Staffing the Health Services.
Tuber- culosis Service.
CHAPTER 12
THE HEALTH SERVICES
12.1 As indicated in Chapter 1, the success of Hong Kong in eradicating and controlling major public health hazards owes a great deal to the priority afforded to the establishment of effective health services in the early years after the Second World War. The full range of measures now undertaken to safeguard and promote public health in Hong Kong are administered by the Medical and Health Department, the Urban Council and the Urban Services Department as well as by the Labour Department and the New Territories Administration.
12.2 The past two decades have seen major strides in the control of communicable diseases, which were once responsible for many deaths in Hong Kong. This pattern has changed; the risk of death is now greater from the diseases of later life and from accidents. Nevertheless Hong Kong must continue to be fully prepared to deal with communicable diseases and to impose neces- sary environmental hygiene measures. These services must now increasingly concentrate on community medicine, which is con- cerned not only with the control of communicable diseases (particularly within the realm of environmental hygiene) but also with other aspects of medical and health services, such as health education and rehabilitation.
12.3 The MDAC recommended that action should be taken first to follow through the report of a Working Party of the Medical and Health Department which was reviewing the establish- ment and distribution of the health and nursing grades in the department's health services. The Working Party was of the opinion that there were staff shortages in parts of these services and recommended that additional posts for health and nursing grades should be created at an early date. This report is now being examined. When this examination has been completed, the MDAC will enquire more fully into the functioning of the services. Some account of the present services is however appropriate at this stage. 12.4 Tuberculosis-formerly Hong Kong's most lethal disease -is now fifth on the list of the common causes of death. Over the past 20 years the notification rate has dropped from 689.0
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to 223.2 per 100,000 and the death rate from 207.9 to 30.9 per 100,000 between 1951 and 1971. Almost 100% of all babies born in Hong Kong now receive B.C.G. vaccination. Such is the pro- gress in controlling this disease, that most cases are now treated on an out-patient basis.
12.5 Considerable emphasis is placed on following up patients and ensuring all contacts are examined. Thus present efforts are directed at tracing contacts, following up out-patients and ensur- ing B.C.G. vaccination of newborn babies in hospitals and of children at schools.
Health.
12.6 A major function of the health services, and one required Port under International Health Regulations, is the provision of a port health service and of ancillary facilities in the harbour and at the airport. The record of Hong Kong's port health service is excellent and to this can be credited the virtual absence of quarantinable diseases in Hong Kong over a long period. Some expansion of services will be required as the airport and other areas develop, but for the present no additional requirements in terms of staff and facilities are foreseen.
12.7 One of the newest innovations in the Government services Family
Planning. is its substantial participation in family planning. Under the ap- proved plan to integrate this service into the Government's maternal and child health programme, 37 Government clinics will be open by the end of 1974. The immediate priority will be to consolidate these services and to assist the Family Planning Association to develop its own plans to operate in areas not served by the Government.
12.8 The health of workers in factories and other industrial Industrial undertakings is the statutory responsibility of the Commissioner Health. of Labour but the Industrial Health Division in the Labour Department is staffed by personnel seconded from the Medical and Health Department. With the industrialization of Hong Kong, the work of this Division is increasing. As a long term plan, it is the intention of the Director of Medical and Health Services to review the organization of the Division in consultation with the Commissioner of Labour with a view to expanding and developing the present service into a full occupational health
service.
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