LCQ13: Public dental services
21.6.2023

Following is a question by the Hon Joephy Chan and a written reply by the Secretary for Health, Professor Lo Chung-mau, in the Legislative Council today (June 21): Question: A recent survey has revealed that 70 per cent of the respondents have suffered from various degrees of dental diseases, and that nearly 60 per cent of the respondents have not taken the initiative to seek consultation due to financial reasons. On the other hand, there are currently 39 government dental clinics in Hong Kong, but only 11 of them provide free emergency dental treatment services (commonly known as "General Public dental sessions" (GP dental sessions)). This, coupled with the limited consultation quota, has rendered public dental services generally unavailable to members of the public. In this connection, will the Government inform this Council: (1) whether it has plans to provide GP dental sessions at the remaining 28 government dental clinics with a view to achieving the goal of "making public dental services available in every district", thereby responding to the urgent call from members of the public for public dental services; if so, of the details; if not, the reasons for that; (2) whether it has plans to introduce "dental care voucher" to divert the demand for public dental services to the private market through the public-private partnership approach; if so, of the details; if not, the reasons for that; (3) whether it will look into expanding the scope of use of the Elderly Health Care Voucher Scheme to cover dental services at the Mainland cities of the Guangdong-Hong Kong-Macao Greater Bay Area, so as to reduce the pressure of demand for public dental services in Hong Kong; and (4) as the Government has earlier pointed out that it will look into the admission of non-locally trained dentists to alleviate the problem of manpower shortage of dentists, and plans to submit a legislative proposal into this Council within this year, of the relevant work progress? Reply: President, The Government's current dental care policy aims to raise public awareness of oral hygiene and health through publicity and education, and to encourage the public to develop good oral hygiene habits. Generally speaking, the need for dental treatment or surgery due to tooth decay and gum diseases can be greatly reduced if good oral hygiene habits are maintained. Under the current policy, the Government mainly undertakes publicity, education and promotion of oral health, particularly with emphases on nurturing children's good oral hygiene habits from an early age and providing the comprehensive School Dental Care Service to children. Apart from the School Dental Care Service, the Government currently also provides or subsidises limited dental care services, which mainly include the implementation of measures catering for persons with special dental care needs, especially the elderly with financial difficulties or persons who have difficulties in accessing general dental services. At present, dental care (particularly curative treatment) for the general public is mainly provided by private dentists. The provision of treatment for the public for emergency cases is only of limited supplementary nature rather than comprehensive dental services. Services provided by the Government for persons with special dental care needs cover special oral care services (including the Healthy Teeth Collaboration) for persons with an intellectual disability, as well as dental care support for the elderly under the Outreach Dental Care Programme for the Elderly and the Elderly Dental Assistance Programme funded by the Community Care Fund. Also, elderly persons may use the Elderly Health Care Vouchers (EHCVs) to receive dental services in the private sector, and persons with financial difficulties may receive subsidy to cover dental treatment expenses under the Comprehensive Social Security Assistance Scheme. These services for targeted groups are not provided by government dental clinics. The reply to the various parts of the question raised by the Hon Joephy Chan is as follows: (1) Under the civil service terms of appointment, the Government is obliged to provide dental benefits for civil servants/pensioners and their eligible dependents. Dental clinics under the Department of Health (DH) are established primarily for fulfilling this obligation. That said, the Government uses a small fraction of the service capacity of the dental clinics to provide free emergency dental treatment to the general public (commonly referred to as General Public or GP sessions). The DH allocates certain sessions each week in its 11 government dental clinics to provide GP sessions for citizens in need, covering services such as treatment of acute dental diseases, prescriptions for pain relief, treatment of oral abscesses and tooth extraction. Dentists will also provide professional advice with regard to the needs of individual patients. Since the DH's dental clinics mainly provide dental benefits for eligible persons and only a small fraction of these dental clinics' service capacity is used for emergency GP sessions to provide limited supplementary support, it is not possible for the DH to increase the number of government dental clinics providing GP sessions, or allocate more slots for these sessions on top of the existing ones. (2) Established in December 2022, the Working Group on Oral Health and Dental Care (the Working Group) advises the Government on the long-term strategy for oral health and dental care, as well as matters including the enhancement of the scope and mode of public or subsidised services. It comprises non-official members and ex-officio members for a two-year tenure until the end of 2024. The Working Group is discussing the enhancement of oral health measures and dental care services based on the following framework: (a) to determine the service scope of primary dental services suitable for different age groups with the premise of preventing oral diseases and enhancing the oral health of the community in line with the Primary Healthcare Blueprint; (b) to define various underprivileged groups, groups with special needs and groups of higher risks, and review the existing needs and service coverage in order to provide more targeted dental care services; (c) to review the manpower resources and related training arrangements of various dental professionals to tie in with the strategic development needs of the overall oral health and dental care; and (d) to review the complementary arrangements for dental services, including the models and financial arrangements under which services provided or subsidised by the public sector are delivered, as well as the use of electronic health records, with a view to ensuring service efficacy. Issues concerning public-private partnership raised in the question will also be covered in the discussion of the Working Group. (3) The pilot scheme for the use of EHCVs at the University of Hong Kong-Shenzhen Hospital (HKU-SZH) was launched on October 6, 2015, and has been regularised since June 26, 2019. Currently, eligible elderly persons can use EHCVs to pay for the fees of outpatient healthcare services provided by a total of 15 designated clinics/departments of the HKU-SZH and the Huawei Li Zhi Yuan Community Health Service Center, including the dental services provided by these service points. The Government allows the use of EHCVs at the HKU-SZH having regard to its adoption of the "Hong Kong management model" with healthcare service standards and clinical governance structures similar to those of Hong Kong. The Government will sum up the experience gained in the EHCV scheme at the HKU-SZH and consider the feasibility of further extending the application of EHCVs to cover the Mainland medical institutions in the Guangdong-Hong Kong-Macao Greater Bay Area, in particular those having adopted the "Hong Kong management model" and with healthcare service standards and clinical governance structures comparable to the HKU-SZH's. The management model and healthcare level of such medical institutions must meet the stipulated requirements and be aligned with those of Hong Kong. To this end, the Government is currently mapping out the detailed standards and prerequisites for extending the coverage. (4) To tackle the shortage of dentists, the Government is actively exploring the amendment of the Dentists Registration Ordinance (Cap. 156) to create new pathways for the admission of qualified non-locally trained dentists to practice in specified institutions, and to reform the regulatory framework for dentists and ancillary dental workers, so as to ensure adequate manpower support for the local public or subsidised dental care services in the long run. The Government has been progressively seeking views from relevant stakeholders on the matters of legislative amendments, and will consult the Legislative Council Panel of Health Services in July this year. The Government's target is to introduce the amendment bill into the Legislative Council by the end of 2023.