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中英社评/引入医护外援 维护病人权益

2023-04-03 04:24:51大公报
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  公共医疗系统长期人手不足的老大难问题可望得到纾缓。特区政府建议修订《护士注册条例》,多管齐下引入非本地培训护士。同时研究修订《牙医注册条例》,要求合资格医护人员需要在公营医院服务一定年期,并引入合资格非本地牙医。有关举措呼应了民意诉求,直击民生难点、痛点,体现了政府推动医疗改革、打破利益藩篱的担当和勇气。

  本港人口老化加速,香港公立医院人手荒问题愈演愈烈,早有“十个茶煲七个盖”之谓。尽管特区政府近年增加了相关学位和培训名额,但仍然与实际需求严重脱节。过去三年新冠疫情肆虐,公共医疗压力沉重,医护人手不足的问题雪上加霜。有统计显示,本港每名护士需照顾10名以上的病人,远高于国际标准1对6的比例,而压力过大导致更多人手流失,形成恶性循环,最终损害的是病人利益。急症室总是大排长龙,专科门诊排位经年累月,不少手术被迫推延,早已引起怨言。

  护士荒并非香港独有现象,许多发达国家包括澳洲、英国等都在抢护士,并将目光瞄准了香港。香港护士流失加速是不争的事实,这显然不是单靠加薪加福利就可以纾缓的,在这种情况下,香港加大力度引入外援,是正确之举。正如有病人权益组织表示,公营和私营机构护士人手都出现短缺,部分医院甚至连病床或手术服务都受影响,引入非本地护士有迫切性。安老事务委员会委员也欢迎政府的建议,认为现时政府津助或合约等院舍很难聘请护士,希望在引入外援、满足公营医疗体系的需要后,剩余名额可流向院舍。

 引入外援当然要唯才是举,不论出处,而且在全球争抢护士的情况下,香港的引援条件不能太苛刻,否则只会为渊驱鱼,事倍功半。政府建议在特别注册下,非本地培训护士如在一间或多间指明机构全职受僱一定年期,并获确认表现满意及称职,就有资格在香港正式注册,毋须参加执业考试,有其合理性,也得到病人组织、业界人士和民意的支持。

  事实上,在指定医疗机构工作一定年期且称职者,都是有经验人士,只要愿意来香港,香港没有理由不张开双臂欢迎。大家都记得,在香港疫情最紧张的时候,内地曾派护士南下驰援,当时不少人担心内地护士职业水准不足,也顾虑他们与病人、本地同行的语言沟通问题,结果却发现,这些担心完全是多余的。内地护士和本港护士合作无间,沟通无碍,专业水平完全合格,得到本港同行及病人的高度认同。内地护士完成驰援使命返回内地时,大批市民前往送别,这足以说明一切。

  除了引入护士外援,特区政府也有意引入牙医外援,并建议牙医毕业生实习一年后才能正式注册,本地培训的非专科牙医须在指定机构服务两年。培养牙医费用不菲,与一般医科生相当,医科生毕业后必须实习一年才能注册,且须先在公立医院服务,回馈社会。今后对牙医一视同仁,再合理不过。

  医疗问题是香港深层次问题之一,香港必须“内求”与“外援”并举才能解决问题,这是最浅显的道理,可惜过去因为种种掣肘而难以推动。新一届特区政府上任后,医疗改革动真格,做到“民有所呼、我有所应”,让市民看到了希望。

  Bringing in overseas doctors and nurses to protect patients' rights

  Staff shortage in the public health system, a long-standing problem, is hopefully to be eased. The SAR Government proposes to revise the Nurses Registration Ordinance, taking a multi-pronged approach to introducing non-locally trained nurses into Hong Kong. At the same time, authorities concerned also study the feasibility of amending the Dentists Registration Ordinance to require all qualified healthcare personnel to serve in public institutions for a certain period of time and to bring in qualified non-locally trained dentists. Such moves respond to public appeals and hit the mark where difficulties and pains of people's livelihood are concerned, showing the government's commitment and courage to push forward healthcare reform and break down the barriers of vested interests.

  With population aging in Hong Kong accelerating, the problem of staff shortage in public hospitals become increasingly acute, described as "ten pots with only nine covers (demand outgrowing supply)" for long.  Despite the SAR Government has increased the numbers of relevant school and training places, it is still a far cry from satisfying the growing demand. Amid the Covid-19 epidemic in the past three years, the public healthcare system was under heavy pressure making the bad manpower shortage even worse. According to some statistics, each nurse in Hong Kong has to take care of more than 10 patients, far behind the international standard of 1:6 nurse-to-patient ratio. And growing pressure leads to the departure of more healthcare staff, forming a vicious circle. In the end, patients' interests are damaged. Hours-long queues always form at public hospitals' emergency departments, a patient has to wait for months or even years to visit a specialist out-patient clinic, and quite a few surgical operations have to be put off. This has for long aroused complaints.  

  Shortage of nurses is not a unique phenomenon in Hong Kong. Many developed countries including Australia and the United Kingdom are competing for nurses with a focus on Hong Kong. It is an indisputable fact that the number of departed nurses in Hong Kong grows. Apparently this problem cannot be eased simply by increasing pay and welfare. Under such circumstances, it is a right move for Hong Kong to boost its effort to seek external help. As some patient rights prganisation said, it is urgent to bring in overseas nurses as both public and private institutions are so short of nurses that even in-patient and surgical-operation services in some hospitals are affected. The Elderly Commission also welcomes the government's proposal. It says that it is very difficult at present for government subsidized or contracted care homes to hire nurses and expresses its hope that when overseas nurses are brought in and the need of public healthcare system is satisfied, the remaining number of such nurses could be allocated to care homes.

  Bringing in external help surely must be done in a meritocratic way, regardless of where one comes from. Moreover while nurses are globally competed for, Hong Kong's requirements for luring external aid must not be too rigid, or we will simply "drive the fish into deep waters" and get half the result with twice the effort. The government proposes to create a temporary registration system to allow non-locally trained nurses to be registered in Hong Kong without the need to take the Licensing Examination, once they have been working full-time in "specified institutions" for "a certain duration" and subject to the confirmation that they have served satisfactorily and competently as nurses. Such a proposal has its reasons and wins supports from patient organisations, healthcare practitioners and public opinion.

  Actually, those who have served full-time in specified healthcare institution for "a certain duration" satisfactorily and competently are experienced practitioners. There is no reason for Hong Kong not to welcome them with open arms, when they are willing to come to the SAR. It is still in our memory that when the epidemic situation in Hong Kong was very tense, the Mainland sent nurses down to help. At that time, quite a few people were concerned whether Mainland nurses had sufficient professionalism and with the problem of their verbal communication with local patients and colleagues. It turned out such concerns were utterly unnecessary. The nurses from the Mainland made a good team and communicated smoothly with local ones, and they were fully qualified with their professionalism winning high recognition from local colleagues and patients. When they were to go back home after accomplishing their mission, a great number of citizens came to see them off. This said it all.

  In addition to lure overseas nurses, the SAR Government also intend to attract overseas dentists and proposes that dental graduates fulfil a one-year internship and locally trained non-specialist dentists serve in public institutions for two years. The cost of training a dentist is not cheap, as much as the cost of training a medical doctor. Medical graduates cannot be registered before fulfilling a one-year internship and they must serve in public hospitals first to give back to society. It is only reasonable for dental graduates to be treated in the same way from now on.

  Healthcare is one of Hong Kong's deep-rooted problems, which can only be solved by "digging up more internal resources" and "bringing in external aid" together. The reason behind this is most obvious. Unfortunately, there has been no way to start doing this due to all kinds of hindrances. After the new-term government took office, healthcare is to be truly carried out in response to the people's needs. Citizens now can see the future.

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