LCQ5: Procuring dental services from the Mainland
Following is a question by the Hon Paul Tse and a reply by the Secretary for Health, Professor Lo Chung-mau, in the Legislative Council today (June 26):
Question:
Many members of the public who are not civil servants have relayed that in recent years, there has been a shortage of dental manpower and that the fees for dental consultations and surgeries have risen sharply, which are unaffordable for both the grass roots and the middle class. There are views that the Government should study the implementation of a scheme, which is similar to the one proposing to procure dental services from the Mainland for civil servants, to procure dental services from the Mainland or provide subsidies for members of the public who are not civil servants, so as to alleviate the plight of members of the public with dental problems through a two-pronged approach. In this connection, will the Government inform this Council:
(1) as there are views pointing out that dental services affordable for members of the public are limited and that the main service targets of government dental clinics are civil servants, why the Government procures dental services from the Mainland only for civil servants and not for the general public at the same time;
(2) of the estimated expenditure, service quotas, scope of treatment and implementation timetable of the scheme under consideration to procure dental services from the Mainland for civil servants; whether it has assessed the manpower in government dental clinics that can be released to serve members of the public who are not civil servants upon the implementation of the scheme, as well as the estimated number of beneficiaries; and
(3) as some members of the public opine that the Government's procurement of dental services from the Mainland for members of the public will yield more immediate results and serve the public in a more practical way than spending hundreds of millions of dollars on organising the courtesy campaign, Chubby Hearts Hong Kong and the "teamLab: Continuous" exhibition, the actual economic benefits of which are doubtful and they are even expendable, whether the Government will, from the perspective of addressing the pressing needs of the public, at least procure dental services for members of the public of Hong Kong from the Mainland cities of the Guangdong-Hong Kong-Macao Greater Bay Area while studying the procurement of dental services from the Mainland for civil servants, so as to give members of the public an additional option?
Reply:
President,
I would like to express my gratitude to the Hon Paul Tse for his concern about government dental services. The Government attaches great importance to citizens' oral health. Our prevention-oriented dental care policy aims to raise public awareness of oral hygiene and health through publicity and education, and to encourage the public to develop good oral hygiene habits. In fact, the need for dental treatment or surgery due to tooth decay and gum diseases can be greatly reduced if good oral hygiene habits are maintained. Agreeing to the recommendations made by the Working Group on Oral Health and Dental Care (the Working Group) established earlier by the Health Bureau, the Government should attach more importance to prevention, early identification and timely intervention in the future development of dental services, with a view to achieving the goal of retention of natural teeth and enhancing the overall level of citizens' oral health. When considering the provision of government-funded curative dental services, long-term financial sustainability must be taken into account. It will be more cost-effective to put the emphasis on preventive primary dental services.
In consultation with the Civil Service Bureau (CSB), the consolidated reply to the question raised by the Hon Paul Tse is as follows:
At present, the Government mainly undertakes publicity, education and promotion of oral health, with particular emphasis on nurturing good oral hygiene habits among children from an early age, including the provision of the School Dental Care Service for children. Dental services provided or subsidised by the Government mainly cater for persons with special needs in dental care, especially (i) persons with financial difficulties and (ii) persons with difficulties in accessing general dental services, such as elderly persons in residential care homes and persons with intellectual disabilities. Besides, elderly persons can also receive dental services in the private sector under the Government's Elderly Health Care Voucher Scheme.
The Government's expenditure on public or subsidised dental services has been on the rise in the past years. The total expenditure increased from $886.4 million in 2020-21 to approximately $1.2753 billion in 2023-24, representing an increase of about 44 per cent over three years. In the future, the Government will promote primary dental services to assist citizens in managing their own oral health and prevent oral diseases, while providing targeted services for underprivileged groups and persons with special needs by developing appropriate dental services for these groups.
On the other hand, it is stipulated in the terms of employment for civil servants that the Government will provide dental care services for civil servants and their eligible dependants. We must emphasise that this is a benefit of employees. The relevant services have been provided by government dental clinics under the Department of Health, and the expenditure is met by the resources earmarked for civil service medical and dental benefits. Such services do not form part of the public dental services provided to the general public.
To alleviate the excessively long wait of civil service eligible persons (CSEPs) for dental services amidst the increasing demand for civil service dental services and manpower shortage of government dental clinics, the CSB launched the Pilot Scheme on Dental Services (Dental Scaling) for Civil Service Eligible Persons (Pilot Scheme) last year by using the existing resources for civil service medical and dental benefits. Under the Pilot Scheme, CSEPs can receive dental scaling services at participating private dental clinics. The CSB is also looking into the feasibility of other proposals, including the provision of dental services to CSEPs in the Guangdong-Hong Kong-Macao Greater Bay Area. As the CSB is still considering the related proposals and has not yet come up with any specific plans, no further information is available at the present stage. Like the Pilot Scheme, any civil service dental services that may be implemented in the future will be funded by the resources earmarked for civil service medical and dental benefits, instead of the resources for public dental services.
As for the proposal on the procurement of healthcare services from the Mainland, the Hong Kong Special Administrative Region (HKSAR) Government will not arbitrarily shift its responsibility of taking care of the well-being of Hong Kong citizens to the Mainland healthcare system as it all along holds fast to shouldering the important role of safeguarding the well-being of Hong Kong citizens and providing quality healthcare services. When formulating cross-boundary healthcare measures, apart from supporting the healthcare needs of Hong Kong citizens who choose to reside in the Mainland or use the services there, the HKSAR Government will also take into account the potential impact of such measures on the social resources and livelihood of the citizens in the Mainland. At the same time, due consideration has to be given to the actual situation of each of these services. Taking dental services as an example, on the provision of emergency dental services or ongoing dental treatments for underprivileged groups and persons with special needs, we have to consider carefully whether procuring such dental services from the Mainland is suitable.
In fact, in light of the preliminary recommendations of the Working Group, the Chief Executive announced in the Policy Address 2023 a series of measures to strengthen dental services, including (i) enhancement of Community Care Fund Elderly Dental Assistance Programme services from July 2 to not only benefit elderly persons who have removable dentures fitting but also enable them to receive services such as dental scaling and polishing, fillings, tooth extractions and root canal treatment; (ii) strengthening of the Healthy Teeth Collaboration which will be extended with quotas to be expanded; (iii) the launch of the Primary Dental Co-care Pilot Scheme for Adolescents for those aged between 13 and 17, and collaboration with non-governmental organisations to increase emergency dental services targeting underprivileged groups with financial difficulties by providing an additional capacity that will be at least twice the current capacity of General Public Sessions offered by government dental clinics. The Working Group will issue the Final Report before the end of its tenure by late 2024. By then, the Government will consider the various policy directions for developing dental services.