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SCMP Debate

One of the most controversial topics in Hong Kong today is the large number of mainland women who come to the city to give birth. Hoping to stem the tide, incoming chief executive Leung Chun-ying has proposed a 'zero' quota to stop pregnant mainland women who do not have Hong Kong husbands from giving birth here. In the latest SCMP debate, we asked local lawmakers and mainland and Hong Kong women how they view the issue, what impact it has on them and what solutions they propose. The mothers did not want their faces shown for privacy reasons.

Regina Ip Lau Suk-yee

Lawmaker and former secretary for security

Q1 Incoming chief executive Leung Chun-ying has proposed there be a 'zero quota' for mainland women who don't have local husbands giving birth in Hong Kong. Will this and other administrative measures be effective in preventing such women giving birth in the city? What other administrative measures should the next government introduce?

The question of whether administrative measures would be adequate to counter the influx of mainland pregnant women was raised at a meeting the chief executive-elect held in early April with prominent lawyers to discuss the right of abode issue. The legal experts confirmed that the Hospital Authority's quotas for mainland pregnant women had no legal basis. It remains unclear how the Secretary for Food and Health can compel private hospitals to stop admitting mainland women in order to give priority to local women, or require them not to exceed certain quotas, in the absence of specific legal authority to do so. The private hospitals could ignore the secretary's instruction if they are determined to play hardball. Be that as it may, it appears that Mr Leung's warning that there would be a zero quota next year, and that he could not guarantee that mainland babies born in Hong Kong would have the right of abode, has had some deterrent effect. This is in spite of the fact that his comments were not based on any discernible legal provisions and he has not yet assumed office as chief executive!

As for stopping pregnant women at control points, immigration officers are relying on existing provisions in the Immigration Ordinance. But it is not easy to detect pregnant women by adopting a simple 'eyeball test'. Although some health officials are stationed at some control points, the government needs to deploy a lot more of them for much longer hours to enhance the ability of frontline staff to intercept pregnant mainlanders. Moreover, it is hard even for trained health officials to determine whether a woman is pregnant beyond a certain term without the necessary medical equipment. So reliance on administrative measures alone would prove elusive in stopping the entry of mainland pregnant women seeking the right of abode for their children.

Q2 Some lawmakers and commentators argue that administrative measures are not enough. They point out that apart from the influx of women coming to give birth, there is the issue of right of abode for children born in Hong Kong to mainland mothers who do not have local husbands. Should the next government take measures through other channels, such as an interpretation of the Basic Law, to tackle the issue?

The Court of Final Appeal's judgment in the Chong Fung Yuen case in July 2001 dismissed the administration's concerns that conferring the right of abode on mainland children born in Hong Kong would lead to an influx of such children. The court noted that during the 43 months between July 1, 1997, and January 31, 2001, a total of 1,991 Chinese residents born in Hong Kong would qualify as permanent residents within Basic Law 24(2)(1) if the Director of Immigration's contention on that article were rejected. The number did not suggest to the court that there would be an immediate influx. Indeed, it took a few years for the news to spread in the mainland before the numbers started to rise significantly after 2005. But there is no doubt the influx in the past few years has been fuelled by the allure of the right of abode, together with all the concomitant benefits such as free compulsory education.

The solutions on the table include amendments to article 24(2)(1) and any other relevant provisions of the Basic Law to spell out in detail under what circumstances Chinese nationals born in Hong Kong would acquire the right of abode; an interpretation of the relevant provisions of the Basic Law by the Standing Committee of the National People's Congress, or local legislation.

Mainland officials have pointed out on more than one occasion that they do not favour amending the Basic Law, as they see nothing wrong with it but problems with the Court of Final Appeal's interpretation of the legislative intent of the relevant provisions of the Basic Law. Thus an amendment to the Basic Law is unlikely to be acceptable to the mainland authorities. The chief executive-elect is fully aware of sentiment of the legal profession that interpretation by the Standing Committee should be adopted only as a last resort, if all other possible measures have proved unfeasible. As for local legislation, it would go against the law to introduce legislative amendments which would contravene the judgment of the Court of Final Appeal. But the rising middle class families of the mainland are unlikely to be discouraged from arranging for their children to be born in Hong Kong unless it is clear to them it would not ensure right of abode. So at the end of the day, some local legislation, which is in conformity with the Basic Law and does not contravene the Court of Final Appeal's judgment, would be necessary to put a definitive end to this decade-long saga.

Leung Ka-lau

Medical sector lawmaker

Q1 Incoming chief executive Leung Chun-ying has proposed there be a 'zero quota' for mainland women who don't have local husbands giving birth in Hong Kong. Will this and other administrative measures be effective in preventing such women giving birth in the city? What other administrative measures should the next government introduce?

Mainland women giving birth in Hong Kong is an issue of the Basic Law and population policy; it should be resolved by legal measures. Administrative measures can only be partly effective. The influx of mainland mothers surged after the Court of Final Appeal ruled that Zhuang Fengyuan, a baby boy born in Hong Kong to mainland parents, should be a permanent Hong Kong resident in accordance with Article 24 of the Basic Law and implementation of the Individual Visit Scheme in 2003, which allows mainland travellers to visit Hong Kong on an individual basis.

As a result, numerous mainland families prefer to give birth in Hong Kong so that their children may get the status of a Hong Kong resident, which is perceived to be advantageous. Some parents are also eager for their second child to be born in Hong Kong because of the mainland's one-child policy. The number of mainland mothers increased from 8,137 in 2000 to 26,132 in 2006, of whom 9,767 attended accident and emergency departments (AED) of public hospitals without booking.

In early 2007, to deter mainland mothers from attending AEDs at the last minute, the government implemented a 'confirmation certificate' policy, requiring mainland mothers to obtain the certificate from a hospital after an ante-natal check and reserving a bed, otherwise they would be denied entry to Hong Kong at an advanced stage of pregnancy.

Since then the number of mainland mothers attending AEDs has been greatly reduced, but the total number continued to rise to 43,982 in 2011. In response to public concern, last year the government limited the number of 'confirmation certificates' to 34,400 for 2012. As the public is still not satisfied, chief executive-elect Leung Chun-ying proposed there be a 'zero quota' on giving birth in Hong Kong by mainland women who do not have local husbands.

However 'zero quota' only means that no 'confirmation certificate' will be issued. The certificate serves more as an entry permit than as a receipt for obtaining medical services. Although private and public hospitals will not offer bookings for mainland mothers, if they manage to enter and stay in Hong Kong by whatever means in an advanced stage of pregnancy, the hospitals will still provide medical services to them for ethical and humanitarian reasons. Their babies will be Hong Kong residents.

Therefore, 'zero quota' will rely solely on immigration measures, for example, to closely monitor all cross-border vehicles which may transport mainland pregnant women; enhancing and reinforcing interception of non-local pregnant women and promptly sending them back to the mainland; combating agencies who may assist in smuggling pregnant women into Hong Kong; and monitoring hotels or guesthouses which may house pregnant women. It is expected the number of mainland mothers will decrease, but no matter how tight the controlling measures, some mainland mothers will still take the risk and resort to various means to enter and stay in Hong Kong. It is not illegal to enter Hong Kong without disclosing that they are pregnant, or because they are pregnant; and the penalty for overstaying cannot be too serious compared with the benefits their babies may obtain. The proposed policy of 'zero quota' is therefore not an effective measure to prevent the influx of mainland women from giving birth in Hong Kong, largely because the fundamental legal issue has not been resolved.

Q2 In what ways should private hospitals and private obstetric doctors, which have been relying heavily on providing obstetric services for mainland women who do not have local husbands, diversify their business following implementation of 'zero quota' policy?

In 2011, 48,924 women gave birth to their babies in private hospitals in Hong Kong, of which 33,465 (68.4 per cent) were non-local women. The same year, the total number of patients discharged from private hospitals was 387,900, so non-local pregnant women contributed 8.6 per cent to the hospitals' business in term of number of patients discharged. Assume that the government successfully stops all mainland mothers from coming, then the discharge rates of private hospitals would be reduced by only less than 10 per cent on average. Since these figures include spouses of Hong Kong residents which may be allowed to come, the scale of the impact will be further diminished. In addition, the demand for other specialties is increasing. Given reasonable transition time, private hospitals should be able to diversify into other services.

But for private obstetric doctors, the 'zero quota' policy will on average take away 70 per cent of their obstetric clients. As they have been trained and worked in obstetrics and gynaecology for years, it will be difficult for them to switch to a different specialty. While they may try to diversify their business by providing more gynaecological services, the demand will be a lot less than for current obstetric services. Assuming the same split of market share as other specialty services between private and public sectors, private gynaecological services will account for about 15 per cent of the share in the city. As a result, private obstetricians will eventually find themselves having quite a lot of idle time after implementation of the 'zero quota' policy.

It seems there is not much private obstetricians can do. Nevertheless, the excessive manpower should be taken in account when estimating the demand to train new obstetricians.

Abbie Chan

A pregnant mainland woman who does not have a Hong Kong husband

Q1 Will the administrative measures recently introduced by the Hong Kong government discourage you from giving birth in Hong Kong?

No matter how high the doctors' fees or how strict [chief executive-elect] Leung Chun-ying's new administrative measures, I will try my best to give birth in Hong Kong because of the automatic right of abode given to children of mainland parents born there. I know that right was upheld in a Court of Final Appeal ruling in Hong Kong, which Leung cannot scrap overnight.

I have been married for four years and have a three-year-old son. I'm the only child of my parents and deeply understand how lonely it is to be an only child. But it's almost impossible for me to have a second child born on the mainland because my husband works for a Beijing-based, state-run enterprise. Under the current one-child control policy in China, if we have another child my husband will lose his job and all his colleagues will be punished for being connected to him. Giving birth outside the mainland is the only choice for us.

I found I was pregnant on April 6. I made more phone calls than I could count to Hong Kong hospitals, to book an appointment with a doctor for April 18. I feel very lucky that I caught the last bus [booking a Hong Kong obstetrics bed], after [chief executive-elect] Leung Chun-ying said mainland women without a Hong Kong husband will not be allowed to give birth at a hospital in the city next year. But now my feelings are confused about whether my choice will be right for my unborn baby.

I flew to Hong Kong on the morning of April 17 and was given a chilly look at the border check-point from a female Hong Kong customs officer. 'One more shuang fei [a mainland woman without a Hongkonger husband],' I heard her say to her workmate. I feel sad that I have to go to Hong Kong to give birth since we - non local mothers - have become objects of public anger and Hong Kong is no longer friendly to us. However, Hong Kong is still my top choice because it's the most practical place for mainland mothers who violate the mainland's one-child policy to deliver their baby legally.

It's really a mess now for mainland women trying to book hospital beds in Hong Kong maternity wards this year after Leung Chun-ying announced his zero-quota policy. The fees have risen dramatically in the past year. I have heard many doctors are raising their prices three-fold and even five-fold. They are taking advantage of our misfortune to fill their pockets. It may not be illegal in Hong Kong, but it's really a shame for the city's health care community, which was once well-known for being professional and noble-minded.

From next year, no more babies will be born in Hong Kong to mainland mums. I hope Leung and his Hong Kong government will respect human rights and the justice system will treat our babies fairly. They are part of the Hong Kong populace, with the social benefits that come with Hong Kong residency under the rule of law in Hong Kong. Please call our babies 'born-in-Hong-Kong' and do not hurt them by calling them 'children with non-local mothers'.

The children have done nothing wrong. Their parents went to Hong Kong to deliver them when the Hong Kong government catered to their mothers, saying 'we welcome you to use Hong Kong private hospitals and we welcome your children to be Hong Kong residents'. Now the government just switches its policy.

Q2 As an expectant mother, do you think acquiring permanent residency in Hong Kong will make a difference in the life of your child? Do you have any plans to raise your child in Hong Kong if he or she is born in the city?

I still prefer to believe that acquiring permanent residency in Hong Kong will make a better life for my unborn baby even though Hong Kong is full of complaints against mainlanders. But there's no doubt that people there enjoy much better education, freedom, medical care and food safety than on the mainland.

I also believe our children will contribute well to Hong Kong instead of being a burden. Most of us are from the affluent middle class and will definitely educate our children well, no matter where he or she grows up.

I expect to give birth in December. Soon after that I will return to Beijing with my new-born baby. I have no idea if I will let the child return to Hong Kong for an education. On the one hand I don't want to be separated from the child and have him live alone in Hong Kong.

On the other hand, I'm worried that Leung's speeches will increase discrimination against mainlanders born in Hong Kong.

In fact, Leung's stance has already encouraged more prejudice in Hong Kong. On April 18 I had lunch in Hong Kong with a friend who married a Hong Kong man and has been settled in Hong Kong for years. She told me her Grade Four daughter had a test recently with a question involving shuang fei. I'm so shocked that her elementary school, in Sheung Shui, would ask children such a sensitive examination question full of discrimination.

The children are innocent. Why teach them to discriminate? I'm afraid that, in future, more Hong Kong children will be taught this, and be tempted to pay such insults to classmates with mainland mothers. That would be very hurtful to a young child.

If Hongkongers remain full of complaints and anger in future, and keep saying our children are using up the city's resources, I definitely will not let my baby come to Hong Kong.

At this moment, first and foremost, I want to give birth to my second child in a city where I can escape the mainland's one-child policy. And Hong Kong is the most convenient and practical place to do that.

Zhang Jie

A pregnant mainland woman with a Hong Kong husband

Q1 Do you think the new administrative measures recently introduced by the Hong Kong government will discourage you from giving birth in Hong Kong?

I'm a 25-year-old native of Shaoyang city, Hunan . My first child, a son, was born in Hong Kong in 2010. My [Hong Kong] husband is a successful entrepreneur with several plants in Hunan. I had planned to give birth in Hong Kong to my second and future third children. However, Leung's [chief executive-elect Leung Chun-ying] decision ruined my plan as my expected date of childbirth will be mid-January next year. [For 2013, there are no public hospital quota places for mainland women to give birth in the city, even if they have Hong Kong husbands.]

Hong Kong was once the top choice for my family to migrate to: the city's cultural and geographic proximity to the mainland, its world-class medical system and the wide-acceptance of its travel documents.

A human being should enjoy the right of childbirth. Hong Kong was once a haven for poor mainland mothers to enjoy such a human right by encouraging them to give birth here and granting their babies the city's citizenship. Now, it is total one-party rule to close the door, as imposed by the mainland authorities.

I'm thinking of giving birth in the United States. It costs about 150,000 yuan (HK$183,730) to deliver a baby there, which is affordable for many middle-class families on the mainland.

And I will drop the plan to migrate to Hong Kong. I may turn to Singapore or Canada instead. I will also not let my son study in Hong Kong as we are so disappointed. Hong Kong is no longer a fair, democratic and free society, as we once thought. Actually, its government can change its population policies to suit its purpose. And society becomes not friendly but mean to mainlanders.

Q2 As an expectant mother, do you think acquiring permanent residency in Hong Kong would make a difference in the life of your child? Do you have any plan to raise your child in Hong Kong if he or she is born in the city?

I planned to buy one or two apartments in Hong Kong and move to the city three or four years later. At that time, three of my children would be Hong Kong residents and I would let them grow up in Hong Kong.

Hong Kong is very convenient for us. I can live with the children there. Their father and grandparents could take the high-speed train from Hunan to Hong Kong every month. We can shop and have good weekends and holidays there. We can also take good care of our factory in Hunan and also develop a branch in Hong Kong for overseas orders.

In my original plan, my children could have a better and more international education in Hong Kong. They could learn to speak Putonghua, Cantonese and English quite well. With Hong Kong residency, they could travel overseas at any time.

However, I will change the plan because of Leung's comments about the children born in Hong Kong to mainland parents. I can see potential discrimination against those children in future, starting from Leung's stance to every Hong Kong citizen. We cannot speak Cantonese and we would be treated as non-local people. I won't let my children grow up in such an atmosphere. Hong Kong once had a free and open society with world-class education and healthcare systems that were the envy of many countries. If it is not the Hong Kong we respected, why would we go there like beggars?

Kelly Chan Po-king

Hong Kong mother of six-year-old son and member of local mothers' group

Q1In what ways do babies born to mainland women without Hong Kong husbands squeeze resources available to local parents and their babies?

When I was giving birth to my son in 2006, the influx of mainland mothers rushing to the city to give birth was not in the spotlight. The problem was merely starting to surface and the public was not aware of the seriousness and implications of it.

But local mothers competing for obstetric services experienced directly how many such cases there were. I gave birth in a public hospital and the obstetric wards were 90 per cent full. To my surprise, there were many fewer local mothers than I had expected.

Up to 80 per cent of the mothers with whom I was learning how to feed babies were speaking Putonghua. From what I have heard, the proportion has become much bigger in recent years. My friends tell me it is very hard to reserve an obstetric bed in a private or public hospital. They have to do it as soon as they know they are pregnant.

Those whose pregnancy took them by surprise would be asked by the hospital staff, 'Why are you booking so late?', when in fact they were only a few months pregnant.

Other than maternity services, I am also concerned about how my son's future will be affected. If most of these mainland babies stay in Hong Kong for their education, there may not be enough places in schools, or students will have to squeeze into more congested classrooms.

When I was young, we had a class of 40 students and I know how difficult it was for the teacher to take care of us and how it could affect our studies.

That is why the primary schools now have classes with only about 33 pupils, and as a mother I would love to see the number cut further. I would not like to see a return to big classes.

Q2 Do you think the Hong Kong government is doing enough to guarantee sufficient resources for babies born to local women?

The government has always said it welcomes mainland babies to come to Hong Kong to provide new blood, and it has long issued policies along these lines.

It is true that Hongkongers now have less incentive to give birth due to their stressful lifestyles. The burden of a mortgage is great, and being a working mum means the need to hire a maid to take care of the children.

Welfare during pregnancy is also not good when compared with many developed countries. That is why I was not keen on having another baby after my son was born - it was often said 'one is enough, two may be too much', and I am sure many local mothers feel the same.

So the government may be right in expecting shrinking numbers of local newborns.

But more population planning is needed if the government opens the door to mainland babies, and it seems the number may have been getting out of hand in recent years.

Almost half of my sons' schoolmates in kindergarten are from the mainland, including new arrivals. We are not sure whether the government is ready for the influx.

As for the 'zero quota' for mainland mothers imposed on private hospitals recently, I am not sure whether it means there will be a policy change by the new government.

We are still looking keenly for some concrete work to be done. It is too early to draw a conclusion now on whether the change is helpful.

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