LCQ14: Safety of facilities and structures of public hospitals
29.3.2023

Following is a question by the Hon Lai Tung-kwok and a written reply by the Acting Secretary for Health, Dr Libby Lee, in the Legislative Council today (March 29): Question: It has been reported that incidents of ceiling concrete spalling and surgical light falling off have occurred successively in public hospitals recently. Regarding the safety of the facilities and structures of public hospitals, will the Government inform this Council: (1) whether it knows the number of incidents similar to those mentioned above that occurred in each of the past three years, and the follow-up work on each of those incidents (including whether relevant information was notified internally and disseminated externally), with a breakdown by hospital cluster; (2) whether it knows the years in which various public hospitals were completed and the years in which they last underwent major renovation works/redevelopment; (3) whether it knows the details of the repair and maintenance works of public hospitals at present (including the frequency, the manpower responsible for the relevant works and the scope of the relevant works); (4) whether it knows the tendering and evaluation mechanism adopted by the Hospital Authority (HA) in respect of the repair and maintenance works of public hospitals (including the evaluation criteria, the factors for consideration, and the respective weightings for technical and price scores); and (5) as it has been reported that the facility inspection work of all public hospitals in the territory is currently carried out by the same contractor, and there are views that such practice is not desirable, whether the Government knows how long the situation of HA engaging only one contractor to carry out such work has been maintained and whether it has plans to split the facility inspection work as well as repair and maintenance works of different public hospitals into multiple contracts; if so, of the details; if not, the reasons for that? Reply: President, In consultation with the Hospital Authority (HA), the reply to the Hon Lai Tung-kwok is as follows: (1) To improve service quality and standardise information, the HA has established the Advance Incident Reporting System as a reporting platform to encourage staff to provide an outline of incidents in time. The management and healthcare team will conduct risk assessment on the reported incidents, and report major events or events with significant risk internally and/or externally in a timely manner. Meanwhile, the team also seeks to identify the root causes and solve systemic problems through analysis and investigation of the reported incidents, with a view to learning from experiences and mutual sharing for improvement of service quality. The breakdown of incidents reported under "Facilities and Environment" or "Medical Equipment, Apparatus and Consumables" through the Advance Incident Reporting System in the past three years is as follows: Year "Facilities and Environment" related incidents (Note 1) "Medical Equipment, Apparatus and Consumables" related incidents (Note 1) 2020 1 611 329 2021 1 898 482 2022 1 495 461 The HA has been upholding the principle of openness and transparency for making external announcements on major incidents of public hospitals. The HA will take into account of various factors when considering public dissemination of incidents, including whether any patient, staff or visitor have been injured, any impact to services, and the seriousness of the incident. For those incidents reported by hospitals involving "Facilities and Environment" or "Medical Equipment, Apparatus and Consumables" in the past three years, most of them were minor incidents not involving casualties or service interruptions. Having made assessment of these incidents, the HA had not considered them major incidents and hence did not make public announcements. For those more serious ones involving casualties or affected services, the HA will make public announcements. The number of incidents reported under relevant categories and announced through press releases by the HA in the past three years is as follows: Year "Facilities and Environment" related incidents "Medical Equipment, Apparatus and Consumables" related incidents 2020 10 1 2021 9 0 2022 1 0 (2) At present, the HA manages 43 public hospitals and medical institutions, 49 specialist out-patient clinics and 74 general out-patient clinics. These hospitals and clinics represents one of the largest and most complex building stocks in Hong Kong, covering over 300 buildings with floor area of around three million square metres. Among them, about 100 buildings are 30-50 years old, and about 130 buildings are more than 50 years old. The major renovation/redevelopment projects completed by the HA in past ten years include the expansion of Tseung Kwan O Hospital, the Phase II redevelopment project of Caritas Medical Centre, the ward renovation in Kwai Chung Hospital, the redevelopment of Yan Chai Hospital, the refurbishment of Hong Kong Buddhist Hospital, the expansion of the Hong Kong Red Cross Blood Transfusion Service Headquarters, and the expansion of Haven of Hope Hospital. In addition, the government is now stepping up efforts to drive forward various redevelopment and expansion projects under the First Ten-year Hospital Development Plan (HDP), with a view to increasing the capacity of inpatient services, improving service quality and upgrading hospital facilities. Besides, the Finance Committee of the Legislative Council approved a one-off grant of $13 billion to the HA under Head 708 Subhead 8083MM of the Capital Works Reserve Fund on December 20, 2013, for HA to implement minor works projects in around 10 years starting from 2014-15. This includes the renovation of over 500 wards and other regular maintenance/minor works. (3) In order to improve the condition and environment of the HA's aging building facilities and enhance the service capacity to complement other major projects such as construction of new hospitals or renovation of hospitals, the current repair and maintenance work in public hospitals mainly includes facility rejuvenation programme, service capacity enhancement programme, safe engineering programme, and other regular maintenance works. Relevant works are mainly carried out through engaging contractors with relevant professional qualifications and experiences on contract basis through tendering procedures. They include term contractors to carry out the works, and term maintenance surveyors and term quantity surveyors for monitoring purpose. Besides, the repair and maintenance work of the electrical and mechanical equipment in most hospitals are carried out by the Electrical and Mechanical Services Trading Fund (Note 2), while others are regularly maintained and repaired by the relevant electrical and mechanical suppliers or maintenance contractors. (4) Eligible companies on relevant lists of approved consultants or contractors for public works will be invited to submit tenders for HA's repair and maintenance work contracts in accordance with established tendering procedures. The tendering process mainly considers whether the services provided by the relevant companies meet the HA's requirements. The evaluation method includes reference to the appraisal of relevant companies by the Development Bureau. Professional qualifications, past performance, hospital or relevant works experience and tender price of relevant companies will also be considered. (5) The current building inspection project of the HA has been provided by a consultancy service contract covering seven clusters since 2021. The scope of the inspection covers all facilities managed by the HA, including public hospitals and clinics. Inspection items include indoor concrete structures and components, external facades and components and false ceilings followed with mandatory submission of reports. If further follow-up is found to be required for the building structure, the hospital will arrange repair work according to the type and scale of repair service needed. As for building repair and maintenance and minor works, etc., the HA currently engages seven different term contractors (generally engaged on a three-year contract basis). The work of each term contractor shall be monitored by a term maintenance surveying consultant and a term quantity surveying consultant. In addition, the term maintenance surveying consultants are also responsible for design work and issuing work orders to term contractors. The term quantity surveying consultants are responsible for cost control of work projects, contract payments and preparation of final accounts, etc. In view of recent incidents, the HA established the Review Committee on Medical Equipment and Facility Maintenance in March 2023. The committee will review the maintenance issues of medical equipment and facilities in public hospitals and advise policy direction on HA's management of relevant issues including contractual arrangements for the above-mentioned building inspection project. The HA will follow up on future contractual arrangements in accordance with the directions advised by the Committee. The HA will continue to follow up actively and seriously on any matters relating to hospital safety, including enhancing the monitoring of maintenance and repair work of contractors to ensure environmental safety of the hospitals. The Health Bureau has requested the HA to review and submit a report on the repair and maintenance of hospital facilities as well as the incident reporting and handling mechanism involving the safety of hospital patients. Note 1: The Advance Incident Reporting System has not categorised "spalling of concrete ceilings" or "suspended medical equipment", relevant detailed figures cannot be retrieved from the system. Note 2: The Electrical and Mechanical Services Trading Fund was established in August 1996 under the Trading Funds Ordinance (Cap. 430) to manage and audit the operation of certain services of the Electrical and Mechanical Services Department. Services provided by the trading fund include operation and maintenance of electrical, mechanical, electronic and building services systems and equipment.