Table of Contents

HK J Paediatr (New Series)
Vol 18. No. 1, 2013

HK J Paediatr (New Series) 2013;18:3-5

Special Article

Moving Ahead Towards the Centre of Excellence in Paediatrics in Hong Kong

Y Chow


I would like to thank you for giving me this most important opportunity to address the paediatric community of Hong Kong and to receive the award. I am deeply honoured and privileged. This Award is indeed recognition of the community and our Government's commitment and unswerving efforts to promote child health. This Award belongs to all of you who have helped make a difference in our children's health and well-being.

Children are our future. As a father of two, I understand fully how important it is to create an environment that is conducive to nurturing the growth and development of our children. Good health is the keystone to a child's all-rounded development. To ensure that our future generations enjoy the highest health standards, the Government is committed to providing the most appropriate preventive programme and the best quality of healthcare services to our children.

Through the Department of Health (DH) and the Hospital Authority (HA), we provide a full range of preventive and healthcare services for our children since birth, covering the areas of disease prevention, health surveillance, health education and promotion, as well as provision of professional and high-quality secondary, tertiary and specialised medical care and treatments. Through these services, we aim to safeguard both the physical and psychosocial well-being of our children.

Preventive and Surveillance Programme

Since birth, infants and children up to the age of five can receive a comprehensive range of services at the Maternal and Child Health Centres managed by DH. These services include free childhood immunisation, health and developmental surveillance, physical examinations, growth and developmental monitoring, as well as hearing and vision screening. Hong Kong's childhood immunisation programme is one of the most comprehensive in the region covering 10 infectious diseases. The coverage rate exceeds 98% which is one of the highest in the world. We also provide subsidies under the Childhood Influenza Vaccination Subsidy Scheme for eligible children to receive seasonal influenza vaccines at private clinics.

For primary and secondary school students, free health checks and individual counselling services are provided by DH's Student Health Service Centres. DH also provides an outreach psychosocial health promotion service to secondary school students with the participation of multi-disciplinary professionals including doctors, nurses, dieticians, clinical psychologists and social workers. Health talks and workshops are provided to schools from time to time to increase the awareness of our younger generations on the harmful effects of smoking, drug abuse and alcohol consumption.

DH also runs the Child Assessment Service to provide a comprehensive diagnostic assessment for children under 12 suspected to have developmental problems. In addition, we launched the inter-departmental Comprehensive Child Development Service in July 2005, as a pilot in four districts with the objective to identify children under 5 and their families with special health and social needs. Identified children and families will be referred to the appropriate settings for treatment, therapy, counselling, training and other specialist and community services. We plan to roll out the Service to all districts in 2012-13.

Prevention is always better than cure. We have thus devoted strenuous efforts to enhance health promotion and education and make use of a variety of platforms to inculcate the fundamentals of healthy living. Through various programmes such as the "EatSmart@school.hk" and "StartSmart@school.hk" campaigns, we aim to promote a healthy school environment so that our younger generations have a healthy start in life.

Secondary and Tertiary Medical Services

At the secondary and tertiary care levels, we have substantially enhanced the provision of paediatric services in Hong Kong since the 1960s. Starting with only one in-patient referral paediatric unit at Queen Mary Hospital back in the 1960s, we now provide a wide range of secondary and tertiary services in paediatric specialties and subspecialties at 13 public hospitals under HA. The five tertiary referral centres of HA currently handle cases involving complex illnesses involving oncology, cardiology, nephrology and infectious diseases. In addition, there are two public hospitals specialising in providing rehabilitation services for paediatric patients. In this year's Budget, the Financial Secretary announced the plan to increase the number of beds in neonatal intensive care units in HA hospitals by about 10%.

Establishment of the Centre of Excellence in Paediatrics

Notwithstanding the above, we consider that there is an imminent need to develop a medical Centre of Excellence in Paediatrics, or the "CEP" in short, to strengthen the care for our children. This is also a project that the paediatric community has been calling for in the past years. In fact, the idea of building a children's hospital was brought to me in 2004, when I was still in the Hospital Authority.

The objective of establishing the CEP is to promote multi-partite participation and collaboration of the public and private healthcare sectors, the academia and overseas experts by putting clinical services, medical research, as well as professional development together. Through concentrating the caseload of complex, serious and uncommon diseases among children, we can pool the skills and expertise in paediatrics from public, private and academic sectors locally and abroad, facilitate training and research, and delivery of high quality care for children through advanced technology facilities and trans-disciplinary teamwork.

Our ultimate goal is to raise professional standards and quality of clinical services to children patients, and to enhance the standards of research and training in the areas of paediatrics. In this regard, unlike conventional hospitals which only focus on providing clinical services, the CEP will double as a teaching and research hospital supporting clinical services, medical research and professional training.

Clinical Services

On clinical services, the CEP will be a public tertiary specialist hospital in paediatrics to provide family- and child-centred tertiary and specialised clinical services for all children under the age of 18 with complex and serious illnesses throughout the territory. Our current plan is to provide some 460 beds with a wide range of services and facilities including in-patient and day-patient services, ambulatory care services, specialist outpatient clinics, community care services, supporting diagnostic and treatment facilities, as well as support facilities for families of patients.

While the CEP will be a public hospital, we will ensure that clinical services to be provided there will be accessible to children under the care of medical practitioners and institutions outside the public healthcare system. This serves to facilitate continuity of care and ensure that those genuinely in need can also benefit from the expertise and facilities at the CEP. Our overall objective is to ensure that the CEP, the regional public hospitals, the private medical sector, and community-based services will all work together in partnership to provide patients with the most appropriate level of care at different stages of their diseases.

Research

Another key function of the CEP is medical research. Medical research is part and parcel to the development of high quality medical services, and is essential in striving for clinical excellence and medical advancement in any healthcare system. With concentrated caseload, pooled expertise and advanced facilities, the CEP will provide essential support for driving high quality medical research in paediatrics, in collaboration with the two local medical schools and science faculties of other tertiary institutions. In this regard, we will include advanced facilities such as theme-based research laboratories at the CEP to support basic medical, epidemiological and clinical research in paediatrics.

By co-locating clinical and research facilities at the CEP, we envisage that the CEP will facilitate collaboration between clinical and research teams from both the academia and the healthcare profession, and for international linkage and co-operation. This in turn will help facilitate the development of knowledge regarding the management of complex and rare diseases, the nature and health outcomes of important childhood illnesses, and the development of innovative treatment interventions and technologies. In the long run, the process of translational research from the laboratory to the patient, and from the patient to the community, could be speed up thereby improving the health and quality of medical services to our future generations.

Professional Training and Development

The third core function of the CEP is to serve as a training ground for future generation of specialists in paediatrics. Such training will cover doctors, nurses and other allied health professionals at all levels including undergraduates, postgraduates, specialist training, in-service or continuing education, as well as research training. We will emphasise interdisciplinary training and knowledge sharing, with participation of local and overseas experts. Our goal is to train up a strong team of experts in the field of paediatrics with advanced knowledge of the physical and psycho-social needs of children to raise the overall professional standards and quality of clinical services to the young patients in Hong Kong.

Progress of the Establishment of CEP

Stakeholders, including many of you here today, have all along been giving us valuable advice on the design, management as well as governance of the CEP. We have now come up with the conceptual layout plan of the CEP. We will adopt a "Design and Build" model for the CEP development, and we just invited tender for the design and construction of the project last month. We will communicate and liaise closely with the selected contractor and relevant stakeholders and users to ensure that the design of the CEP can achieve our objective of creating a child-friendly, comfortable and cosy environment that provides the best clinical practice under a patient-centered approach. Subject to funding approval of the Legislative Council, we plan to commence construction works in mid next year for completion by 2017. Our target is to commence services at the CEP by phases starting from mid 2018.

Physical infrastructure alone is not enough. We are acutely aware of the need to further strengthen support for medical research and expertise development. That is why in December last year, we consolidated the former Research Funds for Health Services and Control of Infectious Diseases to establish a new Health and Medical Research Fund, with an additional injection of $10 billion to further promote research and development in health and medical services. We have also broadened the funding scope to include advanced medical research in the fields of paediatrics, clinical genetics and clinical trials. We are also supporting the two medical schools to develop clinical trial centres at their respective teaching hospitals.

Manpower is another issue we need to examine carefully. Much as we talk about the increasing service demand brought about by an aging population, we should not lose sight of the challenges now faced by other specialties including paediatrics such as increasing demand for sophisticated skills in NICU due to prematurity of newborns; calls for better care and support to children with psychological difficulties; development in genomics and genetics technologies; and the emergence of paediatric clinical pharmacology, etc. In future, our greater emphasis on primary care will also require a greater role be played by our healthcare professionals.

To ensure the healthy and sustainable development of Hong Kong's healthcare system, the Government is conducting a strategic review on the manpower and professional development needs of the entire healthcare sector, covering doctors, nurses, allied health professionals, dentists, Chinese medicine practitioners and pharmacists. A steering committee, underpinned by six sector-specific working groups, has been formed earlier this year. We aim to complete this review by mid-2013, and we look forward to your advice and support in this most important exercise.

Concluding Remarks

Ladies and gentlemen, thanks to our team of dedicated healthcare professionals, scientists, researchers, academia, non-governmental organisations, our healthcare outcome today can rank amongst the top in the world. For example, we have one of the lowest infant mortality and morbidity rates in the world. But we can never afford complacency.

The Government's continuous efforts in safeguarding public health and providing the highest quality of care will not be successful without the support, commitment and collaboration from all stakeholders in the community. In this regard, I thank the Hong Kong Paediatric Society and its members for working hand in hand with the Government in promoting child health over the past 50 years. Through the organisation of a wide range of activities, scientific and social forums, the Society has successfully facilitated the advancement of knowledge in paediatrics, helped maintain the standard of paediatric care in Hong Kong, and promoted child health. As this year marks the 50th anniversary of the Hong Kong Paediatric Society, I would like to express my heartfelt appreciation to the Society for its remarkable achievements and invaluable contributions.

Once again, I thank all of you for the sterling efforts you have made in promoting public health. Building on our strengths and with the concerted efforts of the Government, the medical professionals, the academia, researchers, NGOs and the community at large, I have every confidence that we can confront the challenges ahead and find the way forward to ensure better health and to improve the quality of life of our future generations. Let's join hands together to overcome the future challenges and move ahead towards the development of Centre of Excellence in Paediatrics for Hong Kong!

 
 

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