Unfair to speak ill of private doctors

PUBLISHED : Wednesday, 12 July, 2006, 12:00am
UPDATED : Wednesday, 12 July, 2006, 12:00am

In an article published on these pages recently, the University of Hong Kong's dean of medicine, Lam Shiu-kum, suggested that those who most want a change in Hong Kong's health-care system are private doctors and insurance providers - 'because they want a bigger share of the pie' ('Let the market drive reform', June 20).

In fact, nothing could be further from the truth. The Hong Kong Medical Association cannot speak for the insurance industry, but most private doctors would like to return to the status quo of 1990, when the Hospital Authority looked after 90 per cent of hospital patients and the private service cared for 85 per cent of outpatients. Unfortunately, the Hospital Authority now cares for up to 95 per cent of hospital patients and is aiming to expand its outpatient care.

While many of our members are Hong Kong University alumni and would agree with Professor Lam that its medical school has had 'a profound influence on health-care delivery', it cannot take all the credit. As frontline doctors, our members have played an equally important role. What is more, contrary to Professor Lam's argument, ethics committees, education programmes for postgraduates and records and peer-assessment are part of the system in many private hospitals.

He declared that 'the quality and pricing of private medicine are unacceptable', but poor-quality medicines are prescribed in public hospitals. Methyldopa, which is rarely used in the west these days because of its side effects, is commonly prescribed to public-sector patients for high blood pressure, and classical antipsychotics are still the first choice for schizophrenic patients, despite their side effects and the arrival of better drugs.

As for Professor Lam's claims that private medical charges are 'unpredictable', many general practitioners display their prices clearly in front of their clinics, and their average fees range from $80 to $160, inclusive of medicine.

Uttered often enough, claims like 'the public has much less confidence in the private service than in the public one' become accepted as truth, but no survey has asked why so many patients choose private doctors over the almost free public service.

Professor Lam shows ignorance with his view that the health-care system provides 'very little choice' and 'the rule is all or none'. Many patients use public and private services at the same time, as most of us in the real world know.

Professor Lam wants Hong Kong to spend more of its gross domestic product on health care so that his university can have a bigger share of the pie. Canvassing for the university may be acceptable, but speaking ill of the private sector is unnecessary.

DR CHOI KIN, president, The Hong Kong Medical Association

Small democracy

Much of the debate stirred by Regina Ip Lau Suk-yee's thesis has focused on 'big democracy' issues such as the election of the chief executive and the structure of the Legislative Council. What is overlooked is our 'small democracy': the government's advisory boards and committees. Given the large number of people involved, any changes in their mode of operation will have a far-reaching impact on the administration's decision-making process.

One urgent improvement would be the timely publication of all agendas and minutes, and a mandatory internet record of voting, if any. A second improvement can be achieved by making the chair and secretariat of key committees independent.

To improve the management of our urban environment, a clear and obvious priority is the independence of the chair and secretariats of the Town Planning Board and the Transport Advisory Committee.


Definitions muddled

The edited extract of Regina Ip Lau Suk-yee's thesis, 'We the people' (July 4), consistently used the term 'direct election', as did your accompanying editorial, 'Regina Ip's rethink on democracy welcome'. The report 'Stanford scholar hails Regina Ip's historic 'journey'' (July 7) used the term 'universal suffrage' throughout.

It was as if the two terms are synonymous and interchangeable, but they are not. One refers to the right to vote whereas the other refers to the system of election. The Basic Law is quite specific. When it means universal suffrage it says 'universal suffrage', as in Article 45. When it means direct election it says 'direct election', as in Annex II. Can we be more specific before we claim we are ready for either?

PETER LOK, Heng Fa Chuen

Top of the spam list

Your article on the government's proposals to control electronic junk mail ('Tough anti-spam laws proposed for HK', July 7) was timely. For the past week or so, I have been unable to send e-mail to AOL addresses. Some superficial research on the internet quickly reveals the reason why: Hong Kong is the spam capital of the world and Netvigator consistently tops the list of spam sources. Quite simply, all mail from Netvigator has been blacklisted by AOL. A call to Netvigator's helpline was no help at all. They refused to acknowledge the blacklisting and their solution was to 'ask AOL to stop blocking e-mails'.

Netvigator must take action. To make it easy, I have the following advice - any address sending thousands of e-mails a day is almost certainly spamming, and should be disconnected. How hard can this be to monitor? It does not require new laws; it requires a provider who is prepared to take responsibility.

PAUL MARSKELL, Discovery Bay