CHAPTER 6
AN ESTIMATE OF THE REQUIREMENTS OF THE PUBLIC AND PRIVATE SECTORS FOR DOCTORS, THE SUPPLY
TO BE EXPECTED AND ANY DEFICIENCIES
53. In order to calculate the needs of the Colony as a whole for doctors it is necessary to begin with a survey of the requirements for doctors in Government service. This broad category of staff includes all qualified doctors from housemen to consultants.
54. The general approach has been to
(a) calculate the present staff ratios for hospital beds and doctor
sessions per year at clinics;
(b) examine reasons why the ratios for hospital beds should be
varied in future;
(c) propose ratios for future planning; (these ratios are put forward purely as a reasonable basis from which to assess likely future needs; no commitment is implied and specific requests for more staff will still be considered under normal procedures);
(d) multiply the planning ratios by the forecast needs for Govern- ment hospital beds, i.e. divide the bed requirements by the appropriate number of beds per doctor.
55. Present ratios for hospitals:
(a) Medical, surgical and maternity ratios have been calculated using Queen Elizabeth Hospital, including beds at Kowloon Hospital attended by Q.E. doctors, as a sample. If anaesthetists and other specialists are allocated on the basis of workload the position is
Other Total
Doctors Anaesth. Special- Doctors Beds Ratio
ties
Med. and Paed.
75
8
83
Surg. and Gyn.
91
24
123
1,008 12.14 1,045
8.49
Maternity
10
2
11
13
267
20.53
24
(b) T.B. ratio is based on Kowloon Hospital which contains most of Government's T.B. beds. The present ratio is one doctor to 27 beds.
(c) Infectious diseases and leprosy. These beds are under-occupied at present but, if allowance is made for this, the equivalent ratio is one doctor per 17 beds.
(d) Psychiatric beds. The present ratio for Castle Peak Hospital, which has most of Hong Kong's patients, is one doctor to 137 beds.
56. For clinics the ratio is one doctor per 480 doctor sessions per year, i.e., each doctor works two sessions per day Monday to Friday, one session on Saturday and has 17 public holidays and 30 days leave. However, for general specialties no separate provision is required because these are staffed by doctors from hospitals or the teaching hospital.
57. Changes required. For some specialties the present ratios are about right, but in others changes are required.
(a) Medical, surgical and maternity ratios at Queen Elizabeth
Hospital are slightly lower than necessary because
(i) extra staff are included who will be transferred to Princess Margaret Hospital when it opens; allowing for these 'surplus' staff, the ratios for medical should be 13 and surgical 9; (ii) maternity cases at Queen Elizabeth Hospital are more complicated than average, and hence overall ratios for all hospitals should be higher than 20.53, at about 25.
(b) Psychiatric staff are at present very scarce and consequently the ratio of 137 is far too high. A more appropriate level would be 60.
(c) Geriatric. Separate provision is not made at present but, when such beds are open, a doctor ratio of one per 30 beds would be appropriate.
58. Planning ratios for hospital doctors can therefore be summarized as follows:
25