LCQ6: Shortening patients' waiting time for consultation
17.5.2023

Following is a question by the Hon Yung Hoi-yan and a reply by the Secretary for Health, Professor Lo Chung-mau, in the Legislative Council today (May 17): Question: It is learnt that at present, patients with episodic diseases and chronic disease patients who require follow-up consultations both have to wait for a long time in public hospitals before they can receive the healthcare services they need. Regarding shortening patients' waiting time for consultation in public hospitals, will the Government inform this Council: (1) whether it has compiled statistics on the average time currently taken by patients (i) from being issued with numbered tickets to receiving diagnoses and treatments by doctors in general out-patient clinics (GOPCs) and (ii) from registration to receiving diagnoses and treatments by doctors in accident and emergency (A&E) departments, as well as the respective average time taken by patients seeking consultation at these two departments from completion of receipt of diagnoses and treatments by doctors to being dispensed medicines; (2) whether it has studied how to enhance the care received by patients while they are waiting for consultation in GOPCs and A&E departments (e.g. by making good use of technologies to inform patients of the waiting time required and providing more ad hoc beds or waiting rooms), and set indicators for the waiting time for consultation; if so, of the details; if not, the reasons for that; and (3) as the Hospital Authority currently provides non-emergency ambulance transfer service (NEATS), whether the Government knows the number of vehicles in the fleet concerned and the utilisation rate of the service, and whether the Government has studied the establishment of a database on patients' waiting time for consultation in public hospitals, and made good use of NEATS vehicles to divert patients waiting for consultation to neighbouring hospitals with shorter waiting time for consultation; if the Government has, of the details; if not, the reasons for that? Reply: President, The healthcare system of Hong Kong provides primary, secondary and tertiary healthcare services to cater for the different needs of the public. Primary healthcare (PHC) is the first point of contact in a healthcare process, taking care of citizens with mild symptoms and emphasising on disease prevention and chronic disease management. At present, PHC services are mainly provided by private doctors and public General Out-patient Clinics (GOPCs). The public healthcare system, in particular public hospitals, is on the other hand mainly responsible for the provision of secondary (including Accident and Emergency (A&E) and specialist services) and tertiary healthcare services for patients with urgent or more severe conditions, as well as serving as a healthcare safety net for the public. Under the Government's planning for the public healthcare system of Hong Kong, the public hospitals managed by the Hospital Authority (HA) administer service planning based on four priority service areas including A&E and emergency care services. To provide better care for patients with episodic illnesses and chronic diseases, we are strengthening community-based PHC services. The Government launched the Primary Healthcare Blueprint to promote the development of community networks among family doctors and District Health Centres so that the public would not need to visit hospitals frequently thereby allowing public hospitals to better utilise the resources for patients with urgent or severe conditions. In consultation with the HA, the reply to the question raised by the Hon Yung is as follows: (1) and (2) Regarding parts one and two, 18 public hospitals under the HA currently provide A&E services for critically ill or seriously injured people and victims of disasters. To ensure that citizens in need of urgent care can receive timely service, the A&E departments implement a triage system. Patients are classified into five categories, namely Critical (Priority 1), Emergency, Urgent, Semi-urgent and Non-urgent (Priority 5) according to their clinical conditions, and would receive treatment as prioritised by their urgency category. The HA's service target specifies that Priority 1 (Critical) patients will receive immediate treatment, in other words, "zero waiting time" for them. Most Priority 2 (Emergency) patients (95 per cent) will be treated within 15 minutes. About 90 per cent of Priority 3 (Urgent) patients will be treated within 30 minutes. I will provide the average waiting time for each triage category of A&E services for the last three years as an annex for Members' reference. In gist, the average waiting time for Priority 1 (Critical) patients is zero minutes, meaning there is basically is no waiting required and patients can receive immediate treatment. The average waiting time for Priority 2 (Emergency) patients is eight minutes and the average waiting time for Priority 3 (Urgent) patients is 26 minutes. About half of the patients belong to the Critical, Emergency and Urgent categories. In respect of PHC, as mentioned above, most of such services are mainly provided by the private doctors which complement the public hospital system. The GOPCs in the public sector are mainly for some target groups, in particular low income persons and the vulnerable groups. HA's GOPCs currently have an annual attendance of over five million, providing services for people in need especially the elderly, low income families and chronic disease patients. Citizens using services provided by HA's GOPCs are in general non-urgent cases and booking for consultation is required. The consultation sessions of GOPCs (i.e. morning, afternoon and evening) have each been further divided into various timeslots to facilitate patients booking appointments and attending consultations at the designated time. Patients will also be arranged for medical consultation and collection of medications within the relevant clinic sessions. In general, around three-fourths of the patients could attend consultation within one hour after registration, and collect medications within half an hour after handing in the prescription to the pharmacy. Over the years, the Government has been implementing a number of subsidised and Public-Private Partnership programmes to encourage the public to use more PHC services in the community, so as to allow the public healthcare system to focus on provision of A&E and emergency services while acting as the safety net for all. As such, we do not encourage non-urgent patients (i.e. Priority 4 and 5) to use public A&E healthcare services. The Primary Healthcare Blueprint recommends the re-positioning of the HA's GOPCs progressively, including promotion of "family doctor for all", with a view to focusing GOPCs' services to serve the vulnerable groups, especially targeting low income families and the elderly with financial difficulties. In fact, the comparatively low service fees of A&E and GOPC is one of the reasons drawing some of those citizens who can afford private healthcare services to HA's A&E and GOPCs services, resulting in shortage. In the long run, we have to divert the demand effectively to PHC and family doctor services in order to alleviate the pressure on relevant services. (3) For the third part, the HA's Non-emergency Ambulance Transfer Service (NEATS) mainly provides point-to-point transfer service for public hospital patients who are unable to use other transportation means due to mobility handicap or mental/sensory impairment, with patients under discharge and inter-hospital transfer as primary targets. Service quota are also allocated for specific groups of patients of Specialist Out-patient Clinics or Geriatric Day Hospitals, who are generally unsuitable to take public transport. Generally speaking, healthcare staff will confirm with eligible patients and their families/carers if use of the NEATS is required and make appropriate arrangements. In 2022/23, the NEATS of HA had a total of 276 vehicles and recorded a total of 562 173 patient transfers. In view of the positioning of NEATS and the keen service demands of patients, the HA will continue to focus on providing such service to patients under discharge and inter-hospital transfer, as well as patients with specific needs. The HA does not have any plan to deploy these vehicles for transferring non-urgent patients waiting for consultations to other hospitals. Thank you, President.