For Discussion
On 14.9.1998

LegCo Panel on Health Services
Monitoring of Private Hospitals

Background

Hong Kong has a dual health care delivery system whereby services are provided by both public and private sectors. At present, there are 12 private hospitals providing 2965 beds¹ , which account for 9.6% of the total hospital beds in Hong Kong.

Statutory Control

2. The Hospitals, Nursing Homes and Maternity Homes Registration Ordinance (Cap. 165) requires private hospitals to be registered with the Director of Health, subject to conditions relating to accommodation, staffing and equipment. The Director is also empowered to inspect any hospital premises and the records required to be kept under the Ordinance.

3. The licensing conditions outlined above relate only in general to the appropriateness of accommodation, staffing and equipment with respect to the nature and scope of services provided by individual hospitals. Each institution is also subject to additional controls, such as registration of and disciplinary control over medical and para-medical personnel, and any other requirements as may be imposed by relevant authorities, such as with regard to fire safety and dangerous goods storage.

4. Cap. 165 provides that the Director may refuse registration if she is satisfied that the applicant or any person employed by him at the hospital is not a fit person, that the premises are not fit to be used for hospital purpose, that the hospital is not under the charge of a person who is either a duly qualified medical practitioner or a registered nurse or that there is not proper proportion of registered nurses working in the hospital.

Regulation and Monitoring

5. Since the Department of Health took over the licensing of private hospitals in December 1991, inspections are conducted to these hospitals prior to their first registration or annual renewal of licences. To assist the Department in assessing the merits for registration, each medical institution is required to furnish a report providing information on its organisational structure, staffing, facilities, equipment and services, staff development, education and training, and future service and development plans. Besides this annual exercise, ad hoc and unannounced visits are carried out as and when necessary.

6. Current standards adopted are largely the result of recommendations made by the then Medical Development Advisory Committee (MDAC) in 1990. Standards set are two-folded, namely, those for medical professionals and those for hospitals per se. On the former, reliance is placed on Medical Council and Hong Kong Academy of Medicine together with its accreditation system. As regards the latter, MDAC has endorsed " A Guide to Hospital Standards" which has been issued to all private hospitals. In this Guide, hospital practices which are considered essential to ensure delivery of quality care to patients are described. Topics including organisation and administration, staffing, facilities and equipment, policies and procedures, patients' rights, staff development and education, and evaluation, are covered.

7. Although individual hospitals have their own in-house control ( common issues under scrutiny include scope of service, hospital hygiene, infection control, laboratory provisions, safety precautions and equipment maintenance ), the Department of Health issues guidelines, advice, medical alerts of relevance to hospitals for reference or adherence. Where situation warranted, meetings are held with the senior management from these institutions.

8. Registered medical institutions are required to submit information related to in-patients treated, hospital deaths, perinatal statistics, and other information such as reports of notifiable/infectious diseases. They are also obliged to furnish reports on incidents of public health concern or matters pertaining to patient care as instructed by the Director of Health.

Advice Sought

9. Members are invited to note the content of this paper.

Department of Health
8 September, 1998


1.As at end 1997