Hospitals to get new equipment to cut waits
The Hospital Authority is modernising its ageing equipment with new government funding as a study shows Hong Kong scores poorly among some developed economies in the availability of advanced medical devices.
While the city takes pride in its average life expectancy being among the world's highest, and its maternal and infant mortality rank among the lowest, one area in which its health care system lags behind is the provision of advanced medical equipment such as magnetic resonance imaging (MRI) scanners and computerised tomography (CT) scanners.
A study commissioned by the authority shows that the numbers of MRI scanners and CT scanners in the public health care system per million people are about a third of those in Singapore or Britain.
Armed with a record high of HK$600 million in funds for medical equipment this financial year, the authority, which runs more than 40 public hospitals, hopes to gradually catch up with the latest technology and shorten patients' waiting time by buying more new machines.
Its goal is to get rid of all major equipment more than 10 years old.
In the study, major medical equipment refers to devices costing more than HK$1 million, such as MRI, CT and ultrasound scanners, mammography machines (for breast X-rays) and cardiac catheterisation machines (which insert a tube into the heart to check for abnormalities).
Authority chief executive Shane Solomon said Hong Kong fared badly when compared with more than 10 Organisation for Economic Co-operation and Development members and other developed countries.
'We are behind ... we are near the bottom of the list,' he said.
Solomon said long waiting times for diagnostic investigations had been a concern for the authority. He said the 'modernisation' project would shorten the wait public patients had to endure for the scans.
Diagnosis using advanced medical equipment is key to the early detection of cancer, blocked blood vessels and bone fractures, to name just a few serious conditions. With an early diagnosis, treatment can start earlier.
The authority's figures show there are just 2.9 CT scanners in Hong Kong's public hospitals per million people, compared with 7.5 in Britain and 7.8 in Singapore. The ratio for MRI scanners is 1.7 in Hong Kong, compared with 5.4 in Britain and 5.2 in Singapore.
Last year, the average waiting time for an MRI scan and a CT scan for a routine case at public hospitals was 160 days and 27 days, respectively. The wait for an MRI scan could be more than a year at busy hospitals.
Some public patients opt for scans in the private sector, which cost several thousand dollars each. Those who cannot afford that may travel to mainland hospitals for the scans.
The market price in Hong Kong for a private MRI scan of the head, for example, is about HK$4,000. Hospitals in Shenzhen or Guangzhou charge about a third of that price, but radiologists say the quality of many of those images is not good enough for an accurate diagnosis.
Solomon said that when he took up his post in 2006, front-line staff often complained of old medical equipment. During a visit to Prince of Wales Hospital, he was alarmed to see an 'antique' artificial ventilator.
'All these forced me to look at the size of the problem,' he said.
In 2006, the medical equipment in the authority's hospitals was worth HK$6 billion. The annual budget to replace old machines as well as buy new ones was just HK$200 million.
It would have taken the authority 30 years to replace its major medical equipment, which had a normal life span of 10 years, he said.
Noting the 'massive backlog', the authority told the government that the funding was not sufficient. The government increased the budget for medical equipment to HK$500 million in 2007/08 and to a record HK$600 million in 2010/11. The authority is now able to buy equipment in bulk, at a discount of 10 to 20 per cent.
From 2007 to this year, the authority spent HK$1.28 billion on major replacement exercises. The percentage of major equipment more than 10 years old has dropped to 36 per cent from 42 per cent in 2007/08.
The percentage of MRI scanners more than seven years old has fallen to 18 per cent from 55 per cent before 2007. This compares with 15 per cent for Britain's National Health Service.
There are now 23 CT scanners at public hospitals, and two more will be added this year. The number of MRI scanners will increase from 11 to 12 after one is installed at Tuen Mun Hospital.
Patients' Rights Association spokesman Tim Pang Hung-cheong said the long wait for MRI and CT scans deprived patients of prompt care.
'It has become the norm for public doctors to ask public patients to get a scan in the private market. An MRI costs more than HK$4,000 per location. It is too expensive for many grass-roots patients,' Pang said.
'Their only choice is to stay in the queue and have their diagnosis seriously delayed.'
Solomon said new machines could shorten waiting times. As they were faster and had less down time, throughput was 20 to 30 per cent higher.
He said the current waiting time data was misleading because patients needing first diagnostic examinations and those who just needed regular follow-ups were intermingled in the queues.
Solomon said the authority would launch a pilot programme to closely monitor the waiting time for scans and would reform the referral system.
'We are not restricting doctors' referrals but making them more accurate,' he said.
Earlier, the authority set up a new health technology office to formulate strategic plans for developing medical technology.
A prioritisation system has been set up to bring in new medical technology under which every piece of equipment is assessed against a set of criteria, such as age and advances in technology.
'There is no international rule on how much technology you should have. If you had too much technology, it would lead to too much intervention and investigations,' Solomon said.
The authority is also turning all its radiographic equipment digital, with a target of going 'filmless' by 2013, at an expected cost of HK$450 million.
The 3-D images will be sent directly to special workstations, accessible by health care workers in different areas.
The average turnaround time for archived images to reach clinicians could be cut by 90 per cent.
The government has raised the budget for medical equipment this financial year to a record, in HK$: $600m
Under the knife
The percentage of equipment at public hospitals more than seven years old
Before 2007: 55%
By 2010: 18%
Before 2007: 50%
By 2010: 0%
The percentage of equipment at public hospitals more than 10 years old
Before 2007: 76%
By 2010: 52%
Cardiac catheter machines
Before 2007: 50%
By 2010: 7%
Before 2007: 55%
By 2010: 7%
Before 2007: 79%
By 2010: 60%
General radiography units
Before 2007: 70%
By 2010: 61%
SOURCE: HOSPITAL AUTHORITY