treatment rooms, waiting areas etc.) which costs about $2 million, the broad order of cost for a new style clinic comprising six general out- patient department rooms, four specialty rooms, 24 maternity beds, 20 general, 20 psychiatric and 20 geriatric day-beds and the features above, would be $7 million non-recurrent, and $3.9 million recurrent (Appendix 8).
38. As with clinics so with polyclinics the design might well be reconsidered at this stage, with reference to the following:
(a) They should be planned according to the proposed idea of regionalization, i.e., to serve a district in the region and be situated at a geographical vantage point.
(b) There is no reason why all the specialties should not be included, and that besides the medical and surgical specialties, chest diseases and psychiatry should not also be served.
(c)
There should be more emphasis on rehabilitation; thus, physiotherapy and occupational therapy departments should be planned within a polyclinic.
(d) There should also be laboratory facilities for clinical pathology and possibly for public health bacteriological examinations and an x-ray survey unit.
(e)
Numbers of day-beds should be added. (It would be a new departure to put beds of any sort in a polyclinic).
39. For polyclinics, further provision along these lines could be available from 1978 onwards. Early priorities might be Sha Tin, Kwun Tong and Castle Peak, and although the case for them is not yet clear it would be as well to have sites earmarked now, if this has not already been done.
40. As for the substandard clinics named in paragraph 33, it seems clear that some of them will have to remain open. Others will be demolished as redevelopment overtakes the areas in which they are situated.
41. Estimates of annual increased needs for staff and money for clinics have been included, where possible, in Appendices 4 to 6.
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CHAPTER 5
HOW A MORE EVEN USE COULD BE ACHIEVED OF GOVERNMENT AND GOVERNMENT-ASSISTED HOSPITAL BEDS
42. To achieve the aim of this chapter heading a means must be found to remove or reduce disincentives to use Government-assisted hospitals. Although service to patients may not be as high as in Government hospitals, the charges can be much higher. Compared with Government's $2 per day all-inclusive charge for patients in third-class beds, some Government-assisted hospitals charge $10 or more for maintenance and, in addition, patients may have to pay for treatment which, for the category of beds mentioned, is free in Government hospitals. Not surprisingly, occupancy rates are in general lower than in Government hospitals, exceptions being the Tung Wah Hospitals which are free. the Ruttonjee and Nam Long Hospitals which are in effect free, and the Nethersole Hospital. Aside from these the bed occupancy rates range from 47% to 80%. It is suggested that a means to make more use of the vacant beds could be found through a grouping together of certain Government and Government-assisted hospitals situated in common geographical areas, to form an integrated network of services, and by levying uniform fees for patients occupying their third-class beds.
43. An acute hospital bed is expensive to build and expensive to operate because of the sophisticated equipment and numbers of skilled staff required. Generally a patient is in need of this level of provision for only part of the hospital stay, and many patients with less serious complaints never require such provision at all. Unless steps are taken to direct patients to the right types of bed or to move patients for different phases of treatment, the expensive facilities will be under- utilized. Efforts are made already-for example, patients are transferred from Queen Elizabeth Hospital to Kowloon Hospital for convalescence --but a regional organization, as is being introduced with success in other countries, could improve utilization still further.
44. The change would involve dividing Hong Kong into regions each containing:
(a) A regional hospital equipped with all special services, e.g., intensive care, neurosurgery, radiotherapy, renal dialysis. Here
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