Replies to LegCo questions
LCQ18: Psychiatric services of public hospitals
Following is a question by the Dr Hon Kwok Ka-ki and a written reply by the Secretary for Health, Welfare and Food, Dr York Chow, in the Legislative Council today (December 13):
Question:
According to the Hospital Authority (HA), the attendance at the departments of
psychiatry in public hospitals in Hong Kong is on the rise in recent years. Some
psychiatrists have relayed to me that the resources allocated to the psychiatric
services of public hospitals are far from adequate. Patients have to wait as
long as one year for their first appointments but each consultation lasts for
only a few minutes. The drug cost for each patient is only two dollars a day.
The resources allocated to child psychiatric service are also limited. In this
connection, will the Government inform this Council:
(a) whether it knows the amount of funding and other resources allocated by HA
to the department of psychiatry in each public hospital in each of the past
three years, with a detailed breakdown by expenditure items, including the
salaries of health care personnel and other staff, as well as expenses on drugs
and medical facilities, etc;
(b) whether it knows if HA has set any limit on the cost of psychiatric drugs to
be provided by each hospital; if it has, of the details of the limit;
(c) whether it knows the numbers of health care personnel required for various
specialties in the departments of psychiatry (including child and adolescent,
psychogeriatric, community and forensic psychiatric services) in public
hospitals as calculated on the basis of the needs of the current population, and
how these numbers compare to the current manpower of the existing health care
personnel in these specialties; and
(d) of the membership list, objectives and work progress of the working group on
mental health services established by the Health, Welfare and Food Bureau this
year, the date of announcing the work schedule, and whether the working group
will review the manpower of health care personnel in the departments of
psychiatry in public hospitals?
Reply:
Madam President,
(a) Breakdowns of the expenditure by various hospital clusters of the Hospital
Authority (HA) on psychiatric services for the past three years are set out in
the Table 1.
(b) It is the practice of the HA to prescribe psychiatric drugs for psychiatric
patients on the basis of their clinical needs to achieve therapeutic efficacy
and facilitate early recovery. The psychiatry departments in various hospital
clusters follow the prescription guidelines when prescribing drugs for patients,
and the cost of individual drug is not a major factor in clinical consideration.
As a matter of fact, the Administration has increased the HA's recurrent
subvention twice in recent years by a total amount of $95 million a year for the
provision of new generation psychiatric drugs for more patients.
(c) In planning for its psychiatric services and manpower needs, the HA would
take into account various factors including the service needs of the population,
demographic changes and past trends in service demand in each hospital cluster.
In fact, the HA has been increasing the manpower of its psychiatric staff in
recent years. The number of psychiatrists has grown from 212 in 2001-02 to 258
in 2005-06 and the number of psychiatric nurses from 1 797 to 1 944 over the
same period.
Since healthcare staff in psychiatry departments are required to take care of a
number of service areas including the provision of in-patient service,
specialist out-patient service and community outreach service for patients in
different age groups, the HA does not have a fixed staffing establishment for
each type of psychiatric service. Staff deployment within psychiatric
departments is reviewed and adjusted from time to time in accordance with
operational needs. The forensic psychiatric service is a special service unit.
It is mainly responsible for serving the Siu Lam Psychiatric Centre of the
Correctional Services Department as well as providing forensic psychiatric
service support for all hospital clusters under HA. The staffing establishment
of that unit is more stable and currently consists of 6 medical practitioners
and 73 nurses.
(d) The main objectives of the Working Group on Mental Health Services are to -
- review the current mental health services and explore possible scope for
improvement;
- propose and prioritise new initiatives on the development of community mental
health services; and
- review the existing inter-departmental communication and collaboration
mechanism.
The Working Group has already held one meeting since its establishment in late
August this year. Members are now developing a framework for the future work of
the Working Group and drawing up an agenda for discussion. The Working Group is
planning to meet again after the groundwork is completed.
The membership list of the Working Group is shown in Table 2. In future, the
Working Group will invite the participation of co-opted members from related
sectors as and when necessary.
Ends/Wednesday, December 13, 2006
Issued at HKT 14:35
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Attachment:
Table 1 & 2 to LCQ18