Before his departure, Dr Michael Leung stumbled upon an old email from 2013. "I was asked to give some advice on HKCH's operating theatres. I didn't expect it would become such a huge responsibility later on. I had to vet a pile of building layout every week. It also entailed equipment procurement and nitty gritty like floor loading and sockets!"

An even more painstaking task was to re-organise the paediatric surgery network. He said, "To get stakeholders' support, we had to offer incentive and trust. Otherwise it'd just be wishful thinking. The final consensus was that there should be three paediatric surgery centres in Hong Kong. Queen Mary Hospital and Prince of Wales Hospital would handle secondary and emergency cases (e.g. appendicitis, intussusception, peritonitis) in their respective regions, while HKCH would deal with complex cases (e.g. oncological, neonatal, cleft lip and palate surgeries) across the territory, as well as emergency cases in its region."

After a decade's effort, this vision has been partially fulfilled. For example, the paediatric surgery service of Queen Elizabeth Hospital and United Christian Hospital was already translocated to HKCH. Another recent milestone is the clear delineation of six sub-specialties (i.e. urology, cleft surgery, surgical oncology, hepatobiliary surgery, thoracic surgery, and vascular anomalies) in the governance structure. Every team now consists of surgeons from HKCH, PWH and QMH who serve patients together. Each team also works on its own service development, quality improvement, training and research.

Dr Leung concluded, "We have only covered the first 10km of the marathon. Demand, manpower, resources and technology determine how close the finish line is. These factors will keep changing."

▲Dr Michael Leung said, "HKCH is a whole new world to me. Multidisciplinary collaboration is so strong with everybody sharing their expertise selflessly. All teams have a share of our patients, including appreciation and responsibility."

Dr Peter Tam, the new Chief of Service, agreed, "I won't underestimate the difficulty, but the direction is definitely correct. System integration is the first step, but what we need is true union. Colleagues are most concerned about having clinical autonomy and respect. I will take a decentralisation approach so that our teams can play to their strengths and have a sense of belonging."

His immediate plan is to set up a regular platform where all team heads can meet to discuss policies and resolve differences in a more transparent way. Also, he targets to gather more new blood to ensure manpower continuity, "Talents have to be groomed early. When they come to HKCH for basic surgical training, we will try to inspire them by offering more interesting exposure, and arrange mentors to support their various needs. We hope more people would choose to become paediatric surgeons."

▲Dr Peter Tam said, "Early succession planning is important for a department. My job to find a suitable successor starts now."

▲Staff of Paediatric Surgery