For submission to the Provisional Legislative Council

Purpose

This report gives an account of the work of the Panel on Health Services during the term of the Provisional Legislative Council. It will be tabled at the meeting of the Council on 1 April 1998 in accordance with Rule 77(14) of the Rules of Procedure of the Council.

The Panel

2. The Panel was formed by resolution of this Council on 16 July 1997 for the purpose of monitoring and examining Government policies and issues of public concern relating to health services matters. The terms of reference of the Panel are in Appendix I.

3. The Panel comprises eight members. Dr Hon TANG Siu-tong and Dr Hon LEONG Che-hung were elected Chairman and Deputy Chairman of the Panel respectively. The membership list of the Panel is in Appendix II.

Major work

Screening of blood for transfusion

4.In August 1997, following the discovery of a case of a patient found to be HIV positive after receiving blood transfusion at a public hospital, the Panel met the Hospital Chief Executive of the Hong Kong Red Cross Blood Transfusion Service (BTS) and other representatives of the Administration to discuss the measures adopted by the Hospital Authority (HA) and the BTS to prevent the transmission of communicable diseases through blood transfusion. Members noted that donors whose blood was considered unsuitable for transfusion were barred from donation and all donated blood were subject to stringent screening tests in accordance with internationally accepted practices. In addition, a panel consisting of microbiologists, hematologists and experts on AIDS had been formed to regularly monitor the procedures and practices for the blood transfusion process. As to the Panel' question of whether other blood screening tests would be adopted to address the indow period* of HIV tests, members were informed that there were two other tests which could detect the AIDS virus after shorter window periods, but both tests had major shortcomings. Given the low incidence of infection by AIDS virus, BTS had no plan to use either test for blood screening.

Medical incidents at public hospitals

5. In the same month, in the wake of a series of medical incidents at public hospitals, the Panel met representatives of the HA to express its concern over the incidents and urged the HA to ensure the independence of the investigations to be conducted. To better understand how the HA ensure the quality and standards of its patient care services as well as the professional accountability of its clinical staff, members discussed the following items with the HA at the meetings of the Panel in September and November 1997 and January 1998 respectively -

1. review on clinical audit and monitoring;

2. report on the comprehensive reviews conducted by the HA to assure quality of care and enhance professional accountability; and

3. remedial measures for medical incidents and review of complaints management.

H5N1 virus

6. Following the discovery of the first case of influenza A H5N1 virus in man in Hong Kong, the Administration informed the Panel at its meeting in early September 1997 that a special Task Force comprising experts from the Centre for Disease Control in Atlanta, USA, microbiologists from two local universities and officials of the Department of Health and the Agriculture and Fisheries Department had been established to conduct an in-depth investigation into the case. Members noted that when the laboratory investigation results were available, the Department of Health would work with the Centre for Disease Control and the World Health Organization to analyse and interpret the data and to devise new plans on the way forward, if necessary. After three other confirmed cases of influenza A H5N1 virus infection had been found, the Panel discussed the matter again at its meeting in early December 1997. Members were concerned whether public hospitals had sufficient resources and medicine in the event of a major outbreak. Members urged the Administration to adopt a more open approach in releasing information on the virus, to set up a special task group to publicize up-to-date information and to educate the public on precautionary measures against infection.

7. Following the Administration's decision to slaughter all chickens in Hong Kong, a special meeting was held on 31 December 1997 with the participation of other non-Panel Members. Members expressed their concern over the way in which the chicken slaughtering operation was conducted and stressed the need for the Administration to improve public confidence in the Government's ability to handle the crisis. They urged the Administration to draw up a contingency plan in the event of an epidemic. The matter was followed up at two subsequent meetings.

Accidental spill of cyanide

8. Following the accidental spill of cyanide by a goods vehicle near a country park in December 1997, the Panel held a special meeting with the Administration (with the participation of members of the Panels on Security and Environmental Affairs) to discuss the remedial measures to prevent the re-occurrence of such incidents.

Licensing requirements for pharmaceutical products

9. Arising from the incident of a diagnostic test reagent reported to have been contaminated by the causative agent of Creutzfeldt-Jakob Disease in January 1998, the Panel discussed with the Administration the legislative control for pharmaceutical products and radioactive substances at its meeting in early February. Members urged the Administration to improve the co-ordination between the two licensing bodies and also to ensure that importers of pharmaceutical products were fully aware of the licensing requirements.

Infectious diseases surveillance

10. On infectious diseases surveillance and data collection/management, members stressed the need to strengthen this area of work. Members expressed their dissatisfaction with the present arrangement under which the Department of Health had to work with the two municipal councils and two other departments in order to carry out its responsibility for the prevention and control of infectious diseases. Members considered that there was a need for a review of such an arrangement. The Administration assured members that that there was close co-ordination and co-operation. Moreover, to enhance the technology and training in this area of work, the construction of a modern, highly automated Public Health Laboratory with sophisticated equipment would be completed in mid-2001.

Other matters discussed

11. Other subject matters discussed by the Panel included manpower review of medical doctors, the Student Health Service, the assessment criteria for the Samaritan Fund, non-emergency ambulance service, elderly health centres, medical rehabilitation service for ex-mental patients, monitoring of dispensaries in general outpatient clinics, implementation of the Smoking (Public Health) (Amendment) (No. 2) Ordinance 1997, ciguatera fish poisoning, prevention of hepatitis A and legislation of traditional Chinese medicine.

12. From July 1997 to March 1998, the Panel held a total of 13 meetings, of which one was a joint meeting with the Panel on Environmental Affairs, and visited two health care institutions. It also considered research papers on Health Care for Elderly People, Long Term Health Care Policy, Health Care Expenditure and Financing in Hong Kong, and Health Care Financing in Australia, USA, Taiwan and the United Kingdom prepared by the Research and Library Services Division of the Provisional Legislative Council Secretariat at the request of the Panel.

Provisional Legislative Council Secretariat
4 March 1998