Press Releases

SFH on obstetric services and scarlet fever

Following is the transcript of remarks (English portion) made by the Secretary for Food and Health, Dr York Chow, at a media stand-up session at the lobby, West Wing, Central Government Offices, today (June 24):

Secretary for Food and Health: In the past two months, we have thoroughly discussed with the Hospital Authority (HA), the private hospitals, the obstetric professional group and the paediatric professional group in order to address the problems arising from the influx of non-local pregnant women in recent years.

All of the parties concerned have taken a positive response and agreed that there is a need to cap the number of non-local pregnant women giving birth in Hong Kong starting from 2012 in order to maintain the professional standards of our obstetric services as well as to ensure the sustainable development of our obstetric and paediatric services.

We have decided that in 2012, HA will reserve sufficient places in public hospitals for local pregnant women. HA will only accept bookings from non-local women when spare service capacity is available. It is estimated that some 3,400 booking places from public hospitals could be allocated to non-local women in 2012. HA will stop accepting bookings once this service capacity is full.

At the same time, the 10 private hospitals offering obstetric services also agreed to reduce bookings from non-local pregnant women based on their individual circumstances. The level of reduction varied among different hospitals. The number set for deliveries by non-local pregnant women in private hospitals in 2012 will be around 31,000; the figure is similar to that of 2010 but indicates a decrease of about 7 per cent as compared with the bookings of this year, that is 33,000.

The Government will determine the number of deliveries in 2013 after discussion with the Hospital Authority and the 10 private hospitals in the first quarter of 2012.

The Department of Health will provide two types of "Certificate on confirmed antenatal and delivery booking" to public and private hospitals respectively. The certificates, which carry personal information of the pregnant women, names and contacts of the obstetricians as well as antenatal check-up recorded dates and issued by the hospitals concerned, will serve as booking confirmation and proof of entry for non-local pregnant women. They are required to present the certificates at the immigration control points when entering Hong Kong.

This arrangement will facilitate the Department of Health to keep a close watch on the services provided by individual hospitals and obstetricians.

Apart from limiting the number of deliveries by non-local pregnant women, the Government will also require them to undergo antenatal check-ups locally by obstetricians in Hong Kong at an appropriate stage to assess if they are suitable to give birth in Hong Kong.

The Hong Kong College of Obstetricians and Gynaecologists is now formulating guidelines for the check-ups to facilitate obstetricians in making clinical assessment. The guidelines are expected to be compiled in the coming two months.

Meanwhile, more resources will be put in place by the Hospital Authority to enhance and expand the services of the neonatal intensive care units (NICUs).

Individual private hospitals, as far as I know, will also have further improvement in their special baby care services in order to reduce referral to the NICUs of public hospitals.

Finally I would like to take this opportunity to thank the private hospital operators, medical staff and all the professional groups in the public and private hospitals, the concern groups from local obstetrics and neonatal services, the Hong Kong College of Obstetricians and Gynaecologists, as well as the Hong Kong College of Paediatricians for their concerted efforts in safeguarding the well-being of women giving birth in Hong Kong as well as their babies.

Reporter: (About non-local pregnant women rushing to the Accident and Emergency Departments of public hospitals for delivery without undergoing antenatal check-ups.)

Secretary for Food and Health: I have repeatedly discouraged any pregnant women going to any place to deliver without any antenatal check-ups or records, particularly at the places where they are going to deliver the babies. This is an extremely dangerous behaviour, putting both the mother and child into high risk. We have seen very tragic cases relating to those incidents. Secondly, I have also stressed time and again that the hospital services in Hong Kong, like other public hospital services anywhere in the world, will be targeting the persons who are receiving the services, but not the relationship of that particular person with another person or spouse. We have to respect that this is the rule of the game everywhere. We also need to ensure that we have sufficient services for people who are entitled to have the public services in Hong Kong, i.e. our local women.

Reporter: (About non-local pregnant women who have Hong Kong husbands.)

Secretary for Food and Health: We cannot address the relationship of any patients with their spouse or any other relations. Like any public services, we are targeting the person, based on his or her identity and not his or her relationship with anybody else.

Reporter: How can you ensure that private hospitals will listen to what you say? Are you going to offer them cash incentive?

Secretary for Food and Health: I think the private hospitals do not need any cash incentive. Most of them are doing quite well right now because of the economy of Hong Kong. The reason why they agreed to do this is they also feel that there is a need for them to cap the capacity so that they can maintain the service quality and standard. We would not like to see any unhappy incidents relating to the care of pregnant mothers as well as their babies. Particularly, as I have mentioned time and again, the bottleneck of service is relating to the neonatal intensive care unit, which is run by the public medical sector. The obstetricians can do as many cases as possible, but the increasing number of babies would in turn be found to have more referrals for intensive care. For the private hospitals, this percentage is roughly 1 to 2 per cent of their deliveries. If that is the case, we of course need to cap the number from different hospitals and they all agreed to do that.

Reporter: (About pregnant women with foreign nationality other than the Mainland.)

Secretary for Food and Health: This will not affect women with foreign nationality residing in Hong Kong and deciding to have babies in Hong Kong.

Reporter: Are you worrying that it will give rise to some human rights issues that you are barring some nationalities from coming and not others?

Secretary for Food and Health: No. I do not think that is the case because we are addressing the issues of service capacity and also the professional quality of our obstetric services. We have to make a limit of how much we can serve.

Reporter: (About the review of obstetrics fees imposed on non-local pregnant women.)

Secretary for Food and Health: I have already stated some months ago that we need to review some fees and charges of the Hospital Authority. There are certain principles regarding the adjustment of fees. We cannot just increase the fees because of commercial reason or any other reasons. The fees of the Hospital Authority, in particular fees for non-eligible persons, have to be related to the costs of the services as well as some of the market service costs. We have to do the analysis before we make that decision.

Reporter: When you talk about non-local patients, do you just mean the Mainlanders?

Secretary for Food and Health: I think we are talking about people that are carrying a foreign identity who come here and require maternity services, i.e. non-eligible patients. If they are non-eligible, they belong to this category. If we are talking about people with foreign passports who are residing in Hong Kong, they are considered as a temporary resident of Hong Kong.

Reporter: (About the latest situation of scarlet fever.)

Secretary for Food and Health: As you know, the incidents of scarlet fever have increased tremendously in the last few weeks. Three weeks ago, when we started to notice the increase in incidents, we already requested the University of Hong Kong to investigate the nature of the bacteria to see if they had mutated. Indeed, I think there are some genetic changes relating to that. According to the experts, these genetic changes are responsible for the increase in transmission, and also the increase of the streptococcal bacteria staying on the mucosa of the oral cavity of the infected patients. So this might account for the increased number of patients. According to the epidemiology, most of the cases are still sporadic, i.e. they do not come in clusters except in a few kindergartens. So there is no need to consider closing schools or early summer holiday at this point of time. But we will closely monitor the situation. The number of cases has increased in the last few days, particularly after we have alerted the private doctors, and the number of cases in the last two days was 28 and 32 respectively. This increase in incidents will be maintained for at least the next one or two months. We need to observe more closely whether this will linger on. As far as treatment goes, although 50 per cent of these bacteria were found to be resistant to Erythromycin, one of the common antibiotics, they are sensitive to all the other first-line penicillin-related antibiotics. In a way, it is not a difficult disease to treat as far as doctors go, but it is important that the patients need to be treated early so that they will not develop septicemia.

(Please also refer to the Chinese portion of the transcript.)


Ends/Friday, June 24, 2011
Issued at HKT 17:15

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