Panel suggests tight limits on night surgery

PUBLISHED : Friday, 16 November, 2007, 12:00am
UPDATED : Friday, 16 November, 2007, 12:00am

Surgeons at public hospitals should operate on patients after 10pm only if they have life-, limb- or sight-threatening conditions, a Hospital Authority committee studying cuts to doctors' working hours has proposed.

The steering committee's report recommends extending the hours operating theatres work during the daytime, and opening more theatres, to make up for the drop in night surgery. The proposal is one of several it has put forward to cut doctors' night shifts.

The report cited an authority survey of three public hospitals which showed only 5 per cent of night activities were related to 'life-threatening conditions' that required the immediate attention of doctors. It also cited a study by the authority of 49 emergency operations performed between 10pm and 8.30am at two public hospitals in November last year that showed only four involved risks to life, limb or sight requiring immediate action.

Still, during consultations about the proposal, some surgeons expressed concern about patient safety and the risk of patients' conditions worsening if non-emergency operations were not allowed at night or had to be conducted early in the morning.

Some even considered the initiative a cost-cutting tactic.

But the committee said restricting emergency operations at night was 'not about cutting service or saving resources, but for safer operating conditions and better use of scarce resources'.

Currently, some non-emergency operations are carried out in late evening, in some cases to help reduce backlogs.

The proposals are among 30 contained in the 115-page report, which will be submitted for approval in two weeks' time. They are the fruit of a year-long effort launched after doctors successfully sued the authority for depriving them of rest days and statutory holidays for six years.

The committee said the authority should reduce doctors' night-shift work, and they should work no more than five consecutive nights.

'Doctors rostered throughout the night may suffer sleep deprivation. Their inability to concentrate and propensity for inattentiveness after long hours of work may pose risk not only to themselves but also to patients,' the report said.

The panel, led by Leong Che-hung, a former chairman of the authority, also called for it to cut doctors' working hours to 65 a week by 2010 and to cap their continuous working hours at 16 on weekdays and 24 on weekends and public holidays.

The measures it is proposing would cost between HK$180 million and HK$240 million a year.