Prenatal screening for Down's syndrome and community healthcare programmes will be scaled down at public hospitals in response to the manpower shortage crisis, the Hospital Authority chief executive Dr Leung Pak-yin revealed yesterday. He spoke just hours before the Legislative Council last night passed a non-binding motion urging the government to reform the Hospital Authority. Dr Leung (pictured) said that his team was working out a package of financial incentives as well as initiatives to reduce doctors' hours which he hoped would receive a positive response at a staff meeting scheduled for next Friday and stop the exodus of doctors from public hospitals. Doctors have threatened to take industrial action if the authority fails to solve the crisis and have called on the authority to stop increasing the number of beds and to cut non-core services. 'Inevitably we have to slow down some projects such as hospital accreditation and prenatal screening and scale down some community programmes,' Leung said in an interview with the South China Morning Post. 'We also have to consolidate some services to save manpower.' In reaction to criticisms that the authority has been too aggressive in expanding services, Leung said: 'We always have to strike a balance between services expansion and our manpower supply.' Dr Cheung Tak-hong, chief of obstetrics and gynaecology at Prince of Wales Hospital, said his department had already drawn up contingency plans to cut screening by about 30 per cent. 'At present, we provide Down's syndrome screening for all mothers. If the manpower situation gets worse, we may have to limit the tests to high-risk mothers such as those aged over 30 or 35,' Cheung said. 'We have to keep enough manpower at the delivery rooms. The core service, we have to maintain.' Within the year, the authority plans to promote 170 doctors who have been qualified as specialists for more than five years. They will go from junior medical officer grade to associate consultants at a cost of about HK$30 million. Leung envisaged that this would form the basis of promotions in the future, assuming a doctor's performance was up to standard. At present, 777 doctors with specialist qualifications are still on the medical officer grade. 'We have to work out a financially sustainable policy,' Leung said. 'I have talked to many frontline doctors and the five-year rule is well accepted.' The authority estimates that, in five years, the new promotions system would exceed HK$90 million per year and extra funding would have to come from the government. The authority is also asking individual departments to issue extra pay to doctors who have to shoulder additional night shifts because of the manpower shortage. Leung spent a few hours early on Tuesday morning at the Caritas Medical Centre with doctors manning the night shift. 'The doctors worked very hard,' he said. 'This experience helps me to share their feelings. What they are saying about the heavy workload is very true and we are trying our best to help them, but it takes time.' The lawmaker for the medical sector, Dr Leung Ka-lau, won the backing of fellow legislators last night when he called for reform of the Hospital Authority. He said the government should review how it operated and suggested patients should be being referred to hospitals that were not so busy, that managerial posts should be cut and that patients should be given information on the efficacy of prescription drugs. Secretary for Food and Health Dr York Chow Yat-ngok said reforms were needed but could not be rushed. 'We have to plan carefully for the exact number of staff needed.'
