Hospital Authority faces increasing demands on its services

Leung Pak-yin says the Hospital Authority is constantly striving to meet increasing demands on services, which have been stretched by an ageing population and a rise in chronic illnesses

PUBLISHED : Thursday, 16 May, 2013, 12:00am
UPDATED : Thursday, 16 May, 2013, 2:47am

Over the past 22 years, the Hospital Authority has grown and developed to become a leading public health care system providing comprehensive medical services. Through an extensive network of 41 hospitals and institutions, 47 specialist outpatient clinics and 74 general outpatient clinics, our dedicated team of more than 63,000 staff fulfil around 90 per cent of Hong Kong's secondary and tertiary medical needs, using just 2.4 per cent of our city's gross domestic product.

Based on 2012 statistics, the authority will handle an average of 24,000 specialist outpatient attendances in the next 24 hours. That's about 8.9 million a year. Annually, there are also 1.5 million patient discharges, 2.2 million accident and emergency attendances, 5.7 million primary care visits and 1.9 million community outreach visits.

The accelerating growth in need for our services is placing...more complex demands on our staff

It is likely that these numbers will continue to grow while we face increasingly complex medical needs.

The authority will require an extra 2,600 beds to meet the projected service demand a little under a decade from now, which implies the need for 800 more doctors, 2,700 new nurses and 1,000 extra allied health professionals. That need will continue to escalate, and we project a demand for an additional 6,600 new beds 10 years further on, in 2031.

And even with strong government support, we do not have unlimited resources. We must therefore seek new ways to efficiently deploy our assets to the greatest benefit of the community.

The accelerating growth in need for our services is placing increasing and more complex demands on our staff, and serious manpower shortages have occurred in certain high-pressure areas.

Through better communication between management and staff, and among frontline colleagues in different departments and teams, we have identified the worst pinch points and have improved what we are already doing well.

Attrition rates among doctors have stabilised following the opening up of more promotion opportunities across all specialties and enhancing the honorarium scheme for doctors in departments facing acute staff shortages. We have improved the part-time employment scheme and have hired 272 part-time doctors in the past year. We have recruited non-local doctors under limited registration for specialties in serious need.

We have, in the past two years, also recruited an additional 700 nurses and 160 allied health professionals to fill the gaps created by long-unaddressed workload pressure. We will recruit an extra 200 nurses and 120 professionals and supporting staff for allied health services this year.

To enhance training opportunities and facilitate career progression for our professionals, more than 1,000 nurses have attended specialty training courses while more than 500 nurses and 200 allied health professionals have been promoted. We also sponsored 103 nurses and 57 allied health professionals to undertake overseas training.

We have taken significant strides in enhancing corporate governance and risk management. Our efforts to improve transparency include our public release in April of waiting times for ear, nose and throat specialist outpatient services and cataract surgery.

To understand the needs and concerns of stakeholders about the appropriate allocation of resources, we gather information from a broad range of groups, including Hospital Authority committees and staff, while patient feedback is also sought. We have enhanced our systems for analysing data trends and government statistics, and strengthened relationships with external health professionals and international peers to make our forecast modelling more robust.

We have identified a number of high-risk areas for the authority. Several - particularly the shortage of experienced doctors and the possibility of a lack of a successor at senior management level - require steps to improve human resource management.

Addressing external risks such as the demand created by the ageing population, the rise in chronic illnesses and potential impact of seasonal surges or future outbreaks of infectious diseases, we are implementing measures to increase throughput and the number of inpatient beds, and reinforce our crisis response systems.

Other initiatives planned for this year include improvements to systems for managing drug prescription, dispensing and administration, and enhancements to quality assurance using IT-based clinical systems.

The ageing population and increased incidence of chronic illnesses are placing greater strain on certain services. The number of patients with complex medical problems that require integrated care and close collaboration between multiple units or health-care professionals continues to rise. To reduce pressure on resources, we will expand and enhance health care models that minimise hospitalisation where possible. Improvements to diagnostic services will reduce the need for more complex treatments at a later stage.

To better manage the ageing population, illnesses that require cross-discipline care, and the high demand in geographical areas such as the New Territories West and Kowloon East clusters, we will add 287 new beds in 2013-14.

We will enhance the treatment of life-threatening diseases while elderly patients will be more effectively served through measures to strengthen the treatment of various degenerative diseases.

To improve patient throughput and waiting times, we will set up new case clinics, conduct additional doctor sessions and increase the general outpatient clinic quota. We will explore the potential for expanding our recently established cross-cluster patient referral scheme. We will invest HK$812 million in new equipment this year to help enhance the effectiveness and safety of our services.

Lastly, building on our previous success with public-private partnerships, we will strengthen external relationships with qualified medical service providers to increase our capacity for cataract surgery, haemodialysis and radiological imaging services.

Dr Leung Pak-yin is chief executive of the Hospital Authority. This is an edited abstract of his keynote address at yesterday's opening ceremony of the Hospital Authority Convention