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cirrhosis and cancer, and in line with a WHO recommendation on the control of viral hepatitis, the Medical and Health Department has introduced a hepatitis B vaccination programme. A special advisory committee was set up in early 1983 to advise the government on an overall strategy to provide immunisation against hepatitis B to certain high risk groups in the community. The first group comprises babies born to mothers who are carriers of the disease. The second group comprises health care workers who are in frequent contact with blood and blood products or tissue fluids.
During the year, the Medical and Health Department began a combined neo-natal screening programme for glucose 6 phosphatase dehydrogenose deficiency and congenital hypothyroidism to facilitate early diagnosis and treatment of infants who may otherwise develop disabilities or mental retardation. The programme covers babies born in govern- ment and subvented institutions.
Hospitals and Development Programmes
There are three types of hospitals in Hong Kong- government, government-assisted and private with a total of 24 073 beds, representing 4.5 beds per thousand of the population. During the year, pressure on the service was experienced on all fronts; this was reflected by the increase in attendance at out-patient clinics, and accident and emergency departments, and by the number of hospital admissions.
The Medical and Health Department's overall plan for the decade involves the construction of at least four more government hospitals: a 1 600-bed hospital in Tuen Mun, a 1 600-bed hospital in Chai Wan and 1 400-bed hospitals in East Kowloon and Tai Po. Plans also include the provision of extension blocks to the first three regional hospitals: the Queen Mary, Queen Elizabeth and Princess Margaret Hospitals.
Other projects in the pipeline include further extensions to the Caritas Medical Centre, Yan Chai Hospital and Pok Oi Hospital and the redevelopment of the Ruttonjee Sanatorium into a 432-bed general hospital. One new private hospital with a capacity of 600 beds is in the planning stage.
In 1984, the total attendance at government and government-assisted accident and emergency departments was 1 078 000, averaging 2 950 attendances per day. More than 623 000 patients were treated at the 14 government and 20 government-assisted hospitals.
Clinics
General out-patient services form a vital part of the health care system. The government now operates 62 general out-patient clinics as well as polyclinics and specialist clinics. Evening, Sunday and public holiday sessions continued at clinics in the more densely populated areas as part of the overall measures to meet the expanding demand for out- patient services. The medical development programme includes 19 clinic and polyclinic projects throughout the territory.
Mobile dispensaries and floating clinics take medical services to the outlying islands and the more remote areas of the New Territories. Other inaccessible areas are visited regularly by the 'flying doctor' service, with the assistance of the Royal Hong Kong Auxiliary Air Force.
At the end of 1984, 345 clinics were registered under the Medical Clinics Ordinance. Of these, 91 clinics were under the control of a registered medical practitioner and 254 were registered under the provisions for exempting certain clinics. Registered medical practitioners members of the Estate Doctor Association set up clinics in housing estates to provide a low-cost service for residents.
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