A welcome effort to ease pressure on hospitals

PUBLISHED : Monday, 14 July, 2008, 12:00am
UPDATED : Monday, 14 July, 2008, 12:00am

The disconnect between public hospitals and private doctors lies at the core of much-needed reform of Hong Kong's health-care system. Sadly, progress towards such reform remains stalled by debate on future financing options. The pressure on hospitals and the government's budget continues to grow. Access to cheap, world-class medical care for all now comes at the price of lengthening queues and waiting times.

Meanwhile, incremental reforms, however modest, can help relieve the pressure and point the way forward. A proposal being considered by the Hospital Authority to bridge the public-private gulf is welcome. It is driven by ever-growing attendances at its specialist and general outpatient clinics, with some patients waiting more than a year for their first appointment. Many are repeat visits by long-term patients. The authority proposes that they be encouraged to switch to private doctors, where their consultations and drugs will continue to be subsidised by the government.

This does not undermine the principle of universal access to affordable hospital medical services, which has strong public support. Indeed, if it found wide acceptance among doctors and patients, it could enhance access. More importantly, it is a small step towards the public-private interface envisaged in proposals to improve delivery of health care, with a greater role for family medical practitioners and more emphasis on preventive health care.

The medical association president is pessimistic about public-private collaboration, citing rejection of the association's views on support for doctors' computers and reasonable service fees. The sharing of patient data is a critical element in the interface. The authority and the association should not allow the initiative to founder on considerations that obscure the bigger issue.

Reform of health-care financing has been delayed again and again. The current consultation on options, including greater responsibility for people who can well afford it, is yet to forge consensus. It is important to get it right, but the community cannot afford further procrastination. If people continue to overwhelm public hospitals, supply can be expected to fall even further behind demand. Without delivery reforms including a public-private partnership, supply must be rationed sooner or later either by price or longer queues.