Optometrists must be in core team at district health hubs

The Hong Kong public would benefit from an expansion of publicly funded services to include more health professions. These include the services highlighted in the Primary Healthcare Blueprint, such as district health centres (DHC) and publicprivate partnership programmes. I am excited by the progress already achieved in the effort to increase the accessibility of healthcare services.

However, as proposed hubs for healthcare services and resources, DHCs should include all primary care providers in the directly accessible core team. Currently, optometrists are absent, alongside dentists and Chinese medicine practitioners, even though some allied health professionals are included, such as physiotherapists. Whether on the grounds that optometrists are primary care providers or that allied health professionals are already included, optometrists’ services should be directly accessible to the public through each DHC’s core team.

This can be achieved in several ways. One point of reference is the Jockey Club Cadenza Hub, which provides directly accessible comprehensive eye assessments and diagnoses by optometrists. With this already successful operating system in mind, DHCs may consider including one part-time or full-time optometrist in each of the 18 districts.

To ensure the most efficient distribution of resources and limit unneeded expenses, the optometrists can provide their services through appointments, being available on a specific day every week for face-to-face assessments and consultations at the DHC or even remote consultations.

Additionally, the government should consider expanding its range of public-private partnership programmes to include new ones with other primary care providers, such as optometrists, in addition to the programme it already has with family doctors.

Poor vision is associated with systemic diseases, such as diabetes and hypertension, so for some people, their optometrist may open the door to much-needed care. The current care pathway for public eye care – which requires a patient to get a referral from government-run outpatient clinics – unnecessarily burdens family doctors in the Hospital Authority’s clinics with having to triage patients.

As primary care providers, optometrists provide more direct, accessible and efficient care, which could address most eye care needs and refer patients to specialist care at the appropriate time. Therefore, utilising the capabilities of optometrists is another way to reduce the workload of public-sector family doctors.

Accessibility should be key in Hong Kong’s healthcare. Optometry should be better reflected in a contemporary blueprint for sustainably developing primary healthcare services in Hong Kong, considering the growing need for healthcare. George Woo, emeritus professor, School of Optometry, Hong Kong Polytechnic University