Hospitals index to guide decisions on staff levels
A new index will be introduced by the Hospital Authority to measure the staffing needs of individual hospitals and departments, according to a package of emergency measures aimed at tackling the record high turnover in public doctors.
It is the first time that a scientific formula - which the authority says will be transparent to all - will be used to work out staffing situations so medical graduates hired each July can be fairly deployed.
The authority will officially present its package of measures for retaining doctors at a meeting tonight with union representatives. Doctors have threatened to take industrial action if the authority fails to solve the staffing crisis. Some hospitals have a 10 to 20 per cent shortfall in some areas, with departments of medicine most seriously hit.
However, the chance of a settlement being reached is believed to be slim, as the two main doctors' unions object to the package.
The authority, which has been criticised for lacking a long-term manpower plan, has pledged to review staffing and workloads and release the information regularly on its website.
The 'relative need index' will be introduced to reflect doctor turnover, vacancies and demand for new services. The authority will deploy fresh medical graduates to individual hospitals according to the index. It will hire more than 300 doctors from the city's two medical schools this year.
But the Public Doctors' Association and Frontline Doctors' Union say that while the index may improve transparency, it fails to take into account doctors' actual workloads.
'At present, human factors control manpower distribution; it is mostly the chief executive of each hospital cluster who has a say on the number of new doctors for each department,' association president Dr Loletta So Kit-ying said. 'The new index will make the process more transparent and fair. However, the index only measures headcounts but not doctors' workloads.'
Union president Dr Adrian Tse Yiu-cheong said the index should look at the actual hours worked by doctors. 'Enhancing transparency is good but the formula is wrong. For example, a small department losing half of its staff could still be less busy than the one which has full strength but with all its doctors working serious overtime. But according to the index, the small department in this case will get new doctors first,' he said.
Senior management for the authority met doctors' representatives on Wednesday night in a 'test the water' briefing ahead of tonight's formal discussion.
Tse said his union was unlikely to reach agreement with the authority, describing special allowances proposed by it as 'too mean''.
The authority proposes paying special allowances to compensate doctors for extra night shifts.
Medics in the busiest departments, such as the medicine, surgery, paediatrics, obstetrics and gynaecology departments, will be given an extra HK$5,000 a month.
Those from intensive care, the accident and emergency department, psychiatric and oncology will receive HK$2,000 a month.
The allowances will cost the authority an extra HK$80 million a year.
'What worries us is once doctors receive this special allowance, there is no limit on his or her working hours,' Tse said.
He called on the authority to conduct a large-scale consultation exercise on the package.
'We will consider further action pending the canvassing of views from frontline staff,' he said.
To boost morale, the authority will create more senior posts for frontline doctors later this year.
Some 179 doctors with five years or more of specialist practice will be promoted to associate consultants in the next three years, starting with 100 this year.
Each promotion will cost about HK$23,000 a month. The authority estimates the promotions will cost HK$20 million in the first year.
The two unions reject the promotion plan, saying all 700-plus medical officers with specialist qualifications should be promoted immediately.
Key points of the Hospital Authority doctors' manpower package
Promote 179 medical officers with at least five years of specialist qualifications. Cost to the authority: HK$20 million in the first year, rising to more than HK$100 million in the fourth year.
Special allowance for extra night duties. HK$80 million a year
Set up 'Relative Need Index' to measure manpower needs of individual departments
Hire part-time doctors
Reimburse doctors' professional examination fees. HK9.2 million a year
Provide more technical and clerical support to doctors
Postpone less urgent programmes to save manpower