Doctors cool to home visits scheme

PUBLISHED : Wednesday, 03 January, 2007, 12:00am
UPDATED : Wednesday, 03 January, 2007, 12:00am

Weekly consultations for disabled pay too little and responsibilities are vague, say lawmakers

Doctors are lukewarm to a government pilot project that pays them to make weekly consultation visits to residential care homes for the disabled.

Legislators and the Medical Association blamed the low pay, and unclear responsibilities and duties set out under the Social Welfare Department's Visiting Medical Practitioner Scheme for the lack of interest.

The Social Welfare Department said that by yesterday, 36 per cent of the eligible 178 residential care homes covered by the scheme were still seeking a doctor, although the scheme has been operating for nearly six months.

The project is aimed at subsidising two categories of home care residences to establish a contract with a private general practitioner to provide medical care.

The first category is homes for mentally or physically disabled people, while hostels for recovering mentally ill patients come under the second category.

The scheme pays doctors HK$1,000 a year for each Category A resident and HK$300 a year for each Category B resident they look after.

The doctors must visit the Category A residential homes every week, while they need to provide only telephone consultation on the management of emergency conditions for Category B residents.

For the Category A residents, the doctors also need to provide regular health assessments and physical checkups, advice or assistance in maintenance of proper patient records and medical history, and drug storage and management.

'It is difficult for the Category A hostels to find a partner. The subsidy, which covers medical consultation and drugs, is too little to attract private doctors to join,' said Fernando Cheung Chiu-hung, the legislator representing the social welfare sector.

Dr Cheung said that if a doctor established a contract with a 50-resident hostel under Category A and visited it for two hours a week, he would be paid only about HK$400 an hour.

'The doctors can actually earn the same amount easily within minutes at their own clinics,' he said. 'The HK$400 may even be unable to cover the cost of medicine they dispense to the patients. They have to sacrifice a lot.

'We may be able to encourage the doctors to join the scheme as a community service, but it is unfair to them if we ask them to pay out of their own pocket.'

Medical sector legislator Kwok Ka-ki said some doctors also had reservations about the scheme due to some unclear clauses in the contract.

For example, the doctors are required to give advice on measures for infectious disease prevention and control, as well as environmental hygiene.

'Does the doctor need to take the responsibility if the hostel has an infectious disease outbreak?' Dr Kwok said.

'Doctors are not told clearly about their roles. They are worried about any unclear legal duties,' he added.

The legislators called on the Social Welfare Department to raise the subsidy, reduce some requirements and clarify the duties to entice more private doctors.

'Even if the budget is raised, the government can still save money as the scheme can help reduce the chance of the residents being admitted to hospitals,' Dr Cheung said.

Louis Shih Tai-cho, vice-president of Medical Association, whose 6,000-plus members are mostly private doctors, said they respected the idea, but they would not recommend members to join before details with the Social Welfare Department were sorted out.