【明報專訊】THE DEPARTMENT OF HEALTH (DH) launched its online registration and ballot system for public dental services on Monday (30 Dec). Although the new arrangement indeed spelt the end of scenarios of grassroots or elderly queuing for hours, it has also brought up new doubts and concerns — wastage of precious public resources caused by no-shows of successful applicants and treatment delays for seriously ill dental patients with bad luck in balloting, for example.
Hong Kong suffers from a shortage of dentists and is particularly strained in public dental clinics. The government is determined to reform dental healthcare with the aim of serving underprivileged groups in a fairer way. Despite the good intentions, the authorities must closely monitor the actual implementation of the reform measure and smooth out various operational problems.
The DH runs more than 40 dental clinics, with 11 of them designating specific time slots to provide emergency dental services for underprivileged groups with economic difficulties. Due to the limited quotas of public dental service slots, some elderly and grassroots used to queue up at DH dental clinics from the early hours to secure a slot.
One of the government's reforms was the adoption of the online registration and ballot system. Citizens can log in to the system through the eHealth mobile application and register for an appointment with their real name a day in advance. The authorities reserve half of the quotas for elderly people. All successful applicants will receive a notification via SMS.
On the first day of the new arrangement, all 88 slots were snapped up, and the system received 686 registrations in total, with nearly eight people vying for a slot. However, only 62 patients allocated a quota turned up for treatment. The absence rate was about 30%. The situation on the second day was similar, with an absence rate of more than 20%. Over the first two days, out of 151 slots, 40 people did not show up, which was clearly not ideal.
The DH stated that, upon preliminary investigation, some citizens who did not show up cited personal reasons or forgot their appointments. Some were not aware that the general dental public session only provides emergency dental services. The department will continue to monitor the new system's operation and effectiveness, and make appropriate adjustments and improvement measures, including the consideration of a waiting list mechanism.
Theoretically, a waiting list mechanism could prevent the wastage of dental service quotas. However, ''no-shows'' often occur at the last moment. It remains a technical challenge to ensure that standby patients can promptly fill these slots and arrive at the clinic on time.
In the past, the grassroots or the elderly with severe dental diseases could almost guarantee a clinic visit by being willing to spend more time queuing. After the change to ballot draws, everything is decided by luck instead. The authorities should closely monitor the actual implementation of the measure, listen more to the patients and stakeholders and improve the system. In the case of prolonged major problems that cannot be resolved or even continue to worsen, the authorities may need to consider the worst-case scenario and call a halt to the measure until proper solutions are found.
明報社評 2025.01.03：牙科街症改革用意雖好 實際操作問題有待改善
衛生署牙科街症服務，本周一起改採網上登記抽籤，基層市民及長者長時間排隊輪候街症的情况，確是從此絕迹，惟亦引來一些新的疑問和關注，例如中籤者臨場缺席浪費珍貴公共資源、牙患嚴重病人因抽籤欠運耽誤治療等。
本港牙醫短缺，公營牙科情况尤其嚴重，政府銳意改革牙科護理服務，盼以更公平方式，聚焦服務弱勢社群，用意用心很好，與此同時，當局也須密切留意改革措施「落地」情况，理順實際操作各種問題。
衛生署有超過40間牙科診所，當中11間會劃出特定時段，為有經濟困難的弱勢社群提供緊急牙科服務。由於公營牙科門診名額有限，以往一些長者和基層市民凌晨就到衛生署牙科診所輪候街症。
政府提出的其中一項改革，是改採網上登記及抽籤制度。市民可透過「醫健通」登入系統，提前一天實名登記預約，當局會預留一半籌額給長者。所有中籤者會收到手機短訊通知。
新安排首日88個名額迅即爆滿，系統合共接獲686宗登記，相當於近8人爭1個名額，惟最終只有62名獲籌病人應約接受治療，缺席率近30%；第二天的情况也相似，缺席率逾兩成。首兩天合共151個名額，有40人沒到診，情况肯定不理想。
衛生署表示，經初步了解，部分無到診市民表示因事未能出席，又或忘記預約，也有市民表示不清楚牙科街症服務範圍是提供緊急牙科服務，署方會繼續監察新系統的運作及成效，作出合適的調整和改善措施，包括考慮引入候補機制。
理論上，設立候補機制可以避免門診名額白白浪費，但預約者「甩底」，往往都是臨場一刻才知道，其他輪候人士能否隨即補上、及時趕來診所，連串技術問題都需要妥善處理。
以往基層市民和長者，若有嚴重牙患疼痛難耐，只要肯付出更多時間排隊，基本上可確保看到牙科門診。改為抽籤，反而變成運氣決定一切。當局應密切留意實際執行情况，多聽病人和持份者意見，完善機制安排。如果有重大問題持續無法解決，甚或不斷惡化，當局確有需要做最壞打算，叫停措施，待妥善解決才推行。
■/ Glossary 生字 /
spell (sth)：to have sth, usually sth bad, as a result
snap (sth) up：to buy or obtain sth quickly because it is cheap or you want it very much
call a halt to (sth)：to stop an activity or process