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Letters

PUBLISHED : Tuesday, 12 February, 2008, 12:00am
UPDATED : Tuesday, 12 February, 2008, 12:00am

Why HK needs a patient safety agency

S. P. Li has correctly called for more transparency regarding the incidence of medical mishaps in Hong Kong ('Real number of 'error' deaths unreported', February 5).

In view of organisational similarities, the epidemic of medical error in other developed health care systems is destined to be repeated here. As I have explained previously ('At the sharp end', September 24), medical errors are the product of a complex delivery system staffed by necessarily fallible human beings. No unfairness to doctors flows from these observations, but rather the difficulty of their work and the need for systems-based safety programmes are highlighted.

Incredulity is common when the scale of harm due to medical error is exposed (for example, even by conservative estimates, an error in care will cause or contribute to the death of one out of every 300 patients admitted to hospital). Anger and indignation on the part of the public engender defensiveness from doctors, hospital managers and governments. Eventually a co-operative sense of purpose evolves which recognises safety as a priority. This is now just beginning to happen in Hong Kong, but we can learn from the progress made in other countries.

The US Patient Safety and Quality Improvement Act of 2005 was enacted to improve patient safety by the use of confidential reporting of events that adversely affect patients. This law provides for the creation of patient safety organisations which collect, aggregate and analyse reports from health care providers.

The identification of patterns of failures allows proposals to be formulated on measures to eliminate safety hazards. The national quality forum, a collaborative project between providers and patients' groups, has identified a set of serious, preventable adverse events that form the basis for a national reporting system. Federal legal privilege and confidentiality protection apply.

The public and legislators should urge the government to establish a body with these responsibilities in Hong Kong, which should be tailored to our local conditions. A statutory patient safety agency would have responsibility for the public and private sectors and comprise representatives from medicine, administration and the public. A long-held business school doctrine says: 'If you can't measure, you can't manage.' Adverse event reporting systems are in their infancy in Hong Kong, and efforts to organise robust improvements in safety appear to be fragmented.

Those of us working in health care are well aware of the need for a better co-ordinated approach to the management of avoidable health care mishaps. A patient safety agency can help.

Darren V. Mann, consultant surgeon, Central

Observatory is getting it wrong

I am disappointed by the error-ridden forecasts of the Hong Kong Observatory in connection with the prolonged cold snap starting from January 24. Not only has the Observatory consistently under-estimated the duration and intensity of the cold spell, there have been instances where it even failed to warn of a significant temperature drop until there was already a frigid surge of cold air.

What is the point of issuing those five and seven-day forecasts, if they can be completely wrong, as was the case for extended forecasts released just prior to January 24?

It may be difficult for the Observatory to accurately predict of squally thunderstorms and the movement of tropical cyclones. However, I would have thought that, with all the sophisticated equipment at its disposal, it could at least be reasonably accurate when forecasting large and more sedate systems, like the genesis of continental anti-cyclones and the associated winter monsoon.

Unfortunately, the Observatory has let us down even in this regard.

Raymond Wong, Happy Valley

Readings put elderly at risk

According to a government fact sheet, 52.1 per cent of our population lives in the New Territories.

It, therefore, makes no sense for the Observatory to adopt the temperature readings at its headquarters in the heart and heat of Kowloon as the official record given to the lay public. It is unscientific and creates unneeded health hazards for half of Hong Kong's population, including elderly citizens, particularly in times of severe weather, like heat or cold. Cases of severe hypothermia and possibly death because of prolonged exposure to temperatures substantially lower than the Observatory's reading in the New Territories are possible.

How come our legislative councillors are so ignorant on this simple but important issue?

Joseph Lee, Ap Lei Chau

Wine tax cut changes nothing

As an avid wine drinker, I have to disagree with the comments of Tommy Cheung Yu-yan, of the Hong Kong Wine and Spirits Industry Coalition, on the savings of wine tax reduction being passed on to us consumers ('Wine drinkers in Hong Kong did benefit from sales tax cut', February 5).

I don't know where he drinks, but everywhere I go to, not one of them reduced their wine prices after the last tax reduction. Every time I asked why, it was the same old story, 'old stock'. I very much doubt that if the government reduced the tax again, it would be passed on to us consumers but would be used to further line the pockets of the wine industry.

To rely on the industry to pass on any more savings would be ludicrous.

Come on, this is Hong Kong, where making a profit takes precedence before civility, or just being downright fair. What does Mr Cheung want us to believe? If they want to move the industry to Macau, go ahead, it's the wine industry's choice. Don't expect me to pay for their further blatant abuse of the tax reductions here.

Darrin Adcock, Mid-Levels

Bending rules unacceptable

I refer to the report ('Zhou or Yip? A headache for selectors', February 2). The answer to the question is simple - follow the rule.

The rule is that only holders of Hong Kong Special Administrative Region passports can represent Hong Kong in this year's Olympics. It is completely against fair play - a core value of Hong Kong - for the Hong Kong Olympic Committee to seek dispensation from the rule with a view to giving the coveted place to Zhou Mi at the expense of Yip Pui-yin. As a Hong Kong sports lover, I am embarrassed by the committee's begging for preferential treatment.

An anonymous member of the Hong Kong Sports Institute was reported in the article to have asked: 'If [Zhou] has a better chance of winning a medal for Hong Kong why not let her go?' My answer is: winning a medal is not everything and winning one through bending the rules is a disgrace. Furthermore, the so-called better chance is not all that significant: Yip's world ranking is 12 as compared with Zhou's recent promotion from 11 to 10.

Another strong factor in favour of Yip is the two badminton players' ages. Yip, at the age of 20, has more years of sports life than Zhou, aged 28. The former, therefore, should be given as much international exposure as practicable for the sake of Hong Kong's future in badminton.

To choose an older, imported player who becomes eligible only if a well-established international rule is thrown out of the window would pour cold water on not only Yip but also, many other young, home-grown sportsmen.

Ng Hon-wah, Pok Fu Lam

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