The development of primary medical care has been the focus of Hong Kong's medical reform in recent years.
Among them, the establishment of "regional health stations" is to promote high-profile projects in primary care.
Since Chief Executive Carrie Lam Cheng Yuet-ngor took office in 2017, his first "policy address", every "policy address" has focused on this, and the community has also hoped for this.
However, a recent survey report of the Hong Kong College of Family Medicine showed that even doctors may not understand this project.
Regarding the regular services of the regional health stations and the practical actions in the epidemic, we have to reflect on how far they are from the goal of strengthening primary care.
In the outbreak of the new crown epidemic, the Kwai Tsing Health Center set up street stations to promote health information, produced short videos of anti-epidemic information in different languages, released epidemic prevention information through hotlines and social platforms, and strengthened prevention work on information.
In terms of supplies, the Health and Health Center has distributed nearly 7,000 deep-throat saliva sample bottles to the target group as of March this year, and also distributed anti-epidemic materials such as masks and alcohol to the public.
At the same time, under the referral of the Hospital Authority, the Kwai Tsing Health and Wellness Centre provides community rehabilitation support to those who have returned to the community after their condition has stabilized.
Service effectiveness is limited
After the vaccination was opened, the Kwai Tsing Health Center also strengthened publicity in the district, and proactively contacted and assisted members belonging to the priority vaccination group to make vaccination appointments, and discussed how to collaborate with private doctors in nearby areas who have participated in the vaccination plan , Facilitate the vaccination of members and citizens in the district.
It can be seen that the regional health centers have the ability to support public health in many ways.
It is only limited to resources, how much its role and function are played, and how many people know and enjoy it is another question.
The Kwai Tsing Health Centre has been in service since September 2019.
(Profile picture / Photo by Liang Pengwei)
In terms of regular services, the Kwai Tsing District Health Center, which has been in operation for nearly three years, also has limited resources, and its effectiveness in the implementation of primary care is questionable.
In a question in the Legislative Council in March, the medical councillor Chen Pei-ran asked the center to provide information on the number of cases referred by public hospitals, the number of cases referred to service providers and community partners, and the number of cases each month since the opening of the service. Data on the number of people receiving services by patients with various chronic diseases in the month.
However, the center does not fully comply with the monthly statistics of the above categories. It can only give a rough estimate of the total 2800 cases of chronic disease management and community rehabilitation programs since its operation and as of December 2020, and a total of diabetes and hypertension screenings have been carried out. 1800 cases and 11,300 basic health risk factors were assessed.
In other words, the Kwai Tsing Health Centre tries to provide various primary prevention and chronic disease management services, but the completeness of the project and the number of services may not be satisfactory.
Promote that the primary care government cannot "outsource" the matter
Adequacy of resources also depends on whether there are enough professionals to provide appropriate services.
There are no more than three physical therapists and occupational therapists under the establishment of the Kwai Tsing Health Center. There are only two nurses, and there are only 30 or 40 Western medicine and Chinese medicine doctors among its network service providers.
Whether the professionals are sufficient depends on the budget on the one hand, but also on the knowledge of the professionals on the health center.
A survey conducted by the Hong Kong School of Family Medicine in January this year on "Family Doctors' Perceptions of Hong Kong Regional Health Centers" showed that since the opening of the Kwai Tsing Regional Health Center in 2019, more than half of the interviewed doctors still do not understand its goals.
Among the private doctors interviewed who did not consider joining the regional health center, the most common reason was that the center did not help their existing work.
In other words, whether it is publicity or actual support, the lack of government work makes it difficult for health centers to hire a large number of professionals to expand the provision of primary medical services.
The medical voucher program was extended to 60 years old.
(Profile picture)
Regional health centers are an important direction for the government to promote primary medical care. At present, the government may, based on cost, efficiency, and other considerations, hand over the regional health centers to non-governmental organizations to operate in the form of service contracts.
But this does not mean that the government can shirk its responsibility for operations.
For example, the government may be more influential and efficient than non-government operating agencies in publicity and increasing the attraction of private doctors, and the government should provide corresponding support.
In fact, the government has shown that it attaches great importance to primary medical care in many government reports, but the effects of various measures are often unsatisfactory.
Not only is it a regional health center operated by a non-governmental organization, the government’s medical vouchers are intended to allow the elderly to spend more on chronic disease improvement, physical examination and screening and other primary medical projects, but the government has adopted market vouchers to promote this measure to the market. , The final result was ineffective.
It can be seen that the government's promotion of primary medical care cannot be the beginning, but must find ways to support and supervise the implementation process.
In April of this year, the government again approved the operation service contract for the "Regional Health Station" in 11 districts. The government should learn from the lesson and no longer be the shopkeeper. Instead, it should set operating standards and targets, and promote issues such as attracting and assigning staff. The government used the administrative advantages of the government to provide adequate support to prevent it from becoming a face-saving project of medical reform.
Investigation: More than half of the doctors do not understand the target family medical school of the district health center. Private doctors are urged to participate in the Kwai Tsing district health center. The number of members is lower than expected. Large-scale outreach is expected to reach the public
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