Following a recent spate of medical blunders, special teams are to patrol our hospital wards to monitor compliance with patient safety guidelines. Health minister Dr York Chow Yat-ngok says the blunders involved repetition of the same kinds of mistake in routine, basic procedures. That is a worry. Lapses in everyday routines that result in injections being wrongly given and drugs being wrongly labelled can have serious consequences for patients.
According to one hospital chief, some of the recent incidents can be put down to lack of teamwork and co-operation among frontline staff. Dr Fung Hong, chief executive of the New Territories East hospital cluster, pinpointed nurses' shift-handover procedures as one area with room for improvement. Given that nurses have been changing shifts since the days of Florence Nightingale, it is disappointing to hear that this could be a patient-safety blind spot in a 21st century hospital.
Two unrelated factors may also have something to do with the recent frequency of blunders. One is the practice introduced by the authority two years ago of revealing incidents promptly, along with transparent action to remedy any defects in the system. So a rash of disclosures does not necessarily mean things are getting worse, although they do not seem to be getting any better under a policy of openness.
The other is nurses' workloads, with each nurse having to care for about 10 patients, compared with a nurse-patient ratio of one to six in developed countries, according to nursing staff association chairman Dr Joseph Lee Kok-long. Noting that each nurse has to make 'hundreds of clinical decisions in each shift', Fung of the New Territories East cluster said patient safety could be enhanced if shifts could remind each other of high-risk areas and possible errors.
The onerous nurse-patient ratio reflects budgetary constraints that are unlikely to ease without reform of health care financing. With the government picking up 95 per cent of the cost of patient care and health's share of public expenditure growing as the population ages, there will be pressure to contain costs.
The government's proposals for the second round of public consultation on reform of financing are therefore relevant to the maintenance of good-quality patient care. Now that mandatory medical savings and insurance have apparently been ruled out, because of public opposition, after the first round, the new proposals should at least include an increase in the current low user fees for public hospital services for those who can afford it, with a safety net for lower income earners and the chronically ill.