LCQ16: Provision of medical treatment to patients with Coronavirus Disease 2019
7.6.2023

Following is a question by the Hon Yang Wing-kit and a written reply by the Secretary for Health, Professor Lo Chung-mau, in the Legislative Council today (June 7): Question: It has been reported that the number of confirmed cases of the Coronavirus Disease 2019 (COVID-19) in Hong Kong has increased in recent months. Some confirmed patients have relayed that it is difficult to make appointments for general outpatient clinic (GOPC) services of public hospitals, and that only a small number of private doctors are willing to treat COVID-19 patients, resulting in a shortage of consultation services and long queues at private clinics in many districts. Moreover, quite a number of grass-roots people have indicated that they can hardly afford the high consultation fees or administrative fees charged by private clinics, and have no choice but to seek consultation at the accident and emergency (A&E) departments of public hospitals. In this connection, will the Government inform this Council: (1) as it has been reported that some private clinics charge COVID-19 patients higher consultation fees, whether the Government knows the reasons and criteria for private doctors to charge COVID-19 patients additional administrative fees or consultation fees; if so, of the details, and whether it will appeal to such private doctors to charge COVID-19 patients the normal fees; if not, the reasons for that; (2) whether it knows under what circumstances the Hospital Authority (HA) will increase the GOPC consultation quotas reserved for COVID-19 patients and reopen the designated clinics for COVID-19 confirmed cases, so that the patients can receive appropriate medical treatment as early as possible; (3) as it is learnt that some COVID-19 patients do not know how to use the mobile application "HA Go" to make appointments for consultation services, whether the Government will assist COVID-19 patients in making mobile appointments and request HA to provide an additional on-site quota allocation arrangement; if so, of the details; if not, the reasons for that; (4) whether it knows if HA will keep data on the number of COVID-19 patients seeking consultation at A&E departments, as well as their symptoms; if HA will, of the details; if not, the reasons for that; (5) whether it will collect and publish information on the consultation fees, administrative fees and drug fees charged by private doctors providing medical treatment to COVID-19 patients, so as to enhance the transparency of their charges; if so, of the details; if not, the reasons for that; and (6) whether it has formulated measures to encourage more private doctors to provide medical treatment services for COVID-19 patients; if so, of the details; if not, the reasons for that? Reply: President, In consultation with the Department of Health (DH) and the Hospital Authority (HA), the consolidated reply to the question raised by the Hon Yang is as follows: Having regard to the development of the coronavirus disease 2019 (COVID-19) epidemic, the Government has been summing up experiences periodically so as to continuously improve the responses on all fronts. While the virus has been evolving, the prevention and treatment capacities of the local healthcare system and the handling capacity of the society as a whole have been enhanced significantly with the concerted efforts of the whole community. The risk posed by COVID-19 to local public health has thus been significantly reduced. COVID-19 has been managed as an upper respiratory tract illness since early this year, while relevant measures are now focusing on the protection of the high-risk groups. Having taken into account the World Health Organization (WHO)'s latest advice as well as having assessed the local situation, risks and mutation of COVID-19 strains, the Government has also lowered the response level under the Preparedness and Response Plan for Novel Infectious Disease of Public Health Significance from Emergency to Alert level since May 30 this year. At present, most of the infected persons, especially those who have been vaccinated for COVID-19, are mild cases. Symptomatic citizens may directly attend medical consultations at private doctors/clinics or the General Out-patient Clinics (GOPCs) under the HA. Visiting Accident and Emergency (A&E) departments or public hospitals is not necessary, so as to focus relevant public healthcare resources on attending to patients with more urgent or severe conditions. As for public GOPCs, having regard to service needs, the GOPCs under the HA currently offer about 20 000 consultation quotas each day on weekdays (including consultation quotas for episodic illnesses and chronic diseases) and some consultation quotas are reserved for persons infected with COVID-19. For A&E departments of public hospitals, 18 927 (Note) persons attended A&E departments in the past one month (i.e. April 19 to May 20) with primary diagnosis as COVID-19 and the majority were mild cases. A large number of COVID-19 and seasonal influenza patients with mild conditions visiting A&E departments inevitably poses pressure on A&E departments in handling and admitting other emergency or severe cases. The HA will continue to closely monitor the situation of each clinic and adjust consultation quotas as necessary in a timely manner to ensure that patients receive appropriate treatment. The Government does not have any plan at the current stage to re-activate designated clinics that are mainly for coping with large-scale epidemic situations. Regarding booking of appointments, currently persons infected with COVID-19 can make an appointment for consultation service through the "BookCOVID" function of the HA's one-stop mobile app "HA Go" or the telephone appointment system of GOPCs. Most citizens can complete booking of appointment following the steps shown in the app. In addition, "HA Go" also provides assistance to those who may need it through various channels (e.g. promotion at the "HA Go" website, demonstration videos as well as frequently asked questions). Citizens can also book an appointment for other infected persons in need by using the "Book for others" option under "BookCOVID" function in "HA Go". Moreover, help desks have been set up in GOPCs to assist those who encounter difficulty in appointment booking service for GOPCs. The mobile app and telephone appointment system of GOPCs operate round-the-clock, so that patients no longer need to queue in advance at clinics for booking appointment. This not only improves the crowding problem in the clinics, but also reduces the chance of cross-infection among patients. For private healthcare, private hospitals and doctors have been providing consultation and treatment services for persons infected with COVID-19. Since April 2022, the Government has also started to provide two COVID-19 oral drugs to private doctors for free prescription to "Eligible Persons" who are infected. As at early June, 2023, 865 doctors and 743 clinics have been given free COVID-19 oral drugs from the Government. As it is not mandatory for private doctors to upload medical diagnosis records to patients' accounts via the Electronic Health Record Sharing System (eHealth), the statistics of private doctors in treating persons infected with COVID-19 cannot be collected or compiled. However, according to the records of the COVID-19 antiviral drug register, more than 34 400 COVID-19 oral drug treatment courses were prescribed by private doctors in May 2023. To relieve the burden on public healthcare system, the Centre for Health Protection (CHP) of the DH has issued a letter to doctors and medical organisations on January 6 this year, appealing to private doctors for their provision of out-patient and in-patient, or telemedicine services to persons infected with COVID-19. The CHP has also updated infection control guidelines in hospital and clinic settings and persons infected with COVID-19 may seek medical consultation at private healthcare institutions as with those with other respiratory infectious diseases. As for the consultation and other related fees charged by private doctors for providing treatment for COVID-19 patients, the Government does not mandate the price level, which is also the case for other diagnostic and treatment services offered by private doctors. To protect their interests, citizens should first enquire about the fee levels from private doctors before using such services. To make every effort to safeguard public health, the Government will continue to closely monitor the latest situation and risks of COVID-19 with an emphasis on protecting high-risk groups and keep in view of the WHO's latest assessments. In fact, vaccination is one of the effective means to prevent COVID-19 and its complications, as well as to reduce hospitalisation and death cases due to infection. The Government again strongly call on citizens who have not completed the first three doses of vaccine, as well as persons from high-risk groups who have yet to receive a booster dose per experts' recommendation, to get vaccinated as early as possible for protection of themselves and their family. Note: This is a provisional figure that will be continuously updated during processing of the records.