Replies to LegCo questions
LCQ18: Charging policy for treating sexually transmitted diseases
Following is a question by the Hon Emily Lau and a written reply by the
Secretary for Health, Welfare and Food, Dr Yeoh Eng-kiong, in the Legislative
Council today (February 18):
Question :
The policy of charging non-eligible persons for receiving medical attention and
treatment for sexually transmitted diseases (STD) at clinics under the
Department of Health has been implemented since April 1, 2003. For example,
these persons are charged $700 and $1,910 per attendance at Social Hygiene
clinics and Human Immuno-deficiency Virus (HIV) clinics respectively. As many
sex workers are not Hong Kong residents and hence are non-eligible persons(NEPs),
there are criticisms that the policy discourages these people from seeking
medical attention and treatment at such clinics. It has also been reported that
there is a 30 per cent drop in the number of samples obtained at clinics for HIV
testing from April to September 2003, as compared to that for the same period in
2002. In this connection, will the Executive Authorities inform this Council
whether:
(a) they had assessed the public health implications of the fee-charging policy
before its implementation; if so, the justifications for its implementation;
(b) there has been a drop in attendance rates at clinics by non-eligible persons
for treating STD;
(c) they are aware of the concern of sex workers with regard to the fee-charging
policy; if so, the measures in place to address their concern;
(d) they will re-assess the public health implications of the fee-charging
policy; and
(e) they will lower the charges for NEPs' attendance at clinics for STD; if so,
by how much; if not, the reasons for that?
Reply:
Madam President,
The Report of the Task Force on Population Policy (the Report) was released in
2002. The Report recommended, among other things, that the principle of
"seven-year" residence requirement for providing public healthcare services
heavily subsidised by public funds should be adopted. In relation to the
relevant recommendations of the Report, the Department of Health (DH) has
reviewed the fees and charges of its services, taking into account the potential
public health implications which might be brought about by any fee and charge
adjustments. Specifically, DH has carefully considered the nature of different
diseases and the overall service provision in Hong Kong such as existing
services provided in public sector, alternative providers in the private sector
and utilisation patterns of individual services, and came to a conclusion that
the fees for selected DH's services chargeable to NEPs should be adjusted from
the fiscal year 2003/04 onwards.
Currently, most of the STD medical consultation, diagnostic investigation and
treatment services are provided at affordable prices by the private sector, and
are very accessible to members of the public. DH's Social Hygiene Clinics (SHCs),
on the other hand, are responsible for a small share of STD management.
Essentially, DH is the major provider of health education and contact tracing
targeted at STD prevention and control.
There was a drop in NEPs' attendance at SHCs during the period of April to
December 2003 when compared to the corresponding period in 2002. The drop could
be attributed partly to the SARS (Severe Acute Respiratory Syndrome) outbreak
last year which might have an impact on people's consultation behaviour and
pattern, and partly to shifting of demand for services to the private sector. In
collaboration with the private sector and the relevant non-governmental
organisations (NGOs), including those targeting at sex workers, the
Administration will continue to monitor closely the situation, with a view to
ascertaining how SHCs can best serve the healthcare needs of the public, and as
necessary, determining whether there is a need to revisit the fee levels in the
context of public health priorities.
Free HIV screening and counselling service is provided at DH's Integrated
Treatment Centre at Kowloon Bay and its SHCs for any person who is in need of
the service, including NEPs.
Advocacy for health education on safer sex and early treatment are useful means
to promote sexual health of commercial sex workers. In this connection, DH has
been enhancing efforts in getting general practitioners more geared-up for the
provision of STD diagnostic and treatment services. Pamphlets on standard
professional management of STD cases in general have been issued to all
registered doctors. Talks and seminars conducted in collaboration with
professional bodies as well as continuous medical education activities on STD
are organised for all doctors on a regular basis. Thematic symposium on STD is
also organised on an annual basis.
In respect of public education, DH has been putting in a large amount of efforts
on the subjects of safer sex as well as prevention of AIDS and other STDs, in
collaboration with partners in the community. Sexual health information is
disseminated through various means, such as websites, (e.g. SexEdonline (http://www.sexedonline.tv)
and Healthzone (http://www.cheu.gov.hk)), announcements in the public interests,
roving exhibitions, leaflets, health talks and seminars etc.
The Government also set up the AIDS Trust Fund in April 1993. One of its
objectives is to strengthen publicity and public education work on the
prevention of AIDS, for which sex workers are one of the priority target groups.
So far the Trust Fund has granted over $73 million to NGOs for the organisation
of publicity and public education projects as well as activities to disseminate
information on safe sex and AIDS prevention.
Ends/Wednesday, February 18, 2004
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