Legislative Council

LC Paper No. CB(2) 1652/98-99
(These minutes have been
seen by the Administration)

Ref : CB2/PL/HS

Members Present :

Hon Michael HO Mun-ka (Chairman)
Dr Hon LEONG Che-hung, JP (Deputy Chairman)
Hon Cyd HO Sau-lan
Hon CHAN Yuen-han
Hon Mrs Sophie LEUNG LAU Yau-fun, JP
Dr Hon YEUNG Sum
Hon YEUNG Yiu-chung
Dr Hon TANG Siu-tong, JP
Hon LAW Chi-kwong, JP

Member Absent :

Hon HO Sai-chu, JP

Public Officers Attending :

For All Items

Mr Stephen NG

Deputy Secretary for Health and Welfare

Mr Edwin LAU

Assistant Secretary for Health and Welfare

Dr Constance CHAN

Principal Medical & Health Officer

Item III - Monitoring of private hospitals

Dr MAK Sin-ping

Acting Deputy Director of Health

Mr Derek B GOULD

Principal Assistant Secretary for Health and Welfare (Medical)3

Item IV - Implementation of the Enhanced Productivity Programme in the Department of Health

Dr MAK Sin-ping

Acting Deputy Director of Health

Miss Eliza YAU

Principal Assistant Secretary for Health and Welfare (Medical)1

Item V - Statutory control of physiotherapists

Dr MAK Sin-ping

Acting Deputy Director of Health

Mr TSE Man-shing

Head of Boards & Councils Office

Miss Eliza YAU

Principal Assistant Secretary for Health and Welfare (Medical) 1

Mr Fletch CHAN

Assistant Secretary for Health and Welfare

Clerk in Attendance :

Ms Doris CHAN

Chief Assistant Secretary (2) 4

Staff in Attendance :

Mr LEE Yu-sung

Senior Assistant Legal Adviser

Mrs Eleanor CHOW

Senior Assistant Secretary (2) 4

I. Confirmation of minutes of meeting held on 14 September 1998 and matters arising
(LC Paper No. CB(2) 558/98-99)

The minutes of the meeting held on 14 September 1998 were confirmed.

II. Date of next meeting and items for discussion
(LC Paper No. CB(2) 557/98-99 (01))

2. The Chairman proposed discussing the following items at the next regular meeting to be held on Monday, 14 December 1998 at 8:30 am -

1. Progress of employing extra 580 nurses;
   
   
2. Mental Health Service; and
   
   
3. Unregistered pharmaceutical products.

Dr LEONG Che-hung suggested and the Chairman agreed that item (c) should include discussion on the legislative control of blood/blood products in Hong Kong. Dr LEONG also suggested to discuss the implementation of the Enhanced Productivity Programme in the Hospital Authority (HA) at a future meeting.

3. The Chairman noted that Department of Health (DH) had completed its investigation into the kidney dialysis incident at the Hong Kong Sanatorium and Hospital. However, as an inquest into the deaths involved in the incident would be held early next year, the Chairman agreed not to discuss the issue until after completion of the inquest.

Special meeting for discussion of the Human Organ Transplant Ordinance (HOTO) (Cap. 465)

4. Members agreed to convene a special meeting on 23 November 1998 at 8:30 am to discuss the operational difficulty and areas of controversy of the HOTO.

III. Monitoring of private hospitals
(LC Paper No. CB(2) 557/98-99 (02))

Government's investigation report on the kidney dialysis incident at the Hong Kong Sanatorium and Hospital

5. Acting Deputy Director of Health (DD(H)(Atg)) informed members that DH's Investigation Team concurred in general with the findings of the three-member investigation committee appointed by the Hong Kong Sanatorium and Hospital. She said that the incident was thought to be related to contamination of the water treatment system used for haemodialysis. A multitude of factors acted together to result in the event. The Administration was satisfied that the Hospital provisions in relation to accommodation, equipment and manpower at the time of the incident were appropriate for the purpose of carrying out haemodialysis treatment. It also considered that the immediate measures taken by the Hospital in response to the incident were generally in order. Moreover, the Hospital had agreed to adopt more long-term measures to prevent recurrence of similar incidents.

6. DD(H)(Atg) reported that the dialysis unit concerned had been closed after the accident. It would not be re-opened until it had made the necessary improvements to the satisfaction of DH. Dr LEONG Che-hung was concerned about the progress of the Hospital in implementing the enhancement programmes. In response, DD(H)(Atg) said that the Hospital had already started its improvement work. DH would keep a close watch on the progress and conduct inspections on completion of the work. The progress and achievements made by the Hospital in implementing the improvements measures would be taken into consideration when the Hospital was due for licence renewal. Dr LEONG Che-hung asked whether DH was satisfied that the improvement measures being implemented by the Hospital were adequate. In response, DD(H)(Atg) explained that the Hospital also had to take into account its own needs and circumstances in deciding the specific physical/structural improvements to be made.

7. To further ensure the safety of kidney dialysis, DD(H)(Atg) said that DH had issued safety guidelines to all medical institutions providing such service. The guidelines served as the basis for the medical institutions to develop their own set of procedures and guidelines to ensure safety in providing haemodialysis service relevant to their particular clinical settings. DD(H)(Atg) agreed to provide a copy of the safety guidelines for members' reference.

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8. In response to Dr YEUNG Sum's enquiry, DD(H)(Atg) explained that DH conducted regular inspections to all registered kidney dialysis centres and private medical institutions providing such service. Additional visits were also made as and when necessary. Following the incident, DH had conducted more inspections to these institutions and maintained close liaison with them to facilitate their seeking advice and assistance in enhancing safety standards of their service.

9. Mr YEUNG Yiu-chung enquired whether it was the first time for DH to issue guidelines on kidney dialysis to the relevant medical institutions. DD(H)(Atg) said that it was but added that all public and private medical institutions providing such service had all along provided relevant procedures and code of practice for their staff to follow. DH had issued the safety guidelines on kidney dialysis because it believed that the guidelines would further help to ensure the safety standards of the service.

Monitoring of private hospitals

10. Mr LAW Chi-kwong enquired whether the Administration would tighten its control in monitoring the standards of private hospitals such as by introducing the system of International Standards Organization (ISO) to private hospitals in Hong Kong. He questioned how patients' feedback on those medical practitioners affiliated with a private hospital could be reflected and how far patients' feedback as a whole was taken into account when DH considered the licence renewal of a private hospital. In response, DD(H)(Atg) briefed members on the experience of foreign countries in adopting the accreditation system for improving the standards and quality of care provided by hospitals. She explained that in Hong Kong, DH assumed the responsibility for licensing private hospitals in accordance with Cap 165. She pointed out that for the purpose of licence renewal, each private hospital was required to complete a questionnaire, a sample copy of which had been provided to members for reference. DD(H)(Atg) pointed out that the questionnaire was drawn up on the basis of the Guide to Hospital Standards (the Guide) endorsed by the Medical Development Advisory Committee (MDAC) in 1990. The questionnaire was updated from time to time and the information required from private hospitals was comprehensive. In case of doubt, DH would seek clarification of information provided by the hospital in the questionnaire. Follow-up inspections would be conducted to ensure necessary improvements were made.

11. DD(H)(Atg) further explained that each private hospital was required to establish a mechanism for handling complaints. Patients could lodge complaints either to the hospital concerned or to DH. DH would investigate into the complaint case and if necessary refer it to the relevant professional boards/councils for action.

12. Miss Cyd HO enquired whether there were cases that investigations conducted by DH into problems revealed by the questionnaires had led to prosecutions against the hospitals concerned. In response, DD(H)(Atg) said that some 10 cases involving conditions such as unsatisfactory hygienic conditions and improper storage of medicine had been found over the past few years through the inspections conducted by DH. As the hospitals concerned had managed to make improvements to rectify the problems, there were no prosecutions instituted against any one of them. However, two warning letters had been issued regarding storage of expired medicine.

13. Miss Cyd HO was concerned whether the questionnaire was able to provide adequate information to DH to enable it to monitor the standards of private hospitals and detect potential areas of problems. She further enquired whether there were medical incidents which had actually been foretold by signs of irregularities shown by the questionnaire collected from the hospital concerned. In reply, DD(H)(Atg) said that there had been no such cases. She said that most problems had been detected through inspections and the problems found were generally related to minor issues. When these problems were found, the inspection team of DH would request the hospital concerned to make improvements immediately.

14. In response to Mr LAW Chi-kwong's enquiry, DD(H)(Atg) said that in 1997, some 300 complaints were received by private hospitals from their patients and eight such complaints were received by DH this year. Mr LAW Chi-kwong considered that the number was too small compared with the existing number of private hospitals. He expressed doubt as to the effectiveness of the existing monitoring mechanism.

15. Dr LEONG Che-hung expressed dissatisfaction with the Administration's paper as it had only provided general information. It failed to give the number of complaint cases received and the outcome of the investigations conducted by DH concerning private hospitals. He stressed that he did not intend to criticize the standards of private hospitals but wanted DH to ensure that their operation was up to standard. He considered that the Administration should have provided more details such as problems in private hospitals revealed by the questionnaires and the follow-up actions thus taken. In response, DD(H)(Atg) said that the eight complaint cases on private hospitals received by DH this year were concerned mainly about staff manners, charging of fees and professional conduct. DH had requested explanations from the concerned hospital in each case and improvements to be made where necessary.

16. Dr LEONG Che-hung took the view that DH as the licensing authority should take full responsibility for ensuring the standards of private hospitals. He was particularly not satisfied that DH had responded to the recent renal dialysis incident by just saying that the incident would be taken into account when renewing the Hospital's licence. To ensure the standards of private hospitals and to cope with the manpower constraint of DH in monitoring private hospitals, Dr LEONG considered that DH should implement the recommendation for 'self-regulatory committees' in each private hospital as proposed by MDAC in 1990. He read out the following recommendations made by MDAC in its Paper No. 4/89-90, which had been endorsed by the Government, and urged DH to follow them up -

"(Paragraph 28) For the purpose of reviewing and redefining existing standards of service, private hospitals should be encouraged to set up self-regulatory committees concerned with such areas as hospital management, medical audit, nursing procedures, ethics as well as laboratory review...(Paragraph 29) In the long run, it may be worthwhile to explore the feasibility of setting up a central monitoring body for the purpose of assessing standards of practice in all hospitals, whether private or public. However, given the large proportion of hospitals which would come under the Hospital Authority, the idea has to be looked at against the background of the sorts of standards that HA would apply to hospitals."

Dr LEONG pointed out that as HA had already been set up for more than seven years, it was high time the Administration considered the proposals now. Deputy Secretary for Health and Welfare (DS(HW)) agreed that the Administration would conduct an in-depth study of the quoted MDAC paper.

17. The Chairman said that he was also dissatisfied with the Administration's paper although it was more detailed than the one submitted last time. Regarding the self-regulatory system advocated by Dr LEONG Che-hung, the Chairman considered the accreditation system, which was different from the self-regulatory system in the following ways, was more satisfactory -

1. Under the accreditation system, assessment of the standards of a private hospital was not conducted by the management of the hospital concerned;
   
   
2. the authority responsible for conducting the assessment could devise the clinical standards for the private hospitals to follow and these standards would serve as the basis for assessment; and
   
   
3. independent assessments of standards were allowed under the accreditation system and the findings were released to the public.

18. The Chairman considered that DH was lagging behind in its policies as it was still at the stage of implementing, not the accreditation system, but only the self-regulatory committees at private hospitals. He urged the Administration to consider hiring the international accreditation bodies to undertake the assessment of the standards of private hospitals and then provide the evaluation reports to DH. He considered that the cost could be borne by the hospitals concerned. In response, DD(H)(Atg) said that DH needed to undertake more research before it could come to a view on the matter. The Chairman pointed out that there was actually abundant information on the service which could be easily found on the Internet as well as by other means. He found it surprising that the Administration had no such information when the system was widely adopted by hospitals in foreign countries. He requested the Administration to report to the Panel its deliberations three months later. By then the Administration also had to report to the Panel -

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1. the cost incurred by the existing arrangement of having an investigation team to conduct the inspections and assessments; and
   
   
2. whether savings could be achieved by implementing the accreditation system.

DS(HW) undertook to follow up the matter.

IV. Implementation of the Enhanced Productivity Programme (EPP) in the Department of Health
(LC Paper No. CB(2) 557/98-99 (03))

19. Members were dissatisfied with the Administration's paper which was too brief and lacking in details. Members considered that the paper failed to tell what specific measures DH would take to achieve productivity gains and therefore members were unable to comment or follow up this paper.

20. Dr LEONG Che-hung queried how DH could achieve productivity gains in the face of abolition of the two provisional municipal councils. He took the view that while working out plans to achieve EPP, the Administration should also decide on its policies in respect of the provision of outpatient service and dental service. He noted that improvements were being made to the outpatient service provided by DH in a bid to encourage the public to use it and thus the workload of the Accident and Emergency Departments of public hospitals during public holidays could be eased. It was not clear from the paper whether EPP would affect the implementation of these improvements. He also queried whether free dental service should continue to be provided only to civil and public servants. He requested the Administration to address these issues in working out the implementation plan of EPP.

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21. Members were very concerned about whether the implementation of EPP in DH would lead to a deterioration in the standards of services. They requested the Administration to provide more detailed information on the specific measures DH would take to achieve cumulative savings in recurrent baseline expenditure of 1% by 2000/01 and 3% by 2001/02.

22. DS(HW) said that the Health and Welfare Bureau (HWB) and DH would submit their proposals on the implementation of EPP to the Government in December 1998. DD(H)(Atg) agreed to provide a more detailed paper to the Panel in January/February 1999 to explain what DH would do to meet the short-term targets of achieving enhanced productivity in 1999/2000. Dr LEONG Che-hung reminded the Administration that some time ago it had pledged to implement new initiatives of health services such as the setting up of District Health Centres and Old Age Centres subject to availability of funds. He considered that the Administration should take these into account in preparing the paper on the implementation of EPP.

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V. Statutory control of physiotherapists
(LC Paper No. CB(2) 557/98-99 (04) )

23. Head of Boards & Councils Office (H/BCO) briefed members on the Administration's paper and pointed out that statutory control of the physiotherapy profession was proposed to commence in January/February 1999. From then onwards, a person who practised physiotherapy without being registered with the Physiotherapists Board committed an offence. The effective date of commencement of statutory control of the profession would be a date to be appointed by the Chief Executive by an order published in the Gazette.

24. In reply to the Chairman's enquiry about the progress of the registration exercise of serving physiotherapists, H/BCO said that 1 065 serving physiotherapists had been registered with the Physiotherapists Board. 30 applications for registration had been turned down. Two practising physiotherapists who did not meet the required academic requirements had been required to sit for an examination held in September 1998. However, they had failed in the examination and were waiting to sit for another one to be arranged. H/BCO was confident that the registration exercise would be completed in two months' time.

25. At the Chairman's enquiry, H/BCO said that the examiners were coming from lecturers of the Polytechnic University of Hong Kong and practising physiotherapists. The examination was held at the Prince of Wales Hospital. Candidates were tested in both academic knowledge and practical skill.

26. In reply to Dr LEONG Che-hung's enquiry, H/BCO said that an applicant who was required to take the examination was allowed three attempts at most. After failing the third attempt, the applicant would not be allowed to practise physiotherapy in accordance with the policy of the Physiotherapists Board.

27. H/BCO informed members that the deadline for application of provisional registration was 30 September 1997. The Physiotherapists Board was not empowered to accept applications beyond this deadline. In response to the Chairman's enquiry, H/BCO pointed out that any delay in bringing the relevant consequential amendments into effect would not affect the commencement date of the statutory control of the physiotherapy profession.

(Post-meeting note: Commencement of statutory control of physiotherapists is now scheduled for July 1999 to be commensurate with the date for annual renewal of the physiotherapists' practising certificates.)

VI. Healthy Living into the 21st Century Campaign (the Campaign)
(LC Paper No. CB(2) 557/98-99 (05) )

28. DS(HW) briefed members on the Administration's paper and pointed out that in the next six months, the key areas of the Campaign would be -

1. to review level and form of penalties;
   
   
2. to improve refuse treatment;
   
   
3. to tighten licensing conditions for food premises;
   
   
4. to clear up litter blackspots; and
   
   
5. to enhance enforcement and prosecution.

In addition, there would be a territory-wide scheme to be launched in December 1998/January 1999 which would involve the community in reporting litter blackspots and monitoring the clean-up of such blackspots. Furthermore, tertiary institutions would be commissioned to conduct a survey in 1999 to measure public awareness of the importance of personal and food hygiene as well as their attitudes and behaviour.

29. Dr LEONG Che-hung supported the target of promoting personal hygiene and health knowledge from childhood. He suggested that these topics should be included in the school curriculum for children and that Education Department (ED) should play an active role by undertaking the education work. In response, DS(HW) said that a two-thronged approach was being applied to raise the hygiene standards. First, civic education was strengthened to raise children's sense of responsibility and their public spirit so that they would learn not to litter. Second, publicity and family education would be stepped up with a view to promoting general awareness of general hygiene and personal cleanliness so that children would be influenced by their families to develop good habits of personal hygiene. DS(HW) also revealed that the authority might set up in districts some groups formed by teachers, social workers and so on. They would be trained to disseminate health knowledge in respective districts.

30. Dr LEONG Che-hung urged the Administration to set benchmarks for achievements to be made in the Campaign. For example, it should identify some kinds of diseases (such as heart disease) and set targets of reducing the incidence of Hong Kong people suffering from the diseases in ten years' time. In reply, DS(HW) said that surveys would first be conducted to collect information on the general health conditions of Hong Kong people, which would serve as the basis for assessment of the effectiveness of the Campaign. In setting the benchmarks and in the choice of which diseases to be covered, DS(HW) said that he could not provide specific details now as more information had to be sought from World Health Organization and DH before some realistic benchmarks could be worked out.

31. Mr LAW Chi-kwong shared the view that the setting of benchmarks was very important without which the vast resources devoted to the Campaign were unjustified. He also supported that health education in schools was of primary importance to the success of the Campaign and suggested that both the development of public spirit and promotion of knowledge of food and personal hygiene were of the same importance in the design of the curriculum. DS(HW) agreed that health education should be strengthened and also be provided to at least up to junior secondary students. He pointed out that DH had been actively promoting health education not only in schools but also in child centres. DS(HW) agreed that DH would further liaise with ED to strengthen education on food hygiene.

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32. With reference to Annex A of the Administration's paper, the Chairman expressed doubt as to the need of establishing the seven sub-committees. He quoted the example that, even without forming the Clean Market and Food Premises Sub-committee chaired by Director of Urban Services, the same work was being performed by Urban Services Department. In response, DS(HW) explained that the setting up of the seven sub-committees had enabled work to be done with better coordination and higher efficiency especially in handling some grey areas of work.

33. Mr LAW Chi-kwong considered that the Campaign was mainly concerned about improving environmental and promoting food hygiene which had been the work undertaken by the two municipal councils. He expressed doubt as to whether the Campaign was organized to pave the way for the abolition of the two municipal councils. With reference to the last paragraph of the Administration's paper, Mr LAW queried why additional resources would be required to cope with the workload arising from the Campaign. Dr TANG Siu-tong referred to paragraph 8 of the Administration's paper and pointed out that the tasks planned to be accomplished through the Campaign were essentially the scope of work of the two provisional municipal councils. He considered that the implementation of the Campaign was a prelude to the abolition of the two municipal councils. In response, DS(HW) pointed out that the Campaign had nothing to do with the abolition of the two municipal councils. He explained that the idea of organizing the Campaign was initiated against the background of the outbreak of H5N1 virus and a spate of public health and food hygiene issues which had shown that there was a need to raise general awareness of hygiene and improve cleanliness in Hong Kong. He said that the concept of "a Healthy City" was quite a popular concept now in the international context.

34. Mrs Sophie LEUNG took the view that Hong Kong had deteriorated in its hygienic conditions and expressed support for promotion of the public spirit of Hong Kong people. She urged the Administration to actively identify the litter blackspots throughout the territory and clean up these blackspots. She took the view that the community should be encouraged to do the same and prevent places which had been cleaned up from reverting back to litter blackspots again. In response, DS(HW) said that the Administration was considering to organize a campaign at the end of December 1998 to encourage the public to report litter blackspots and monitor the clean-up of the blackspots.

35. Dr YEUNG Sum requested that the next time when the Administration prepared a progress report for submission to the Panel, it should provide more detailed information, such as -	Adm

1. how many litter blackspots had been cleaned up since launching the Campaign;
   
   
2. how effective it was in reducing the incidence of Hong Kong people suffering from the common diseases; and
   
   
3. an assessment of overall cleanliness and hygienic conditions in Hong Kong.

36. At the Chairman's enquiry, DS(HW) said that there was no plan at the moment to seek provisions for creation of a Deputy Secretary to oversee the implementation of the Campaign.

VII. Any other Business

Commencement of outstanding provisions in the Smoking (Public Health) (Amendment) Ordinance 1997
(LC Paper No. CB(2) 577/98-99 (01))

37. In response to Dr LEONG Che-hung's enquiries, Principal Assistant Secretary for Health and Welfare (Medical)3 (PAS(M)3) said that the Administration had not instituted prosecutions against any shopping malls but had sent warnings to some malls which had not been in compliance with the provision prohibiting smoking in these indoor areas. He indicated that the Administration would institute prosecutions in future cases after warnings had been served if there was a continued breach of the legislation.

38. Responding to Dr LEONG's enquiry as to why a 12-month grace period was proposed for packets and containers of tobacco products to comply with the new requirements, PAS(M)3 explained that this length of time was agreed in discussion with the tobacco industry, who advised that they would need this length of time to re-design and print the new cigarette packets containing the new health warnings. PAS(M)3 pointed out that the industry had not seen the final design of the health warnings for the cigarette packets yet. He said that the Administration had been in discussion with the industry only in the previous week and they had reverted back and told the Administration that there were technical issues still unresolved. The industry needed a 12-month grace period to re-design the cigarette packets to accommodate the new health warnings. This 12-month grace period was the same length of time as was given to the tobacco industry when the requirement of printing health warnings on cigarette packets first came out in 1992.

39. PAS(M)3 further explained that the design of the health warnings was based on a particular shape of cigarette packet. However, the industry had told HWB that the packet which HWB assumed as a standard shape was not universal and a very large number of cigarettes were sold in other shapes of packets which could not easily accommodate the health warnings based on the legislation as drafted. The Administration would therefore have to consider how to re-draft the legislation to accommodate these different shapes of cigarette packets. Dr LEONG Che-hung enquired about the exact date that the draft Amendment Order would take effect. In reply, PAS(M)3 said that the Administration had intended to gazette the Amendment Order in November 1998 and bring it into effect in December 1998 with a 12-month grace period. So by December 1999, all cigarette packets would be bearing the new health warnings.

Human Organ Transplant Ordinance (Cap. 465) - briefing by the Administration
(LC Paper No. CB(2) 586/98-99)

40. The Chairman said that due to shortage of time, it would not be possible for members to discuss in detail the HOTO at this meeting and it could only be more thoroughly discussed at the special meeting scheduled for 23 November 1998. Dr LEONG Che-hung requested the Administration to prepare for the special meeting a paper to inform members of the problems encountered in connection with implementation of the HOTO since its enactment. The Chairman advised that members should not refer to individual human organ transplant cases in the ensuing discussion.

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41. As requested by the Chairman, Senior Assistant Legal Adviser (SALA) briefed members on the provisions of the HOTO. He made the following points -

1. Under section 5 of the HOTO, it was an offence to remove from a living person an organ intended to be transplanted, or to transplant an organ so removed unless the donor and recipient were genetically related or had a marriage relationship which had subsisted for not less than three years. The definition of genetic relationship was set out in section 5(2) of the Ordinance.
   
   
2. For transplants between living persons who were not genetically related nor married for at least three years, the HOTO enabled removal of organ for transplant and transplant to be done where written approval of the Human Organ Transplant Board (the Board) had been given. The Board might give its approval subject to the five conditions set out in section 5(4)(a) to (e) of the Ordinance being met.
   
   
3. In case in which written approvals from the Board were not required, before removing from a living person an organ intended to be transplanted into another person, the medical practitioner removing it should satisfy himself that the requirements in section 5(4)(b) to (e) had been complied with.

42. DS(HW) briefed members that the Ordinance sought to, inter alia, prohibit commercial dealings in human organs intended for transplanting. It also required express consent be given by the donor and the recipient for carrying out the transplant due to the high risk involved in the medical operation. However, the Administration noted from some cases that this requirement had posed a problem such as in the case of recipients who were unconscious due to their illness and therefore were not able to express their consent. DS(HW) said that the Administration would collect views in respect of the areas of controversy concerning the Ordinance and propose appropriate amendments.

43. The Chairman declared interest as a member of the former LegCo Ad hoc Group (the Ad hoc Group) to study the Human Organ Transplant Bill in 1992-95. Other members of the Panel in the Ad Hoc Group included Dr LEONG Che-hung, Dr TANG Siu-tong, Dr YEUNG Sum, Mr LAW Chi-kwong and Miss CHAN Yuen-han.

(Post-meeting note: Subsequent to the meeting, it was confirmed that Dr TANG Siu-tong, Dr YEUNG Sum, Mr LAW Chi-kwong and Miss CHAN Yuen-han were not members of the Ad hoc Group.)

44. Mrs Sophie LEUNG declared interest as the Chairman of the Board. She pointed out that the Board had experienced much operational difficulty in implementing the Ordinance. To facilitate the Panel's discussion on the subject, she agreed to provide a copy of the press statement of the Board issued on 8 November 1998 which had set out the views of the Board. Mrs Sophie LEUNG also suggested that the Panel should take into account the deliberation of the former Ad hoc Group so that it could understand better how it had come to deciding the conditions as set out in the Ordinance.

45. Dr YEUNG Sum requested SALA to advise whether section 5(4), which required both the donor and recipient to understand the procedure, the risk involved in an organ transplant and their entitlement to withdraw consent at any time, was too rigid and would be difficult for implementation in some cases. On the other hand, Miss Cyd HO questioned whether or not the Ordinance had provided for a third party to be authorized to give consent on behalf of the recipient who might not be able to do so due to his poor health conditions or the fact that he was a mentally incapacitated person.

46. Miss Cyd HO further made the point that in the case of forming a Subcommittee by LegCo in the future to review this Ordinance, it should include more members who had not been members of the former LegCo Ad hoc Group on the Human Organ Transplant Bill in order to avoid any impartiality perceived by the public and to enhance the credibility of the Subcommittee. Miss CHAN Yuen-han shared Miss HO's view and further proposed that members of the Board should be invited to attend the special meeting of the Panel for discussion of the HOTO. Both Miss CHAN Yuen-han and Dr LEONG Che-hung suggested that the Board should provide, in addition to its press statement, more detailed information on the operational difficulty experienced by the Board in implementing the HOTO for members' reference.

47. Dr LEONG Che-hung said that ordinances without exception could be subject to review in the light of the problems encountered in their implementation. Therefore, he would not object to conducting a review of the HOTO if it was deemed necessary and stressed that any LegCo Members would be most welcomed to participate in the review. Dr LEONG also took the opportunity to clarify that the recent concern expressed by members and the Administration about any problems posed by the provisions of the Ordinance should not be mistaken by the public as advocation for donation of human organs by live donors. Dr LEONG said that he noted that there was a substantial decrease in the number of cadaveric organ donations. He requested the Administration to explore the reasons behind.

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48. Regarding the provisions of the HOTO, Dr LEONG Che-hung requested the Administration to explain -

1. the basis of the Board in deciding whether or not the condition of section 5(4)(d) was fulfilled before granting approvals to organ transplantation; and
   
   
2. the differences in a medical practitioner's handling of an unconscious patient and a conscious patient who both needed organ transplant.

49. Due to shortage of time, the Chairman directed that the HOTO be further discussed at the special meeting to be held on 23 November 1998. He requested the Administration to take into account members' concerns and their enquiries raised in preparing its paper for the special meeting and provide it early to the Panel. Members also agreed to invite members of the Board to attend the special meeting.

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50. The meeting ended at 10:45 am.


Legislative Council Secretariat
7 April 1999