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Annual Report
2010-2011
Helping People
Stay Healthy
Table of Contents
Vision, Mission and Values Membership of the Hospital Authority 1 5 Chapter 1 Corporate Governance 10 Chapter 2 Chairmans Review 14 Chapter 3 Chief Executives Report 20 Chapter 4 Milestones of the Year 26 Chapter 5 Engagement, Teamwork and Innovations 34 Chapter 6 Head Office Report and Cluster Reports 42 Independent Auditors Report 73 Audited Financial Statements 76 Appendices 130
Advising the Government of the needs of the public for hospital services and of the resources required to meet those needs Managing and developing the public hospital system
Promoting, assisting and taking part in the education and training of persons involved in hospital or related services
Recommending to the Secretary for Food and Health appropriate policies on the fees for the use of hospital services by the public
Mission
Helping People Stay Healthy
Values
People-centred Care Professional Service Committed Staff Teamwork
Vision
Healthy People Happy Staff Trusted by the Community
Corporate Strategies
The Authority aims to achieve its VMV by adopting five strategic priorities:
In his report presented in Chapter 3, the Chief Executive outlined the major achievements of HA under these strategies. The Authority formulated a total of 145 improvement targets for 2010/11, of which all but nine were achieved. Notable events during the year were listed in Chapter 4 and major programmes and achievements were summarised in the Head Office and Cluster reports in Chapter 6 of this report.
Mr CHENG Yan-kee, JP
Appointed on 1 December 2009, Mr Cheng is the managing director of a consulting engineering company.
Dr LAM Ping-yan, JP
Director of Health Dr Lam has been a member of the Authority in his capacity as Director of Health since 21 August 2003.
Ms Alice LAU, JP
Deputy Secretary for Financial Services and the Treasury Ms Lau has been representing Secretary for Financial Services and the Treasury of the Hong Kong Special Administrative Region Government as a member of the Authority since 31 March 2010.
Ms LAU Ka-shi
Appointed on 1 April 2008, Ms Lau is the managing director and chief executive officer of a pension and trust service provider.
Ms Sandra LEE, JP
Permanent Secretary for Health Appointed on 8 May 2006, Ms Lee is a member of the Authority in her capacity as Permanent Secretary for Health of the Hong Kong Special Administrative Region Government.
Dr P Y LEUNG, JP
Chief Executive, HA (from 8.11.2010) Appointed on 8 November 2010, Dr Leung is a member of the Authority in his capacity as Chief Executive of the Hospital Authority.
Mr Peter LO Chi-lik
Appointed on 1 April 2005, Mr Lo is a solicitor.
Ms Winnie NG
(from 1.12.2010) Appointed on 1 December 2010, Ms Ng is a director of a bus company.She has also served on other public services.
Mr Shane SOLOMON
Chief Executive, HA (up to 24.10.2010) Appointed on 1 March 2006, Mr Solomon was a member of the Authority in his capacity as Chief Executive of the Hospital Authority.
Chapter 1
Corporate Governance
Corporate Governance
he Hospital Authority (HA) is a statutory body established under the Hospital Authority Ordinance in December 1990, responsible for managing public hospitals in Hong Kong. We are accountable to the Hong Kong Special Administrative Region (HKSAR) Government through the Secretary for Food and Health.
Principles
Recognising that the Authoritys stakeholders expect the highest standards of performance, accountability and ethical behaviour, the Board acknowledges its responsibility for and commitment to corporate governance principles. The following outlines the approach and practices of corporate governance of the Authority.
Board Committees
For optimal performance of roles and exercise of powers, the HA Board has established 11 committees: Audit Committee, Emergency Executive Committee, Executive Committee, Finance Committee, Human Resources Committee, Information Technology Services Governing Committee, Main Tender Board, Medical Services Development Committee, Public Complaints Committee, Staff Appeals Committee and Supporting Services Development Committee. Membership of the committees, their terms of reference and focus of work in 2010/11 are outlined in Appendix 3.
and institutions. These committees are listed in Appendix 4. During the year, these committees received regular management reports from Hospital Chief Executives, monitored operational and financial performance of the hospitals, participated in human resources and procurement functions, as well as hospital and community partnership activities. In 2010/11, the 31 Hospital Governing Committees held a total of 129 meetings.
Executive Management
The executive management team of the Hospital Authority is outlined in Appendix 2(b). The executives are charged by the Hospital Authority Board with the responsibility to manage and administer day-to-day business and operations. To ensure that the management can discharge its duties in an effective and efficient manner, the Hospital Authority Board has set out clear delegated authority, policies and codes of conduct. The Board also approves an annual plan prepared by the executives in accordance with the Boards direction. Regular executive reports on the progress of agreed performance indicators and targets are presented to the Board. Under the powers stipulated in the Hospital Authority Ordinance, the Authority determines the remuneration and terms and conditions of employment for all its employees. Remuneration packages of executive directors and other senior managers are devised so as to attract, motivate and retain high calibre individuals in a competitive international market. Remuneration packages of all senior executives are considered and endorsed by the Hospital Authority Board through the Executive Committee.
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Chapter 2
Chairmans Review
010/11 was a momentous year as we celebrated our 20th birthday. When we reflect on what we did in the last twenty years, we should all feel very proud of what we have achieved. We have transformed Hong Kongs healthcare services to become one of the best in the world. The progress and accomplishments in public healthcare services in Hong Kong made the Hospital Authority (HA) a model for the healthcare reform in Mainland China. In November 2010, I was appointed by the Ministry of Health of the Peoples Republic of China as an advisor to the Overseas Expert Consulting Committee for Health Care Reform of China. This is a profound honour, not for me, but for everyone at HA. This appointment is the recognition of HAs excellent work and outstanding achievement.
Chairmans Review
ugust 2010 was an exceptional month for Hong Kong. It was a time of both joy and sadness. We saw exhilaratory success in the first-ever combined heart-and-liver transplant in Hong Kong. In a 20-hour operation involving 68 medical staff, a female patient received the heart and liver from a brain-dead donor, while giving her own failing but still functioning liver to a man with liver cancer. The dedication and skills of our medical staff made this momentous occasion possible. Their achievement augmented the standards of public healthcare services of Hong Kong to a new high. We feel immensely proud. August of last year was also a heartbreaking month. The Manila hostage incident occurred right after our ground-breaking heart-liver surgery. Eight Hong Kong citizens lost their lives and seven were injured. During this traumatic time, a medical team of eight specialists and nurses was quickly mobilised and set off to the Philippines to deliver emergency assistance to our fellow citizens in distress. This horrible event had painful impact on us when we discovered that one of the victims was a nurse of an HA hospital. Though escaped with her son from atrocity, the nurse lost her beloved husband during the hostage crisis. These agonising moments bound us together. The medical team returned with the injured victims for further treatment in Hong Kong. Our colleagues demonstrated exceptional compassion and professionalism in helping them recover both physically and psychologically. Amid such trauma, we stood up against adversity together.
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Over the last year, our colleagues also faced an unprecedented workload due to the increase in turnover and service demands. Many frontline colleagues expressed concerns on manpower and career development. The HA Board made these challenges surpassable with their continuous support. My gratitude goes to the Board for approving a basket of initiatives and extra annual budget to retain doctors, relieve workload and strengthen the workforce. We fully appreciate the dedication and commitment of frontline doctors in serving the public. I would also like to express my gratitude to the Government for its steadfast support to HA. The recurrent budget allocated to HA was increased for the third consecutive year. Additional recurrent funding was allocated for us to cope with new and increasing demand, while healthcare service reform initiatives were implemented. I thank the Secretary for Food and Health for his visionary leadership and unwavering support. We are committed to continue working with the Government to move healthcare reform forward. I wish to extend warm welcome to Dr Leung Pak-yin, who was appointed as our new Chief Executive in November 2010. Dr Leung has not only set a clear vision for the future development of HA, but also targeted at achieving practical solutions and
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Chairmans Review
results. With continuous support of all colleagues, we are confident that Dr Leung will be successful in leading and driving changes. On the other hand, my appreciation goes to Mr Shane Solomon, who served as the Chief Executive up to October 2010 with exemplary leadership, expertise and commitment. During the past fourand-a-half years in HA, he has driven numerous reforms with his outstanding capability and experience. The Board and I deeply appreciate his contribution to improving the healthcare services of Hong Kong. There were changes to the membership of the HA Board. I wish to thank Ms Vivien Chan, Professor Lai Kar-neng, Mr Peter Lo Chi-lik, Mr Charles Peter Mok and Professor George Woo, who retired from the Board during 2010/11. I also want to welcome our new Board members Ms Quince Chong Wai-yan, Mr Ricky Fung Choi-cheung and Ms Winnie Ng. My deepest gratitude goes to all members of the Board, Regional Advisory Committees, Hospital Governing Committees, as well as the co-opted members of all functional committees. I am exceptionally grateful to all Board members for their invaluable advice and support towards the executives and myself in formulating strategic directions and policies of HA throughout the year. There are, of course, many others who contributed to HA in other ways. We would not have successfully discharged our roles and functions without the involvement and input from the community, patient groups, District Councils, the Legislative
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Council, and of course, the volunteers who work selflessly in our hospitals and institutions. I would also like to congratulate all the recipients of this years Outstanding Staff and Teams Award. They are all role models in professional service, teamwork, leadership and personal character. Once again I pay tribute to the public for their collaboration, to colleagues for their splendid efforts and dedication. With their commitment and wisdom, I am confident that HA will continue to provide a strong safety net for the people of Hong Kong.
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Chapter 3
his year marked the 20th anniversary of the Hospital Authority (HA). We commemorated this important occasion by paying tribute to our predecessors and all stakeholders for their invaluable contribution to our success over the past years through hosting a gala dinner themed 20 Years of Helping People Stay Healthy. The event was well attended with 1,900 guests including Mr Donald Tsang, Chief Executive of Hong Kong Special Administrative Region (HKSAR); Mr Peng Qinghua, Director of Liaison Office of the Central Peoples Government in HKSAR; and Mr Wang Guoqiang, Vice-Minister of Health of the Peoples Republic of China. In line with the Governments direction of healthcare reform to enhance primary care and promote publicprivate partnership, new programmes and service models were developed to address growing demand. Community health call centres were established in all Clusters to improve community support for discharged elderly patients and prevent avoidable hospitalisation. The cataract surgeries programme continued to grow in success, benefiting nearly 10,000 people. To cope with long term demand for hospital services on Lantau Island, HA assisted the Government to conduct a consultancy study and identifiy feasible public-private partnership models in the phase two development of North Lantau Hospital.
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In recent years, an increasing number of Hong Kong people live or work in the Mainland, especially in Shenzhen. To facilitate better continuity of care, HA signed a collaboration agreement with the Health, Population and Family Planning Commission (HPFPC) of Shenzhen Municipality on the Hong Kong Patient Referral Project in March 2011. The project facilitates the transfer of medical records of Hong Kong residents admitted to Shenzhen hospitals when they need to be referred back to Hong Kong. Piloted at two Shenzhen hospitals, the project was initially implemented in two designated hospitals in HA, namely Tuen Mun Hospital and North District Hospital. On the quality side, HA has strived to improve patient care quality since its establishment in the early 1990s. The successful launch of hospital accreditation programmes marked a milestone in developing a sustainable system for continuous quality improvement of healthcare services in Hong Kong. Thanks to the efforts of our colleagues, five HA hospitals namely, Caritas Medical Centre, Queen Elizabeth Hospital, Queen Mary Hospital, Pamela Youde Nethersole Eastern Hospital and Tuen Mun Hospital attained full accreditation status in 2010/11, demonstrating world-class standards in patient service delivery. The scheme will be extended to fifteen more hospitals in the next five years. Empowering patients to manage their own health remains a key strategy for HA to actualise the mission of helping people stay healthy. Patient empowerment programmes organised in collaboration with nongovernment organisations equipped patients with knowledge and ability to manage their chronic diseases in order to prevent possible complications. The programme was implemented in four Clusters in 2010/11. On the other hand, we demonstrated greater transparency and accountability to our stakeholders, particularly patients, through the first HA-wide Patient Satisfaction Survey (PSS). Although most public hospitals had individual regular small scale patient satisfaction surveys in the past, the PSS has not only formed a framework for future benchmarking purposes, but is also a great step forward in patient engagement. Through instilling the culture of proactively
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engaging patients, we target to drive quality improvement from the patients perspective alongside gathering input from healthcare professionals. Managing manpower shortage and addressing concerns of frontline doctors and nurses was a focus area of work in 2010/11. We wish to express our appreciation to all staff group consultative committees and the unions in soliciting views from frontline colleagues and making constructive suggestions in addressing the current challenges. We had introduced various measures to relieve immediate workload of our medical staff, as well as to improve the working condition and career prospect of doctors and nurses. A taskforce on medical manpower review was set up in July 2011, comprising internal and external representatives of the profession and staff groups. The taskforce will review long term medical manpower issues and address concerns of frontline staff. It is of equal importance to maintain a stable and competent workforce of supporting staff who demonstrate exemplary performance in order to ensure efficient and effective delivery of quality hospital services. In demonstrating our high regard for the contribution of supporting staff, we conducted a comprehensive review of the workforce of General Services Assistant/ Technical Services Assistant (GSA/TSA) grade of 12,000-strong workforce. Over 3,000 written comments were solicited from line managers and frontline staff. Serving staff of GSA/TSA grade would be converted to the new structure with better remuneration packages and a clear training and career progression pathway.
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Staff is our most important asset. Formulating outcome focused strategies would not be possible without listening actively to the voices of our colleagues. To meet different needs of a workforce with changing demographics, we capitalised on the new media as a channel of communication with staff from different background and generations. We created a blog on the newly revamped HA intranet to facilitate two-way communication with colleagues.
Important senior staff movement in HA last year was the appointment of Dr Hing-Wing Liu as Director of Quality & Safety. I also extend my best
wishes to Mr David Rossiter who had left HA on his own accord upon the expiry of his contract.
Besides patients and staff, HA is indebted to all its stakeholders, namely the local community, non-government organisations and the media, for unwavering support over the past years. I also wish to express my gratitude to the Government and the Secretary for Food & Health for their continuous and generous support, both in terms of leadership and resource allocation, as well as their confidence in HA, of which the recurrent funding of HK$34 billion accounted for 14.8% of the total government expenditure. Without the hard work, dedication and commitment of our staff, it would be impossible for HA to deliver quality healthcare to the people of Hong Kong. My appreciation also goes to all members of the HA Board, Regional Advisory Committees, and Hospital Governing Committees for their tireless efforts. Last but not least, I wish to convey my heartiest gratitude to the HA Chairman for his trust and staunch support.
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Chapter 4
April 2010
Down syndrome test extended to all eligible pregnant women
The Universal Prenatal Testing for Down Syndrome has been offered to all eligible pregnant women at all eight obstetric units of HA since April 2010. It helps reduce miscarriage caused by invasive procedure.
May 2010
Hospital Authority Chinese Orchestra comforts earthquake stricken Sichuan
Formed by medical staff members, the HA Chinese Orchestra hosted a concert named A Journey to Sichuan with Music and Love at the Sichuan Provincial Peoples Hospital to comfort distressed patients and medical staff in the affected area.
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June 2010
Patient Satisfaction Survey taps patient opinion
The first territory-wide patient satisfaction survey gauged opinion from more than 5,000 discharged patients on their experiences as inpatients at HA hospitals during the period of 15 June to 27 September 2010.
July 2010
Interactive electronic platform targets at better communication
The one-stop Electronic Patient Resource Platform is an interactive communication platform newly designed to serve patients, carers, volunteers and the local community in the Kowloon Central district. The new platform enhances collaboration among patients, the community, and the Cluster.
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August 2010
Four public hospitals win Asian Hospital Management Awards
Kwong Wah Hospital, North District Hospital, Princess Margaret Hospital and Tuen Mun Hospital won Asian Hospital Management Awards with exemplary achievements in hospital management.
September 2010
PYNEH receives accreditation
Pamela Youde Nethersole Eastern Hospital (PYNEH) was awarded full accreditation for four years by the Australian Council on Healthcare Standards.
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October 2010
QEH and CMC receive accreditation
Queen Elizabeth Hospital (QEH) and Caritas Medical Centre (CMC) were granted four-year full accreditation status by the Australian Council on Healthcare Standards.
November 2010
HA celebrates 20th anniversary
Hospital Authority hosted the 20 Years of Helping People Stay Healthy gala dinner as part of its 20th anniversary celebration. More than 1,900 guests including community partners, patient groups, and staff members attended the event.
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December 2010
TMH celebrates 20th anniversary
Serving the New Territories West district for two decades, Tuen Mun Hospital (TMH) celebrated the milestone at a party with community partners, volunteers and employees to show appreciation for their dedicated efforts.
January 2011
NTEC brings warmth to elderly during Chinese New Year
More than 250 staff of New Territories East Cluster (NTEC) and volunteers from secondary schools, agencies and corporations brought warmth and blessings to elderlies discharged from Prince of Wales Hospital and Shatin Hospital on Lunar New Year eve, celebrating festivities with warm soup, new year snacks and good wishes for the new year.
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February 2011
QMH receives accreditation
A four-year full accreditation status was granted to Queen Mary Hospital (QMH) by the Australian Council on Healthcare Standards.
March 2011
Five-Year Mental Health Service Plan endorsed by HA Board
The HA Board endorsed the Mental Health Service Plan which formed a framework for the development of mental health services for adults in Hong Kong from 2010 to 2015.
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Chapter 5
Gaining Trust
eing a public organisation, HA is committed to engaging all stakeholders in various aspects of policy formulation, service development and implementation, as well as internally on organisational development matters. Understanding the needs and concerns of our stakeholders is pivotal from crafting strategic directions to mapping out implementation plans so as to actualise the vision of the organisation and gain trust from the community.
he past year has been a memorable one in terms of stakeholder communication. Both formal and informal communication channels were strengthened to engage key stakeholders including policy bureaux, government departments, Legislative Council members, District Council members, non-government organisations (NGOs), patient groups, the private sector, other service providers, employees, media and the public at large. This chapter summarises particular endeavours undertaken in 2010/11 at both HA Head Office and the Clusters in establishing rapport and gaining trust from patients and employees. It also outlines innovative initiatives taken by HA to discharge its corporate social responsibility in contributing to an environmentally friendly society.
Engaging Patients
Engaging patients as partners in health is a strategic direction of HA in achieving the vision of helping people stay healthy. Patient empowerment programmes were implemented in collaboration with NGOs to educate and motivate patients with chronic illnesses to assume part of the disease management responsibilities through self care and lifestyle modification. These programmes were rolled out in four Clusters in 2010/11, including Hong Kong East, Kowloon Central, Kowloon West and New Territories East. Empowerment of patients is also manifested by involving them as partners in health. The Patient Partnership in Action (PPIA) training programme was launched jointly with patient self-help groups to enhance their awareness of Hong Kongs healthcare system. Sixteen patient group leaders became PPIA ambassadors after completing the programme, and were invited to participate in different projects and committees at the HA Head Office. Developed through concerted efforts of patient groups, community partners and clinicians, the Smart Patient Website was enriched with multi-media content to provide patients with diseasespecific information, such as video footage of surgical procedures and soundtrack of radio health programmes. The website was awarded Meritorious Website 2010 by the Television and Entertainment Licensing Authority of the Hong Kong Government.
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At the Cluster level, various health promotion activities were organised by Clusters to arouse public awareness on health and disease management. The Community Health Promotion Day and the Community Resuscitation Training Day organised by Kowloon East Cluster were well accepted by participants from all walks of life. In addition, the Cluster delivered education classes targeting at teenagers with asthma and patients with Parkinsons disease to empower them with essential know-how to manage their conditions. On the other hand, Hong Kong East Cluster engaged the community through the fifth symposium on community engagement titled Family - The Key to a Healthy Community and the third seminar on quality and safety, titled Better Health for All: Mission, Passion and Action. Organised jointly with community partners, government departments, District Councils, volunteers and elderly homes, the events received overwhelming response from both patients and the community. In addition, events recognising contribution of hospital volunteers were held by various Clusters not only to express appreciation, but also to boost staff team spirit, tighten community networks and strengthen relationship with patients. Apart from community activities, Hong Kong West Cluster engaged patients and the public through organising summer school for student volunteers, patient mutual support network, annual plan meeting and forum for patient groups. New Territories East Cluster continued to engage patient group representatives extensively at the levels of governance and planning of hospital through inviting them
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to serve as members of Hospital Governing Committees, participating in the Cluster annual planning process, regular Patient Relations Review meetings, as well as co-hosting the annual Cluster Patient Relations forum. Similarly, New Territories West Cluster established platforms of communication between patient focus groups and healthcare workers to facilitate interactive discussion and exchange in which patients needs and priorities were understood and addressed. Involving ethnic minority, asthma and thalassemia patients, these focus groups furnished the hospitals with feedback, forming basis of various improvement measures and leading to greater satisfaction of patients.
facilitate information sharing with all staff. The blogs started by the HA Chairman and Chief Executive on the new internal portal in 2011 provided alternative channels of interaction with employees. A large scale review of the terms and conditions of the General Services Assistant and Technical Services Assistant workforce of 12,000 was conducted during the year. Encompassing job responsibilities, requirements, career path and remuneration package, extensive consultation and communication was conducted to engage staff of different levels before implementing recommendations of the review. New Territories East Cluster (NTEC) engaged staff in establishing rapport with patients through innovative initiatives, such as producing videos featuring authentic patient voices, posting interactive case scenarios on web, organising caring forums, and publishing a newsletter to foster better relation with patients. Like other Clusters, staff volunteered to participate in charitable work jointly with other agencies to address issues of public concern, including fighting substance abuse and helping elderlies living alone in the local community through programmes such as the outreach UROK (yoU aRe OK) Clinic in which urologists, psychiatrists, nurses and physiotherapists joined hands to serve the community when they are off duty. On the other hand, NTEC strengthened internal communication with staff through launching a new social media platform with periodic webcasting and online discussion on the Cluster intranet (iNTEC), thus enhancing interaction with its employees with an expanded reach and broadened participation. Hong Kong East Cluster stepped up communication with staff and collaboration
Hospital Authority Annual Report 2010-2011
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amongst disciplines in her quality journey. Capitalising on Crew Resource Management (CRM) which is an integrated training, process improvement and management system that uses all available resources including people, process and technology to enhance safety and operational efficiency, the Cluster reinforced effective application of CRM tools through CRM gallery, the CRM-in-Action campaign and departmental CRM ambassadors. Cluster-wide promotion on correct patient identification strengthened knowledge and awareness in quality issues. The newly adopted Classic Senior Executive Walk-round encouraged open communication and active participation of frontline staff in risk management.
and waste reduction and foster culture of a green environment. While the management encouraged staff to use less paper, toner and consumables, green initiatives were regularly practised, including the use of electronic bulletin boards and collecting waste paper, plastic bottles, aluminium cans, rechargeable batteries, CDs and clothes for recycling. New infrastructure was installed and measures were implemented to save energy, such as the use of high efficiency T5 light tubes, intelligent use of elevators, and introducing the first electric car in New Territories West Cluster. Employees were encouraged to think green from different facets of work and life. Significant results were registered by Pamela Youde Nethersole Eastern Hospital of which the Environmental Management System (EMS) was ISO 14000 certified. Last but not least, Wastewi$e awards for Environmental Excellence were gained by Queen Mary Hospital, Grantham Hospital, Tung Wah Hospital, United Christian Hospital, Tseung Kwan O Hospital, Haven of Hope Hospital and the HA Head Office during the year.
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Chapter 6
The Hospital Authority (HA) provides public healthcare services to the people of Hong Kong through the Head Office and seven hospital clusters: Hong Kong East Cluster Hong Kong West Cluster Kowloon Central Cluster Kowloon East Cluster Kowloon West Cluster New Territories East Cluster New Territories West Cluster
This chapter presents an overview of the work and key achievements of the past year of the HA Head Office and Clusters under five corporate strategic directions.
he HA Head Office (HAHO) plays a strategic role in leading corporate development and supporting hospital Clusters through interactive collaboration of six divisions, namely Cluster Services, Corporate Services, Finance & Information Technology, Human Resources, Quality & Safety, and Strategy & Planning. Aligning corporate values and directions, the HAHO co-ordinates cluster hospitals and professional committees on the development of clinical and professional services. In 2010/11, HAHO initiated 95 corporate targets corresponding to five key strategic objectives outlined in the HA Annual Plan.
To cater for growing demand of renal replacement therapy for patients with end stage renal failure, the capacity of various forms of dialysis was increased, including hospital haemodialysis (HD), nocturnal home HD and automated peritoneal dialysis. The HD shared care programme with private providers was also implemented. Enhanced models for doctor manpower planning were developed to facilitate planned responses in demand management. This includes a methodology using relative needs index as a basis for allocating resident trainee doctors at both the cluster and specialty levels. In addition, a service demand projection model for sub-acute care services was developed to address increasing need for convalescent and rehabilitation services. Service demands for mental health were managed through strengthening community care of patients with severe mental illness through launching case management programmes in Kwai Tsing, Kwun Tong and Yuen Long districts. Common Mental Disorders Clinics were set up in all seven Clusters while more sessions were added to Substance Abuse Clinics to provide patients with timely multi-disciplinary assessment and management. Planning for the future needs of modern psychiatric care is also demonstrated by publishing a comprehensive Mental Health Service Plan for Adults for 2010-2015 after extensive consultation with both internal and external stakeholders.
Advanced Incident Reporting System currently in use at all public hospitals was upgraded to facilitate the reporting and monitoring of incidents. The Drug Quality Assurance Office established in 2010 has improved medication safety through enhancing the procurement system, quality assurance and monitoring of pharmaceuticals. Benchmarking with international standards of healthcare quality is a major focus of work in HAs quality journey. EQuIP 4 Hong Kong Guide, comprising territorywide accreditation standards, was accredited by the International Society for Quality in Health Care. 33 healthcare professionals in Hong Kong completed training and were appointed Australian Council on Healthcare Standards Surveyors. Five HA pilot hospitals completed their first organisation-wide surveys and awarded 4-year full accreditation status. The field work of the first HA-wide Patient Satisfaction Survey was completed with some 5,000 discharged patients in 25 public hospitals. A system for the development of quality improvement plan was formulated. Meanwhile, a study on stroke rehabilitation service was conducted to provide recommendations on service improvement. Fulfilling its commitment in promoting Chinese medicine in Hong Kong, the HA Chinese medicine centre for training and research at Southern district commenced operation in March 2011 while a similar centre for Kowloon City district was in the pipeline.
Keep Modernising HA
Enhancing corporate governance through periodic monitoring and review was a major focus of work. The progress of key performance indicators was regularly reported to the management and the HA Board. Strengthened community participation and governance of public hospitals were manifested through regular review of membership matters as well as conducting regular meetings of Hospital Governing Committees and Regional Advisory Committees.
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The Drug Formulary was expanded with eight new drugs of proven effectiveness and efficacy introduced as special drugs for rare metabolic diseases, as well as colorectal and lung cancer while the clinical application of nine drug classes were expanded in the treatment of cardio-vascular disease, breast cancer, hepatitis, mental illness, age-related macular degeneration, and diabetes mellitus. In addition, regular review of the scope of coverage of Samaritan Fund had introduced six new drugs, providing subsidy for the needy. Technology upgrade has equipped HA with infrastructure required for delivery of modern healthcare services. First introduced in 2009, digital imaging technology in public hospitals reduced the use of traditional films through capturing digital radiology images as part of patients electronic medical records. In 2010/11, image viewing facilities were established in Accident & Emergency departments, specialist outpatient clinics and wards of seven major acute hospitals. New technology was also introduced to eliminate possible errors on the identification of dead bodies and specimens, namely Radio Frequency Identification (RFID) and Unique Patient Identification (UPI). RFID implemented in five mortuaries provided each Cluster with a mortuary equipped with the technology while phase 3 UPI project for specimens collection was completed with the expansion of 2D barcode system that covers all blood and microbiological tests in HA hospitals. Continuous revamp of HAs Clinical Management System enables patient care activities to be conducted on web-based platforms in an integrated and comprehensive system with enhanced capability that supports new mobile devices and wireless network, subsequently facilitating daily workflow of frontline clinical staff.
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HA supports the Government in the development of an integrated electronic health record system. The territory-wide e-Health Record (eHR) Sharing System not only facilitates information sharing at the point of care delivery in both the public and private systems, but also contributes to enhancing public awareness of primary care in Hong Kong. The programmes include core infrastructure, Clinical Management System Extension modules and various standards. Targeted to be completed by the end of 2013/14, the system will facilitate smooth operation of the Elderly Health-care Voucher Scheme, Influenza Vaccination Sponsorship Scheme and the development of Primary Care Directory System. Strengthening the reporting capability and integration amongst different administrative systems in HA is of equal importance in enhancing internal controls and operational efficiency. The Human Resources and Payroll module of the Enterprise Resource Planning (ERP) system, named Human Capital Management, was fully implemented in 2010 to facilitate effective management of human resources and payroll functions of over 59,000 staff in HA. Being one of the largest systems of its kind in Asia owing to the scale and complexity of HA, development of the system involved hundreds of multi-disciplinary employees from various departments comprising information technology, human resources and finance in both HA Head Office and Clusters. The Capital Block Vote of HK$600 million enabled continuous modernisation in HA by installing a total of 703 pieces of medical equipment to replace obsolete ones and also replacing 42 engineering plants so as to provide quality services. Renovation works were carried out in 12 general outpatient clinics to improve outdated amenities, barrier-free access and pharmacy facility. In addition, HA also supports the Government in developing the Centre of Excellence in Paediatrics, with a series of facility and service planning in the pipeline. On the soft side, the HA has embarked on various publicity initiatives to continuously enhance corporate image and promote public understanding of healthcare services and issues through corporate communication programmes. Maintaining close relations
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Hospital Authority Annual Report 2010-2011
with the media is a key component of our work. During the year, a total of 390 media events and activities were organised, 350 press releases were issued and 2,200 media enquiries were handled. To mark the 20th anniversary of the HA, a gala dinner held in November 2010 announced the celebration with 1,900 guests, community partners and employees. A photo competition, a slogan contest for 20-year-old youngsters and newspaper supplements were organised to commemorate this important milestone in the history of the organisation. A Chinese theme song was specially composed to glorify the hard work and contribution of HA employees.
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Alongside publicity of corporate and hospital service programmes throughout the year, winners of Outstanding Staff and Teams Award were also featured extensively in the media as part of our continuous effort in promoting our People First culture. Enhancing internal communication with employees is always top on our agenda. Revamp of the HA intranet (http://ha.home) during the year strengthened internal communication on a new media platform. While the design concept of the new communication portal aligns with the corporate values of professionalism and teamwork, the website delivers an active and lively style. Displaying timely information through a content architecture created with employees input, the new media platform offers new functions and features, including a rich media video gallery, upgraded search function and RSS subscription service. Besides, a pilot research project targeted to modernise communication in HA was conducted with conjoint multi-disciplinary efforts to identify issues and explore improvement measures in order to strengthen communication with employees from different generations and background. Other than study of early adopters of modern internal communication models in other sectors, the research project comprised online and paper survey and focus group discussions with an overall encouraging response rates from various staff groups. Training and development is a key human resources strategy for HA in developing a competent workforce. Elements of the new HA vision, mission and values were incorporated into training programmes to promote the values of teamwork and innovation. These programmes include 7-Habits, Teaming Up: Effective Team Leadership Skills for Frontline Staff, Think On Your Feet and Thinkertoys. Notable management training programmes continued from last year include Management 101 for newly promoted managers, HA Leadership Pipeline and Development Centres for leaders of the next generation. Also embarking into the second year is the Crew Resource Management (CRM) training programme through which an accumulative total of 1,400 doctors and nurses participated. The programme is an integrated training, process improvement and management system that uses all available resources including people, process and technology to enhance safety and operational efficiency. Professional training in podiatry and diagnostic radiography was implemented to ensure a sustainable workforce of allied health professionals in HA. Since local training for podiatrist is not available and recruitment for diagnostic radiographer is difficult, HA implemented an overseas
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sponsorship scheme in 2010 to secure manpower supply in these two disciplines. In 2010, a total of 13 (two in podiatry and 11 in diagnostic radiography) candidates were sponsored on 3-year degree programme in podiatry and diagnostic radiography respectively in the United Kingdom. They were expected to commence service in HA in 2013. Besides, mediation and conflict resolution training in complaint management was also organised to equip frontline patient relations officers, doctors, and managers with essential conflict resolution knowledge and skills. 33 employees completed a 40-hour local accredited mediation course and 1,500 gained exposure to mediation approaches in complaint management through seminars and workshops.
he Hong Kong East Cluster serves an estimated population of 0.83 million covering the Eastern and Wanchai districts of the Hong Kong Island as well as the Outlying Islands (excluding North Lantau region). It comprises six hospitals and 12 general outpatient clinics. The six hospitals are Pamela Youde Nethersole Eastern Hospital (PYNEH), Ruttonjee & Tang Shiu Kin Hospitals (RHTSK), Tung Wah Eastern Hospital, Wong Chuk Hang Hospital, Cheshire Home (Chung Hom Kok) and St. John Hospital. The general outpatient clinics include eight in urban areas and four on the outlying islands of Cheung Chau, Lamma and Peng Chau. The Cluster provides a full range of comprehensive inpatient, outpatient, ambulatory, Accident & Emergency, allied health and community-based healthcare services. In addition, the Hong Kong Tuberculosis, Chest & Heart Diseases Association supports the Cluster by promoting health education programmes for primary and secondary prevention.
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Key Achievements
HKEC stepped up its responses to meet challenges ahead, including the opening of 30 acute beds and 30 convalescent beds in PYNEH and RHTSK. The Cluster opened two additional Cardiac Care Unit beds and commissioned the second computer tomography (CT) scanner in PYNEH. It also launched pilot projects on Aged Home Telephone Support Hotline and on Chronic Disease Management to reduce avoidable hospital admissions. Pressing need of the elderly with severe degenerative, osteoporotic or metastatic musculoskeletal problems or with hip fractures was relieved with 210 additional surgeries operated. Our strong teamwork has maintained the momentum of quality and safety initiatives in HKEC. Multi-disciplinary models of improvement measures effectively reduced incidences of pressure ulcer, patient suicide and catheter-related blood stream infection. In September 2010, PYNEH
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was the first public hospital in Hong Kong awarded full accreditation for four years by the Australian Council on Healthcare Standards. On modernisation, PYNEH introduced radio frequency identification technology in mortuary service and achieved 96% filmless radiology service. Minimal access surgery was applied more extensively to other specialties including Orthopaedics & Traumatology, Obstetrics & Gynaecology and Ear, Nose and Throat. To foster People First culture, HKEC organised more than 80 training sessions to meet the training and development needs of different levels of staff; launched occupational safety and health programmes which were proved effective in nurturing healthy and safe workplaces; and kept exploring innovative measures to improve staff retention. Communication ambassadors, focus groups and forums opened effective communication channels with staff. Bright Suggestion Scheme was relaunched to encourage constructive ideas from all staff so as to improve work processes and systems. HKEC has practised strategic demand management with prudent expansion of capacity in a strong patient safety culture to maintain its financial sustainability.
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Grantham Hospital
Key Achievements
The organ transplant service in Hong Kong has entered a new era in 2010. In August 2010, the first combined heart-and-liver transplant with sequential liver transplant was successfully conducted in HKWC. The first implantation of left ventricular assist device was also performed in the territory in the same month, improving the quality of life for patients waiting for heart transplant. The number of transplants performed in 2010/11 includes 85 liver transplants, 11 heart transplants, one heart-lung transplant, and two lung transplants. In order to manage growing service demand, HKWC registered 2,000 additional attendances in psychiatric specialist clinics and introduced integrated mental health programme in primary care setting for patients with common mental disorders. 3,100 additional cataract surgeries were performed in the Cataract Centre at GH. A new Integrated Ambulatory Centre was set up in QMH, enhancing ambulatory care service of the Cluster.
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Recognising the importance of continuous improvement in service quality and safety, QMH implemented the pilot accreditation programme, attaining full four-year accreditation. A contemporary antibody detection technology was used to provide regular pre- and post-transplant antibody screening for renal patients to guard transplant recipients against failed transplant.
To keep modernising HA, high resolution typing for bone marrow transplant service was enhanced to reduce Graft Versus Host Disease and graft rejection. 4,500 additional rapid molecular diagnostic tests were conducted to enhance effective infection control measures and reduce prolonged hospitalisation and mortality. With continuous commitment to build People First culture, staff health screening programme was strengthened and mental health assessment was introduced in the Cluster. One Staff One Training Plan initiative was also implemented to cater for the development needs of individual employees.
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Hong Kong Eye Hospital Hong Kong Buddhist Hospital Kowloon Hospital
he Kowloon Central Cluster serves an estimated population of 0.5 million covering the districts of Yau Tsim and Kowloon City. The Cluster comprises six hospitals / institutions and six satellite institutions. The six hospitals / institutions are Queen Elizabeth Hospital (QEH), Hong Kong Buddhist Hospital (HKBH), Hong Kong Red Cross Blood Transfusion Service, Hong Kong Eye Hospital (HKEH), Kowloon Hospital (KH) and Rehabaid Centre. The Cluster provides a full range of ambulatory, acute, convalescent, rehabilitation and extended care services to the public. The Cluster launched its new Vision, Mission and Values in October 2007. The Vision is To pursue excellence in health services in life we share, in health we care and in excellence we fare, emphasising the RESPECT values (Respect, Empathy, Sharing, Professionalism, Efficiency, Creativity, and Trust). The Cluster mission statements are:
We deliver quality health service to our clients. We partner with the community to provide holistic care. We train healthcare professionals to pursue excellence. We promote learning culture, research and innovations.
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Building on its core values of RESPECT since 2008/09, KCC has earmarked three consecutive years as Years of Safety. The specific theme for each year was patient safety, staff safety and quality respectively. QEH has attained outstanding performance in the healthcare industry during the year. The hospital was granted a 4-year full accreditation by the Australian Council on Healthcare Standards in late October 2010. It was the Grand Award Winner of the Year in the Asia Pacific Business Excellence Standard (APBEST) Awards and also accorded the honour of BEST Hospital in Asia-Pacific and other individual awards. The successful completion of these two external assessments provided QEH with greater impetus in striving for continuous improvement and development.
Key Achievements
In 2010/11, KCC implemented many initiatives to facilitate the provision of the right care for the right patient at the right place. To implement planned responses to growing service demand, the number of cataract operations was increased to 5,769, or 24% increase over the same period of last year. Waiting time for cataract surgery was shortened. An Integrated Cardiac Nurse Clinic was set up in QEH to provide additional 4,600 outpatient attendances for patients with cardiovascular diseases. An on-site medical physician was assigned in the Accident & Emergency Department to enhance triage and management of patients.
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Initiatives were implemented to continuously improve service quality and safety. An ultrasound machine was acquired at the surgical breast outpatient clinic so that patients with suspected breast cancer could receive ultrasound examination at the same setting. A Geriatric Orthopaedic Team was set up to enhance discharge planning and outpatient services for orthopaedic patients. 20% increase in community home visits were delivered under Li Ka Shing Hospice programme in HKBH where a Day Rehabilitation Centre was also established. End-oflife support for terminally ill patients in KCC was strengthened with 800 Community Geriatric Assessment Team attendances for patients of old aged homes while an osiris room was established in the Accident & Emergency Department of QEH for patients relatives to bid farewell to their loved ones. To keep modernising HA, the steroid profiling services in KCC commenced and accepted referrals for diagnosis of disorders of sex development or steroidogenesis, steroid secreting tumours and endocrinopathies in April 2010. Fibroscan service was introduced in QEH in June 2010 for patients with hepatitis B and C virus. A specialist centre was established for joint replacement in HKBH in December 2010. To align with People First culture advocated by HA, frontline nursing manpower in specialty area was relieved by introducing technical support team. A book on nursing services and development titled To Nurse with Love was published in May 2010. Maintaining financial sustainability is important in KCC. The quality of procedure coding was enhanced through standardisation of workflow in specialty areas. Strategies to shorten length of stay were explored and implemented in HKBH through discharge planning enhancement and workflow re-engineering.
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he Kowloon East Cluster serves an estimated population of 0.98 million covering the districts of Kwun Tong, Tseung Kwan O and part of Sai Kung. The Cluster comprises three hospitals, namely United Christian Hospital (UCH), Tseung Kwan O Hospital (TKOH) and Haven of Hope Hospital (HHH), and eight general outpatient clinics. KEC also manages the outpatient and day patient facilities in Yung Fung Shee Memorial Centre and Pamela Youde Polyclinic. The Cluster provides a full range of comprehensive inpatient, day patient, outpatient, Accident & Emergency, as well as general, specialist, allied health, and community-based healthcare services.
Key Achievements
Facing challenges of escalating service demand with high complexity of illnesses from a growing elderly population, KEC strives to fully utilise existing resources to meet community needs and cater for service gaps in specific areas.
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In 2010/11, the Cluster opened 42 additional acute beds at TKOH and 18 rehabilitation beds at UCH. Through the outcome focused and well-coordinated programmes, the Cluster has improved the capacity in a range of services including mental health, oncology, palliative care, cardiology, cataract operation, joint replacement and renal dialysis services. In parallel, clinical support services including radiological examination, laboratory investigation, pharmacy support and information technology were also strengthened to ensure the delivery of seamless quality healthcare services. In line with HAs priority focus on community-based healthcare, the KEC has established multi-disciplinary team to provide patients with chronic diseases with disease-specific risk factor assessment and targeted management. An integrated mental health programme was introduced in primary care setting for patients with common mental disorders while a community case management programme was established for patients with severe mental illness. To improve service quality and safety, UCH was developed as a regional centre specialising in surgeries for children with cleft lip and palate. The multi-disciplinary team offering the service was also awarded one of HAs Outstanding Teams in 2011. As a caring organisation, KEC continued to adopt a holistic approach to promote staff wellness and enhance occupational safety and health. Various channels were introduced to foster communication with staff at all levels within the Cluster, including open forums, lunches with Cluster Chief Executive (CCE) and Hospital Chief Executives (HCE), Talk to CCE letterbox, as well as regular gathering with interns and newly joined employees.
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he Kowloon West Cluster serves an estimated population of 1.9 million covering the districts of Wong Tai Sin, Mongkok, Shamshuipo, Kwai Chung, Tsing Yi, Tsuen Wan and Tung Chung. The Cluster comprises seven hospitals and 23 general outpatient clinics. The seven hospitals include Caritas Medical Centre (CMC), Kwai Chung Hospital (KCH), Kwong Wah Hospital (KWH), Princess Margaret Hospital (PMH), Our Lady of Maryknoll Hospital (OLMH), Tung Wah Group of Hospitals Wong Tai Sin Hospital (TWGHs WTSH) and Yan Chai Hospital (YCH). The Cluster provides a full range of inpatient, day patient, outpatient, Accident & Emergency as well as general, specialist, allied health, rehabilitation and convalescent services.
Key Achievements
KWC strengthened its services in key priority areas in 2010/11. To address increased service demand, the Cluster expanded radiological imaging services as well as services for urology, joint replacement, cataract, macular surgeries and radiotherapy. As a result, waiting time for these services was reduced. The support for end-stage renal failure patients was also enhanced with increase in hospital and home haemodialysis and palliative care service. Additional resources were injected to enhance primary care and chronic disease management. An integrated mental health programme was launched to manage common mental disorders. A community-based case management programme was also launched to support mentally ill patients discharged from hospital. The rapid advances of medical technology upgraded the quality in both diagnostics and therapeutics. Molecular diagnostic tests provided selected groups of cancer patients with effective prediction of therapies. Molecular technologies were also applied on Methicillinresistant Staphylococcus Aureus (MRSA), atypical pneumonia and clostridium difficile, which enabled effective management on infection control, and reduced prolonged hospitalisation and mortality. In addition, filmless radiological imaging service was implemented by phases in KWH.
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The Cluster continuously endeavours to promote a quality culture and implements various patient safety and risk management initiatives during the year. Universal Down Syndrome screening was offered to eligible pregnant women at PMH and KWH. Medication safety was enhanced with the introduction of reconciliation services piloted in KWH in which the pharmacist would keep track of selected patients drug history before admission, during hospitalisation and upon discharge. Specific groups of drug were supplied in blister pack to further reduce the risk of using pre-packed pharmaceutical products. KWC has implemented a series of cluster-wide safety initiatives and programmes in 2010/11 to enhance the safety and health of patients, visitors and employees. These programmes included Safety Climate Index Survey, Work Safe Behaviour Programme, Safety Auditors Training, Training Need Survey, Hospital Safety Plan, Safety Audit, Quality Improvement Plan and on-site audit by Occupational Safety & Health Council.
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Staff is the most valuable asset. The School of Central Nursing at CMC continued the intake for the 3-year higher diploma programme in nursing to address the shortage of nurses. A well-structured and comprehensive orientation programme for newly graduated registered nurses was organised in KWC in 2010/11, with a view to promoting caring culture among preceptors, mentors, ward supervisors and new graduates. Piloted in PMH, the tailor-made programme covered workshops, surveys, sharing sessions, clinical teaching and skill enhancement courses, registering overwhelming response from new graduates. Survey results indicated that they had successfully built up confidence and capability in taking up the role as registered nurses.
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KWC continued various career progression initiatives to retain staff and sustain the quality of our workforce, including enhancement programmes for nurses of Community Nursing Service and strengthened support for midwifery training. Additional resources were allocated to relieve medical social workers from taking up non-professional duties. In line with HAs Pay-for-Performance internal resource allocation system, the Cluster Casemix Office continued to implement cost modeling and improve the quality of clinical coding.
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he New Territories East Cluster serves an estimated population of 1.3 million covering the districts of Shatin, Tai Po, North District and part of Sai Kung. It comprises seven hospitals and 11 general outpatient clinics. The seven hospitals are Prince of Wales Hospital (PWH), North District Hospital (NDH), Alice Ho Miu Ling Nethersole Hospital, Tai Po Hospital, Shatin Hospital, Cheshire Home (Shatin) and Bradbury Hospice. The Cluster provides a full range of acute, convalescent, rehabilitation and extended care, inpatient and specialist outpatient services to the public. There are three Accident & Emergency centres serving three major districts. Apart from the general outpatient clinics, NTEC also provides ambulatory care services in a number of day hospitals and centres as well as a large network of community outreach services including the Community Geriatric Assessment Teams and the Community Nursing Service.
Key Achievements
In response to growing demand for services, NTEC opened the PWH Extension Block in October 2010. Major acute and trauma services of the hospital were relocated to the new building with a total gross floor area of 71,500 sq.m. The new facility enabled the streamlining and improvement to the patient care processes, with the alleviation of prolonged waiting for admission in the Accident &
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Bradbury Hospice
Emergency Department. A new model of care was implemented under the Respiratory Collaborative Care Programme at NDH to provide the patients with Chronic Obstructive Pulmonany Diseases with integrated home and discharge support. The Cluster had implemented various initiatives to improve quality and safety. A major programme was launched to promote medical safety, including an interactive electronic platform for staff engagement. The number of reported medication incidents continued to drop during the year. Safe surgery checklist was successfully rolled out to all three acute hospitals in NTEC. An audit conducted in 2010 showed an overall compliance rate of 98.8%. The surgical Checklist 123 was also introduced to non-operating theatre settings.
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Shatin Hospital
Tai Po Hospital
NTEC also put continuous emphasis on building up the People First culture. Traditional staff communication platforms of CCE/HCE visits and staff forums, staff lunch gatherings, as well as workshops andevents were organised to foster a caring culture and team spirit. The Cluster intranet platform was further strengthened to promote staff engagement and communication.
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Pok Oi Hospital
he New Territories West Cluster serves an estimated population of 1.05 million covering the Tuen Mun and Yuen Long districts. It comprises four hospitals and eight general outpatient clinics. The four hospitals are Castle Peak Hospital, Pok Oi Hospital (POH), Siu Lam Hospital and Tuen Mun Hospital (TMH). Besides, the Cluster also manages Tuen Mun Ambulatory Care Centre, Tuen Mun Mental Health Centre, Tuen Mun Eye Centre and the Butterfly Bay Laundry. NTWC provides a full range of comprehensive general, psychiatry, inpatient, outpatient, acute, convalescent, rehabilitation, ambulatory, allied health and community-based healthcare services.
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NTWC has made significant progress in 2010/11 and achieved all key pledges. It has not only expanded its services to address the twin demographic challenges of population growth and population ageing, but has also weighed up priorities to cope with increasing demand for general and psychiatric services. With various improvement measures and concerted efforts of departments, the Cluster has managed to achieve a balanced accrual budget.
Key Achievements
To meet rising demand for elective operations and rehabilitation support, the surgical services of the Cluster were expanded in phases with two new operating theatres and 31 additional beds at POH in 2010. In addition, one bed each of Intensive Care Unit and High Dependency Unit were added to strengthen higher level individual care to cater for growing complexity of patient conditions in POH. Meanwhile, a total of 47 rehabilitation beds and 17 day beds were added in TMH and POH to relieve bed congestion at acute medical wards in the Cluster. While NTWC has the largest pool of patients with Continuous Ambulatory Peritoneal Dialysis (CAPD) amongst all Clusters, it has the lowest proportion of dialysis patients on haemodialysis (HD) compared with the HA average. In 2010/11, the Cluster expanded its HD capacity by treating five more patients with end-stage renal failure and providing 907 extra HD sessions. In line with corporate target, NTWC continued to strengthen mental health services. The Cluster started the communitybased multi-disciplinary case management programme for patients with severe mental illness, serving 1,518 additional patients and providing 12,333 additional psychiatric outreach attendances. Ambulatory care in Child and Adolescent Psychiatry was enhanced with 10% reduction in waiting time for first time appointment of specialist outpatient clinics. It also expanded the capacity of forensic psychiatry for mentally-disordered offenders in Siu Lam Psychiatric Centre by providing assessment and hospital order attendances, support for court cases, outreach and home visits.
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Initiatives were implemented to improve service quality. Installation of the second magnetic resonance imaging (MRI) machine at TMH addressed increasing demand for specialised radiological imaging services and thus shortened waiting time for MRI examinations in NTWC. An electronic Pressure Ulcer Reporting System was developed to monitor and control pressure ulcers and ameliorate quality of care. Auto-refill systems were rolled out to 26 wards to alleviate administrative workload of ward nurses. On the other hand, evidence-based nursing practice was enhanced through establishment of nurse-led clinics during the year to extend the roles of nurses and promote excellence in patient care. The Cluster participated in hospital accreditation which formed an essential element in materialising the vision of becoming a preferred healthcare provider and exhibited the deeply rooted People First values. A three-year Grow Our Capable Leaders for Success (GOALS) programme was launched to identify and develop 30 upcoming leaders for new challenges of the future. On the other hand, carers and supporting staff of the Cluster received equal attention on training and development. Core competence training programmes were developed for junior doctors and nurses to equip them for challenges of increasing complexity of modern healthcare settings. 1,300 supporting staff received refresher training in patient transportation, last-office work, occupational safety and health, and communication with patients.
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Independent Auditors Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74-75 Financial Statements Consolidated balance sheet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76 Balance sheet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77 Consolidated statement of income and expenditure . . . . . . . . . . . . . . . . . . . . . . . . . 78 Consolidated statement of comprehensive income . . . . . . . . . . . . . . . . . . . . . . . . . . 79 Consolidated cash flow statement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80 Consolidated statement of changes in net assets . . . . . . . . . . . . . . . . . . . . . . . . . . . 81 Notes to the financial statements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82-129
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Auditors Responsibility
Our responsibility is to express an opinion on these consolidated financial statements based on our audit and to report our opinion solely to you, as a body, in accordance with section 10 of the Hospital Authority Ordinance and for no other purpose. We do not assume responsibility towards or accept liability to any other person for the contents of this report. We conducted our audit in accordance with Hong Kong Standards on Auditing issued by the Hong Kong Institute of Certified Public Accountants. Those standards require that we comply with ethical requirements and plan and perform the audit to obtain reasonable assurance about whether the consolidated financial statements are free from material misstatement. An audit involves performing procedures to obtain audit evidence about the amounts and disclosures in the consolidated financial statements. The procedures selected depend on the auditors judgement, including the assessment of the risks of material misstatement of the consolidated financial statements, whether due to fraud or error. In making those risk
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assessments, the auditor considers internal control relevant to the entitys preparation of consolidated financial statements that give a true and fair view in order to design audit procedures that are appropriate in the circumstances, but not for the purpose of expressing an opinion on the effectiveness of the entitys internal control. An audit also includes evaluating the appropriateness of accounting policies used and the reasonableness of accounting estimates made by the management, as well as evaluating the overall presentation of the consolidated financial statements. We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our audit opinion.
Opinion
In our opinion, the consolidated financial statements give a true and fair view of the state of affairs of HA and of the Group as at 31 March 2011 and of the Groups surplus and cash flows for the year then ended in accordance with Hong Kong Financial Reporting Standards.
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76
Balance Sheet
Note Balance at 31 March 2011 HK$000 Non-Current Assets Property, plant and equipment Intangible assets Loans receivable Fixed income instruments 5 6 7 8 3,255,016 336,794 12,630 2,030,979 5,635,419 Current Assets Inventories Loans receivable Accounts receivable Other receivables Deposits and prepayments Fixed income instruments Bank deposits with maturity over three months Cash and cash equivalents 9 7 10 11 12 8 13 13 892,890 1,918 224,834 90,990 231,107 6,110,375 872,240 8,424,354 Current Liabilities Creditors and accrued charges Deposits received 14 15 4,496,945 297,802 4,794,747 Net Current Assets Total Assets Less Current Liabilities Non-Current Liabilities Death and disability liabilities Deferred income Net Assets Capital subventions and donations Designated fund Revenue reserve Capital Subventions and Donations, Designated Fund and Reserves 18 19 16 17 3,629,607 9,265,026 142,082 515,884 8,607,060 3,591,810 5,077,369 (62,119) 8,607,060 Balance at 31 March 2010 HK$000 2,853,885 235,530 17,772 1,430,966 4,538,153 823,316 2,250 176,336 118,779 160,856 280,000 4,248,746 2,121,093 7,931,376 3,776,295 230,231 4,006,526 3,924,850 8,463,003 135,928 464,524 7,862,551 3,089,415 5,077,369 (304,233) 7,862,551
77
78
79
18 18
80
265,527 3,090,120
5,077,369
(28,220) (304,227)
237,307 7,863,262
502,530 3,592,650
5,077,369
242,114 (62,113)
744,644 8,607,906
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Pursuant to an arrangement, detailed in a draft Memorandum of Administrative Arrangement (MAA) with the Hong Kong Government (the Government), the Government passed the management and control of the ex-Government hospitals (the Schedule 1 Hospitals) to HA. Under this arrangement, certain specified assets were transferred to HA. The ownership of other assets was retained by the Government. HA has also entered into agreements with the individual governing bodies of the ex-subvented hospitals (the Schedule 2 Hospitals) which allowed HA to assume ownership of some operating assets as at 1 December 1991 and to manage and control other assets, the ownership of which remains with the individual governing bodies. As a result, HA has assumed full responsibility for the management of the hospital operations since 1 December 1991. Also, all operating and capital commitments outstanding as at 1 December 1991 were assumed by HA, except for the capital works projects funded under the Capital Works Reserve Fund of the Government.
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83
84
85
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(d) Subsidiaries
Subsidiaries are entities over which the Group has the power to govern the financial and operating policies. Subsidiaries are fully consolidated from the date that control is transferred to the Group. They are de-consolidated from the date that control ceases. Intra-group transactions, balances and unrealised gains on transactions within the Group have been eliminated on consolidation. Unrealised losses are also eliminated unless the transaction provides evidence of an impairment of the assets transferred. The accounting policies of the subsidiaries have been changed where necessary to ensure consistency with the policies adopted by the Group. At as 31 March 2011, the principal subsidiary of HA comprises:
Name HACM Limited (limited by guarantee) Principal activities To steer the development and delivery of Chinese medicine services Place of incorporation / operation Hong Kong Effective percentage held by the Group 100
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(g) Donations
(i) Donated assets Properties, computer software and systems donated to the Group with a value below HK$250,000 each and other donated assets with a value below HK$100,000 each are recorded as income and expenditure in the year of receipt of the assets. Properties, computer software and systems donated to the Group with a value of HK$250,000 or more each and other donated assets with a value of HK$100,000 or more each are capitalised on receipt of assets according to the policy set out in note 2(h)(i) and note 2(j). The amount of the donated assets is credited to the capital donations account. Each year, an amount equal to the depreciation or amortisation charge for these assets and the net book value of assets disposed is transferred from the capital donations account and credited to the statement of income and expenditure. (ii) Cash donations Cash donations for specific use as prescribed by the donor are accounted for in the designated donation fund. When the fund is utilised and spent for expenditure not meeting the capitalisation policy as set out in note 2(h)(i) or note 2(j), they are accounted for as expenditure of the designated donation fund and, in the case of capital expenditure, in accordance with the policy for donated assets outlined above. Non-specified donations for general operating purposes are recorded as donations in the statement of income and expenditure upon receipt of cash donations.
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The useful lives of assets are reviewed and adjusted, if appropriate, at each balance sheet date. The gain or loss arising from disposal or retirement of an asset is determined as the difference between the sales proceeds and the carrying amount of the asset and is recognised in the statement of income and expenditure. Capital expenditure in progress is not depreciated until the asset is placed into commission.
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(l) Inventories
Inventories, which comprise drugs, other medical and general consumable stores, are valued at the lower of cost and net realisable value. Cost is calculated using the weighted average method. Where applicable, provision is made for obsolete and slow-moving items. Inventories are stated net of such provision in the balance sheet. Net realisable value is determined with reference to the replacement cost.
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93
94
95
96
97
The carrying values of other financial assets and liabilities such as cash and bank balances, loans receivable, accounts receivable and trade payable approximate their fair values and accordingly, no disclosure of fair values for these items is presented.
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In this regard, the capital of the Group comprises revenue reserve, designated fund, capital subventions and donations and deferred income as shown in the consolidated balance sheet. As at 31 March 2011, the capital of the Group was HK$9,123,790,000 (2010: HK$8,327,786,000). The Groups objective for managing capital is to safeguard the Groups ability to continue as a going concern to ensure sustainability of the public health care system. As in previous years, the Group undertook a budget planning process to work out a viable budget plan for financial year 2010/11. The 2010/11 budget is compiled by assessing and mapping the optimal level of manpower and other resources requirement against the funding indicated by the Government together with other sources of income, including patient fee and other alternative source of income, to be generated in the coming year to meet the baseline activities and newly approved programmes or initiatives incorporated in the HA annual plan. The Group targeted to achieve a balanced budgetary position by containing the overall expenditure within the annual subvention provided by the Government. To enhance accountability for the appropriate use of resources, key performance indicators have been developed to measure performance of hospitals / clusters and monitor the spending level against budget on an ongoing basis.
99
101
Total HK$000
Total HK$000
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Total HK$000
Total HK$000
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HA
Computer software and systems 2011 HK$000 Cost At beginning of year Reclassifications Additions Disposals At end of year Accumulated amortisation At beginning of year Reclassifications Charge for the year Disposals At end of year Net book value At 31 March 1,290,071 (163) 144,668 (103,386) 1,331,190 1,054,541 (163) 41,922 (101,904) 994,396 336,794 2010 HK$000 1,260,425 (12,799) 148,916 (106,471) 1,290,071 1,108,583 52,429 (106,471) 1,054,541 235,530
The loans receivable is neither past due nor impaired. The maximum exposure to credit risk at the reporting date is the carrying value of receivable mentioned above. According to the terms and conditions of the scheme, the monthly principal repayment and payment of interest in respect of the downpayment loans are deducted from the employees wages and that any benefits to which an employee will be entitled to receive under the HA Provident Fund Scheme shall stand charged with repayment of downpayment loan and interest thereon if such debt has not been paid by the employee upon resignation or on an agreed date. On this basis, the receivable balance is considered to be fully recoverable.
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The above financial assets are neither past due nor impaired. The credit quality of these assets is disclosed in note 3(a) while the maximum exposure to credit risk at the reporting date is the fair value of these assets as stated in note 3(b). The Group does not hold any collateral as security.
9.
Inventories
The Group and HA
Balance at 31 March 2011 HK$000 Drugs Medical consumables General consumables 713,070 156,150 23,670 892,890 Balance at 31 March 2010 HK$000 640,496 144,880 37,940 823,316
(a)
The Groups policy in respect of patient billing is as follows: (i) Patients attending outpatient and accident and emergency services are required to pay fees before services are performed. (ii) Private patients and non-eligible persons are required to pay deposit on admission to hospital. (iii) Interim bills are sent to patients during hospitalisation. Final bills are sent if the outstanding amounts have not been settled on discharge.
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Receivables that are past due but not impaired include outstanding debts to be settled by government departments, charitable organisations or other institutions for whom the credit risk associated with these receivables is relatively low. The Group does not hold any collateral over these balances.
(b)
At 31 March 2011, bills receivable of HK$77,830,000 (2010: HK$71,415,000) were impaired by HK$42,699,000 (2010: HK$34,471,000) of which HK$23,230,000 (2010: HK$12,457,000) was related to receivables individually determined to be impaired. These were mainly related to non-eligible persons, the recoverability of which are considered to be low after taking all possible debt recovery actions. Remaining allowance for impairment of HK$19,469,000 (2010: HK$22,014,000) was made by reference to historical past due recovery patterns. It was assessed that a portion of the receivables is expected to be recovered.
The maximum exposure to credit risk at the reporting date is the fair value of receivable mentioned above. The Group does not hold any collateral as security.
Other receivables do not contain impaired assets. The maximum exposure to credit risk at the reporting date is the fair value of each class of receivable mentioned above. The Group does not hold any collateral as security.
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The above balances do not contain impaired assets. The maximum exposure to credit risk at the reporting date is the fair value of the assets mentioned above. The Group does not hold any collateral as security.
The effective interest rate on short term bank deposits is between 0.01% and 4.35% (2010: 0.01% to 3.51%). These deposits have an average maturity of 35 days (2010: 39 days).
HA
Balance at 31 March 2011 HK$000 Trade payable [note 14 (a)] Accrued charges and other payables [note 14 (b)] Current account with the Government Current account with a subsidiary 302,025 3,379,962 814,952 6 4,496,945 Balance at 31 March 2010 HK$000 406,444 2,928,790 441,022 39 3,776,295
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HA
Balance at 31 March 2011 HK$000 0-30 days 31-60 days 61-90 days Over 90 days 242,675 49,044 7,724 2,582 302,025 Balance at 31 March 2010 HK$000 324,498 64,960 5,634 11,352 406,444
All trade payable as at 31 March 2011 are expected to be settled within one year. The Group has maintained adequate cash flows and banking facilities for settlement of trade payable. (b) Accrued charges and other payables included accrual for unutilised annual leave of HK$1,228,568,000 (2010: HK$1,181,905,000) and contract gratuity accrual of HK$628,013,000 (2010: HK$514,141,000). The balance also included a provision for doctors claims of HK$556,000,000 (2010: HK$442,000,000) as described in note 4(a).
Movements in the liabilities recognised in the balance sheet are as follows: The Group and HA
2011 HK$000 At beginning of year Total expense Net premiums and benefits paid At end of year 135,928 9,802 (3,648) 142,082 2010 HK$000 133,690 5,707 (3,469) 135,928
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The amounts recognised in the consolidated statement of income and expenditure have been calculated by reference to an actuarial valuation and are as follows: The Group and HA
For the year ended 31 March 2011 HK$000 Current service cost Interest cost Actuarial gains recognised Total, included in staff costs 16,651 3,631 (10,480) 9,802 For the year ended 31 March 2010 HK$000 16,920 2,721 (13,934) 5,707
Principal actuarial assumptions used in the actuarial valuation are as follows: The Group and HA
For the year ended 31 March 2011 % Discount rate Assumed rate of future salary increases 2.90 3.40 For the year ended 31 March 2010 % 2.80 2.80
1,807 -
89,991 (2,910)
(142,966) 431,715
1,807
(4,719) 82,362
(3,713) -
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HA
Capital subventions [Note 2(s)] HK$000 At 1 April 2009 Additions during the year Transfers to consolidated statement of income and expenditure At 31 March 2010 Additions during the year Transfers to consolidated statement of income and expenditure At 31 March 2011 1,808,069 832,305 (576,837) 2,063,537 1,103,102 (618,762) 2,547,877 Capital donations [Note 2(g)] HK$000 1,014,065 121,469 (109,656) 1,025,878 131,318 (113,263) 1,043,933 Total HK$000 2,822,134 953,774 (686,493) 3,089,415 1,234,420 (732,025) 3,591,810
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23. Remuneration of Members of the Board and Five Highest Paid Executives
(a) (b) No Board members are remunerated in the capacity as Board members. The remuneration of the five highest paid executives, which is included in the staff costs for the year, is as follows: For the year ended 31 March 2011
Basic pay, allowance, retirement scheme contribution and other benefits Current Position / Name of Executives Chief Executive Mr Shane, SOLOMON (1/4/2010 24/10/2010) Dr Pak Yin LEUNG (8/11/2010 31/3/2011) Director (Finance)* Ms Nancy TSE Cluster Chief Executive (New Territories East) Dr Hong FUNG Director (Cluster Services) Dr Wai Lun CHEUNG Cluster Chief Executive (Hong Kong East) Dr Loretta YAM HK$000 2,702 1,716 4,418 3,871
3,849 3,766
3,735 19,639
Note: All executives do not receive any variable remuneration related to performance. * Served as Deputised Chief Executive from 25/10/2010 to 7/11/2010 in addition to her duties as Director (Finance).
121
3,890 3,831
3,830
3,830 19,909
Note: All executives do not receive any variable remuneration related to performance.
123
(b)
(d)
Other significant related party transactions with the Government include annual recurrent grants (note 20), capital subventions (note 18) and designated funds (notes 17 and 19). Details of transactions relating to the Groups retirement schemes are included in note 24. Outstanding balances with the Government as at 31 March 2011 are disclosed in notes 11, 12, 14 and 15. The current account with a subsidiary, HACM Limited, is disclosed in note 14.
(e)
125
The donations were accounted for in the designated donation fund in accordance with the accounting policy set out in note 2(g)(ii).
29. Commitments
As at the balance sheet date, the Group and HA had the following commitments:
HA
At 31 March 2011 HK$000 Authorised but not contracted for Contracted for but not provided 2,808,727 618,623 3,427,350 At 31 March 2010 HK$000 3,180,495 886,150 4,066,645
The capital commitments disclosed above include both costs to be capitalised under property, plant and equipment or intangible assets and also costs which are to be charged to the statement of income and expenditure in accordance with the accounting policy set out in note 2(h).
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31. Taxation
No taxation is provided as HA is exempt from taxation under the Hospital Authority Ordinance.
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Appendices
Appendix 1 Appendix 2 Appendix 3 Appendix 4 Appendix 5 Appendix 6 Appendix 7 Appendix 8 Appendix 9 Membership of the Hospital Authority . . . . . . . . . . . . . . . . . . . . . . . . 131 (a) Hospital Authority Committee Structure . . . . . . . . . . . . . . . . . . . 135 (b) Hospital Authority Executive Structure . . . . . . . . . . . . . . . . . . . . 136 Membership and Terms of Reference of Functional Committees . . . . 137 Membership of Hospital Governing Committees . . . . . . . . . . . . . . . . 158 Membership of Regional Advisory Committees . . . . . . . . . . . . . . . . . 175 Membership of the Board of Trustees of the Hospital Authority Provident Fund Scheme . . . . . . . . . . . . . . . . . . . . 178 Public Feedback Statistics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179 Statistics of the Controlling Officers Report . . . . . . . . . . . . . . . . . . . 180 Statistics on Number of Beds, Inpatient, Outpatient and Accident & Emergency Services in 2010/11 . . . . . . . . . . . . . . . . . . . . 184
Appendix 10 Statistics on Community and Rehabilitation Services in 2010/11 . . . . 187 Appendix 11 (a) Manpower Position by Cluster and Institution . . . . . . . . . . . . . . 190 (b) Manpower Position by Staff Group . . . . . . . . . . . . . . . . . . . . . . 193 Appendix 12 (a) Resource Utilisation for 2010/11 . . . . . . . . . . . . . . . . . . . . . . . . . . 196 (b) Training and Development Expenditure for 2010/11 . . . . . . . . . . . 196 Appendix 13 Five-year Financial Highlights . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 197 Appendix 14 Analysis of Hospital/Clinic Fees and Charges . . . . . . . . . . . . . . . . . . 200
Appendix 1
Membership of the Hospital Authority
No. of plenary meetings attended in Committee participation in 2010/11 2010/11*
14/14 Chairman of plenary meetings, EC, EEC, HACF, Taskforce on Doctors Work Hours and Taskforce on Legal Matters. Member of HRC, MTB and PCC; HGC member of Pamela Youde Nethersole Eastern Hospital, Chairman of HRAC. Vice-chairman of AC; Member of MTB and SSDC; and HGC Member of Prince of Wales Hospital. Member of ITGC, MSDC, MTB and SSDC. Member of HRC and MSDC ( from 14.12.2010). Chairman of PCC and Member of EC, EEC and MSDC; Chairman of NTRAC; HGC Chairman of Shatin Hospital. Chairman of MSDC, Member of EC, EEC and FC; HGC Member of Prince of Wales Hospital. Member of AC and PCC (from 7.12.2010). Vice-Chairman of FC.
Name
Mr Anthony WU Ting-yuk, GBS, JP Chairman, HA
13/14
2/8
Mr CHENG Yan-kee, JP Ms Quince CHONG Wai-yan (from 1.12.2010) Dr Margaret CHUNG Wai-ling
11/14
6/6 11/14
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Appendix 1
Name
Prof LAI Kar-neng, JP Dr P Y LAM, JP Director of Health Ms Ka-shi LAU Ms Alice LAU, JP Deputy Secretary for Financial Services and the Treasury Mrs Yvonne LAW SHING Mo-han
12/14
Member of HRC, MTB and Taskforce on Doctors Work Hours and Chairman of KRAC. Chairman of AC and MTB; Member of EC, EEC, FC, MSDC and Taskforce on Legal Matters; and HGC Chairman of Pamela Youde Nethersole Eastern Hospital and Member of Grantham Hospital. Member of HRC, MSDC and MTB; and HGC Member of Kwai Chung Hospital and Princess Margaret Hospital. Chairman of FC and HAPFS; Member of EC, EEC and Taskforce on Legal Matters; and HGC Chairman of Queen Elizabeth Hospital. Member of EEC, FC, HRC, MSDC, SSDC and Taskforce on Legal Matters.
12/14
11/14
13/14
14/14
Name
Prof LEE Sum-ping
Ms Queenie LEUNG Pik-man Dr Donald LI Kwok-tung, SBS, JP Mr David LIE Tai-chong, SBS, JP Mr Peter LO Chi-lik
Mr Patrick MA Ching-hang, BBS, JP Mr Charles Peter MOK Ms Winnie NG (from 1.12.2010) Mr Shane SOLOMON Chief Executive, HA (up to 24.10.2010)/ Dr LEUNG Pak-yin, JP Chief Executive, HA (from 8.11.2010) Prof George WOO Mr Stephen YIP Moon-wah, BBS, JP
133
Appendix 1
* Note Apart from the principal officer (the Hospital Authority Chief Executive), other members are not remunerated in the capacity as Board members. They discharge the role of governance of the Authority through formulating policies/directions and overseeing executive performance at Board meetings, as well as taking part in steering the work of various committees of the Authority including:
AC EC EEC FC HAPFS HACF HGC HRAC HRC ITGC KRAC MSDC MTB NRAC PCC SAC SSDC
- Audit Committee - Executive Committee - Emergency Executive Committee - Finance Committee - Hospital Authority Provident Fund Scheme - Hospital Authority Charitable Foundation - Hospital Governing Committee - Regional Advisory Committee of Hong Kong - Human Resources Committee - Information Technology Services Governing Committee - Regional Advisory Committee of Kowloon - Medical Services Development Committee - Main Tender Board - Regional Advisory Committee of the New Territories - Public Complaints Committee - Staff Appeals Committee - Supporting Services Development Committee
Appendix 2(a)
Hospital Authority Committee Structure
Audit Committee
Executive Committee
Finance Committee
135
Appendix 2
Appendix 2(b)
Hospital Authority Executive Structure
Chief Executive (up to 24.10.2010 )
Mr Shane SOLOMON
Dr LEUNG Pak-yin, JP
Clusters Hong Kong East Cluster Hong Kong West Cluster Kowloon Central Cluster Dr Loretta YAM Yin-chun, BBS
Cluster Chief Executive
Dr LUK Che-chung
Cluster Chief Executive
Dr HUNG Chi-tim
Cluster Chief Executive
Mr David ROSSITER
Head of Human Resources (up to 24.11.2010)
Dr Derrick AU Kit-sing
Deputising Head of Human Resources (from 25.11.2010 to 31.3.2011)
Kowlooon West Cluster New Territories East Cluster New Territories West Cluster
Dr LEUNG Pak-yin, JP
Director (Quality & Safety) (up to 7.11.2010)
Dr FUNG Hong, JP
Cluster Chief Executive
Dr LIU Hing-wing
Deputising Director (Quality & Safety) (from 8.11.2010 to 31.1.2011) Director (Quality & Safety) (from 1.2.2011 to 31.3.2011)
Dr Albert LO Chi-yuen
Cluster Chief Executive
Dr LO Su-vui
Director (Strategy & Planning)
Appendix 3
Membership and Terms of Reference of Functional Committees Audit Committee
Membership List Chairman Vice-Chairman Members : Mr Lawrence LEE Kam-hung, JP : Ms Vivien CHAN, BBS, JP (up to 30.11.2010) : Mr Ricky FUNG Choi-cheung, SBS, JP (from 7.12.2010) Dr Donald LI Kwok-tung, SBS, JP Mr David LIE Tai-chong, SBS, JP Mr Patrick MA Ching-hang, BBS, JP Ms Estella Y K NG Mr Paul YU Shiu-tin, BBS, JP In attendance : Ms Sandra LEE, JP, Permanent Secretary for Health Mr Shane SOLOMON, Chief Executive (up to 24.10.2010) DrP Y LEUNG,JP, Chief Executive (from 8.11.2010)
Terms of Reference 1. Exercise an active oversight of the internal audit function to ensure that its: mandate, resources and organisational status are appropriate; plans and activities are adequate to provide systematic coverage of internal control and risk management systems put in place by the Management; and findings are actioned appropriately and timely; Recommend the appointment of the external auditor and the audit fee to the HA Board, endorse any non-audit services to be provided by the external auditor, and to consider any questions of resignation or dismissal; Consult with the External Auditor on all relevant matters including the: nature and scope of audit; audited financial statements and audit opinion; management letter and managements response; and matters of which the External Auditor may wish to draw attention; Gain reasonable assurance on the completeness, accuracy, and fairness of audited financial statements, including appropriateness of accounting policies and standards, adequacy of disclosures and significant audit adjustments (in collaboration with the Finance Committee);
Hospital Authority Annual Report 2010-2011
2.
3.
4.
137
Appendix 3 5. Monitor HAs financial and administrative control processes, including those designed to ensure the safeguarding of resources and operational efficiency, through the results of internal and external audit; and Oversee the processes implemented by the Management for monitoring: compliance with pertinent statutes and regulations; compliance with HAs Code of Conduct; and effectiveness of controls against conflicts of interest and fraud.
It should be noted that although the functions of the Audit Committee cover a wide area, matters that are of a pure clinical nature (such as medical ethics) are not within its purview.
6.
Note:
Focus of Work in 2010/11 The Audit Committee met six times in 2010/11 with every meeting considering a planned agenda to cover the Committees Terms of Reference. To exercise an active oversight of internal audit function, the Committee approved the Annual Internal Audit Plan for 2010/11 and directly received quarterly progress reports from the Chief Internal Auditor on completed audit results and follow-up actions. The internal audits reviewed during the year included the following: Statutory holidays / public holidays and rest days for doctors compliance follow-up Leave management Revenue collection private patients Queen Mary Hospital (PricewaterhouseCoopers) Fee waiver / cluster checking units Public-private interface radiological image sharing pilot project Information technology hardware inventory and maintenance management HA term contracts for minor works Non-Emergency Ambulance Transfer Service (NEATS) fleet management Use of physical restraint Personal data privacy follow-up Oracle environment security and controls, and Management of quality and safety of food supplies
In the area of external audit, the Committee reviewed the external auditors Audit Strategy Memorandum, including their audit risk assessment and work plan. Subsequently, the Committee received and discussed their audit opinion on HAs financial statements in a joint meeting with the Finance Committee. The Committee considered accountability reports from responsible subject officers to monitor the financial and administrative control processes in place such as measures in enhancing corporate governance and drug procurement safety, Enterprise Resources Planning implementation and patient billing development and implementation. The Committee also received an update on best practices on corporate governance and considered reports on management for multi-drug resistant organisms, public-private partnership projects and risk management of major capital works projects.
Members
Note: The Emergency Executive Committee was set up by the Board on 15 January 2004. It will automatically be called into action when the Authority activates the Tier-three Strategic Response to a major incident, which is defined as an incident with prolonged and territory-wide implications, such as the Serious Level (S2) or Emergency Level Response (E1 and E2) to influenza pandemic.
Terms of Reference 1. To act for the Hospital Authority Board and exercise its powers and functions, including: (a) altering, amending or overriding existing Hospital Authority policies, standards, guidelines and procedures and; (b) the establishment of sub-committees or task forces to tackle particular matters at hand;
139
Appendix 3 2. 3. To identify the objectives and assess the risks facing Hospital Authority in the emergency situation; To approve the strategies and policies for managing the emergency formulated by the Hospital Authority Central Command Committee, and monitor implementation progress in all HA hospitals and institutions; To coordinate activities of the other Hospital Authority committees including Hospital Governing Committees; To ensure effective communication of clear and concise messages to key stakeholders, including staff, patients, Government and the public; and To be accountable to the Hospital Authority Board and the making of regular reports to Hospital Authority Members as soon as practicable.
4. 5. 6.
Executive Committee
Membership List Chairman Members : Mr Anthony WU Ting-yuk, GBS, JP : Prof FOK Tai-fai, SBS, JP Dr Margaret CHUNG Wai-ling Mr Peter LO Chi-lik Mr Lawrence LEE Kam-hung, JP Mr John LEE Luen-wai, BBS, JP Mr Shane SOLOMON (up to 24.10.2010) Dr LEUNG Pak-yin, JP (from 8.11.2010) Chief Executive (in his absence, the Deputising CE) Mr Stephen YIP Moon-wah, BBS, JP
Terms of Reference 1. 2. 3. 4. 5. Advise the Board on the organisation structure and functions of the HA Head Office and its Divisions; Advise the Board on the appointment, remuneration changes, contract variation of Directors and Cluster Chief Executives; Approve the appointment, remuneration changes, and contract variation of Hospital Chief Executives, Deputy Directors and Heads of Division; Review the performance of Chief Executive, Directors and Cluster Chief Executives; Convene as the Emergency Executive Committee (EEC) consistent with HAs Emergency Contingency Plan (supplemented by a senior Food & Health Bureau official when meeting as EEC); and Oversee self-assessment of the Board and advise on changes to Board structure and processes.
6.
Focus of Work in 2010/11 In 2010/11, the Executive Committee met six times. The Committee discussed and approved 16 papers (including four through circulation) covering issues on appointment and remuneration matters of senior executives and those of chiefs of clusters and hospitals. Issues on cluster structure review and doctors settlement package and manpower strain were also discussed.
141
Appendix 3
Finance Committee
Membership List Chairman Vice-Chairman Members : Mr John LEE Luen-wai, BBS, JP : Mr Benjamin HUNG Pi-cheng, JP : Prof FOK Tai-fai, SBS, JP Ms Alice LAU, JP / Miss Katy FONG (representing Secretary for Financial Services and the Treasury) Mr Lawrence LEE Kam-hung, JP Mr Patrick MA Ching-hang, BBS, JP Mrs Susan MAK, JP (representing Permanent Secretary for Health) Mr Shane SOLOMON, Chief Executive (up to 24.10.2010) DrP Y LEUNG,JP, Chief Executive (from 8.11.2010) Mr Michael N SOMERVILLE
Terms of Reference 1. 2. 3. 4. 5. 6. To advise and make recommendations on the financial aspects of the Hospital Authority Corporate Plan and Annual Plan; To advise and make recommendations on the financial planning, control, performance, monitoring and reporting aspects of the Hospital Authority; To advise on policy guidelines for all financial matters, including investment, business and insurance; To advise and make recommendations on the resource allocation policies; To advise and recommend to the Hospital Authority on the financial statements (audited and unaudited) of the Hospital Authority; To liaise with the Trustees of the Hospital Authority Provident Fund Scheme and the Hospital Authority Mandatory Provident Fund Scheme and make recommendations to the Hospital Authority; and To monitor the financial position of the Hospital Authority.
7.
Focus of Work in 2010/11 In 2010/11, the Finance Committee held four meetings to advise and make recommendations to the Board on the financial planning, control, performance, monitoring and reporting aspects of the Authority. It considered the renewal of HAs insurance programme for 2010/11; progress updates on treasury operations and management; Enterprise Resource Planning (Human Capital Management) system implementation; and development of the Next Generation Patient Billing System. It reviewed monthly financial reports, the draft unaudited financial statements for 2009/10, mid-year financial review, and the unaudited financial statements for the six months ended 30 September 2010. It also received reports on an audit for the electronic Health Record Programme development undertaken by HA Information Technology Services and the experience on Pay for Performance internal resources allocation system one year down the road. It also considered a report on the 2009/10 financial position of the Samaritan Fund, a proposal for the addition of six banks and updates on treasury operations and management, 2011/12 HA budget and resources allocation, 2011/12 insurance approach and direction and the Annual Work Plan of the Finance Division.
143
Appendix 3
Terms of Reference 1. 2. 3. 4. To advise on staff training and development matters; To advise on manpower planning; To advise, review and make recommendations on human resources policies and related issues; To advise, review and make recommendations to HA on the terms and conditions of employment for staff;
5. 6.
To advise, review and make recommendations to HA on staff pay awards and overall staffing structure; and To advise, review and make recommendations to HA on any other staff related matters.
Focus of Work in 2010/11 The Human Resources Committee met six times in 2010/11 to discuss various human resources (HR) matters. The Committee endorsed and gave comments on grade reviews and the pay packages of nurses, allied health professionals, part-time doctors and General Services Assistants / Technical Services Assistants. It considered the starting salaries of entry ranks as well as the increment arrangement for employees joining the Hospital Authority (HA) on fixed pay contracts; and reviewed various allowances such as the Special Honorarium Scheme, allowance of continuous night shift and managerial responsibility allowance. Staff benefits including enhancement of medical benefits were also considered. During the year, the Committee was updated on the cluster structure review. In addition, it noted the findings of a tax consultancy study on HAs payments / reimbursement to staff and the performance of HAs Mandatory Provident Fund Scheme. It also noted the progress of the HA staff engagement programme, the launching of electronic human resources (eHR) services in HA, the implementation of Enterprise Resource Planning with its go-live of Human Capital Management. Regarding staff issues, the Committee discussed and endorsed the Authoritys proposed measures to address issues arising from medical staff manpower strain. On staff training and development, it supported the proposed direction and foci of training and development as well as the future roles of the Training & Development team. It also noted and gave comments on the Management 101 Integrated Training Curriculum.
145
Appendix 3
Terms of Reference 1. 2. 3. 4. 5. 6. 7. Approve corporate policies and standards for information technology / information systems; Approve and monitor the overall progress of the implementation of the information technology / information systems strategic plan; Approve and monitor the execution of the information technology / information systems annual business plan; Receive recommendations on the priorities for information technology systems development and implementation; Receive advice from the Information Technology Advisory Committee; Receive performance and status reports; and Provide periodic progress report to the Hospital Authority Board.
Focus of Work in 2010/11 The Information Technology (IT) Services Governing Committee met four times in 2010/11 to discuss various issues relating to the strategic development of information technology/ information systems in HA. During this period, members discussed and deliberated the HA Green IT strategy and plans in supporting environmental sustainability and energy conservation; strategies on the procurement of data centre facility through contracted services to support demand on accommodating the corporate IT equipment in HA; the revised electronic communication policy to meet information security and privacy challenges; the institutional arrangements for HA in support of licensing for the Governments electronic Health Record (e-HR) related intellectual property; enhanced IT governance structure in mitigating overall IT operational risk and improving IT asset management enterprise-wide. To meet growing demand for IT systems to support the operation of the organisation, members also discussed and deliberated the future development plans of HA IT Services in order to respond to challenges in continuing existing service delivery and delivering major strategic IT enabled projects; and the progress on information security and privacy action plan. To support HAs business needs and accountability reporting, the Committee also endorsed the IT Block Vote Submission for 2011/12; the IT Services Annual Budget and Services Plan 2011/12; IT Services Performance Reports; and Clinical Management System Phase III Progress Reports.
147
Appendix 3
Ex-officio members : Mr Shane SOLOMON, Chief Executive (up to 24.10.2010) DrP Y LEUNG,JP, Chief Executive (from 8.11.2010) (Chief Executive or his nominated representative) Ms Nancy TSE Sau-ling Director (Finance) or her nominated representative Members : Two of the following rotating members: Mr CHAN Bing-woon, SBS, JP Ms Vivien CHAN, BBS, JP (up to 30.11.2010) Mr CHENG Yan-kee, JP Prof LAI Kar-neng, JP Mrs Yvonne LAW SHING Mo-han Dr Hon Joseph LEE Kok-long, SBS, JP Mr Charles Peter MOK
Terms of Reference 1. 2. 3. To review and assess the recommendations made by the assessment panel; To review the procedures and criteria adopted by the assessment panel in the course of its selection; and To approve the selection made by the assessment panel after satisfying itself that (i) and (ii) are in order and such approval should be final.
Focus of Work in 2010/11 In 2010/11, the Main Tender Board met 23 times to consider a total of 572 tender papers for procurement of supplies and services with value of over $1 million for Hospital Authority Head Office and above $4 million for Clusters and hospitals. Tenders for procurement of supplies mainly covered purchases of pharmaceutical products, medical and laboratory equipment and consumables whereas service tenders were mainly related to hospital domestic and supporting services, maintenance of medical and laboratory equipment, and information technology systems and data hosting facilities. Capital works tenders were mainly related to hospital redevelopment projects and minor works improvements for maintenance of hospital premises.
149
Appendix 3 Terms of Reference 1. 2. To examine, review and make recommendations on the changing needs of the community in respect of clinical services provided by public hospitals and institutions; To advise and make recommendations on the overall policies, directions and strategies relating to the provision, planning and development of public hospitals and related services, having regard to the availability of technology, staff and other resources and the need to provide a patient-centred, outcome-focused quality healthcare service by a knowledge-based organisation; To consider and make recommendations on the overall priorities for the planning and development of public hospitals and related services in order to ensure an optimal utilisation of available resources; and To consider, review and make recommendations on any other matters related to the planning and development of public hospitals and related services.
3.
4.
Focus of Work in 2010/11 The Medical Services Development Committee met five times in 2010/11 to discuss issues relating to the planning, development and management of clinical services. On clinical services planning and development, the Committee considered and deliberated on the manpower requirement and strategy for doctors, nurses and allied health professionals; strategic areas of development in general out-patient clinics; development of mental health service plan for adults in the HA; renal service development; consultancy study on the development of a public-private partnership model for phase two of the North Lantau Hospital project; and reorganisation of paediatric services. The Committee considered and gave advice on clinical management issues relating to inclusion of new drugs and indications under the Samaritan Fund from 2010/11; development of mortuary services; quality assurance and pharmacovigilance of Chinese Medicine; reducing the reprocessing and reuse of single used devices; management of interventional medical devices in the HA and enhancement of the HAs complaints and feedback management system. The Committee also received progress reports of different clinical programmes including the cataract surgeries programme; the Tin Shui Wai primary care partnership project, the filmless HA project, and the establishment of Youth Wellness Centre in the New Territories West Cluster.
151
Appendix 3 Terms of Reference 1. 2. The Public Complaints Committee (PCC) is the final complaint redress and appeal body of the Hospital Authority (HA). The PCC shall independently: (a) consider and decide upon complaints from members of the public who are dissatisfied with the response of the HA/hospital to which they have initially directed their complaints; and (b) monitor HAs handling of complaints. Pursuant to Para 2 above, the PCC shall independently advise and monitor the HA on the PCCs recommendations and their implementation. In handling complaint cases, the PCC shall follow the PCC Complaint Handling Guidelines which may be amended from time to time. The PCC shall from time to time and at least once a year, make reports to the HA Board and public, including statistics or raising important issues where applicable.
3. 4. 5.
Complaint Handling Guidelines 1. The PCC is an appeal body within the Hospital Authority (HA) that considers appeals made by the public relating to its services. Based on its Terms of Reference, the following are guidelines set by the PCC to facilitate the handling of complaints. The PCC shall not normally handle a complaint: (a) if the complaint relates to services provided by HA more than two years before the date of the lodging of the complaint, unless the PCC is satisfied that in the particular circumstances it is proper to conduct an investigation into such complaint not made within that period; (b) if the complaint is made anonymously and/or the complainant cannot be identified or traced; (c) if the complainant has failed to obtain proper consent of the patient, to whom the services were provided, in the lodging of the complaint (this restriction will not be applicable if the patient has died or is for any reason unable to act for himself or herself); (d) if the subject matter of the complaint has been referred to or is being considered by the coroner; (e) if the complaint relates to a matter for which a specific statutory complaint procedure exists;
2.
(f) if the complainant or patient concerned has instituted legal proceedings, or has indicated that he/she will institute legal proceedings, against HA, the hospital or any persons who provided the services (in any event, the Committee shall not entertain any request for compensation); (g) if the complaint relates to dispute over the established policies of HA, for example fees charging policy of HA in respect of its services; (h) if the complaint relates to an assessment made by a medical staff pursuant to any statutory scheme whereas such scheme provides for a channel of appeal, for example, the granting of sick leave under the provisions of the Employees Compensation Ordinance, Cap. 282; (i) if the complaint relates to personnel matters or contractual matters and commercial matters; (j) if the PCC considers that the complaint is frivolous or vexatious or is not made in good faith; or (k) if the complaint, or a complaint of a substantially similar nature, has previously been the subject matter of a complaint which had been decided upon by the PCC. 3. Taking into account the following: (a) the disclosure of legal privileged documents in an open hearing; (b) the disclosure of personal data in an open hearing; (c) the PCC is not a judicial or quasi-judicial body; (d) an aggrieved party has other channels to seek redress; and (e) the PCC should not duplicate the functions of other institutions such as the courts or the Medical Council; the PCC considers that its meetings shall not be open to the public. 4. In considering the merits of a complaint, the PCC may from time to time obtain expert opinion by medical professionals or other experts relating to the subject matter of the complaint. If the PCC considers appropriate, it may also invite the complainant, the patient, the medical staff or any other relevant persons to attend an interview. (The above guidelines on the handling of complaint cases may be amended from time to time as appropriate.)
153
Appendix 3 Focus of work in 2010/11 In 2010/11, the Public Complaints Committee held 18 meetings and handled a total of 274 cases, of which 182 were related to medical services, 38 related to administrative procedure, 28 related to staff attitude and 26 others. In addition to the handling of appeal cases, the Committee also formulated complaint handling policies to improve the efficiency and effectiveness of the Authoritys complaints system, and make recommendations for system change and improvement of healthcare services. Regular internal and external communication programmes were conducted to enhance transparency and credibility of HAs complaint system and the Committee as the final appeal body. Through its Secretariat, the Committee also shared important lessons learned for risk management and enhanced the complaint handling skills of frontline staff through regular specialist complaint management training. The Public Complaints Committee Secretariat also handled a total of 15,541 feedback cases from patients and complainants and was tasked to take up 102 cases referred by The Ombudsman, and 3,439 complaint cases directed to the Hospital Authority Head Office.
Terms of Reference 1. To consider and decide upon appeals from staff members who have raised grievances through the normal internal complaint channels and who wish to appeal against the decision made; The Committee shall: consider whether the appeal cases need further investigation by the management; direct the appeal cases to be investigated; have access to all relevant information required from the management for making a decision; ensure that appropriate action is taken; and reply to the appellant; The Committees decision shall represent HAs decision and shall be final; and The Committee shall make annual reports to the HA Board.
2.
3. 4.
Focus of Work in 2010/11 The Staff Appeals Committee was set up on 19 December 2002 as an independent authority for handling staff appeals which have already exhausted the normal staff complaint channels within the Hospital Authoritys operation. The Committee received two cases in 2010/11.
155
Appendix 3
Terms of Reference 1. To advise on the directions and policies related to the development of Business Support Services and Environmental Protection to best support clinical services delivery in the Hospital Authority. To review and advise on the implementation and monitoring of Capital Works projects in the Hospital Authority. To review and advise on the new initiatives in Business Support Services such as improvements in supply chain management, equipment management, strategic outsourcing and public-private-partnership of non-core functions, and the development of supporting services for revenue generation. To advise on the adoption of better practices and industry innovations related to the planning and delivery of business support services and implementation of Capital Works Projects in the Hospital Authority.
2. 3.
4.
Focus of Work in 2010/11 In 2010/11, the Supporting Services Development Committee held four meetings to fulfil its Terms of Reference, mainly to advise on the directions and policies related to the development of business support services and environmental protection to best support clinical service delivery in HA. It considered reports on the procurement risk management of non-drug items, replacement of medical and engineering equipment for 2010/11 and planning for 2011/12, enhancement of drug procurement, performance management of pharmaceutical manufacturers and suppliers, and implementation of Enterprise Resources Planning System for pharmaceutical supplies. It also reviewed reports on the implementation of cook chill cum cold-plating and upgrading of catering facilities, improvement of Non-Emergency Ambulance Transfer Service and the development plan for hospital laundry services. During the year, it also considered reports on the progress of major capital works projects, carbon audit for HA hospitals, barrier free access to HA facilities, use of air-cooled and watercooled air conditioning systems in HA hospitals, enhancement of routine maintenance in HA facilities, hospital fire protection efficiency improvement, and the development of the latest version of the Capital Works Procedural Manual.
157
Appendix 4
Appendix 4
Membership of Hospital Governing Committees Alice Ho Miu Ling Nethersole Hospital
Chairman : MrRoland CHOW Kun-chee Ex-officio members : Hospital Authority Chief Executive or his representative Hospital Chief Executive Members : Dr Bonba CHIU Sik-ho MsMichelle CHOW Yan-wai MrFUNG Sau-chung DrPamela LEUNG,JP MrJohn LI Kwok-heem Rev DrLI Ping-kwong MrWilson MOK Yu-sang RevEric SO Shing-yit Rt Rev DrThomas SOO Yee-po,JP BishopNicholas TAI Ho-fai ProfTAM Sheung-wai,GBS, JP MsWendy TSANG Wan-man RevJosephine TSO Shiu-wan DrWONG Fook-yee MsPeggy WONG Pik-kiu,MH MissNora WONG Pui-ha,JP
Bradbury Hospice
Chairman : DrGeoffrey LIEU Sek-yiu Ex-officio members : Hospital Authority Chief Executive or his representative Hospital Chief Executive Members : DrHubert CHAN Chung-yee, JP DrAmy CHOW Yin-man SisterHelen KENNY DrKWAN Wing-hong ProfSamantha PANG Mei-che FatherJohn RUSSELL,S.J. MrSHUM Si-ki ProfWONG Hoi-kwok,BBS, JP Prof DrDominic WONG Shing-wah,GBS, JP
159
Appendix 4
161
Appendix 4
Grantham Hospital
Chairman : MrPANG Yuk-ling,JP Ex-officio members : Hospital Authority Chief Executive or his representative Hospital Chief Executive Members : DrCHENG Chun-ho ProfFAN Sheung-tat, SBS ProfKaren LAM Siu-ling MrSteve Y F LAN MrSebastian LAU Ki-chit MrLawrence LEE Kam-hung,JP MrEdwin LEUNG Chung-ching DrVitus LEUNG Wing-hang MrsElizabeth LI MrsPurviz Rusy SHROFF MrRocco YIM Sen-kee,BBS, JP
163
Appendix 4
165
Appendix 4
Ex-officio members : Hospital Authority Chief Executive or his representative Hospital Chief Executive Members : MsMabel CHAU Man-ki MrVincent CHENG Wing-ming DrEric CHIEN Ping (up to 26.5.2010) ProfCHOW Shew-ping,JP DrDaniel FANG Tak-sang MrMartin HE ProfKeith LUK Dip-kei MrDavid MONG Tak-yeung DrPOON Tak-lun MrAdrian WONG Koon-man,JP MrDavid YAU Po-wing MrYU See-ho
167
Appendix 4
Pok Oi Hospital
Chairman : MrWONG Fan-foung, MH Ex-officio members : Hospital Authority Chief Executive or his representative Hospital Chief Executive Members : ProfChetwyn CHAN Che-hin MrStanley CHEUNG Tak-kwai DrCHONG Man-yuk MsYvonne CHUA MrLAM Yin-kee MrLEUNG Che-cheung,BBS, MH, JP MrHenry POON Shiu-man,MH MrHenry TONG Sau-chai DrSam WONG Chun-sing,MH MrVictor WONG Kai-tai,MH MrChris YIP Yiu-shing,MH
169
Appendix 4
Rehabaid Centre
Chairman : Hon JudgeKevin Anthony BROWNE Ex-officio members : Hospital Authority Chief Executive or his representative Hospital Chief Executive Members : DrJoseph BOSCO MsKelly CHAN Yuen-sau MrsShelley M CHOW MrRobin GILL MrsKimberley LAM KWONG Lan-heung DrLeonard LI Sheung-wai MrTSANG Chiu-kwan, JP
Shatin Hospital
Chairman : DrMargaret CHUNG Wai-ling Ex-officio members : Hospital Authority Chief Executive or his representative Hospital Chief Executive Members : MrCHEUNG Tak-hai MrFONG Cheung-fat MrJoseph KEUNG Shu-hoi ProfLAM Tai-hing,JP MrThomas PANG Cheung-wai,BBS, JP MrPeter SUEN Yiu-chan
Tai Po Hospital
Chairman : DrLily CHIANG Ex-officio members : Hospital Authority Chief Executive or his representative Hospital Chief Executive Members : MrCHEUNG Wing-fai MrRichard FUNG Lap-chung MrLEUNG Wo-ping,JP MrArthur LI Ka-tat MrMAN Chen-fai,MH DrSammy POONE,SBS, JP (Passed away in March 2011) DrSHUM Chi-wang
171
Appendix 4
Tung Wah Hospital / Tung Wah Eastern Hospital / TWGHs Fung Yiu King Hospital
Chairman : MrBilly LEUNG Ting-yu Ex-officio members : Hospital Authority Chief Executive or his representative Hospital Chief Executive Members : MrsViola CHAN MAN Yee-wai DrIna CHAN Un-chan MrChristopher CHAN Yiu-chong,BBS, JP MrCharles CHANG Juo-hwa MsCHENG Lai-king DrCHU Chor-lup MrFrederick FUNG King-wai DrJohn LEE Sam-yuen,BBS MrStephen LIU Wing-ting,JP MrPatrick MA Ching-hang,BBS, JP MrStephen NG Chi-wing MrPeter ONG Ka-lueng,BBS MrIvan SZE Wing-hang MrTONG Chun-wan MrEddie WANG,BBS
172 Hospital Authority Annual Report 2010-2011
173
Appendix 4
Appendix 5
Membership of Regional Advisory Committees Hong Kong Regional Advisory Committee
Chairman : MrCHAN Bing-woon,SBS, JP Ex-officio members : Hospital Authority Chief Executive or his representative Director of Health or his representative Members : Mr AU Lap-sing Ms Ophelia CHAN MrsViola CHAN MAN Yee-wai DrEric CHIEN Ping Dr Daniel FANG Tak-sang MrJONG Koon-sang Mr KONG Chack-ho, MH Ms Kenny LEE Kwun-yee Mr Edwin LEUNG Chung-ching Mr Tommy LI Ying-sang, BBS, MH, JP Mr PANG Yuk-ling, JP Mr TSANG Wing-wah Mr Lincoln TSO Dr Loretta YAM Yin-chun, BBS DrPaul YOUNG Tze-kong,JP ProfRichard YUEN Man-fung Mr YUNG Chi-ming, MH
175
Appendix 5
177
Appendix 6
Appendix 6
Membership of the Board of Trustees of the Hospital Authority Provident Fund Scheme
Chairman Trustees : Mr John LEE Luen-wai, BBS JP : Dr Gordon JAN Siu-kei Ms LAU Ka-shi Mr Raymond LEE Wing-hung (from 7.4.2010) Mr Lincoln LEONG Kwok-kuen (up to 6.4.2010) Mr Raymond LEUNG Ho-kwan, MH Mr Peter LO Chi-lik Mr LO Kam-shing Mr Patrick MA Ching-hang, BBS Mrs Susan MAK LOK Suet-ling, JP Mr Alan Howard SMITH, JP Ms Nancy TSE Sau-ling Dr WONG Chi-keung
Appendix 7
Public Feedback Statistics Complaint / Appreciation Received (1.4.2010 31.3.2011)
Public Complaints Committee
Nature of cases Medical services Staff attitude Administrative procedure Others Total number of appeal cases handled Number of appeal cases 182 28 38 26 274
179
Appendix 8
Appendix 8
Statistics of the Controlling Officers Report
The Hospital Authority generally achieved its performance targets in 2010/11. The volume of patient care activities across the full range of services in 2010/11 is comparable to the level in 2009/10. The key statistics of the Controlling Officers Report used by the Government to measure the Authoritys performance in 2009/10 and 2010/11 were:
2009/10 2010/11
2009/10 Ambulatory diagnostic & therapeutic services Day patient No. of discharges & deaths No. of day patients as % of total inpatient & day Patient discharges and deaths Accident & Emergency (A&E) services No. of attendance Outpatient services No. of specialist outpatient (clinical) attendances** No. of general outpatient attendances*** No. of family medicine specialist clinic attendances No. of primary care attendances*** Rehabilitation & outreach services No. of home visits by community nurses Psychiatric services No. of psychiatric outreach attendances No. of psychiatric day hospital attendances No. of psychogeriatric outreach attendances Geriatric services No. of outreach attendances No. of older persons assessed for infirmary care service No. of geriatric day hospital attendances**** No. of Visiting Medical Officer attendances No. of allied health outpatient attendances 626,287 1,417 133,992 114,876 2,024,568 135,927 211,675 83,003 823,907 6,392,410 4,700,543 272,146 4,972,689 2,214,422 416,885 31%
2010/11
181
Appendix 8
2009/10
2010/11
(IV)Cost of Services
Cost distribution Cost distribution by service types (%) Inpatient Ambulatory and outreach Cost by service types per 1000 population ($m) Inpatient Ambulatory and outreach Cost of services for persons aged 65 or above Share of cost of services (%) Cost of services per 1000 population ($m) Unit costs Cost per inpatient discharged ($) General (acute and convalescence) Infirmary Mentally ill Mentally handicapped Cost per patient day ($) General (acute and convalescence) Infirmary Mentally ill Mentally handicapped Cost per accident & emergency attendance ($) Cost per specialist outpatient attendance ($) Cost per general outpatient attendance ($) Cost per family medicine specialist clinic attendance ($) Cost per outreach visit by community nurse ($) Cost per psychiatric outreach attendance ($) Cost per geriatric day hospital attendance ($) Waivers ~ % of Comprehensive Social Security Assistance (CSSA) waiver (%) % of non-CSSA waiver (%) 19.6 3.8 18.8 3.9 3,590 1,130 1,780 1,070 800 880 290 820 320 1,100 1,510 3,600 1,130 1,750 1,070 800 910 290 860 330 1,160 1,490 18,920 175,290 112,420 682,100 18,630 161,460 112,660 655,390 44.9% 18.1 45.8% 18.4 2.9 2.2 2.9 2.3 57.2% 42.8% 56.1% 43.9%
Notes : * Derived by dividing the sum of length of stay of inpatient by the corresponding number of inpatient discharged/treated. ** *** Number of specialist outpatient attendances includes number of nurse clinic attendances. Number of primary care attendances comprises the number of general outpatient (GOP) attendances and family medicine specialist clinic attendances. GOP attendances include nurse clinic attendances, it also includes attendances under Integrated Mental Health Program (IMHP) with effective from 2010/11. Eight GOP clinics were designated as Designated Flu Clinics for human swine influenza (H1N1 Influenza A) between13 June 2009 and 23 May 2010. The attendances of the Designated Flu Clinics are not included in the figure.
**** No. of geriatric day hospital attendances under Integrated Discharge Support Program are excluded. ^ Refers to the standardised mortality rate covering all deaths in HA hospitals. This is derived by applying the age-specific mortality rate in HA in a particular year to a standard population which is the 2001 Hong Kong mid-year population. Refers to median waiting time of major clinical specialties which include Ear, Nose and Throat, Gynaecology, Medicine, Ophthalmology, Orthopaedics & Traumatology, Paediatrics and Adolescent Medicine, Psychiatry and Surgery. With effective from 2010/11, the counting basis for unplanned readmission rate is redefined as readmission to same specialty instead of readmission to same hospital. Refers to the amount waived as percentage to total charge.
@ ~
183
Appendix 9
Appendix 9
Statistics on Number of Beds, lnpatient, Outpatient and Accident & Emergency Services in 2010/11
No. of Beds (as at end March 2011) Total IP & DP Discharges and Deaths Inpatient Occupancy Rate (%) Inpatient Average Length of Stay (days) Family Medicine Total SOP Specialist Attendances Clinic (clinical) Attendances Total Allied Health Outpatient Attendances General Outpatient Attendances
Institution
1,597
128,074
82.4
5.6
154,874
534,835
57,757
102,902
298,186
10,063 67,820
Institution
575,388 1,540,874
440,502 1,476,042
185
Appendix 9
Institution
392,585 1,036,075
GRAND TOTAL
27,041 1,441,187
83.5
Notes: 1. The number of beds as at end March 2011 is based on the Annual Survey on Hospital Beds in Public Hospitals, 2010/11. 2. The outpatient attendances for different clinics are grouped under respective hospital management. 3. Total SOP attendances (clinical) include Nurse Clinic attendances. 4. General outpatient attendances include Nurse Clinic attendances and attendances under Integrated Mental Health Program (IMHP). 5. Total Allied Health outpatient attendances exclude follow-up consultations provided by the Medical Social Service Department and joint clinic consultations provided by the Optometry & Orthoptics Department with doctors. 6. Data prepared in July 2011. Abbreviations: IP Inpatient DP Day Patient A&E Accident & Emergency SOP Specialist Outpatient
186 Hospital Authority Annual Report 2010-2011
Appendix 10
Statistics on Community and Rehabilitation Services in 2010/11
Community Nursing Service * Community Psychiatric Service # Psychogeriatric Service # Community Geriatric Assessment Service @ Visiting Medical Officer attendances++ Community Allied Health attendances** Rehabilitation Day & Geriatric Palliative day care day hospital attendances attendances*** Psychiatric day hospital attendances
Institution
96,531
14,534
9,551
799
1,019
10,823
29,845
5,294 101,825
14,534
9,551
115,851 115,851
18,775 18,775
1,541 3 87 2,510
29,845
187
Appendix 10
Institution
Psychogeriatric Service #
Rehabilitation Day & Geriatric Palliative day care day hospital attendances attendances***
Institution
Psychogeriatric Service #
Rehabilitation Day & Geriatric Palliative day care day hospital attendances attendances***
GRAND TOTAL
833,934
167,086
82,716
621,294
114,540
29,552
80,353
141,098 211,993
* #
For Community Nursing Service, the activity refers to number of home visits made. For Community Psychiatric Service and Psychogeriatric Service, the activity refers to the total number of outreach attendances and home visits. The activity of Community Psychiatric Service also includes Recovery Support Programme and Personalised Care Programme for patients with SMI attendances, while the activity of Psychogeriatric Service also includes consultation-liaison attendances. For Community Geriatric Assessment Service, the activity refers to the total number of outreach attendances and infirmary care service assessments performed. Visiting Medical Officer attendances refer to the services provided to elderly persons living in Resident Care Homes for the Elderly under the Visiting Medical Officers Scheme introduced in 2003/04. Community Allied Health attendances exclude follow-up consultations provided by the Medical Social Service Department. Geriatric day hospital attendances include attendances from Integrated Discharge Support Programme (IDSP).
@ ++ ** ***
Note: The activity performed in different centres and teams are grouped under respective hospital management.
189
Appendix 11
Appendix 11(a)
Manpower Position - by Cluster and Institution
No. of Full-time Equivalent (FTE) Staff (as at 31.3.2011)* Institution Hong Kong East Cluster Cheshire Home, Chung Hom Kok HK Tuberculosis, Chest & Heart Diseases Association Hong Kong East Cluster Office Pamela Youde Nethersole Eastern Hospital Ruttonjee & Tang Shiu Kin Hospitals St John Hospital Tung Wah Eastern Hospital Wong Chuk Hang Hospital 1.00 446.81 77.65 5.00 38.00 2.00 30.64 1,369.03 398.49 31.98 173.07 43.75 3.50 402.31 137.00 10.00 57.00 4.00 Medical 573.46 3.00 Nursing 2,099.96 53.00 Allied Health 622.81 9.00 Others 3,231.48 107.00 8.00 421.87 1,657.12 588.49 62.00 282.00 105.00 Total 6,527.71 172.00 8.00 457.01 3,875.27 1,201.63 108.98 550.07 154.75
Hong Kong West Cluster Duchess of Kent Childrens Hospital Grantham Hospital Hong Kong West Cluster Office MacLehose Medical Rehabilitation Centre Queen Mary Hospital TWGHs Fung Yiu King Hospital Tung Wah Hospital
No. of Full-time Equivalent (FTE) Staff (as at 31.3.2011)* Institution Kowloon Central Cluster HK Red Cross Blood Transfusion Service Hong Kong Buddhist Hospital Hong Kong Eye Hospital Kowloon Central Cluster Office Kowloon Hospital Queen Elizabeth Hospital Rehabaid Centre Medical 685.58 4.00 14.00 37.20 1.00 62.23 567.15 719.28 1,789.70 155.67 558.30 12.00 Nursing 2,781.33 66.23 137.44 68.68 Allied Health 826.97 54.00 28.00 19.00 Others 3,583.85 203.00 163.20 140.00 62.00 787.06 2,216.59 12.00 Total 7,877.73 327.23 342.64 264.88 63.00 1,724.24 5,131.74 24.00
Kowloon East Cluster Haven of Hope Hospital Kowloon East Cluster Office Tseung Kwan O Hospital United Christian Hospital
612.61 17.02
2,097.39 228.96
569.03 46.02
138.05 457.54
472.11 1,396.32
133.04 389.97
500.36 1,749.42
Kowloon West Cluster Caritas Medical Centre Kowloon West Cluster Office Kwai Chung Hospital Kwong Wah Hospital Our Lady of Maryknoll Hospital Princess Margaret Hospital TWGHs Wong Tai Sin Hospital Yan Chai Hospital
191
Appendix 11
No. of Full-time Equivalent (FTE) Staff (as at 31.3.2011)* Institution New Territories East Cluster Alice Ho Miu Ling Nethersole Hospital Bradbury Hospice Cheshire Home, Shatin New Territories East Cluster Office North District Hospital Prince of Wales Hospital Shatin Hospital Tai Po Hospital Medical 899.01 132.51 3.23 2.00 1.00 163.30 510.97 44.00 42.00 Nursing 3,272.19 485.00 24.50 81.00 123.97 572.54 1,404.18 285.00 296.00 Allied Health 921.00 159.00 4.00 8.00 1.00 144.00 483.00 57.00 65.00 Others 4,135.94 603.00 18.00 115.00 371.02 640.00 1,610.92 369.00 409.00 Total 9,228.14 1,379.51 49.73 206.00 496.99 1,519.84 4,009.07 755.00 812.00
New Territories West Cluster Castle Peak Hospital New Territories West Cluster Office Pok Oi Hospital Siu Lam Hospital Tuen Mun Hospital
675.32 68.60
2,634.94 528.20
652.05 65.00
Total
5,325.74
20,054.19
5,552.38
26,060.51
56,992.82
* *
This figure excludes 1,480.61 staff in the Hospital Authority shared/agency services and the Head Office. Manpower on full-time equivalent (FTE) basis includes all staff in HAs workforce i.e. permanent, contract and temporary.
Appendix 11(b)
Manpower Position - by Staff Group
No. of Full-time Equivalent (FTE) Staff * 2006/07 Medical Consultant Senior Medical Officer / Associate Consultant Medical Officer / Resident(excluding Visiting Medical Officer) Visiting Medical Officer Intern Senior Dental Officer / Dental Officer Medical Total: 502.7 1,010.0 3,087.9 16.3 313.0 5.5 4,935.4 530.9 1,085.4 3,091.4 14.7 329.0 5.5 5,057.0 563.4 1,172.9 3,110.5 16.3 292.0 5.5 5,160.5 590.1 1,241.5 3,147.4 15.6 277.0 6.3 5,277.9 630.1 1,294.0 3,111.8 16.1 280.0 5.3 5,337.4 2007/08 2008/09 2009/10 2010/11
Nursing Senior Nursing Officer and above Department Operations Manager General Ward Manager / Nurse Specialist / Nursing Officer / Advanced Practice Nurse Registered Nurse Enrolled Nurse Midwife / Others Student Nurse / Pupil Nurse / Temporary Undergraduate Nursing student Psychiatric Ward Manager / Nurse Specialist / Nursing Officer / Advanced Practice Nurse Registered Nurse Enrolled Nurse Student Nurse / Pupil Nurse Nursing Total: 330.5 1,015.6 544.3 22.0 19,212.0 347.0 1,107.7 491.7 8.0 19,273.3 397.7 1,061.5 496.4 0.0 19,521.6 415.3 1,067.5 473.8 9.0 19,866.3 436.3 1,058.8 473.0 6.0 20,093.1 2,409.4 11,787.6 2,718.2 40.7 121.6 2,521.5 11,731.0 2,541.9 37.7 260.7 3,038.4 11,478.1 2,375.4 35.3 397.8 3,161.6 11,780.1 2,199.4 28.6 487.0 3,274.8 11,981.0 2,189.9 24.6 407.7 66.0 156.0 69.0 157.0 83.0 158.0 81.0 163.0 80.0 161.0
193
Appendix 11
No. of Full-time Equivalent (FTE) Staff * 2006/07 Allied Health Audiology Technician Clinical Psychologist Dietitian Dispenser Medical Technologist / Medical Laboratory Technician Mould Technologist / Mould Laboratory Technician Optometrist Orthoptist Occupational Therapist Pharmacist / Resident Pharmacist Physicist / Resident Physicist Physiotherapist Podiatrist Prosthetist-Orthotist Radiographer Scientific Officer (Medical) Speech Therapist Medical Social Worker Dental Technician Allied Health Total: 9.0 78.0 84.5 863.0 1,070.0 27.0 29.0 12.0 469.5 321.7 50.0 701.9 17.1 97.0 843.6 59.6 54.0 177.0 2.0 4,965.8 9.0 85.0 84.0 886.8 1,081.0 27.0 29.0 12.0 480.5 330.7 51.0 709.0 19.1 98.0 853.5 65.6 54.0 186.0 2.0 5,063.1 9.0 92.0 85.7 919.0 1,106.1 27.0 29.0 12.0 498.6 353.7 55.0 729.2 22.2 100.2 869.7 64.6 58.0 198.0 2.0 5,231.1 9.0 92.3 92.2 949.0 1,148.0 27.0 32.0 12.0 531.6 375.7 56.0 755.0 24.0 107.0 898.0 65.6 61.0 210.0 2.0 5,447.4 9.0 100.3 91.9 971.0 1,175.7 27.0 41.0 14.0 572.6 391.7 58.0 774.9 26.8 105.0 905.7 66.9 58.5 223.5 2.0 5,615.4 2007/08 2008/09 2009/10 2010/11
Care-related Support Staff Health Care Assistant Ward Attendant General Services Assistant / Technical Services Assistant (Care-related) / Theatre Technical Assistant Care-related Support Staff Total: 3,728.0 743.0 2,780.1 3,598.0 668.0 3,503.6 3,465.0 599.0 4,265.9 3,283.0 537.0 5,133.2 3,087.0 478.0 5,632.2
7,251.1
7,769.6
8,329.9
8,954.2
9,197.2
36,364.3
37,163.0
38,243.1
39,545.9
40,243.0
No. of Full-time Equivalent (FTE) Staff * 2006/07 Others Chief Executive / Director / Deputy Director / Head Cluster Chief Executive / Hospital Chief Executive Chief Manager / Senior Manager / Executive Manager / General Manager Other Professionals / Administrator, System Manager, Analyst Programmer, etc. Other Supporting Staff - Clerical, Secretarial, Workman, Artisan, Property Attendant, etc. Non-direct Patient Care Total: 7.0 25.0 88.0 938.6 15,499.3 7.0 23.0 89.0 1,032.4 15,774.8 7.0 27.0 86.6 1,213.7 16,333.9 7.0 27.0 87.6 1,407.4 16,638.9 6.0 27.0 85.6 1,514.8 16,597.0 2007/08 2008/09 2009/10 2010/11
16,557.9
16,929.2
17,668.2
18,166.9
18,230.4
HA Total:
52,922.2
54,089.2
55,911.3
57,712.8
58,473.4
Manpower on full-time equivalent (FTE) includes all staff in HAs workforce i.e. permanent, contract and temporary. All FTE manpower counting are based on actual service sessions.
195
Appendix 12
Appendix 12(a)
Resource Utilisation for 2010/11
Clusters Hong Kong East Cluster Hong Kong West Cluster Kowloon Central Cluster Kowloon East Cluster Kowloon West Cluster New Territories East Cluster New Territories West Cluster Hospital Authority Head Office and Others Note Total 2010/11 Resource Utilisation ($Mn) 3,457 3,773 4,444 3,180 7,296 5,242 4,146 1,398 32,936
Note: Others include resources for hospital services (e.g. intern) and corporate programmes (e.g. insurance premium, legal costs / claims and information technology / information systems services, etc) and others.
Appendix 12(b)
Training and Development Expenditure for 2010/11 (*)
Clusters Hong Kong East Cluster Hong Kong West Cluster Kowloon Central Cluster Kowloon East Cluster Kowloon West Cluster New Territories East Cluster New Territories West Cluster Hospital Authority Head Office Total * Amount $5,471,608 $4,706,002 $6,215,436 $2,404,824 $6,821,220 $7,770,840 $6,667,401 $48,771,329 $88,828,660 Expenditure in providing training and development for HA workforce with items including course / conference fees, passages and travel, scholarships, subsistence allowances, teaching aids and devices, publications, trainer fees and other relevant charges.
Appendix 13
Five-Year Financial Highlights Financial Results (for the Year ended 31 March 2011)
2011 HK$Mn Income Government subvention (recurrent and capital) Medical fee income (net of waivers) Non-medical fee income Designated donations Capital donations 34,366 2,994 562 143 113 38,178 Expenditure Staff costs Drugs Medical supplies and equipment Other operating expenses (include depreciation) (26,904) (3,639) (1,354) (6,039) (37,936) Surplus/(Deficit) for the Year 242 (26,680) (3,209) (1,210) (5,473) (36,572) (28) (26,387) (2,812) (1,211) (4,879) (35,289) (183) (24,468) (2,596) (1,105) (4,546) (32,715) 261 (23,047) (2,340) (979) (4,116) (30,482) 198 33,098 2,726 478 132 110 36,544 31,915 2,527 454 112 98 35,106 29,915 2,296 564 108 93 32,976 28,041 1,987 487 76 89 30,680 2010 HK$Mn 2009 HK$Mn 2008 HK$Mn 2007 HK$Mn
197
Appendix 13
199
Appendix 14
Appendix 14
Analysis of Hospital/Clinic Fees and Charges
The fees and charges for medical services provided by the Hospital Authority are levied in accordance with those stipulated in the Gazette. The fees and charges are recognised as income in the Statement of Income and Expenditure when services are provided. Different charge rates are applicable for Eligible Persons and Non-Eligible Persons. Eligible Persons of public health services are holders of Hong Kong Identity Card issued under the Registration of Persons Ordinance or children under 11 years of age with Hong Kong resident status. Persons who are not Eligible Persons are classified as Non-Eligible Persons. Fees and charges that are uncollectible after all possible attempts are written off in the Statement of Income and Expenditure for the year. In addition, provision is made for outstanding fees and charges. Such provision is assessed based on both the aging as well as the recoverability rate of outstanding hospital fees and charges as at the end of the financial year. The amount of provision for doubtful debts as at 31 March 2011 is HK$42,699,000 (as at 31 March 2010: HK$34,471,000). Fees and charges for public medical services are waived for recipients of Comprehensive Social Security Assistance (CSSA). Other patients who have financial difficulties in paying fees and charges for medical services can approach the Medical Social Workers to apply for waivers which may be granted after assessment of the patients financial condition. The analysis of the hospital/clinic fees and charges of the Hospital Authority is as follows:
2010/2011 HK$000 HK$000 Net hospital/clinic fees and charges Hospital/clinic fees written-off and changes in provision for doubtful debts Actual write-off Increase in provision 2,956,360 (%) (83.6%) 2009/2010 HK$000 HK$000 2,688,453 (%) (82.8%)
Waiver of hospital/clinic fees for: Eligible Persons Non-Eligible Persons Total hospital/clinic fees and charges 501,481 40,614 3,535,809 (14.2%) (1.1%) (100%) 493,459 29,680 3,248,687 (15.2%) (0.9%) (100%)
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