Healthcare Delays Due To COVID-19
Dear Hospital Authority,
I am writing to request information on how the Hospital Authority (HA) has allocated resources during the COVID-19 pandemic. It has been widely reported that the HA has delayed, cancelled, or suspended surgical treatments. However, there is very little quantifiable information on this matter. I would like to know:
1.) The time period (start and end date) of any suspension of surgical operations.
2.) Any further breakdown of details such as: number of surgeries affected, average length of delay, name of hospitals affected, and the types of surgeries that are being delayed, cancelled, or suspended.
3.) Clarification over whether cancer patients or 'high priority' patients are also having their surgeries delayed, cancelled, or suspended along with the number of cancer related operations which have been delayed, cancelled, or suspended.
4.) Any information on whether the HA has suspended elective or non-urgent surgeries as compared to a blanket ban on all surgical operations.
5.) Any further quantifiable information about the HA's handling of surgical patients during the COVID-19 pandemic.
Yours faithfully,
Taylor Amarel
This is to acknowledge receipt of your e-mail message.
(The above is generated by an auto-reply programme)
Hospital Authority ([1]www.ha.org.hk)
=====================================
謝謝閣下的電子郵件。
（以上為電腦自動發出的訊息）
醫院管理局 ([2]www.ha.org.hk)
=====================================
谢谢阁下的电子邮件。
（以上为电脑自动发出的讯息）
医院管理局 ([3]www.ha.org.hk)
________________________________
References
Visible links
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2. file:///tmp/www.ha.org.hk
3. file:///tmp/www.ha.org.hk
Dear Mr Amarel,
Thank you for your Application for Access to Information dated 7 August
2020.
As the processing of your request involves consultation with the
department concerned, we are unable to provide you with the information
sought at this stage. You will be advised further in relation to your
request on or before 27 August 2020.
Should you have any questions in the meantime, please do not hesitate to
contact me.
Yours sincerely,
Sandy Chu(Miss)
Access to Information Officer
Hospital Authority Head Office
(Tel.: 2300 6568/2300 6555)
Dear Mr Amarel,
Further to my reply dated 14 August 2020, please find below the Hospital
Authority (HA) Head Office’s response to your request:
With an increasing number of COVID-19 infection cases in the community,
concerted efforts to fight against the outbreak of COVID-19 is of the
utmost importance for the HA. Starting from 17 February 2020, the HA
significantly reduced non-emergency services and non-essential services,
including elective surgeries and endoscopy services, at some stage to
release extra capacity for the HA to manage emergency services and
conserve manpower and personal protection equipment for combating
COVID-19. Around 60% elective surgeries and 70% elective endoscopy
services were postponed. However, emergency surgeries and endoscopy
services have not been affected. With the gradual stabilisation of the
epidemic situation in May and June, after reviewing factors like overall
manpower, stock of personal protective equipment and infection control
measures, the HA has gradually resumed its services by phases starting
from May. By early July, elective surgeries and endoscopy services have
already returned to over 80% of the service volume in January 2020 before
the COVID-19 outbreak.
In view of the continuous upsurge of COVID-19, the HA has once again
adjusted elective surgeries and endoscopy services starting from 10 July
2020. The HA will closely monitor the usage of anti-epidemic equipment and
facilities, as well as flexibly adjust hospital services and deploy
manpower with a view to minimising impact on patients.
Regarding your request for detailed quantifiable information, under normal
deployment of resources, the HA does not compile such statistics.
According to paragraph 1.14 of the Code on Access to Information, the Code
does not oblige departments to create a record which does not exist.
If you have any questions about this reply, please do not hesitate to
contact me.
Yours sincerely,
Sandy Chu(Miss)
Access to Information Officer
Hospital Authority Head Office
(Tel.: 2300 6568/2300 6555)
From: [1][Hospital Authority request email]
Sent: Friday, August 14, 2020 7:21 PM
To: '[FOI #492 email]'
<[2][FOI #492 email]>
Subject: Application for Access to Information (Taylor Amarel) / Freedom
of Information request - Healthcare Delays Due To COVID-19
Dear Mr Amarel,
Thank you for your Application for Access to Information dated 7 August
2020.
As the processing of your request involves consultation with the
department concerned, we are unable to provide you with the information
sought at this stage. You will be advised further in relation to your
request on or before 27 August 2020.
Should you have any questions in the meantime, please do not hesitate to
contact me.
Yours sincerely,
Sandy Chu(Miss)
Access to Information Officer
Hospital Authority Head Office
(Tel.: 2300 6568/2300 6555)
Dear Hospital Authority,
Please pass this on to the person who conducts Freedom of Information reviews.
I am writing to request an internal review of Hospital Authority's handling of my FOI request 'Healthcare Delays Due To COVID-19'.
In response to the reply from the Hospital Authority ("HA"), I would like to seek the disclosure of additional information likely held by the HA. Specifically, based on a review of documents available on legco.gov.hk, public media, and other sources, the HA is more than likely storing data responsible to my initial request that was not disclosed.
A.) According to LegCo Question Serial No. 2085 and Reply Serial No. FHB(H)057, the HA does tabulate data relating to the number of surgeries, patients, and waiting times. (Source: https://www.legco.gov.hk/yr19-20/english...). By analogy, the HA likely also tabulates data for other surgeries for operational decisions and other matters. With an increasing discussion on the adequacy of the HA workforce and proposals to hire additional doctors, it would be unusual for the HA to not tabulate such data when making decisions on workforce, healthcare, and management decisions.
B.) According to LegCo Question Serial No. 4638 and Reply Serial No. FHB(H)390, the HA does tabulate data relating to the number of surgeries and categorizes those surgeries. (Source: https://www.legco.gov.hk/yr19-20/english...). Thus, the HA logically tabulates data for other surgeries and should have disclosed such information in response to my initial Access to Information request.
C.) According to LegCo Question Serial No. 4653 and Reply Serial No. FHB(H) 391, the HA does tabulate data relating to common surgeries, estimated waiting times, and other details. (Source: https://www.legco.gov.hk/yr19-20/english...). Again, because the HA tracks surgical summary surgical data, this data should have been disclosed in response to my initial Access to Information request.
4.) According to colloquial conversations with doctors working at the HA, the number of surgeries scheduled have been drastically reduced. In some instances, it was reported that all surgeries were cancelled, while other sources reported that everything but cancer surgeries were cancelled. Waiting times have increased by far more than 10% to 20% for important sugeries suggesting that the operating capacity is far below the stated 80% to 90%. To reconcile these differences, the HA should provide a clear definition of what constitutes an "elective surgery".
5.) According to medical journals, all elective surgeries were suspended. (Source: https://www.ncbi.nlm.nih.gov/pmc/article...). If a decision was made to suspend all surgeries it is reasonable that the HA must have done a cost benefit analysis and estimate the impact of such suspension before making the decision.
6.) According to The Standard, "more than half of non-emergency surgeries" were postponed. (Source: https://www.thestandard.com.hk/section-n...). This number doesn't precisely match up with the information provided by sources elsewhere. Surely, to come to a decision to suspend surgeries based on availability of hospital beds, a calculation must have been done which. Hospital Authority's chief manager Ian Cheung Tsz-fung, alluded to this decision based on the availability of beds by stating: "Over half of non-emergency surgeries and body checks requiring hospitalization, especially procedures leading to intensive care, will need to be postponed," while also pointing out that isolation wards cannot be fully occupied as a certain proportion must be reserved for emergency patients.
7.) According to data.gov.hk, the HA regularly tabulates data relating to surgery statistics. (Source: https://data.gov.hk/en-datasets/provider...).
8.) According to documents published on the HA's website, 90th percentile waiting time and other surgery statistics are tabulated. (Source: https://www.ha.org.hk/haho/ho/cad_bnc/AO...,
In consideration of the above information, I would like to request a review of my initial request to see if any additional data can or should be disclosed in full or redacted format. There are numerous documents on https://www.legco.gov.hk as well as the HA's own website that illustrates the HA does maintain, track, and tabulate data responsible to my request. If, for any reason, the HA feels the initial request is still not able to be processed, I'd request the HA also provide additional details on:
1.) The number of GERD related surgeries for 2017-18, 2018-19, and 2019-20.
2.) The number of patients on the waiting list for GERD related surgeries for 2017-18, 2018-19, and 2019-20.
3.) The average waiting time for GERD related surgeries by cluster: New Territories East, New Territories West, Kowloon East, Kowloon Central, Kowloon West, Hong Kong East, Hong Kong West
4.) The total number of surgeries for 2017-18, 2018-19, and 2019-20.
5.) The number of patients on waiting list for surgeries for 2017-18, 2018-19, and 2019-20.
6.) The average waiting time for surgeries by cluster: New Territories East, New Territories West, Kowloon East, Kowloon Central, Kowloon West, Hong Kong East, Hong Kong West
A full history of my FOI request and all correspondence is available on the Internet at this address: https://accessinfo.hk/en/request/healthc...
Yours faithfully,
Taylor Amarel
This is to acknowledge receipt of your e-mail message.
(The above is generated by an auto-reply programme)
Hospital Authority ([1]www.ha.org.hk)
=====================================
謝謝閣下的電子郵件。
（以上為電腦自動發出的訊息）
醫院管理局 ([2]www.ha.org.hk)
=====================================
谢谢阁下的电子邮件。
（以上为电脑自动发出的讯息）
医院管理局 ([3]www.ha.org.hk)
________________________________
References
Visible links
1. file:///tmp/www.ha.org.hk
2. file:///tmp/www.ha.org.hk
3. file:///tmp/www.ha.org.hk
Dear Mr Amarel,
Thank you for your email dated 14 September 2020.
Your request for a review of the Hospital Authority’s response dated 24
August 2020 and also for additional information is receiving attention.
You will be advised further in relation to your request on or before 30
September 2020.
Should you have any questions in the meantime, please do not hesitate to
contact me.
Yours sincerely,
Sandy Chu(Miss)
Access to Information Officer
Hospital Authority Head Office
(Tel.: 2300 6568/2300 6555)
Dear Mr Amarel,
Further to my reply dated 23 September 2020, as the departments concerned
are still processing your request, you will be advised further in relation
to your request on or before 14 October 2020.
Should you have any questions in the meantime, please do not hesitate to
contact me.
Yours sincerely,
Sandy Chu(Miss)
Access to Information Officer
Hospital Authority Head Office
(Tel.: 2300 6568/2300 6555)
From: [1][Hospital Authority request email]
Sent: Wednesday, September 23, 2020 7:41 PM
To: '[FOI #492 email]'
<[2][FOI #492 email]>
Subject: (Internal review) Application for Access to Information (Taylor
Amarel) / Freedom of Information request - Healthcare Delays Due To
COVID-19
Dear Mr Amarel,
Thank you for your email dated 14 September 2020.
Your request for a review of the Hospital Authority’s response dated 24
August 2020 and also for additional information is receiving attention.
You will be advised further in relation to your request on or before 30
September 2020.
Should you have any questions in the meantime, please do not hesitate to
contact me.
Yours sincerely,
Sandy Chu(Miss)
Access to Information Officer
Hospital Authority Head Office
(Tel.: 2300 6568/2300 6555)
Dear Mr Amarel,
Further to my reply dated 30 September 2020, please find below the
Hospital Authority (HA) Head Office’s response to your request for an
internal review:
The HA Head Office has reviewed the handling of your initial request for
data about “healthcare delays due to COVID-19”. While service data, such
as inpatient admission, outpatient attendance, number of procedure
performed, etc., are routinely maintained, the HA does not compile
statistics on activities delayed, cancelled or suspended due to COVID-19.
According to paragraph 1.14 of the Code on Access to Information, the Code
does not oblige departments to create a record which does not exist.
Regarding your request for information on additional items, please find
below the HA Head Office’s response:
Items 1 to 3
The HA does not compile statistics you requested about “GERD related
surgeries” performed in public hospitals. According to paragraph 1.14 of
the Code on Access to Information, the Code does not oblige departments to
create a record which does not exist.
Item 5
The HA does not compile statistics about “the number of patients on
waiting list for surgeries for 2017-18, 2018-19 and 2019-20”. According to
paragraph 1.14 of the Code on Access to Information, the Code does not
oblige departments to create a record which does not exist.
Items 4 and 6
The HA does not compile the statistics you requested. According to
paragraph 1.14 of the Code on Access to Information, the Code does not
oblige departments to create a record which does not exist. For relevant
and readily available information, please access via the following
sources:
(i) Replies to initial written questions raised by Finance
Committee Members in examining the Estimates of Expenditures 2020-21
SFC 2020-21 (Reply Serial No. FHB(H)391)
([1]https://www.legco.gov.hk/yr19-20/english...)
The HA has not surveyed the waiting list and waiting time for common
elective surgeries performed in different specialties at various hospitals
due to the wide range of procedures performed. The table below sets out
the estimated waiting time and number of some common elective surgeries
performed in public hospitals in the past three years.
No. of
Range of No. of No. of Cases
Estimated Cases Cases Performed Surgical
Procedure Waiting Performed Performed in 2019‑20 Operation
Time in in Category
(Months) 2017‑18 2018‑19 (up to
31 December
2019)
Herniorrhaphy 2 to 24 4,202 4,356 3,102 Intermediate
I to Major II
Cholecystectomy 3 to 22 3,604 3,619 2,736 Major: I & II
Total Joint 29 to 68 3,841 4,253 3,480 Ultra-major:
Replacement I & II
Transurethral 1 to 13 2,534 2,167 1,680 Major I
Resection of
Prostate
Myomectomy 4 to 24 2 304 2,551 2,010 Minor II to
Major I
Total Abdominal 4 to 36 1,650 1,652 1,231 Major II
Hysterectomy +/-
Bilateral
Salpingectomy
Thyroidectomy 2 to 22 928 982 703 Major: I, II
& III
Haemorrhoidectomy 2 to 42 1,171 1,085 838 Intermediate
I
Anterior Cruciate 2 to 12 735 707 496 Major II
Ligament
Reconstruction
Tonsillectomy 3 to 12 771 783 610 Intermediate:
I & II
(ii) “Elective Surgery” on HA’s corporate website
([2]https://www.ha.org.hk/visitor/ha_visitor...)
The respective waiting times for patients with cataract surgeries and
patients with total joint replacement surgeries performed in the past 12
months (1 July 2019 to 30 June 2020):
Elective Hyperlink
Surgery
Cataract [3]https://www.ha.org.hk/visitor/ha_visitor...
Surgery
Total Joint [4]https://www.ha.org.hk/visitor/ha_visitor...
Replacement
Surgery
(iii) HA Statistical Report
([5]https://www3.ha.org.hk/Data/HAStatistics...)
Number of operations done inside operating theatres:
Financial Hyperlink
year
2017-18 [6]https://www3.ha.org.hk/data/HAStatistics...
(see Table 5.2)
2018-19 [7]https://www3.ha.org.hk/data/HAStatistics...
(see Table 5.2)
If you have any questions about this reply, please do not hesitate to
contact me.
Yours sincerely,
Sandy Chu(Miss)
Access to Information Officer
Hospital Authority Head Office
(Tel.: 2300 6568/2300 6555)
From: [8][Hospital Authority request email]
Sent: Wednesday, September 30, 2020 6:35 PM
To: '[FOI #492 email]'
<[9][FOI #492 email]>
Subject: (Internal review) Application for Access to Information (Taylor
Amarel) / Freedom of Information request - Healthcare Delays Due To
COVID-19
Dear Mr Amarel,
Further to my reply dated 23 September 2020, as the departments concerned
are still processing your request, you will be advised further in relation
to your request on or before 14 October 2020.
Should you have any questions in the meantime, please do not hesitate to
contact me.
Yours sincerely,
Sandy Chu(Miss)
Access to Information Officer
Hospital Authority Head Office
(Tel.: 2300 6568/2300 6555)
From: [10][Hospital Authority request email]
Sent: Wednesday, September 23, 2020 7:41 PM
To: '[FOI #492 email]'
<[11][FOI #492 email]>
Subject: (Internal review) Application for Access to Information (Taylor
Amarel) / Freedom of Information request - Healthcare Delays Due To
COVID-19
Dear Mr Amarel,
Thank you for your email dated 14 September 2020.
Your request for a review of the Hospital Authority’s response dated 24
August 2020 and also for additional information is receiving attention.
You will be advised further in relation to your request on or before 30
September 2020.
Should you have any questions in the meantime, please do not hesitate to
contact me.
Yours sincerely,
Sandy Chu(Miss)
Access to Information Officer
Hospital Authority Head Office
(Tel.: 2300 6568/2300 6555)
