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Thursday, March 21, 2019, 10:39
HK-managed hospitals in Bay Area can ease the city’s healthcare woes
By Paul Yeung
Thursday, March 21, 2019, 10:39 By Paul Yeung

Paul Yeung says medical talent scheme can be applied in HK-run hospitals in the Bay Area  

Health is a basic need and right of all people. That’s why public health is a primary public concern all over the world — including Hong Kong. The issue of problems and deficiencies with the health service is not new in our city. Facing a growing aging population, Hong Kong’s public health system is under increasing pressure. During the recent seasonal flu crisis the system was placed under enormous strain and faced more problems. This subsequently caused considerable anxiety and concern in Hong Kong society.

There are two core problems faced by the local public health system. The first one is long waiting times. One of the most typical examples is that a patient with cataracts can expect to wait for 162 weeks before he or she has a chance to see an eye specialist at a hospital in the Kowloon East area. The second one concerns great pressure being placed on doctors. It is reported that it is usual for a doctor to work 12 hours straight without taking any break in regular days. 

There are several reasons for these problems. One is the structural imbalance between the public and private health systems. The public hospitals and institutions run by the Hospital Authority serve about 90 percent of local inpatients, but they employ only around 40 percent of local doctors. Some blamed inefficient bureaucracy and heavy workloads in public hospitals for the high turnover rate of doctors and medical staff in the public health system. 

The University of Hong Kong-Shenzhen Hospital is seen as a model for future Hong Kong-managed hospitals in mainland cities ... With the Bay Area development and the idea of building a one-hour living circle in the city cluster, we now should also explore how it can help Hong Kong patients, especially those in non-emergency cases

To fix this problem, the government is trying to strengthen human resources training and enhance healthcare quality and efficiency by earmarking more funds in its latest budget. However, these measures are not enough. The crux of the problem is the shortage of public health staff. The supply of doctors has not kept pace with demographic trends and the increasing demands of a growing aging population. According to a strategic review of healthcare staff planning released by the Food and Health Bureau in 2017, Hong Kong will be short of 500 doctors in 2020. While the two medical schools in Hong Kong are recruiting more medical students in the coming academic year, it takes seven years to train a doctor and even 13 years for a specialist. 

Many people are undoubtedly very concerned about the situation facing Hong Kong’s public health system. However, the picture will change if we think outside the box and set our sights on the Guangdong-Hong Kong-Macao Greater Bay Area development strategy. We can explore how the strategic plan can help resolve deficiencies in the public health service in Hong Kong in the long term. 

Let’s take the University of Hong Kong-Shenzhen Hospital (HKU-SZH) as an example. This hospital opened in 2012 and is seen as a model for future Hong Kong-managed hospitals in mainland cities. However, its operational model has focused on how the hospital can serve mainland residents. With the Bay Area development and the idea of building a one-hour living circle in the city cluster, we now should also explore how it can help Hong Kong patients, especially those in non-emergency cases. 

The core element for the success of such an operational model is a flexible and open-minded mechanism for recruiting overseas medical talents. While the Medical Registration (Amendment) Bill 2017 passed by the Legislative Council in 2018 has extended the period of limited registration of overseas doctors from not exceeding one year to not exceeding three, more aggressive measures to bring in more overseas doctors have been thwarted after an attempt to reform the Medical Council of Hong Kong was derailed by a legislative filibuster in 2016. Some suggest Hong Kong should learn from Singapore. The Lion City allows graduates from 158 medical schools in 28 countries and territories to apply for conditional registration and to work in an approved healthcare institution. Such a measure can be pilot tested first in the University of Hong Kong-Shenzhen Hospital — instead of waiting for further medical reforms in Hong Kong. 

The medical talent scheme is one solution. To better serve Hong Kong residents, other facilitation measures are needed. For instance, the medical welfare entitled to Hong Kong residents should be made available to them in mainland cities in the Bay Area. The experience of HKU-SZH, which launched a similar scheme in 2015 to allow the cross-boundary use of Hong Kong Elderly Health Care Voucher, is worth learning from. Moreover, the Hospital Authority signed a collaboration agreement on the “Hong Kong Patient Referral Project” with Shenzhen in 2011 to facilitate the transfer of medical records of Hong Kong residents. The scheme can be extended to let Hong Kong hospitals transfer non-emergency cases to the HKU-SZH.

“Where there is a will, there is a way”. The public will is such that the capacity of the public health system should be expanded to meet the growing needs of Hong Kong people. No patient should be left unattended. We should explore the feasibility of building more “Hong Kong model” hospitals such as the HKU-SZH in the Bay Area.

The author is research officer of the One Country Two Systems Research Institute.


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