【明報專訊】HONG KONG has a shortage of dentists. The situation in public dental services is particularly serious. With the Department of Health's vacancy rate for dentists reaching 27%, dental clinics for students and outpatient dental care alike are being affected.
At a Legco Special Finance Committee meeting yesterday (17 April), lawmakers scrutinised the expenditures of the Health Bureau. According to information from the Bureau, the wastage rates for full-time doctors, nurses and allied health professionals ranged between 6.1% and 9.5% in the year 2023/24. As of the end of March this year, the Hospital Authority (HA) had hired 138 non-locally trained doctors. The number is expected to rise to 200 by the end of this year. Lo Chung-mau, the Secretary for Health, says the overall situation of manpower loss has improved, but the wastage rate of young medical staff is relatively high, which is a worrying trend.
As for dentists, data shows that vacancies for dentists in the Department of Health have jumped nearly nine times over the past four years. As of the beginning of this month, the vacancy rate for dentists was 27.6%, meaning that one in every four positions is vacant. In other words, the number of dentists is over a hundred people short of the normal establishment. The government projects that the problem of dentist shortages will continue until 2035.
Hong Kong's faculty of dentistry is among the best in the world, repeatedly ranked among the top three in university dentistry schools around the globe. However, the city has a serious shortage of dentists. There are currently 2,576 registered dentists and 309 specialist dentists residing in Hong Kong, translating into just approximately 3.8 dentists per 10,000 people. This is lower than the average of around five dentists per 10,000 people in developed regions. Even more serious is the imbalance between the public and private sectors.
Dentists in Hong Kong's public sector are mainly employed by the Department of Health. According to government figures, the overall ratio between dentists in public and private practice is currently about 1:3, meaning that for every four dentists, only one works in the public sector. Documents submitted by the Health Bureau to the Finance Committee show that the public-private practice ratio for newly graduated dentists in 2020/21 was 1:5.6, which further expanded to 1:9.7 and 1:12.8 respectively in the two years that followed. According to some people in the dental sector, dozens of newly graduated dentists used to join the Department of Health every year. Last year, however, the number dropped to single digits.
The worsening of dentist shortages in the public sector over the past few years has been related to multiple factors. On the one hand, the huge number of dentists employed by the government in the 1980s have retired one after another in recent years. The wave of emigration has also created more vacancies. On the other hand, due to the lockdown during the COVID-19 pandemic, Hong Kong has seen huge demand for local dental services over the past three years. Poaching of dentists from the private sector with high pay has also exacerbated the departure from the public sector.
With the integration of the Greater Bay Area, it is cheaper to travel northward to receive dental care, which many Hong Kong people find attractive. However, the government has a duty to provide more suitable and adequate dental services for local disadvantaged people with financial difficulties. In last year's Policy Address, the government announced that it would partner with non-governmental organisations, such as charitable organisations and social welfare institutions, to promote relevant work. However, there have been no further details yet, and it remains unclear how the manpower problem will be dealt with. It is hoped that the government will come up with a practical and viable plan as soon as possible that will benefit the disadvantaged from the lower strata of society.
明報社評2024.04.18：加強牙科服務助弱勢 多管齊下紓人手不足
本港牙醫短缺，公營牙科情况尤其嚴重，衛生署牙醫空缺率高達27%，由學童牙科診所到「街症」牙科服務，皆受影響。
立法會特別財委會昨天審議醫衛局開支。局方資料顯示，2023/24年度全職醫生、護士及專職醫院人員流失率介乎6.1%至9.5%，截至今年3月底，醫管局聘請了138名非本地培訓醫生，預料年底會增至200人。醫衛局長盧寵茂形容，人手流失情况整體有所改善，惟年輕醫護人員流失比率偏高，趨勢令人擔心。
牙醫方面，數據顯示衛生署過去4年牙醫空缺急增近9倍，截至本月初，空缺率達到27.6%，即每4個牙醫職位，便有1個懸空，距正常編制尚欠過百人。根據政府推算，牙醫短缺問題將持續至2035年。
本港擁有世界頂尖的牙醫學院，全球大學牙科排名多次躋身三甲，可是牙醫人手卻嚴重不足。現時本港有2576名居港註冊牙醫及309名專科牙醫，即每萬人口只約有3.8名牙醫，低於發達地區平均每萬人口約有5名牙醫的水平，公私營失衡情况更非常嚴重。
本港公營牙醫主要受僱於衛生署，根據政府數字，目前整體牙醫公私營執業比例約為1：3，意即每4名牙醫只有1人在公營牙科服務。醫衛局提交財委會的文件顯示，2020/21年度新畢業牙醫公私營執業比例為1：5.6，其後兩個年度更分別擴大至1：9.7和1：12.8。有牙科界人士指出，以往新畢業牙醫每年約有數十人加入衛生署，去年卻跌見單位數。
過去數年公營牙醫短缺情况惡化，涉及多重因素。一方面，政府1980年代聘用大批牙醫，近年陸續退休，移民潮亦令空缺擴大；另一方面，香港疫下封關，本地牙科服務在這3年的需求非常龐大，私營市場高薪挖角，也加劇了公營牙醫流失。
大灣區融合，「北上睇牙」相對便宜，吸引不少港人，然而政府有責任為有經濟困難的本地弱勢社群，提供更適切更到位的牙科服務。去年《施政報告》宣布，政府將伙拍非政府機構，諸如慈善組織和社福機構等，推進相關工作，惟暫時未有更多詳情，亦不清楚人手問題如何處理，唯盼當局早日拿出一套切實可行的方案，造福基層弱勢。
■/ Glossary 生字 /
wastage : the loss of employees because they stop working or move to other jobs; the number of students who do not finish a particular course of study
exacerbate : to make something worse, especially a disease or problem
charitable : connected with a charity or charities