Hospital service luck of the draw

PUBLISHED : Monday, 21 March, 2011, 12:00am
UPDATED : Monday, 21 March, 2011, 12:00am

How soon a patient receives an operation at public hospitals appears to depend on the luck of the draw.

A cataract patient may wait anything from three to 37 months, according to hospital figures obtained by the South China Morning Post.

The problem, say many doctors and patients' rights representatives, is caused by the uneven distribution of resources among hospitals. The waiting time for cataract operations - one of the most common procedures - is used as a key indicator of health care resources in different districts.

Critics say the Hospital Authority is failing to address a chronic problem of unfair allocation of resources. This means patients are penalised if they live in areas where public hospitals have poor resources.

'For high-volume operations such as cataracts or joint replacements, putting all patients on one list would be fairer to all,' Patients' Rights Association spokesman Tim Pang Hung-cheong said.

The association criticises the authority for allowing big differences in waiting times for medical services to exist at public hospitals.

There are seven groups of public hospitals in Hong Kong. Latest figures obtained by the South China Morning Post show the wait for cataract surgery varies from three months in the Hong Kong West group to 37 months in Kowloon East. The Hong Kong East group has the second-longest wait, 35 months, followed by Kowloon Central, at 25 months. Some 47,000 public patients are awaiting cataract operations.

The Post reported the problem in 2008, when the waiting time for cataract surgery at Kowloon East hospitals was almost 10 years. Since then, the authority has provided extra resources and brought the city's average waiting time down from 35 months to 26 months so far this year. This was done by setting up two designated cataract centres and subsidising patients to have cataract operations at private hospitals.

But big differences in waiting times between the hospital groups remain a problem, prompting lawmakers to pass a non-binding motion early this month calling for reform and greater transparency in the way the Hospital Authority allocates resources. Kowloon East remains the most poorly resourced group in terms of the ratios of doctors, nurses and hospital beds to the population.

Queen Mary Hospital, which is in the West Hong Kong group, sharply shortened its queue by setting up a cataract centre at Grantham Hospital in Aberdeen in 2009, according to West Hong Kong chief executive Dr Luk Che-chung. The cataract centre served local residents at first and was now ready to treat patients from other districts, Luk said. It was now operating at full capacity, treating 4,000 patients a year.

'It has been a clear policy that the Grantham cataract centre is to serve the whole Hong Kong population, not only residents on Hong Kong Island,' Luk said. 'We have just talked to Kowloon East about logistics in taking their patients. But some patients may not want to come over here for the operations; we give them a choice.'

Some eye doctors have called for a single registry for cataract patients, but the call has never been heeded. The authority plans to publish waiting times for cataract surgery at individual public hospitals but has not said when this would begin.

Luk, formerly chief executive of the Kowloon East group, said centralising waiting lists for cataract or other surgery was complicated.

'Of course we can explore the possibility, but we can foresee it would be very difficult. There are dozens of thousands of patients on the list [for cataract surgery] and some may not want to go to another district for treatment. It is very complex administratively,' he said.

An authority spokesman said cataract surgery was an area of increasing pressure at public hospitals due to increasing demand from the ageing population. The authority would monitor waiting time for cataract surgery and would try to cut the wait by providing more surgery sessions, arranging referrals across hospital groups, and referring patients to private doctors. Before 2009, the authority assessed funding for the groups of hospitals based mainly on the population of the district and group's historical output of medical services. In 2009, it introduced a pay-for-performance funding system that puts more weight on individual hospitals' output.

Join the queue

The average waiting time for cataracts surgery at different hospital groups

HK East: 35 months

HK West: 3 months

Kowloon Central: 25 months

Kowloon East: 37 months

Kowloon West: 21 months

New Territories East: 23 months

New Territories West: 19 months