DOCTORS AND NURSING OFFICERS IN GOVERNMENT RESTRUCTURED HOSPITALS AND ACCIDENT AND EMERGENCY UNITS

Mr Low Thia Khiang asked the Minister for Health whether there are sufficient doctors and nursing officers in Government restructured hospitals and Accident and Emergency Units at night and whether the workload imposed on doctors, nurses and housemen is reasonable.

The Senior Minister of State for Health (Dr Aline K. Wong) (for the Minister for Health): Mr Speaker, Sir, doctors and nurses in hospitals work in teams by speciality departments and wards. They are rostered to perform night duties so that adequate patient care is provided on a 24-hour basis. In general, House Officers and Medical Officers form the first line doctors, supervised by Registrars, all of whom stay in the hospital during the night. As a routine, the Consultant-on-call who is overall in charge of the management of patients does not stay in the hospital. But he will do so if the situation warrants it. Currently, hospitals are, in general, adequately staffed. On the average, the manpower shortfall for doctors is 10%, and for nurses 11%.

The number of doctors and nurses rostered at night depends on the number of patients and the average level of activity in the hospital. Doctors are rostered on night duty 6-8 times a month. For inpatient care during the night, doctors are only to attend to urgent situations and to emergency new admissions. Treatment and investigations for patients are normally administered during the day, and routine activities for inpatients at night are minimal.

As for workload at the A&E departments, doctors and nurses work on a shift system. The number of doctors rostered depends on the number of patients who usually attend the hospital A&E departments. In situations of unexpected demand, there is team work and flexibility in redeploying staff, including senior staff, to cope with the unexpected demand. This will ensure that there are sufficient doctors and nurses to deal with patients' needs, and that their workload is kept at a reasonable level.

Mr Low Thia Khiang: Sir, the Senior Minister of State in her reply said that it would depend on the number of patients in A&E departments. How do they estimate the number of patients in A&E departments?

Second, I would like to know what are the ratios for doctors and nurses vis-a-vis patients in the ward. Are there fixed ratios?

Dr Aline Wong: We monitor the number of A&E attendances very closely. So the kind of manpower we deploy to the A&E departments as well as the wards depends on historical figures and the pattern of usage. For example, in hospitals like SGH where the attendance at the A&E department is larger than other hospitals, we have more doctors in the SGH A&E department.

As for doctor and nurse ratios, I have the figures here. The doctor to patient ratio for inpatient wards in 1995 was 1:10.4, nurse to patient ratio was 1:5.7. At A&E departments, doctor to patient ratio was 1:22, nurse to patient ratio was 1:11.

Mr Low Thia Khiang: Sir, is the Senior Minister of State satisfied that the workload for housemen and nurses at our restructured hospitals and A&E departments is reasonable? Will there be overload in a sense and thereby some mistakes are made because of the workload?

Dr Aline Wong: I think our staffing ratios are satisfactory. They are not ideal, because there is a bit of shortage of doctors and nurses. Doctors are expected to do night calls for about 6-8 times a month. So there is this norm. Depending on the situation and the speciality department, they would do night duty between 6 and 8 times a month. The figures show that the level of service is okay, not ideal, but acceptable.