Date
17 September 2019
A file picture from Jan. 7 shows the A&E department at Queen Elizabeth Hospital. Public hospitals in Hong Kong are grappling with overcrowding as infrastructure is falling short. Photo: CNSA
A file picture from Jan. 7 shows the A&E department at Queen Elizabeth Hospital. Public hospitals in Hong Kong are grappling with overcrowding as infrastructure is falling short. Photo: CNSA

It’s not just new homes, HK also needs more hospital beds

During the peak flu seasons, public hospitals in Hong Kong are often overcrowded 100 percent or more, and the average waiting time for patients at the accident and emergency departments (A&Es) usually exceeds eight hours.

Although the Hospital Authority (HA) has said that an additional HK$500 million has been allocated to ease the super-heavy workload of doctors and nurses, many frontline medical workers feel the pressing issue of overcrowding in public hospitals is yet to be resolved.

It appears Hong Kong people are not only facing a severe housing problem, but also an acute shortage of public hospital beds.

Since 1997, public hospitals have only seen a slight 2.9 percent increase in their total bed number, far lower than the 11 percent growth in the city’s population during the same period of time.

One of the factors contributing to the inadequacy in public hospital beds is the aging population, which triggers a growing demand for healthcare services.

As the “Strategic Service Framework for Elderly Patients” published by the HA has indicated, in 2010, the relative risk of an elderly person, who is aged 65 years or above, being hospitalized is about four times that of a non-elderly person, aged below 65 years.

In the same year, non-elderly people aged below 65 years required 1.3 beds per 1,000 population. For the elderly aged 65 years or above, the bed requirement was 11.8 beds per 1,000 population.

As the population is continuing to age, it isn’t difficult for one to imagine that the pressure for public hospital beds in Hong Kong will only grow in the days ahead.

According to figures provided by the HA, in 2018 there were roughly 28,000 general beds in public hospitals across the territory.

To put that in perspective, given the city’s 7.5 million-strong population, our current hospital bed-to-population ratio stands at around 3.7 beds per 1,000 citizens, which is substantially lower than the ratio of 5.5 beds per 1,000 people recommended by the Hong Kong Planning Standards and Guidelines (HKPSG).

In order to meet public demand, the city would need about 41,250 hospital beds in total. Yet the reality is, we are still 13,250 beds short at the moment.

Worse still, this estimated gap hasn’t taken into account the projected additional growth in the demand for public healthcare service as a result of the aging population.

In other words, even if we manage to close that gap, chances are, the government hospitals may still be unable to meet public demand for in-patient beds in the future.

That probably explains why the emergency measures currently devised by the government to combat the ongoing flu outbreaks have proven to be of little help, since lying at the root of the problem is the fact that the public hospitals simply lack the necessary infrastructure to cope with the epidemic.

So what is the administration’s blueprint for future public hospital development?

According to the projections made by the government’s “Hong Kong 2030+: Towards a Planning Vision and Strategy Transcending 2030″, the city will run short of 1,200 hectares of land in the long run.

While 310 hectares have been designated as “Government, Institution or Community” (GIC) sites, only 5 hectares have been earmarked for building a Chinese medicine hospital, and testing and quarantine facilities.

As far as the problem of intense hospital bed shortages is concerned, the “Hong Kong 2030+” hasn’t proposed any plan to allocate new land for building hospitals.

The previous administration put forward a 10-year plan on hospital development in the 2016 Policy Address, under which a new acute hospital would be constructed in Kai Tak Development Area, and 11 existing public hospitals would either be redeveloped or expanded.

Once completed, the 10-year plan was expected to deliver an extra 5,000 hospital beds.

The problem is, even if the 10-year plan is on course and on schedule, it still can’t make up for the 13,250 hospital bed shortages.

To address the issue, Chief Executive Carrie Lam Cheng Yuet-ngor revealed a second 10-year plan on public hospital development in her 2018 Policy Address.

The administration has claimed that the entire new 10-year plan, once completed, can provide an estimated 9,000 new hospital beds, and can meet growing public demand up to 2036.

And that immediately begs the question: do we really have to wait until 2036 in order to get the problem of severe overcrowding in our public hospitals resolved?

I believe the most urgent task lying before the government right now is to create land for new housing projects, and at the same time divert more resources for developing new public hospitals.

This article appeared in the Hong Kong Economic Journal on Feb 2

Translation by Alan Lee

[Chinese version 中文版]

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Member of the Hong Kong Institute of Architects