Stinging rebuke for Sars chiefs

Health authorities regarded private hospitals as an 'unwanted problem', according to an inquiry into the Baptist outbreak A retired judge investigating April's Sars outbreak at the private Baptist Hospital yesterday delivered a strong rebuke to health authorities, accusing them of leaving private hospitals to fend for themselves during the crisis. Benjamin Liu Tze-ming's independent commission of inquiry, appointed by Baptist Hospital on June 17, concluded in its report: 'Private hospitals seemed to have been regarded as an extra, unwanted problem the Department of Health and Hospital Authority did not need, and were merely to be monitored for compliance [with regulations].' Mr Liu's report added that in any future outbreak, the department and the authority 'should best be made accountable to and responsible for not only all [public hospitals] but for the rest of the public, including private patients'. The inquiry was triggered in June after then director of health Margaret Chan Fung Fu-chun criticised the hospital for being slow to report 'probable and suspected [Sars] cases'. The Baptist report said that in a future crisis, the department and the Hospital Authority would benefit by regarding private hospitals as 'partners ... offering them assistance' on drugs and diagnostic tests, for example. Mr Liu's panel also heavily criticised Baptist Hospital in Kowloon Tong for delaying the reporting of Sars cases to the Health Department. It also said that the hospital was too slow to inform patients on the hospital's ninth floor that two people treated there had been diagnosed with Sars. Hospital executives yesterday said that they accepted the report and would carry out its recommendations. However, they insisted they had committed an honest mistake because the two patients who started the outbreak were 'hidden patients' who did not initially exhibit the typical symptoms of Sars. They had been admitted to the hospital for unrelated treatment. Thirteen hospital staff and seven patients or their relatives went on to catch the disease at the hospital. One patient, Cheung Tak-sing, 45, died. A day after the June 2 reprimand by Dr Chan, Baptist announced that its chief executive, Tsang Chin-wah, 'had been relieved of his duties since May 26'. The two other members of Mr Liu's panel were John Wong, head of surgery at the University of Hong Kong, and Jean Woo Ling-fong, chair professor of community medicine at Chinese University. None of the three panel members appeared at yesterday's press briefing called by Baptist Hospital executives to release the findings. The hospital placed advertisements in newspapers today summarising the report. The hospital's acting chief executive officer, Joseph Lee Chuen-kwun, said that some communications from the Department of Health regarding the reporting of Sars cases 'and criteria for diagnosis may have given rise to problems of interpretations. But the communications were mostly from the internet and we were getting them from the internet'. Professor Lee said the hospital was looking at whether some staff would have to be reprimanded. 'If there is any fault by any of the staff then we will deal with the staff accordingly.' He said the first index patient had surgery for cancer at the hospital on April 20. Several days later, the patient suffered chest pains and was transferred to Yan Chai Hospital. The diagnosis of Sars was confirmed on May 3. 'This means this patient in fact was what we considered a hidden patient,' said Professor Lee. He added that before May 3, there were no Sars diagnostic tests available to any private hospital. 'In fact I contacted the Prince of Wales Hospital, my old hospital and they said, 'We're overworked, we can't do it.' I contacted the Department of Health, they could barely take care of all [the Amoy Gardens] patients that required the test. So there was no test available to private hospitals.' A second index patient was admitted to Baptist on April 23 for a lung ailment and was transferred to Yan Chai Hospital two days later with no sign of Sars. The patient was diagnosed with Sars on May 3. Both index patients survived. 'The hidden patients were not known to be suspected Sars patients, and therefore we did not inform patients,' Professor Lee said. Dr Chan had said that Baptist announced the Sars cases only on May 6. The hospital has spent at least $5 million to remodel its ninth floor, building four new isolation rooms with special ventilation, to be ready in November. It has also remodelled a fever ward. Cheung Tsang Chun-sim, whose husband was the Baptist outbreak's only fatality, said she welcomed the report but would seek legal advice on how to proceed further. The hospital has given the family $100,000. Director of Health Lam Ping-yan said: 'Our colleagues will have a serious look at this report.' He added he was confident that his department would adopt a 'fair and open attitude'.