TNAG-0507-FCO40-572-Development-of-medical-and-health-services-in-Hong-Kong-1974 — Page 55

CHAPTER 5

A REGIONAL APPROACH

5.1 Since 1949 there has been an increasing concentration of population in the urban areas, particularly Kowloon. With the development of Kwun Tong and Tsuen Wan a new pattern of population distribution has occurred, which will be further accen- tuated by the development of the new towns at Sha Tin and Tuen Mun. Medical and health planning must take this into account with a view to ensuring that medical services are available within reasonable access of the new centres of population. It is accord- ingly proposed to introduce a fresh approach to the administration of medical and health services which will ensure a better apprecia- tion of the medical and health needs of each of these main population centres.

5.2 Some parts of the health services are already administered on a regional basis; the administration of medical services (con- cerned particularly with the hospitals) remains centralized at Medical and Health Department headquarters. It is now intended to devise a coordinated management system for both medical and health services at regional level. The medical and health divisions of the department will be more closely integrated, future planning will be better related to the needs of each area and fuller use will be made of available hospital beds.

5.3 To provide a soundly based regional service and to enable the best use to be made of resources, planning will be based on the need for each region to be served by-

(a) a regional hospital: this would be a major acute hospital, equipped to treat patients requiring the highest level of specialist care; some highly specialized facilities may be concentrated in a particular hospital as a colony-wide service, but otherwise a regional acute hospital should be capable of providing the region which it serves with all major general specialist services to an appropriate degree of sophistication.

(b) one or more district hospitals: these hospitals will provide the basic hospital services in the region and will receive

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patients whose condition is not such as to warrant referral directly to the regional hospital; a district hospital will perform a dual role; a patient whose condition so warrants will be referred to the regional hospital for the more specialized levels of treatment; a district hospital will also receive patients from the regional hospital for the later stages of their treatment, when it is medically appropriate for them to be transferred;

(c) one or more specialist clinics or polyclinics: these will provide the necessary support and out-patient specialist services, including those for patients before and after any hospital treatment; and

(d) a number of general clinics based on the needs of the population of the area providing both out-patient and general public health services.

5.4 Such a regional organization can be built around the four major hospitals (Queen Mary, Kwong Wah, Queen Elizabeth and Princess Margaret). There will therefore initially be four regions served by these hospitals respectively:

(a) Hong Kong Island;

(b) West Kowloon;

(c) East Kowloon and East New Territories; and (d) West New Territories.

However, with the anticipated movement of population it will be necessary at a later stage to establish a fifth region to serve East New Territories separately. The need to establish another region for the Tuen Mun area will be kept under review but for the present it is considered likely that the needs of the latter area can be effectively combined in the same region as Tsuen Wan and Kwai Chung. The plan at Appendix 1 indicates the five regions which are envisaged.

5.5 The administration of each hospital region should ideally be conducted from its own individual administrative regional headquarters office. It is however intended that initially the administration of regions should be dealt with from the three offices which presently deal with the regionalized health services.

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