APPENDIX E

Letter of 11^th September 1997 to the Chief Executive
tendering advice on the upgrading of entry
requirement of the X-ray Assistant grade

11^th September 1997

The Honourable TUNG Chee Hwa
The Chief Executive of the
Hong Kong Special Administrative Region
of the People's Republic of China
Chief Executive's Office
Hong Kong

Dear Sir,

Proposed Upgrading of Entry Requirement
of the X-ray Assistant Grade

We have been invited by the Administration to advise, under Clause 1(b) of our Terms of Reference, on its proposal to upgrade the entry requirement of the X-ray Assistant (XRA) grade in the Department of Health, from "Grades not requiring a full School Certificate" to Group I of the "Technician, Supervisory and Relates Grades".

BACKGROUND

2.Created in 1965, the XRA grade is responsible for chest radiography in the Tuberculosis and Chest Services in the Department of Health. Since entry qualification for the grade was set at Form IV level, the grade has been grouped under "Grades not requiring a full School Certificate". A new rank of Senior X-ray Assistant (SXRA) was created in 1981. To qualify for promotion, XRAs are required to possess a Diploma issued by the Hong Kong Radiological Technician Association, or a Certificate in Diagnostic Radiography issued by the Hong Kong Polytechnic or equivalent, plus at least five years of satisfactory service in the grade. In recognition of the nature of work, the skills required and the hardship inherent in working in remote areas with the Mobile X-ray units, the pay scales of the XRA grade (from MPS Point 3 - 12 for the XRA rank and from MPS Point 13 - 17 for the SXRA rank) have a two-point lead above the pay norm for the group at both the minimum and the maximum points.

LEGISLATIVE REQUIREMENTS

3.With effect from 1st November 1996, only persons registered on the Register of the Radiographers Board are permitted to practise radiography. The registration is required pursuant to the commencement on 1st July 1995 of the Radiographers (Registration and Disciplinary Procedure) Regulation made under the Supplementary Medical Professions Ordinance (Cap. 359). This new legislative requirement, introduced for the better protection of the public, effectively spells an end to the career of XRAs and SXRAs who are ineligible for registration and for those who are eligible for registration, a de facto upgrading of their entry requirements by virtue of their registration as a diagnostic radiographer in the appropriate part of the Register. As a result of this change, Form IV is no longer an acceptable entry qualification for appointment to the XRA rank.

4.The criteria for registration as a radiographer are based on academic qualifications, post qualification experience and examinations conducted by the Radiographers Board. Persons with the recognized qualifications and experience can be registered in either Part I, II or III of the Register as appropriate. Persons who have no recognised qualification but are practising radiography before 1st July 1995 could apply for provisional registration not later than 30th December 1995. They have three chances to sit for an examination conducted by the Radiographers Board leading to provisional registration in Part IV starting from August 1996. Failure to pass the examination after three attempts within 21 months will render the individuals ineligible to undertake diagnostic radiography.

REGISTRATION OF XRAs AND SXRAs

5.As at 1st November 1996 (the date on which legislative control over the practice of radiography came into force), only 27 XRAs/SXRAs who were accepted for registration could remain in the service. The other five staff have either opted for retirement on abolition of office terms or have been transferred to another post. Details of the registration of the 27 officers are as follows -

ENHANCEMENT OF RADIOLOGY SERVICE

6.In order to meet increasing demand, the Department of Health has been expanding radiology service and enhancing the standard of radiographic service in terms of higher quality of radiographs, better protection for patients against radiation and better handling and management of patients during radiographic examination.

7.To cope with the Department's service plan and in compliance with the legislative requirements regarding the proper procedures for performing radiographic examinations, the duties and responsibilities of the XRA grade have been enhanced since 1st November 1996. In addition to carrying out the routine procedures of taking X-ray, XRAs have been given additional duties to ensure proper management and care of patients with varying disabilities and illnesses, and proper radiation protection for all patients. XRAs have also gradually taken up the new radiographic duties of taking plain X-ray of heads, limbs, shoulders and other parts of the body hitherto assumed by staff in the Radiographer grade.

8.To better equip serving XRAs for the new challenges, training has been arranged for them since July 1995. This included tutorial and briefing sessions, and attachment to other clinics to gain better knowledge of and exposure to different radiographic examination techniques and new technology. As a result, the quality of radiographs taken has improved and the need to call back patients for repeated radiographic examinations reduced.

9.In an attempt to shorten the waiting time for X-ray investigation and reporting to facilitate doctors' diagnosis and follow-up of patients, the Director of Health plans to set up two new Woman Health Centres by 2002/03 and 29 new Elderly Health Centres in the next two financial years. A general radiological centre in Kowloon Bay is planned to be set up in 1998 to provide general radiography, ultra-sound, fluoroscopy study and intra-venous urography services. A corresponding increase in radiological staff as well as enhancement of the scope of duties and flexible deployment of XRAs are needed to cope with these expansion plans.

THE ADMINISTRATION'S PROPOSALS

10.In the light of the change in entry requirement and having regard to the enhanced responsibilities of staff, the Administration proposes that the XRA grade be upgraded and reclassified under Group I of the "Technician, Supervisory and Related Grades" and its entry requirement revised to include registration in Part IV in the Register of the Radiographers Board. In line with the benchmark and common pay structure of the new qualification group, the Administration proposes that the pay scales of the XRA grade should be revised accordingly. To reflect more accurately the changed status and enhanced duties, the Administration proposes that the XRA grade be retitled as the "Radiographic Technician" ("放射技術員") grade. Accordingly, XRA will be retitled as "Radiographic Technician" and SXRA as "Senior Radiographic Technician". Promotion to the Senior rank requires a registration in Part III in the Register of the Radiographers Board, plus at least five years of satisfactory service in the grade.

11.There are two groups of grades under the "Technician, Supervisory and Related Grades" category. Group I consists of grades which require a Certificate from a Polytechnic (or equivalent) or completion of a recognised apprenticeship. Group II consists of grades transferred from the former Senior Artisan and Artisan segments on Model Scale 1. Having regard to the following two reasons, the Administration proposes that the new "Radiographic Technician" grade should be classified under Group I of the "Technician, Supervisory and Related Grades" -

12.The benchmark pay for Group I of the "Technician, Supervisory and Related Grades" group is set at MPS Point 6 (currently $11,170) and the maximum point of its third tier is normally set at MPS Point 14 (currently $18,010) and that for its fourth tier at MPS Point 20 (currently $24,135). The Administration considers that the pay scale of the XRA grade will be improved upon regrading and that, because of this, less weight should be given to job factors on skill and hardship in remote areas which account for the two-point lead of the pay scale of the XRA grade above the group norm. Notwithstanding the upgrading, the Administration considers that the job factor on dangerous duties through constant exposure to secondary ionizing radiation should be retained and that the new pay scales for the Radiographic Technician (RT) and Senior Radiographic Technician (SRT) ranks should be raised by one point above the group norm at both the scale minimum and the maximum.

13.The proposed pay structure for the new Radiographic Technician grade compared with the existing pay scale for the XRA grade and the pay norm for Group I of the "Technician, Supervisory and Related Grades" are as follows -

SALARY CONVERSION ARRANGEMENTS

14.The Administration proposes that serving XRAs who have been registered in Part I, III or IV should convert to the revised points on the Master Pay Scales in accordance with the normal conversion arrangements as follows -

15.XRAs who have not yet passed the examination leading to registration in Part IV would remain on their existing salary scale. When they have passed the examination, they should convert to the new pay scale according to the rules set out in paragraph 14 above.

EFFECTIVE DATE OF IMPLEMENTATION

16.Members of the XRA grade feel strongly that implementation of the upgrading proposal and the new pay scales should be backdated to take effect from 1st November 1996, the date the new registration requirement came into force.

17.The Administration has given careful consideration to this request since backdating is not normally allowed in pay reviews of individual grades, except in a major exercise involving service-wide reviews. On the other hand, the Administration notes that there has been no precedent cases where changes in entry requirement has been necessitated by a change in legislative requirement, as a result of which XRAs who were not qualified for registration were made redundant on 1st November 1996.

18.The Administration considers that the case of the XRA grade is unique and that it would be extremely rare to come across other grades in a similar situation. The Administration, therefore, supports the backdating request and considers that this will not lead to similar claims in future.

19.The Administration notes further that the upgrading proposal could have been submitted to the Commission for consideration before 1st November 1996. However, because of the time required for staff consultation and exploration of alternative options, submission could not have been finalised before 1st November 1996. One alternative option considered was to appoint all qualified XRAs to the Radiographer grade under the "Higher Diploma, Diploma and Related Grades" group. This was subsequently not pursued because the Administration found that not all XRAs were suitable for appointment and that there was a continued need to retain the XRA grade.

STAFF CONSULTATION

20.When consulted by the Administration, staff of the XRA grade fully accepted the upgrading proposal, the new pay scales, the new grade title and the expanded scope of duties. They requested, however, that the new pay scales should be implemented with retrospective effect from 1st November 1996.

COMMISSION'S VIEWS AND RECOMMENDATIONS

21.We agree with the Administration that the new legislative requirements have imposed a de facto change to the entry requirement for the XRA grade. The new qualification pitched at the Certificate level would justify the reclassification of the XRA grade under Group I of the "Technician, Supervisory and Related Grades". We see no objection to the Administration's proposal to adopt "Radiographic Technician" ("放射技術員) as the replacement title for the XRA grade nor to the new pay scales which have a one-point lead over the pay norm for the group at both the scale minimum and the maximum. The proposed conversion arrangement, which is in line with rules promulgated by this Commission in Report No. 25 (published in 1990), is also supported.

22.In proposing that the new pay scales should be implemented with effect from 1st November 1996 rather than from a current date, the Administration has departed from an established practice, known to and generally accepted by staff since the major service-wide grade review exercise undertaken in 1979. We have carefully examined the Administration's rationale for its current proposal. We note that the force of the Administration's argument is derived from the de facto change brought upon the XRA grade by virtue of the new legislative requirements. This is a unique situation which has never occurred before nor, in the Administration's view, is it likely to recur in future. It is fair to say that staff of the XRA grade, affected by the legislative requirements, do have a legitimate expectation of the new pay scales being implemented upon the coming into effect of the registration requirement on 1st November 1996, the date upon which the careers of XRAs who could not qualify for registration were curtailed. We agree, therefore, that the Administration's proposal for backdating, in the circumstances, is justified. We urge, however, that the Administration should explain this unique case to all staff associations to prevent misunderstanding and to ensure that the established practice of implementing decisions of pay reviews from a current date to be continuously enforced, except in unique circumstances, on which the Commission's advice must first be sought.

CONCLUSION

23.In conclusion, we support the Administration's proposals for the upgrading of the XRA grade. Specifically, we support that -