Safety of patients assured over cut in doctors' hours

PUBLISHED : Monday, 26 November, 2007, 12:00am
UPDATED : Monday, 26 November, 2007, 12:00am

The Hospital Authority has given an assurance that a reform to cut doctors working hours will not be a 'numbers game', saying it will secure adequate resources to assure patients' safety.

Health-care workers have expressed fears that the reform to cap doctors' working hours at 65 a week by the end of 2009 could mean poorer services for patients.

An authority source said pilot programmes to be run at seven public hospitals would provide a clear picture of what additional resources and manpower would be needed.

The source said the authority would spend HK$31 million in the coming year at seven hospitals, hiring 100 more health-care workers and opening three emergency wards to reduce hospital admissions.

A steering committee on the reform recently completed its final report, which recommends extending the hours operating theatres function during the daytime, and opening more theatres, to make up for the drop in night surgery. Surgeons at public hospitals will operate on patients after 10pm only if they have life-, limb- or sight-threatening conditions.

The proposals are among 30 contained in the 115-page report, which will be submitted for approval on Thursday. They are the result 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 also recommends capping doctors' continuous working hours at 16 on weekdays and 24 at weekends and public holidays. The measures it is proposing would cost between HK$180 million and HK$240 million a year.

An authority source said three public hospitals - North District Hospital, United Christian Hospital and Yan Chai Hospital - would have extra sessions on weekdays from 5pm to 10pm to conduct elective surgery currently done at night.

Surgeons have said the limitation on operations at night could compromise patient safety.

The source said doctors would make decisions based on the best interests of patients instead of applying a fixed rule.

'If surgery is really needed, we will do it, it is a very simple rule.'

Of the HK$31 million, HK$19 million would be spent on opening three new emergency wards - at Princess Margaret Hospital, Caritas Medical Centre and Eastern Hospital.

'These admission wards will concentrate resources to finish treatment within the first 48 hours.

'Definitely we will add more manpower for the reform, but we cannot make an accurate estimate until a review of the pilot programmes in the third quarter next year. We foresee lots of difficulties for the reform: a shortage of doctors will be one of the problems.'

The Public Doctors' Association has been pressing the authority to follow European Commission guidelines and cut weekly working hours to 44 and continuous working hours to 14.

But the source said Hong Kong could not achieve this: 'We can't do that practically; we don't have enough resources or doctors.'

Long day

The number of doctors at public hospitals who work shifts of between 31 and 36 hours: 120