More than 30 organisations expressed interest when the government said it would offer four sites for new private hospitals to address an imbalance of supply and demand between the majority of doctors, who work in the private sector, and the 90 per cent of patients who use public hospitals. In the event, when the deadline passed for bids on the first two sites, at Wong Chuk Hang in Aberdeen and Tai Po, 27 local and overseas investors, including private medical companies and universities, had dropped out. In part they blamed bid conditions, including that 50 per cent of beds must be for Hongkongers and no more than 20 per cent can be for expectant mothers. This did not deter India-based Fortis Healthcare, which runs the city's Quality Healthcare clinics, from bidding for both sites or the University of Hong Kong and Raffles Medical Group of Singapore from bidding for Wong Chuk Hang.

The government's conditions do not seem unreasonable in terms of improving health-care delivery and choice for Hongkongers. Obstetrics was likely the sticking point in most cases. Private hospitals have invested heavily in this area to meet the demand from mainland women, but new chief executive Leung Chun-ying has vowed to rein in the influx amid local sensitivities about the availability of beds.

Taking Fortis' plan to provide 400 beds at each site, 80 could be for obstetrics. If each were used once a week, that adds up to more than 4,000 confinements a year, or 16,000 over four hospitals of the same size. How many obstetrics bookings were they expecting? Perhaps Leung's policy was a bigger deterrent than the 20 per cent rule. It remains to be seen if the other two sites at Tseung Kwan O and on Lantau Island attract more bids. It would cost the government nothing politically to liberalise the conditions a little. At the end of the day, the effectiveness of the proposed voluntary health insurance scheme for Hongkongers could matter more to private hospitals.