Letter to Hong Kong

13/8/2017 RTHK

 

Dear Sophronia,

How’s your summer holiday?

This summer, Hong Kong has been overwhelmed by a strong outbreak of seasonal influenza and the surge has been continued till now.  Though the situation in the past two weeks seems to be steadying, our public hospitals have been facing continuous critical challenges during the peak of this summer surge.  Bed occupancy of most public hospitals has been reaching their new height;  the medical wards of these hospitals are having a record high occupancy figure of over 120%.  It is also reported that some of the patients have to wait up to 8 hours before seeing a doctor, and those who are to be admitted have to queue up for another 15 hours after receiving initial treatment in the Accident & Emergency Department.

As a matter of fact, seasonal influenza has become an endemic in the past years.  However, it is rather disappointed that the Hospital Authority seems to be remained under prepared, and, as usual, only able to take a reactive approach to manage the summer surge until the situation turns into a crisis.  Obviously, this year’s flu outbreaks, once again, further exposed the ineffectiveness and inadequacy of the Hospital Authority.

Looking back in March of the last year, an endemic of flu outbreak flooded the public health system during the winter surge.  At that time, the Association of Hong Kong Nursing Staff forward a series of recommendations to the Chief Executive of Hong Kong requesting the Government to earmark additional resources and contrive exceptional measures to support the already overloaded frontline healthcare staff so as to resolve the crisis and help addressing staffs’ frustrations.  These recommendations includes flexible allocation of internal resources, speeding up the recruitment of part-time staff, streamlining of the Special Honorarium Scheme, reducing unnecessary clinical paper work, suspension of all the hospital accreditation activities, expanding service capacity of the General Outpatient Clinics, and triaging non-urgent patients to General Practitioners in the community.  Nevertheless, there was no evidence that the Hospital Authority had adopted any of these suggestions.

A year later, i.e. this year, the winter surge returned as a summer flu outbreak.  What the Hospital Authority has been doing is, again, a classic knee-jerk response: additional beds without extra manpower.

Such reactive approach not only ending up with more patients are queuing up in the Accident & Emergency Department and over-congested hospital wards but also generated unresolved frustration among the already overloaded frontline healthcare staff.

In an attempt to help resolving such pressing situation, the Association, once again, made an appeal to the SAR Government to urge her to implement all possible strategies to rectify the crisis.  Shortly, it is noted that the Hospital Authority finally announced a contingency plan to address the summer flu outbreak.  Interestingly, some of the measures adopted as contingency are simply mirroring the submission that the Association made last year.  It is indeed astonished to see that such risk management approach used by the Hospital Authority to deal with the endemic seasonal influenza outbreak could be an effective one.  Ostensibly, the Hospital Authority has never learnt from experience.  As flu outbreak becomes an expected recurrent annual incident, the Hospital Authority should be able to instigate proactive and precautionary strategies to stop such crisis repeatedly challenging our public hospital systems.

In the long-run, to help easing the flu crisis, the Hospital Authority have to concentrate its human resources in the provision and delivery of healthcare services instead of overloading frontline staff with excessive documentation and endless procedural activities that related to hospital accreditation.  Besides, establishing Nurse-led Clinic and Clinical Pharmacist in the General Out-patient Clinics can increase its service capacity and, in turn, help triaging some of the non-emergency attendees of the Accident and Emergency Departments.  Hopefully, the Hospital Authority could be able to sustain these measures so that the next flu outbreak would not become another chaos.

On the other hand, looking from another perspective, the SAR Government should also be liable for the crisis as well.  Under the existing so-call “Dual Track System”, the Government do encourage patients to seek medical consultations from private sector, however, at the same time, this year, budgeted HK$57 billion to the Hospital Authority and pledged that HK$200 billion has been earmarked for a ten-year public hospital development project.  Such contradictory policy creates a public expectation that the Government aims at continuously expanding and improving public hospital services.  As a result, ironically, it invites more patients using public hospitals and, above all, attending Accident & Emergency Department.

Looking forward, the government should not only review the ineffective organizational and bureaucratic structure of the Hospital Authority but also have the determination to reposition the health policy of Hong Kong, i.e. shifting from a treatment-focused model to a health-centred model, and to balance the resources allocation between primary, secondary & tertiary level care.

Keep enjoying your summer.

Love

Uncle Joe
 
更新日期: 2017-08-16