Tuen Mun Hospital has the worst record among public hospitals for elective surgery and the second worst in emergency operations for the fifth year in a row.
That's the verdict of the Hospital Authority's surgical outcomes monitoring and improvement program.
But a spokesman for Tuen Mun Hospital said the demand for surgery has risen with the increasing - and aging - population in Tuen Mun.
The Hospital Authority evaluated the surgical operations of 17 public hospitals, comparing their death rates and the expected death rates from 23,700 surgeries from 2012 to 2013.
Tuen Mun Hospital had the worst performance in elective surgery as its death rate was higher than expected.
It was followed by United Christian Hospital, second to last, and Pamela Youde Nethersole Eastern Hospital, third to last.
For emergency operations, Prince of Wales Hospital was the poorest, with Tuen Mun Hospital second to last and Queen Elizabeth Hospital third to last.
Prince of Wales' performance fluctuated because its death rate in elective surgery was lower than expected but it was the worst in emergency surgery.
The top three in emergency operations were Yan Chai Hospital, Queen Mary Hospital and Pamela Youde Nethersole Eastern Hospital, with death rates lower than expected.
Tung Wah, Ruttonjee and Prince of Wales hospitals were top in elective operations.
The occupancy rate of beds in the surgical ward of Tuen Mun Hospital was the highest at 106 percent.
The Hospital Authority's chief manager for quality and standards Alexander Chiu said Tuen Mun Hospital should have more beds. He suggested that Pok Oi Hospital in Yuen Long could do emergency surgery to relieve the heavy load at Tuen Mun.
He added Prince of Wales did not use its intensive care unit well, with admission after emergency operations the lowest at 18.6 percent.
A spokesman for Tuen Mun Hospital said the department of surgery has reinforced its emergency operations.
The hospital will try its best to increase the beds in surgical wards, number of operations and manpower.
The occupancy rate of beds in surgical wards exceeds 100 percent, which affects care of patients before and after operations.
"To improve the long waiting time for operations in our hospital, the surgery department in the middle or long term will set up surgical emergency services, and continue to transfer appropriate operations to Pok Oi Hospital," he said.
Alex Lam Chi-yan, vice chairman of the Hong Kong Alliance of Patients Organization, said he was concerned about the situation at Tuen Mun.
"The report showed the death rate is higher than the expected number, which meant more failures came in operations," he said.
"The Hospital Authority should quickly deal with the situation, including to send patients to Pok Oi Hospital and mobilize doctors to different hospitals."
Frontline Doctors' Union chairman Seamus Siu Yuk-leung said the results showed a systemic problem at Tuen Mun.
"The immense workload led to the turnover of some experienced doctors," said Siu. "This is a vicious circle which affects the quality of service provided."