, at present, citizens participating in the Chronic Disease Co-Care Pilot Scheme can manage their family doctor pairing at DHCs and arrange allied health and laboratory services via eHealth. Citizens can also manage related services and records through the one-stop eHealth mobile application (eHealth App), including making service appointments at DHCs and accessing laboratory reports under the Scheme. In the future, the Government will gradually incorporate more primary healthcare services and schemes, including the Elderly Health Service, the Vaccination Subsidy Scheme, and the Elderly Health Care Voucher Scheme, into the SHSOP. The Government will also continue enhancing the functionality of the eHealth App to assist citizens to consolidate the longitudinal electronic health records of citizens spread across a multiple of healthcare processes into their personal eHealth accounts, so as to enable healthcare providers authorised by citizens to respond to their health needs more effectively, thus improving clinical outcomes and saving costs of the care process.
To address the problem of the digital divide among members of the public (particularly the elderly), the Government has been facilitating better understanding and use of eHealth through various consultation forums and online/offline channels (such as social media, production of promotional videos and leaflets, publicity campaigns, mobile registration teams, collaborations with community partners such as Care Teams and elderly centres, and hotline services). Besides, the Government has set up an eHealth App User Advisory Group comprising representatives from patient groups for the elderly. The Group meets regularly to offer advice on the development and design of the eHealth App functions, to ensure that relevant developments could cater for the diverse needs of users across all age groups.
(3) With the implementation of the Primary Healthcare Blueprint, the HA has been actively promoting the application of artificial intelligence (AI) technologies to enhance clinical quality in recent years. The HA has already implemented a number of AI projects. For example, AI technology has been introduced in 18 Accident and Emergency Departments by the HA to assist doctors in identifying abnormal chest X-rays rapidly, detecting hip fracture cases, and analysing brain computed tomography scans, with a view to accelerating the processing of high-risk cases. Additionally, the HA has developed an AI system on medication safety, which can automatically flag hepatitis B virus-positive cases, supporting healthcare professionals in managing medical conditions more accurately. The HA is also actively developing AI solutions to assist patients and doctors in managing chronic diseases, including assessing diabetic macular disease and diabetic retinopathy, combining clinical data to predict the risk of deterioration of a patient's condition, and assisting healthcare professionals to monitor the progress of patients' joint movement rehabilitation through "HA Go". The Hospital Command Centre also leverages AI technology to predict resource needs, assist in bed allocation, and arrange non-emergency ambulance transportation services, with a view to improving resource allocation and enhance operational efficiency.
Furthermore, the HA is actively exploring the application of generative AI technologies to enhance work efficiency. Since March this year, a system that assists doctors in drafting medical reports has been piloted in six public hospitals which helps to reduce the paperwork burden on doctors. The HA is also actively exploring other applications, such as digitising paper-based medical reports and developing an internal large language model platform for staff. This platform can assist staff to refine documents, draft emails, and search records, further improving administrative efficiency.
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